Neuro II: Secondary Complications of SCI

respiratory complications after SCI

inadequate respiration allows dec ventilation of lungs, inadequate coughing allows secretions to build in the lungs

who are pressure ulcers most prevalent in?

individuals who have complete lesions or are tetraplegic

what increases risk of pressure ulcer development

compromised peripheral blood flow, increased skin trauma (shearing/friction), prolonged periods of pressure, moisture

what can pressure ulcers lead to

scars, sepsis, death

strategies to relieve pressure

push up/forward/lateral weight shift, tilt + recline in power seat, cushions

contributing factors to DVT

peripheral vasodilation, absent/dec LE musculature activity, immobility

contracture

deformity that develops when muscle strength imbalances/spasticity/gravity/posture cause 1+ joints to remain in one position for an extended period of time

consequences of contractures

impairs functional status, increased vulnerability to pressure sores

common LE contractures

hip flexion, knee flexion, ankle PF

common UE contractures

finger flexion, shoulder flexion, shoulder IR

should we stretch out of finger flexion contractures

no, at least not with the wrist extended bc we want tenodesis

heterotopic ossifications

Commonly occur near large joints (hip and knees), treat with moderate intensity stretching to maintain ROM and didronel

why are pts at higher risk for heterotopic ossifications after SCI

neurologic injuries begin a cellular cascade that signals the body to make bony deposits in the muscle belly

osteoporosis typical population

female, low BMI, older age

what has been shown to help avoid osteoporosis advancement

standing frames, FES