PHYSIOTHERAPY ASSESSMENT OF SPINAL

CORD INJURIES

DR. DEEPAK ANAP

ASSOCIATE PROFESSOR

OBJECTIVES

At the end of lecture student should be able to assess a spinal cord injury patient under

following headings

Pain

Range of motion

Muscle Performance

Reflexes

Aerobic capacity / Endurance

Arousal, Attention and cognition

Gait, Locomotion and balance

Motor Function,

Self care and Home Management

Ventilation and Integument

2

PAIN ASSESSMENT

Visual Analogue Scale

International Spinal Cord Injury Basic Pain Data Set

Wheelchair users Shoulder Pain index

3

4

RANGE OF MOTION

Goniometer

5

Muscle Performance

ASIA ISNSCI

Manual Muscle Test

Hand Held Dynamometer

6

Motor: how do you test each segment ?

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8

Sensory: how do you determine the level?

• The sensory levels are scored on a 0

to 2 scale for each dermatome.

• If body is divided into two identical

halves there are 28 key sensory

points to be tested.

• Each dermatome is tested for light

touch and pinprick sensations and

labeled as NT (not testable) if

cannot be tested.

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10Reflexes

Deep Tendon Reflexes

Arm

Bicipital: C5

Styloradial: C6

Tricipital: C7

Leg

Patellar: L3, some L4

Achilles: S1

Pathological reflexes11

Babinski (UMN lesion)

Hoffman (UMN lesion at or above cervical spinal cord)

Clonus (plantar or patellar) (long standing UMN lesion)

AEROBIC CAPACITY /ENDURANCE

A 6 min Arm Test

12

AROUSAL, ATTENTION AND COGNITION

Mini Mental Scale Examination

Montreal Cognitive Assessment

13

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ENVIROMNETAL OR WORK BARRIERS

GAIT, LOCOMOTION AND BALANCE

Wheelchair Skill test

Modified functional Reach test

Berg Balance scale

Walking index for spinal cord injury

Spinal Cord injury Functional ambulation Inventory

10 meter walk test

6 min walk test

Neuromuscular Recovery scale

15

Walking Index for

Spinal Cord Injury

(WISCI II)

16

Motor Function

Modified Ashworth scale

Spinal Cord injury spasticity Evaluation tool

17

18

SELF CARE AND HOME MANAGEMENT

Functional Independence Measure

spinal cord injury independence measure

Quadriplegia Index of function

Capabilities of upper extremity instrument

19

20

VENTILATION

Chest circumference with measure tape

Vital capacity

Respiratory Rate

21

INTEGUMENT

Braden Scale

Spinal Cord injury pressure Ulcer scale

Spinal Cord injury pressure ulcer scale - Acute

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BRADEN SCALE FOR PREDICTING PRESSURE ULCER

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Scoring: The Braden Scale is a summated rating scale made up of six subscales scored from 1-3

or 4, for total scores that range from 6-23. A lower Braden Scale Score indicates a lower level of

functioning and, therefore, a higher level of risk for pressure ulcer development. A score of 19 or

higher, for instance, would indicate that the patient is at low risk, with no need for treatment at

this time. The assessment can also be used to evaluate the course of a particular treatment.

WORK COMMUNITY AND LEISURE

INTEGRATION OR REINTEGRATION

Craig Handicap Assessment and Reporting technique

Assessment of life habits

Reintegration to Normal living index

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Thank you