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Spinal Cord Injury Management: Course Outline

A spinal cord injury (SCI) is damage to the spinal cord that causes changes in its function, either temporary or permanent. These changes translate into loss of muscle function, sensation, or autonomic function in parts of the body served by the spinal co

Course Contents

  1. Wheelchair mobility
  2. Mobilizing with power wheelchairs
  3. Mobilizing with manual wheelchairs
  4. Providing assistance for people in manual wheelchairs
  5. Hand function of people with Tetraplegia
  6. Loss of Hand function and  principles of therapy
  7. Tenodesis grip
  8. Reconstructive surgery and electrical stimulation
  9. Standing and walking with lower limb paralysis
  10. Standing for therapeutic purposes
  11. Walking with thoracic paraplegia
  12. Walking with partial paralysis of the lower limbs
  • Electrical stimulation
  • Training motor tasks
  • Motor control and motor learning
  • Principles of effective motor task training
  • Treadmill training with body weight support.
  • A way of providing intensive practice 
  • Strength training
  • Assessment of strength
  • Neurally intact muscles
  • Strength training for partially paralysed muscles
  • Avoiding injury and other complications
  • Strength training for general well-being 

Course Objectives

  • The students will have knowledge about the different condition at different level of spinal cord injury.
  •  The students will be able to understand the proper treatment protocol for different conditions in spinal cord injury.
  • The students will be able to understand the different concepts of neuro rehabilitation approaches and their clinical implementations.

 The students will be able to understand the different neuro rehabilitation approaches and their role in clinical settings

Classification Spinal Cord Injury

Muscle strength ASIA Impairment Scale for classifying spinal cord injury
Grade Musclefunction Grade Description
0 No muscle contraction A Complete injury. No motor or sensory function is preserved in the sacral segments S4 or S5.
1 Muscle flickers B Sensory incomplete. Sensory but not motor function is preserved below the level of injury, including the sacral segments.
2 Full range of motion with gravity eliminated C Motor incomplete. Motor function is preserved below the level of injury, and more than half of muscles tested below the level of injury have a muscle grade less than 3 (see muscle strength scores table).
3 Full range of motion against gravity D Motor incomplete. Motor function is preserved below the level of injury and at least half of the key muscles below the neurological level have a muscle grade of 3 or more.
4 Full range of motion against resistance E Normal. No motor or sensory deficits, but deficits existed in the past.

Course Contents

  1. Background information
  2. Motor, sensory and autonomic pathways
  3. The ASIA assessment of neurological deficit
  4. Common patterns of neurological loss with incomplete lesions
  5. Upper and lower motor neuron lesions
  6. Prognosis
  7. Impairments associated with spinal cord injury
  8. Skin management
  9. Psychological well-being
  10. Spinal cord injury and traumatic brain injury
  • Aging with spinal cord injury
  1. A framework for physiotherapy


  • Assessing impairments, activity limitations and participation restrictions
  • Step two: setting goals
  • Step three: identifying key impairments
  • Step four: identifying and administering treatments
  • Step five: measuring outcomes
  • Physiotherapy as part of the multi-disciplinary team
  1. Transfers and bed mobility of people with lower limb paralysis
  2. Sitting unsupported
  3. Rolling
  4. Lying to long sitting
  5. Vertical lift
  6. Transfers
  7. Vertical transfers
  8. Other factors which influence the ability to perform mobility tasks

Course Contents

  1. Contracture management
  2. Assessment
  3. Treatment and prevention of contractures
  4. Preventing and anticipating contractures
  5. Prioritizing treatments: a touch of reality
  6. Reducing muscle extensibility
  7. Pain management
  8. Assessment
  9. Neuropathic pain
  10. Nociceptive pain
  11. Role of psychosocial factors in chronic pain
  12. Respiratory management
  • The direct and indirect effects of respiratory muscle weakness
  • Respiratory complications in the period immediately after injury
  • Assessment of respiratory function
  • Treatment options
  • Ventilation for patients with C1–C3 tetraplegia
  1. Cardiovascular fitness training
  2. Assessment of cardiovascular fitness
  3. The response of people with spinal cord injury to exercise
  4. Exercise prescription
  5. Exercise in the community.
  6. Wheelchair seating
  7. Wheelchair cushions
  8. Manual wheelchairs
  9. Power wheelchairs
  • Sitting in vehicles
  1. Evidence-based physiotherapy
  2. COVS outcome measurement scale 

Rehabilitation in spinal cord injury