This paper talks about the spinal cord injuries, their capability differences, physical considerations and recommendations. It consists of:

Introduction

Spinal cord injury, normally abbreviated as SCI, is a trauma of the spinal cord that results into a loss in its sensory and mobility function. The spinal cord is a vertebral body extending from the base of the brain to the waist. Common causes of SCI include: motor vehicle accidents, gun shots and accidental falls associated with extracurricular activities (McDonald, 417- 425). Published facts and statistics for traumatic spinal cord injury in the United States range between 28 and 55 million people with an approximate of 10,000 new cases every year. There are 30 segments of the spinal cord; injuries to different parts of the spinal cord results to different conditions. For example, a SCI just above the shoulder height results in quadriplegia, while SCI below the shoulders results in paraplegia. The mechanical trauma includes direct compression of neural constituents by broken bone fragments, damaging of the blood vessels and cell membranes of neural cells broken. Blood loss in the central grey matter spreads radially and axially resulting to swelling of the spinal cord. Blood flow regulation ceases, neurogenic shock which leads to hypotensionwhich eventually triggers ischemia occurs. The process gets worse when neighboring red cells are killed or harmed. Most recorded cases of SCi is prevalent among the adult population (between 15 and 25 years), however, up to 5% of SCI occur in children (Proctor, 11).

Capability Differences

Research has been conducted to investigate the quality of life among the injured people relative to the uninjured. To understand this, knowledge about the effects of SCI is necessary. SCI can be complete or incomplete; the first leads to total loss while the second results in partial loss of motor function and sensation. According to the American Spinal Cord Association’s (ASIA) impairment scale, SCI are classified as follows:

  1. Complete. No sensory or motor function
  2. Incomplete sensory alienation. Sensation is exhibited at the level below the injury
  3. Incomplete motor function. Anal sphincter movements are exhibited. Most key muscles are weak
  4. Same as C but with stronger key muscles
  5. Normal. Recovery to sensation and motor function is exhibited.

Persons with incomplete SCI experience reduced muscle strength which result in reduced functional level of walking and ambulatory performance. Therefore, ability to walk is a major problem associated with SCIs. The primary goal of rehabilitation centers is to help to regain the ability to walk with less than conclusive results. Using the human spinal cord response to sensory information, persons under locomotor training showed an improvement in over ground walking. Relevant exercises to this effect have been established (Behrman & Harkema 80).

Sexual arousal disorders are also common among persons with SCI. The degree of sexual dysfunction following SCI depends on gender, level of lesion and completeness of the SCI. Although it has not been adequately investigated, experiments, mainly with women, suggested that up to 50% of women with SCI failed to achieve orgasm compared with able-bodied persons. With time as a measure it took longer to achieve orgasms in SCI affected persons compared with able-bodied persons. In complete SCI there is no physical orgasm sensation as exhibited before the injury. In incomplete spinal injuries, the probability of experiencing sexual pleasure is relatively higher. However, it should be noted that sexual pleasure results from a combination of both physical and psychological factors. Emotional relationship with a partner is therefore important and can lead to psychological signs of an orgasm-like state. It is also important to note that in women spinal injuries do not impair fertility and menstrual cycles resume in a couple of months. With men, ability to obtain an erection may be impaired as a result of motor paralysis and lack of sensation. In complete spinal injuries psychogenic sexual stimulus has no effect on erections. Involuntary erections do occur as a result of spinal reflexes and is not emotionally or sexually related. In incomplete spinal injuries the probability for a psychogenic induced erection increases significantly making sexual intercourse possible. However, men differ from women with regards to fertility; fertility among men with SCI is usually impaired due to lack of ejaculations. Therefore, artificial insemination becomes an option (Trieschmann, 18).

Effects of spinal cord lesions on autonomic bodily responses such as emotional feelings have also been documented. Disruption of the nervous system causes notable changes in exhibited emotional feelings.  In a research conducted in 2007, involving 26 adult men, it was found that feelings of anger and fear significantly decreased while feelings of sentimentality were significantly increased (Hohmann, 143).

Physical Activity Considerations

After the stabilization and rehabilitation of the injured individual, a wellness routine is established according to several considerations. Mobility considerations for people with SCI involve the selection of an appropriate wheelchair and a seating system. Some individuals with spinal injuries have metallic structures implanted to help stabilize their spine, therefore, pressures at these points, such as fully bending and extending, should be greatly minimized. Selection involves factors such as consideration of the person, immediate and intermediate environment of both home and work, biomechanical examination of the seating posture and seat interface. A neutral position will aid the person to move the muscles while minimizing stress to these parts. Physical therapy is recommended to persons with SCI to help them to engage in physical activities.

With the help of a physician who specializes in SCI, an exercise program can be initiated. The exercise program should incorporate components that promote health, fitness and competition. Consistency and commitment is relevant in any exercise program; a timetable should be created and followed to the letter. Circuit training which involves aerobics and weight lifting cycle is very beneficial in cardiovascular conditioning. Special equipment designed for spinal cord injured persons will be necessary. Muscular endurance should be a primary goal as it would help an individual with SCI to push his or her wheelchair. Muscle tightness in the shoulder and chest and hip regions as a result of sitting for extended periods without stretching can be managed by muscle spasticity. A stretching program can be executed while sitting or lying on a firm surface. Exercises designed to promote standing (using parallel bars) and sitting balance can also be beneficial. Trunk balance can be improved by the use of a “Swiss Ball”. Previous studies have shown that participation in recreation and sports among persons with SCI have psychological and physiological benefits. Activities such as wheelchair rugby, wheelchair tennis, wheelchair basketball and athletics are beneficial. Aspects such as fitness, health, fun, competition and social aspects have to a great extent influenced the survival of persons with SCI in the community and increased their level of community integration. Incorporation of sports and leisure activities may help to catapult rehabilitation centers to a new level (Sheng, Trevor, 177).

Conclusion

Every year nearly a half of the SCI population is readmitted to hospitals depending on the completeness of the injuries. Nursing homes are more popular among the elderly persons. Some cases of deaths have also been recorded, with the major cause been respiratory difficulties. However, in a positive view, mortality rates are higher compared to the past.

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