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Case Studies
The following case studies of patients with spinal cord injuries show the manifold strengths of the Rehab Cycle in clincial practice. The individuals portrayed in these cases differ in regard to the nature and cause of their injuries and the height of the lesion.
1Goal Setting
2Independence
3Hope
4Health Behavior
5SCI in the Elderly
6Recovery after traumatic SCI
7Vocations
8Community Reintegration
9Sports in Rehabilitation
10Walking Recovery
11Care in Developing Countries
12SCI and Environmental Accessibility
13SCI in Adolescence and Peer Relationships
14Bowel and bladder management
15Psychological issues and SCI
16When more time is less
17Motivation and rehabilitation
 
Case Study 6:
Traumatic spinal cord injury-- recovery begins at the accident site
Literature

1 Marino RJ, Ditunno JF, Donovan W, Maynard F. Neurologic recovery after traumatic spinal cord injury: data from the model spinal cord injury systems. Arch Phys Med Rehabil. Nov 1999; 80: 1391-1396

2 Bernhard M, Gries A, Kremer P, Böttiger B. Spinal cord injury - prehospital management. Resuscitation. 2005; 66:127-139

3 Ibid.

4 Sekhon L, Fehlings M. Epidemiology, demographics and pathophysiology of acute SCI. Spine. 2001; 26(24S):S2-S12

5 Ditunno JF, Sipski ML et al. Recovery of upper extremity strength in complete and incomplete tetraplegia: a multicenter study. Arch Phys Med Rehabil. April 2000; 81: 389-393

6 Lisa-Ann Wuermser, Chester H. Ho,  Anthony E. Chiodo, Michael M. Priebe, Steven C. Kirshblum, William M. Scelza. Spinal Cord Injury Medicine - 2. Acute Care Management of Traumatic and Nontraumatic Injury. Arch Phys Med Rehabil. Mar 2007; 88 Suppl 1: S55-S61

7 Crock HV, Yoshizawa H, Yamagishi M, Crock MC. Commentary on the prevention of paralysis after traumatic spinal cord injury in humans: the neglected factor - urgent restoration of spinal cord circulation. Eur Spine J. 2005; 14: 910-914

8 Ibid.

9 Marino RJ, Ditunno JF, Donovan W, Maynard F. Neurologic recovery after traumatic spinal cord injury: data from the model spinal cord injury systems. Arch Phys Med Rehabil. Nov 1999; 80: 1391-1396

10 Ditunno JF, Sipski ML et al. Recovery of upper extremity strength in complete and incomplete tetraplegia: a multicenter study. Arch Phys Med Rehabil. April 2000; 81: 389-393

11 Burns A, Ditunno J. Establishing Prognosis and Maximizing Functional Outcomes After Spinal Cord Injury: A Review of Current and Future Directions in Rehabilitation Management. Spine. 2001. 26(24S): S137 –S145.

12 Ibid.

13 Fawcett JW, Short D, et al. Guidelines for the conduct of clinical trials for spinal cord injury as developed by the ICCP panel: spontaneous recovery after spinal cord injury and statistical power needed for therapeutic clinical trials. Spinal Cord. 2007 45: 190-205

14 Spinal Cord Injury Information Network. Predicting Outcome (Prognosis) in Spinal Cord Injury. Website: http://www.spinalcord.uab.edu/show.asp?durki=21502&site=1021&return=21511; Accessed: Dec 12, 2007.

15 Boldin C, Raith J, Florian Fankhauser F, Haunschmid C, Schwantzer G, Schweighofer F. Predicting Neurologic Recovery in Cervical Spinal Cord Injury With Postoperative MR Imaging. Spine  31(5): 554 –559

16 Geisler F, Coleman WP, Grieco G, Poonian D, and the Sygen Study Group. Measurements and Recovery Patterns in a Multicenter: study of Acute Spinal Cord Injury. Spine  26(24S): S68–S86

17 Marino RJ, Ditunno JF, Donovan W, Maynard F. Neurologic recovery after traumatic spinal cord injury: data from the model spinal cord injury systems. Arch Phys Med Rehabil. Nov 1999; 80: 1391-1396

18 Bernhard M, Gries A, Kremer P, Böttiger B. Spinal cord injury - prehospital management. Resuscitation. 2005; 66:127-139

19 Malik M, Lovell M. Current spinal board usage in emergency departments across the UK. Int. J. Care Injured. 2003; 34: 327–329

20 Porter K, Allison K. The UK emergency department practice for spinal board unloading. Is there conformity? Resuscitation. 2003; 58: 117-120

21 Yeung, JHH, Cheung NK, Graham CA, Rainer, TH. Reduced time on the spinal board: effects of guidelines and education for emergency department staff.  Int. J. Care Injured. 2006; 37: 53-56 

22 Bernhard M, Gries A, Kremer P, Böttiger B. Spinal cord injury - prehospital management. Resuscitation. 2005; 66: 127-139

23 Hodgetts T, Smith J. Essential role of prehospital care in the optimal outcome from major trauma. Emergency Medicine. 2000; 12: 103-111

24  From the British Red Cross, How to deal with a spinal injury. Website: http://www.redcross.org.uk/standard.asp?id=75194, accessed: Jan 16, 2008

25 Bernhard M, Gries A, Kremer P, Böttiger B. Spinal cord injury - prehospital management. Resuscitation. 2005; 66: 127-139

26 Crock HV, Yoshizawa H, Yamagishi M, Crock MC. Commentary on the prevention of paralysis after traumatic spinal cord injury in humans: the neglected factor - urgent restoration of spinal cord circulation. Eur Spine J. 2005; 14: 910-914

27 Ibid.

28 Boldin C, Schweighofer F, et al. Predicting Neurologic Recovery in Cervical Spinal Cord Injury With Postoperative MR Imaging. Spine. 2006;  31(5): 554 –559

29 Wuermser L, Scelza W, et al. Spinal Cord Injury Medicine: Acute Care Management of Traumatic and Nontraumatic Injury. Arch Phys Med Rehabil. Mar 2007; 88 Suppl. 1: S55-S61

30 Hall E, Springer J. Neuroprotection and Acute Spinal Cord Injury: A Reappraisal. J Am Soc Exp Neuro. Jan 2004; 1: 80-100

31 Chapter 8: Blood Pressure Management after Acute Spinal Cord Injury. Neurosurgery. Mar 2002; 50(3 Suppl.): S58-S62

32 Goldsmith H. Can the standard treatment of acute spinal cord injury be improved? Perhaps the time has come. Neurologic Research. Jan 2007; 29: 16-20

33 Hall E, Springer J. Neuroprotection and Acute Spinal Cord Injury: A Reappraisal. J Am Soc Exp Neuro. Jan 2004; 1: 80-100

34 McKinley W, Barnard B et al. Outcomes of Early Surgical Management Versus Late or No Surgical Intervention After Acute Spinal Cord Injury. Arch Phys Med Rehabil. Nov 2004; 85: 1818-1825

35 Fehlings M, Perrin R. The Timing of Surgical Intervention in the Treatment of Spinal Cord Injury: A Systematic Review of Recent Clinical Evidence. Spine. 2006;  31(11 Suppl.): S28 –S35

36 Scivoletto G, Molinari M, et al. Early versus delayed inpatient SCI rehabilitation: an Italian study. Arch Phys Med Rehabil. Mar 2005; 86: 512-516

37 Sumida M, Uchida R, et al. Early Rehabilitation Effect for Traumatic Spinal Cord Injury.  Arch Phys Med Rehabil. Mar 2001; 82: 391-395

38 Scivoletto G, Molinari M, et al. Early versus delayed inpatient SCI rehabilitation: an Italian study. Arch Phys Med Rehabil. Mar 2005; 86: 512-516

39 Little J, Harris R et al. Incomplete Spinal Cord Injury: Neuronal Mechanisms of Motor Recovery and Hyperreflexia. Arch Phys Med Rehabil. May 1999; 80: 587-599

40 Burns A, Ditunno J. Establishing Prognosis and Maximizing Functional Outcomes After Spinal Cord Injury: A Review of Current and Future Directions in Rehabilitation Management. Spine  26(24S): S137–S145

41 Crock HV, Yoshizawa H, Yamagishi M, Crock MC. Commentary on the prevention of paralysis after traumatic spinal cord injury in humans: the neglected factor — urgent restoration of spinal cord circulation. Eur Spine J. 2005; 14: 910-914

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