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Spinal Shock
- Complete loss! (of motor and sensory)
- Secondary to acute SC injury
- Transient absence of voluntary and reflex activity below level of injury
- Can last days (more common) to months
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Autonomic Dysreflexia
- T2 level or above - run risk of autonomic system getting set off (specifically sympathetic)
- Caused by stress, full bladder/bowel, increased pressure, movement activity, sexual activity
- ⇒ Widespread vasoconstriction, hypertension, baroreceptors ⇒ HR increased but BP drops
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ROM Considerations: UE
- Neck: don't overstretch/avoid several pillows, can interfere w/ balance and respiration
- Trunk: don't overstretch (esp. low back), provides passive stability for transfer/rolling/aids proper seating and respiration
- Shoulders: 0-120 ext, 0-90 IR/ER, aids bed mobility, hooking chair, permits elbow ext w/o triceps function (reverse biceps action)
- Elbow/Forearm: need full pronation/supination ROM, aids dressing/ADLs
- Wrist: ext 0-90, linear WB, maximal tenodesis grip
- Finger Flexors/Thumb Web Space: don't overstretch, tenodesis and hooking for ADL's
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ROM Considerations: LE
- Hip: flex 0-120, ER 0-90, IR 0-45, aids dressing, bed mobility, transfers/brace walking, prone lying
- Hamstring Extensibility: 0-110/120 SLR, long sit, dressing, transfers & brace walking
- Ankle DF: need neutral position at minimum, provides suability for transfers, avoid met head breakdown, ambulation w/ braces
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Autonomic Changes w/ SCI
- Spinal shock (initially)
- Bowel/bladder
- Postural hypotension
- Autonomic dysreflexia
- Sexual dysfunction
- DVT
- Impaired temperature regulation
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