Physiotherapy Rehabilitation

Objectives 1. Assist patient with spinal cord injury (SCI) below level Tl to achieve the maximal level offunctional independence and to prepare for rehabilitation or discharge. II. Educate and orient patient and family on precautions and discharge treatment programs, with emphasis on maintenance of functional independence. III. Investigate home situation and coordinate treatment and discharge planning with other disciplines involved. Admission/Evaluation 1. Areas to evaluate (Spinal Cord Injury Evaluation form follows protocol.) A. Range of motion. Evaluate passive and active range of motion of upper and lower extremities. B. Manual muscle test. Test and specifically grade strength of upper and lower ex- tremities. C. Functional ability. Evaluate balance, coming to sit, bed mobility, weight shift, ability to achieve pressure relief, and preparation for stance, if indicated. D. Posture. Evaluate posture in supine and sitting. E. Neurological 1. Evaluate s...

Low Back Pain The accurate, objective study of low back pain (LBP), itsnatural history, and its effective treatment is difficult because of the multiple factors involved. This includes the favorable natural history and spontaneous resolution of most LBP regardless of treatment, the presence of secondary and monetary gain for LBP in Western societies, and the methodological problems in setting up studies. The incidence of low back disability appears to have dramatically increased in Western society since about 1970. Waddell (1998) concluded, however, that this is not indicative of an increase in the prevalence of LBP but rather of an increase in work loss, sick certification, compensation, and long-term disability awards. Among industrialized nations, the United States has the highest rate of spinal surgery-five times that of Great Britain, for example (Taylor 1994). Studies examining the outcome of operative and non-operative treatment of back pain have not shown a distinct ad...