Menu Expand
Spinal Cord Injury Rehabilitation, An Issue of Physical Medicine and Rehabilitation Clinics of North America, E-Book

Spinal Cord Injury Rehabilitation, An Issue of Physical Medicine and Rehabilitation Clinics of North America, E-Book

Diana Cardenas

(2014)

Additional Information

Book Details

Abstract

This issue includes a range of topics in SCI from acute neuroprotection to chronic complications, focusing on some of the technological advances that have informed specific areas.

Table of Contents

Section Title Page Action Price
Front Cover Cover
Spinal Cord Injury Rehabilitation\r i
Copyright\r ii
Contributors\r iii
Contents\r vii
Physical Medicine & Rehabilitation Clinics Of North America\r xi
Foreword\r xiii
Preface\r xv
Updates for the International Standards for Neurological Classification of Spinal Cord Injury 505
Key points 505
Historical background and revisions 505
2011 revisions of the ISNCSCI 507
2013 worksheet 510
Non key muscles 510
Future issues for the ISNCSCI 513
Use of Computerized Algorithms 513
Defining Incomplete Syndromes 513
Issues Relating to Deferring to the Sensory Level 514
Clinical Versus Research Use 514
Summary 515
References 515
Hypothermia as a Clinical Neuroprotectant 519
Key points 519
Introduction: history of hypothermia as a neuroprotectant 519
Core temperature regulation and hypothermia 520
Mechanism of neuroprotection in hypothermia 520
Metabolic Rate of Oxygen Consumed 520
Clinical application 521
Patient Evaluation Overview 521
Cooling methodologies 521
Hypothermia in the SCI population 522
Historical Perspective 522
Contemporary Animal SCI Studies 524
Preliminary Clinical Evidence of Efficacy—Evaluation of Outcome and Long-term Recommendations 525
Summary 527
References 527
Assessment of Neuromuscular Conditions Using Ultrasound 531
Key points 531
Introduction 531
Nature of the problem 532
Possible affected structures 532
Muscles/Tendons and Joints 532
Nerves 532
Ultrasound 533
Why Use Ultrasound? 533
Studies evaluating structures using US in the SCI population 534
Study of the Nerves in the SCI Population 534
Tendons in the SCI Population 535
The potential future of US in the SCI population 535
Diagnostic ultrasound 536
US studies of the shoulder in able-bodied subjects 536
Elbow Non-SCI 537
Wrist/Hand Non-SCI 538
US elastography 539
Summary 539
References 540
Chronic Neuropathic Pain in SCI 545
Key points 545
Introduction 545
Patient evaluation overview 546
Comprehensive Evaluation of Patients in Pain 546
Establishing a Diagnosis of Neuropathic Pain in SCI 547
SCI Pain Taxonomy 550
Types of Neuropathic Pain in Patients with SCI 550
Tools for Diagnosis and Evaluation of Neuropathic Pain 550
Screening tools for diagnosing neuropathic pain 552
Tools for capturing the severity and characteristics of neuropathic pain 552
Tools to evaluate the impact of pain on physical function 553
Tools for evaluating emotional function 553
Pharmacologic treatment options 553
Anticonvulsants 555
Antidepressants 555
Opioids 556
Cannabinoids 557
N-Methyl-d-Aspartate Antagonists 557
Antispasticity Agents 558
Summary 558
Nonpharmacologic treatment options 558
Psychological/Cognitive Interventions 558
Massage 559
Acupuncture 559
Exercise 560
Transcutaneous Electrical Nerve Stimulation 560
Transcranial Stimulation 560
Motor Cortex Stimulation 561
Deep Brain Stimulation 561
Spinal Cord Stimulation 561
Combination therapies 562
Surgical treatment options 563
Evaluation of outcome 563
Summary 564
References 564
Reducing Cardiometabolic Disease in Spinal Cord Injury 573
Key points 573
Cardiometabolic risks in SCI 573
Special Concerns for Persons with SCI (Accelerated Risk and Specific Targets) 574
Therapeutic lifestyle intervention 574
Diet Considerations—Energy Balance, Body Composition, and Malnutrition 576
Assessing energy balance 576
Creating a caloric deficit 577
Malnutrition 578
Correcting nutrient deficiencies/excess 578
Recommended diets 580
Exercise Considerations—Role in Health and Weight Management 580
Exercise and Caloric Balance 580
PA Requirements for Weight Loss, Health, and Wellness 581
Exercise Prescription 581
Specific Considerations for SCI 583
Aerobic exercise considerations 583
Muscle strengthening considerations 583
Stretching considerations 583
Referral to a Clinical Exercise Professional 584
Managing Shoulder Pain 584
Behavioral Modification 584
Key aspects 585
Recent developments 585
Pharmacotherapeutic approaches 585
Drug Approaches to Treat Obesity 589
Drug Approaches to Treat Hyperglycemia 589
Drug Approaches to Treat Dyslipidemia 589
Drug Approaches to Treat Hypertension 594
Summary 596
References 596
Strategies for Prevention of Urinary Tract Infections in Neurogenic Bladder Dysfunction 605
Key points 605
Introduction 605
The problem of UTIs after SCI & D 606
Bacteriuria 606
Pyuria 606
Bacterial Colonization 606
UTI Symptoms 607
UTI Diagnosis 607
Data Sets and Consensus Statements 607
The relationship of bladder management to UTIs 607
Neurourology 607
Bladder Management in Neurogenic Bladder Dysfunction 608
Recurrent UTIs in Individuals with Neurogenic Bladder Dysfunction 610
Mechanical strategies for UTI prevention after SCI & D 610
Intermittent Catheterization 610
Catheter reuse 610
Closed-system versus open-system catheters 610
Hydrophilic catheters 611
External Catheters 611
Indwelling Catheters 611
Silver-coated and antibiotic-coated catheters 612
Bladder irrigation 612
Fluid Restriction 612
Medical strategies for UTI prevention after SCI & D 612
Antibiotic Prophylaxis 612
Nonantibiotic Prophylaxis 613
Cranberry 613
d-Mannose 614
Methenamine 614
Bacterial interference 614
Summary 615
References 615
Diaphragmatic Pacing in Spinal Cord Injury 619
Key points 619
Introduction 619
Physiology of breathing 620
Mechanical ventilation 620
Phrenic nerve pacing 621
Direct diaphragm pacing 621
Selection criteria 622
Electrodiagnostic testing 622
Weaning from mechanical ventilation 623
Equipment 624
Normal physiology 624
Physiology of ventilation 625
Physiology of pacing 625
Morbidity and mortality 625
Expiratory muscle function 625
Availability 627
Future directions 627
Summary 628
References 628
Functional Electrical Stimulation and Spinal Cord Injury 631
Key points 631
The basic properties of electrodes for nerve stimulation 632
Upper extremity functional restoration with FES 633
Availability 635
Future Directions 635
Lower extremity functional restoration with FES 635
Availability 639
Future Directions 639
Trunk control and posture with FES 639
Availability 641
Future Directions 641
FES techniques to restore respiratory muscle function 642
Prevention of pressure ulcers through functional electrical stimulation 642
Intermittent Electrical Stimulation for the Prevention of DTI 643
Implanted Neuromuscular Stimulation for Tissue Health and Pressure Ulcer Prevention 643
Availability 645
Future Directions 645
FES for restoring bladder control 646
Availability 647
Future Directions 647
Intraspinal microstimulation for gait restoration 647
Summary 648
Acknowledgments 648
References 649
Spasticity and the Use of Intrathecal Baclofen in Patients with Spinal Cord Injury 655
Key points 655
Introduction 655
Definition of spasticity and spasms 656
The incidence of spasticity in SCI patients 657
When to treat spasticity 658
Treatment options available for spasticity 658
Intrathecal baclofen therapy 659
Advantages of ITB Therapy 660
The Appropriate Time when SCI Patients Should be Considered for ITB Therapy 660
How to Determine Who is a Good Candidate for ITB 661
Where is an ITB Pump and Catheter Implanted and How is the Size Chosen? 662
Risks and Adverse Effects of ITB Therapy 664
Special Considerations in Patients with an ITB Pump 666
Future Directions 666
Summary 667
References 667
Spinal Cord Injury Pressure Ulcer Treatment 671
Key points 671
Pressure ulcer stages and categories 672
Category/Stage I: Nonblanchable Erythema 672
Category/Stage II: Partial Thickness 672
Category/Stage III: Full-Thickness Skin Loss 672
Category/Stage IV: Full-Thickness Tissue Loss 673
Additional categories and stages for the United States 673
Unstageable/Unclassified: Full-Thickness Skin or Tissue Loss, Depth Unknown 673
Suspected Deep Tissue Injury, Depth Unknown 673
Dressing and treatment by wound classification 673
Stage I Pressure Ulcer 673
Stage II Pressure Ulcer 674
Stage III Pressure Ulcer 676
Stage IV Pressure Ulcer 677
Unstageable Pressure Ulcers 678
Special considerations 679
References 679
Dual Diagnosis 681
Key points 681
Introduction 681
Definition 682
Diagnosis 683
Evaluation 684
Neuroimaging 685
Complications 685
Head/Neck Trauma 685
Fractures at the skull base or frontal bone 685
Orbital fractures 686
Temporal bone fractures 686
Vascular trauma 686
Eye injuries 686
Postconcussion Syndrome 686
Headache 686
Dizziness 687
Hearing loss 687
Sleep impairment 687
Neck pain 687
Neuropsychological symptoms 687
Seizures 687
Complications in Dual Diagnosis with Moderate–Severe TBI 688
Rehabilitation 692
Summary 693
References 694
Index 697