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Damage to anterior spinal artery or indirect damage to anterior spinal cord tissue
Loss of motor function below level of injury; loss of pain, thermal, and tactile sensation below injury
Light touch and proprioceptive awareness are typically unaffected
Anterior Cord Syndrome
Only one side of the spinal cord is damaged
Frequently the result of gunshot or stab wound
Ipsilateral loss of motor function because MOTOR tracts cross over at brainstem
Ipsilateral reduction in deep touch and proprioceptive awareness
Contralateral loss of pain, temperature, and touch as most SENSORY tracts cross at vertebral level
Extremities with the greatest strength typically have the poorest sensation
Brown- Sequard’s Syndrome
On the same side, as opposed to contralateral.
Often seen with structural changes to vertebrae…most common with aging
Motor and sensory in upper extremities are more impaired than lower extremities because most often the damage is to the central cervical or upper thoracic regions of spinal cord – tracts that are central in SC are those that control UEs
Potential for flaccid paralysis of UE
Central Cord Syndrome
Injury to spinal nerves below the end of the spinal cord which are actually considered peripheral nerves…no injury to spinal cord itself
Some chance of nerve recovery since injury is to peripheral nerves … regeneration may occur
Loss of motor and sensation below injury; LMN injury Absence of reflex arc
Cauda Equina Syndrome
Maintain autonomic functions (HR, BP)Stabilize
Bedrest as needed
Protect Spinal Cord
Medical Management of SCI
These are OT goals for?
Maintain PROM throughout UEs
Increase strength in residual muscles to optimal level.
Develop partial or complete independence in self-care OR pt able to direct own care routine (directing or completing).
Teach use of orthotic & adaptive equipment including splints, utensils, cuffs, mobile arm support, adapted clothing, sip/puff.
Explore interest and skill needs for recreational activities.
Independence in skin care.
Prevocational training (OTR)
Adaptive driving (OTR/COTA).
Home set up/IADL performance.
These are OT goals for?
Increase strength in UEs
Improve endurance and up-tolerance.
Develop independence in self-care.
Develop interest and skill base for recreation pursuits.
Independence in skin care (directing or completing).
Encourage resumption of social activities as appropriate and feasible.
Home setup and IADL performance.