Physiotherapy Management of Spinal Cord Injuries

Introduction

This course will be available to all in Physioplus before the end of 2018. To get updated on when this is available please sign up for updates here.

Course Type - Open, Online Course Reference' - PP0314 Course Co-ordinators - Lisa Harvey and Rachael Lowe Institution - Physiopedia About this course - This online course is based on the free modules developed by the International Spinal Cord Society at elearnsci.org. Who can take part- Anyone Date - This course took place in 2014 Time commitment - 15 hours over 5 weeks Requirements - You will complete online lessons, engage with additional resources, take part in the conversation online and complete the course evaluation. Assessment - There will be a final quiz Awards - Completion certificate plus 15 IPT-CEUs from the WCPT

Intended audience

This course is suitable for physiotherapy students and junior physiotherapists who have a good understanding of the key principles of physiotherapy but little prior experience in spinal cord injuries (SCI).

Time commitment

Participants will be required to devote 3 hours per week for 5 weeks to this course.

Course structure

Participants will be given 3 tasks each week, namely:

1. Complete 2 to 3 lessons that are part of www.elearnSCI.org – this is a website that provides freely accessible online training modules
2. Look at additional readings, videos and resources
3. Contribute to an online discussion

Aim

The aim of this course is to equip physiotherapy students and inexperienced physiotherapists with sufficient knowledge to manage a person with SCI. This includes assessing impairments, activity limitations and participation restrictions, setting appropriate goals of treatment, formulating an evidence-based treatment plan, implementing treatment and evaluating its success.

Learning Objectives

1. Outline the 5 key steps involved in physiotherapy management of people with spinal cord injuries.
2. List the key muscles innervated at each level of injury and the implications for function.
3. Describe the common methods used by people with C6 tetraplegia and paraplegia to roll, sit unsupported, transfer and move from supine to long sitting
4. Describe how people with spinal cord injury:
   • Mobilise in a power and manual wheelchair
   • Stand and walk
   • Use their upper limbs and hands
5. Describe assessment and treatment of 6 important impairments that limit activities and participation in people with spinal cord injury:
   • Strength
   • Contractures
   • Motor skill
   • Fitness
   • Respiratory
   • Pain
     

Pre-requisites

Participants must be either enrolled in a physiotherapy course or have completed a physiotherapy course. This prerequisite has been set to ensure the online discussion is appropriate.

Forum for online discussion

The online discussion will be an important aspect of this course and participants will be expected to post at least one comment each week. Only participants of the course will be able to post and read discussions within this group. 

Language

The course will be run in English although participants will only require basic English skills. Participants will be encouraged to be respectful and empathetic to those in whom English is not their first language.

Accreditation, Assessment and Certification

This course has been accredited by the WCPT for 15 International Physical Therapy Continuing Education Units (IPT-CEUs). These plus a certificate of completion from Physiopedia will be awarded provided you have:

1. Contributed to the online facebook discussion each week
2. Complete the pre and post course quiz
3. Completed a course evaluation form

On completion of the course you will also be offered:

• 6 months FREE membership to the Physiopedia members area
• the chance to join SCIPT, the largest network of SCI physiotherapists in the world. Membership is free.
• 20% discount on the course textbook

People involved in this course

Course co-ordinators

The course co-ordinators for this course are Associate Professor Lisa Harvey and Dr Joanne Glinsky.  Both Lisa and Jo are committed to the philosophy of providing free education to all and believe that well educated physiotherapists can help improve the lives of people with SCI in all corners of the world.

Associate Professor Lisa Harvey, Australia. Lisa has 20 years clinical experience in SCI and 30 years teaching experience. She currently holds an academic position at Sydney Medical School, University of Sydney where she teaches, supervises research students and runs her own research program. She has taught extensively in different parts of the world and is currently chairperson of the Education Committee of the International Spinal Cord Society. She has written a textbook on Physiotherapy Management of Spinal Cord Injuries and is on the Editorial Board of Spinal Cord and Journal of Physiotherapy.

Dr Joanne Glinsky, Australia. Jo is a physiotherapist with over 10 years clinical, research and teaching experience in SCI rehabilitation. She has a PhD and multiple publications relating to SCI. She currently works as a senior researcher at Sydney Medical School, University of Sydney

Course contributors

This course will be based on the physiotherapy modules that are part of www.elearnSCI.org which was an initiative of The International Spinal Cord Society. You can view a video explaining the evaluation of the elearn website here.

The physiotherapy modules were developed by many, many very senior SCI physiotherapists from around the world. Sincere thanks to all of them for donating their time and knowledge to make this resource freely available to all. You can see the full list of contributors here.

References

• Carr JH, Shepherd RB. A motor relearning model for rehabilitation. In: Carr JH and Shepherd RB (ed). Movement science: Foundations for physical therapy in rehabilitation. Aspen Publishers: Rockville, MD 2000, pp 33-110.
• Consortium for Spinal Cord Medicine. Outcomes following traumatic spinal cord injury: Clinical practice guidelines for health-care professionals. 1999, Washington, DC: Paralyzed Veterans of America.
• Consortium for Spinal Cord Medicine. Preservation of upper limb function following spinal cord injury: A clinical practice guideline for health-care professionals. 2005, Washington, DC: Paralyzed Veterans of America.
• Consortium for Spinal Cord Medicine Clinical Practice Guidelines. Pressure ulcer prevention and treatment following spinal cord injury: a clinical practice guideline for health-care professionals. J Spinal Cord Med 2001; 24: S40-101.
• Consortium for Spinal Cord Medicine. Respiratory management following spinal cord injury: a clinical practice guideline for health-care professionals. 2005, Washington (DC): Paralyzed Veterans of America.
• Connolly S, Aubut J, Teasell RW, Jarus T. Upper limb rehabilitation following spinal cord injury. In: Spinal Cord Injury Rehabilitation Evidence (SCIRE), Eng JJ, et al., Editors. 2006: Vancouver. pp 5.1-5.16.
• Dobkin B, Apple D, Barbeau H, Basso M, Behrman A, Deforge D. et al. Weight-supported treadmill vs over-ground training for walking after acute incomplete SCI. Neurology 2006; 66: 484–493.
• Harvey L. Management of spinal cord injuries: a guide for physiotherapists. 2008, London: Elsevier.
• Harvey L, Lin CM, Glinsky J, De Wolf A. The effectiveness of physical interventions for people with spinal cord injuries: a systematic review. Spinal Cord 2009; 47: 184-195.
• Katalinic OM, Harvey LA, Herbert RD, Moseley AN, Lannin NA, Schurr K. Stretch for the treatment and prevention of contractures. The Cochrane Database of Systematic Reviews 2010; Issue 9. Art.No.: CD007455. DOI: 10.1002/14651858.CD007455.pub2.
• Mehrholz J, Kugler J, Pohl M. Locomotor training for walking after spinal cord injury. Cochrane Database of Systematic Reviews 2012, Issue 11. Art. No.: CD006676. DOI: 10.1002/14651858.CD006676.pub3.
• Sheel AW, Reid WD, Townson AF, Ayas N (2012). Respiratory Management. In: Eng JJ, Teasell RW, Miller WC, Wolfe DL, Townson AF, Hsieh JTC, Connolly SJ, Noonan V, Mehta S, Sakakibara BM, Boily K, editors. Spinal Cord Injury Rehabilitation Evidence. Version 4.0. Vancouver: p. 1-47.
• Somers MF. Spinal cord injury: functional rehabilitation. 2nd ed. 2001, Upper Saddle River, NJ: Prentice Hall.
• UAB Model SCI Center. Functional goals following spinal cord injury. Online. Available:http://www.spinalcord.uab.edu/show.asp?durki=28922
• Van Langeveld SA, Post MW, Van Asbeck FW, Ter Horst P, Leenders J, Postma K. et al. Contents of physical therapy, occupational therapy, and sports therapy sessions for patients with a spinal cord injury in three Dutch rehabilitation centres. Disabil Rehabil 2011; 33: 412-422.