Page 17 - Mobility Management, June 2017

ATP Series
SCI
It’s Complicated
By Laurie Watanabe
For ATPs & Clinicians,
There’s Much More to Consider Than Paralysis
There are many manifestations of spinal cord injury (SCI), a pressure injury does are causing someone to be out of their
so many that seating and wheeled mobility professionals may focus on the most obvious ones: paralysis and loss of sensation.
But for so many wheelchair users, the impact of SCI doesn’t end there. Those “other” manifestations can have a profound impact on the success of a seating and mobility system, and the consumer’s resulting independence.
Secondary Complications of SCI
Curtis Merring, OTR/L, MOT, a clinical education manager for Permobil, has worked extensively with SCI clients.
“The most common secondary effects from SCI regarding seating and mobility are probably pressure ulcers, pain/ comfort, and spasticity,” he said. “Most of the time I’m working with SCI clients with seating and mobility needs, we are working on those issues.”
Jennith Bernstein, PT, DPT, ATP, a clinical education manager for Permobil, worked with SCI clients at Shepherd Center in Atlanta for more than a decade.
“As a seating clinic therapist, you’re looking for a history of pressure injury,” she said. “The secondary effects of what
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wheelchair and removed from participating in activities, and the complications of bedrest. And you have to think about what it’s doing to the skin integrity and the loading structure. So pressure injury is one of the biggest things that you start thinking about — and what equipment you want to use for that.”
She added, “Postural changes I definitely see as a complication of a spinal cord injury. You always are doing a thorough evalua- tion for that. You want to perpetually stay on top of any changes that you can observe, that you can objectively measure, or that you can subjectively get from the patient’s report. It’s a constant evaluation and re-evaluation. You’re always following up on all the body systems that could potentially have a complication after spinal cord injury: bowel, bladder, orthopaedic, neurologic.”
Complication #1: Pressure Injuries
Understandably, pressure injuries are a concern for clients who have difficulty repositioning themselves and/or cannot discern when their bodies need to be repositioned.
“Pressure ulcers are always in the forefront of everyone’s mind, both therapist and patient,” Merring said. “Our bodies were
not meant to sit all day, so for those who are dependent upon a
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