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Table of Contents
Each person is unique, and each disability affects each person differently. The information in this section is a very simple overview of some common disabilities. It is aimed to provide a starting point for more research. Use the assessment tools to learn as much as you can about the individual. The person with the disability and/or their caregiver will understand their abilities better than anyone else.
Spinal Cord Injury (SCI)
An injury to the spinal cord can lead to impaired or lost function and/or feeling. The damage can be:
Complete – Total loss of movement and sensation.
Incomplete – Partial loss of movement and/or sensation. Individuals with an incomplete SCI can often walk and may participate in activities such as skiing or snowboarding.
Complete – Total loss of movement and sensation.
Incomplete – Partial loss of movement and/or sensation. Individuals with an incomplete SCI can often walk and may participate in activities such as skiing or snowboarding.
Injuries are classified by the affected area of the spine, with different vertebrae and nerves responsible for various functions:
Paraplegia – Affects the legs.
Quadriplegia/Tetraplegia – Affects the majority of the body, including arms and legs.
The spinal column consists of 26 vertebrae divided into 4 areas…
Cervical (C1-C7)
Nerves in the neck that supply movement and feeling to the arms, neck, and upper trunk. Specific functions include:
- C3, 4, 5: Diaphragm (breathing).
- C5: Shoulder muscles, elbow bending.
- C6: Wrist bending.
- C7: Elbow straightening.
- C8: Finger bending.
Thoracic (T1-T12)
Nerves in the upper back that supply the trunk and abdomen.
- T1: Finger spreading.
- T1-T12: Chest wall and abdominal muscles.
Lumbar (L1-L5)
Nerves in the lower back that supply the legs, bladder, bowel, and sexual organs.
- L2: Hip bending.
- L3: Knee straightening.
- L4: Foot pulling up.
- L5: Toe wiggling.
Sacral (S1-S5)
Nerves in the lower back, with functions including:
- S1: Foot pulling down.
- S3, 4, 5: Bladder, bowel, and sex organs, and anal and other pelvic muscles.
Teaching Considerations
- Check seat straps, boots, and clothing for anything that may cause a pressure sore.
- Be aware of cold in legs/feet due to loss of sensation.
- Ensure that straps do not put pressure on a catheter or colostomy bag, and above T6, be aware of Autonomic Dysreflexia Syndrome (ADS).
Common Red Flags
- ADS
- Bladder problems
- Affected muscle control
- Cold susceptibility
Autonomic Dysreflexia Syndrome (ADS)
This syndrome can occur in individuals with a spinal cord injury at level T6 or higher. It is caused by an irritation (such as pressure, temperature, or a full bladder) below the injury level. Without a response to the nerve impulses due to the injury, a dangerously high blood pressure occurs, considered a medical emergency.
Signs of ADS:
- Pounding headache
- Goosebumps
- Sweating above the injury
- Cold and clammy skin below the injury
- Blotching of the skin
Actions for ADS:
- Relieve any potential pressure points, catheter blockages, or other irritants.
- Seek urgent medical attention. Individuals at risk of ADS are typically educated on symptoms and actions to take during rehabilitation.