Daily Archives: October 3, 2003
The UW Department of Rehabilitation Medicine recently acquired a new full-size van for its Driving Rehabilitation Program that is equipped with adaptive technology advanced enough to enable people with C5 spinal cord injuries to drive. “This new van is really cutting-edge. It’s only the second one ever built,” said Frances Tromp van Holst, Occupational Therapist at the University of Washington Medical Center and coordinator of the Driving Rehabilitation Program. “Ours is the only program in the WAMIO (Washington, Alaska, Montana, Idaho and Oregon) region with this technology. It allows me to train people I hadn’t been able to serve before—clients with C5 or weak C6 injuries.”
Pressure ulcers are a common, debilitating, and costly complication of SCI, often requiring long periods of immobility, hospitalization, and/or surgery. Patients with SCI are therefore carefully instructed to perform regular, frequent pressure releases in order to maintain blood flow to the skin and avoid Skin Breakdown.
Yet many individuals with SCI get pressure ulcers despite diligent Pressure Release behavior, and others get pressure ulcers that don’t heal for years, said Jennifer James, MD, clinical assistant professor at the UW Department of Rehabilitation Medicine.
Urinary Tract Infection (UTI) is the most frequent medical complication during initial medical Rehabilitation after SCI, and continues to be a common cause of morbidity throughout life. It may produce only mild-to-moderate illness that can be managed on an outpatient basis, but it has also been reported as the leading cause of rehospitalization after SCI.
The Spasticity Evaluation System is based on an electromechanical method of eliciting and measuring spasticity at the ankle. The system has been used to evaluate spasticity and Contracture in SCI, TBI and CP patients. Other medical conditions with abnormal elastic and viscous ankle joint stiffness can also be evaluated.
The evaluation is performed by measuring ankle stiffness in response to applied ankle movements of various frequencies.
The digestive tract is essentially a long tube that begins at the lips and ends at the anus. After food is swallowed, it moves through the esophagus to the stomach, which is basically a storage bag, and then on to the intestines or bowels, where nutrients are absorbed and waste is collected and prepared for elimination.
The Norman and Sadie Lee Research Centre, Division of Neurobiology, National Institute for Medical Research, Medical Research Council, London NW7 1AA, United Kingdom
Precisely localized focal stereotaxic electrolytic lesions were made in the corticospinal tract at the level of the first to second Cervical segments in the adult rat. This consistently destroyed all central nervous tissue elements (axons, astrocytes, oligodendrocytes, microglia, and microvessels) in a highly circumscribed area.
Recovery of some upper limb function is common following a Cervical spinal cord injury. Patients with initial C4-level Tetraplegia often regain C5 muscle function, enabling them to eat and use a joystick hand control independently, while those with C5-level tetraplegia often regain C6 strength, making possible some independent grasp and pinch by using wrist extensor muscles and a splint.
Two factors that help predict this type of upper limb recovery have been identified. One is initial strength.
Chronic pain is a frequent problem in the majority of the SCI population and can occur not only above the level of injury but also at or below the level of injury and in both complete and incomplete injuries. In a recent study at the UW, 82% of patients with SCI reported persistent, bothersome pain at some time after discharge from their initial inpatient Rehabilitation. Post-SCI pain can be so severe and disabling that some patients have said they would give up the possibility of neurological recovery in favor of pain relief.
The breathing muscles are supplied by nerves that emerge from the spinal cord in various locations, from the Cervical through the Lumbar levels. “Even the abdominal muscles are involved in breathing,” said Joshua O. Benditt, MD, Assistant Professor of Medicine, Pulmonary Division. Injury to the spinal cord at or above these levels therefore affects the ability to breathe. “The higher up the Lesion is, the more serious the effect on the breathing system. In fact, you can almost predict from the injury level the degree of breathing function a patient will have,” Benditt said.
Spinal cord injury (SCI) typically results in sensory paralysis, or a loss of feeling in areas using nerves that connect to the spinal cord below the level of injury. A person with complete paralysis can’t tell if these areas are being tickled with a feather, stuck with a pin, or burned with a match. The lack of pain sensation presents a constant danger; persons with SCI must to learn to compensate with other senses to avoid damaging themselves.
Unfortunately, paralysis does not guarantee freedom from pain. In fact, a number of people with SCI experience chronic pain in areas that otherwise have no sensation.