Spinal Cord Injury
What Is a Spinal Cord Injury?
When a person experiences a
Spinal Cord Injury the communication between the
brain and other parts of the body is disrupted and messages no longer flow past the
damaged area. The extent of the communication breakdown is dependent on both the severity
and location of the injury.
Frequent causes of damage include:
Trauma
car accident
Disease
The spinal cord does not have to be severed in order for a loss of functioning to occur. In fact, in most people with SCI the spinal cord is intact, but the damage to it results in loss of functioning. SCI is very different from back injuries such as ruptured disks, spinal stenosis or pinched nerves.
The human spinal cord is a bundle of nerve cells and fibers approximately 17 inches long that extends from the brain to the lower back.
The spinal cord carries messages from the brain to all parts of the body and receives incoming messages from the body as well. The cord is protected by the spinal column (backbone), which is made up of 33 individual vertebrae. These vertebrae have different names depending on their location:
7 cervical vertebrae located in the neck,
12 thoracic vertebrae in the upper back,
5 lumbar vertebrae in the lower back,
5 fused sacral vertebrae in the hip area, and
4 fused vertebrae in your coccyx (tailbone).
Spinal cord injuries can occur at any level of the spinal cord, and the level of the injury will dictate which bodily functions are altered or lost. SCI might be either complete or incomplete. Complete injuries result in total loss of sensation and function below the injury level. incomplete injuries result in partial loss. "Complete" does not necessarily mean the cord has been severed. Each of the above categories can occur in paraplegia and quadriplegia.
References:
Spinal Cord Injury Resource Center
National Spinal Cord Injury Association
Causes of Spinal Cord Injury
The primary causes of spinal cord injury include:
Motor vehicle accidents (44%)
Acts of violence (24%)
Falls (22%)
Sport Injuries (8%; note 2/3 of sports injuries are from diving)
Falls overtake motor vehicles as leading case of injury after age 45.
Acts of violence and sports cause less injuries as age increases. Acts of violence have overtaken falls as the second most common source of spinal cord injury in the last 4 years.
Except for the Incomplete-Preserved motor (functional), no more than 0.9% fully recover, although all can improve after the initial diagnosis. Overall, slightly more than 1/2 of all injuries result in quadriplegia. However, the proportion of quadriplegics increase markedly after age 45, comprising 2/3 of all injuries after age 60 and 87% of all injuries after age 75.
Adapted Sports and Recreation
Individuals with SCI can successfully participate in almost all physical activities with some modifications. Adapted equipment is crucial for participation. It is important to use sport specialized equipment like sport wheelchairs for basketball, tennis, and racing; handcycles for aerobic fitness; and sit skis or sledges for hockey.
Adaptation and equipment should be based on the individual's functional abilities.
Professionals including the adapted physical education teacher, physical therapist,
and physician should discuss adaptations and modifications with the
individual. Based on the nature and level of injury, there are many functional levels of what
people with SCI can do. It is important to empower individuals with SCI to participate in
physical activities. There are numerous physical activities in which people with spinal cord
injury can participate.
Aerobics/Physical Fitness
Aerobics is a system of exercise designed to improve respiratory and circulatory function. Disabled Sports USA (DSUSA) has developed a series of aerobic and strength training videotapes for amputees, paraplegics, quadriplegics, and those with cerebral palsy
Resources
Fitness Is For Everyone; (30 min.) 1/2" VHS and 3/4"
A series of videotapes developed by National Handicapped Sports for improving aerobic fitness, physical strength and flexibility, regardless of disability.
Aerobic:$29.95 each; Strength/Flexibility: $39.95 each; Complete Set:$95.95
Disabled Sports USA (301) 217-0960
All-Terrain Vehicles: All-terrain vehicles (ATVs) include from three- to eight-wheel vehicles for use in snow, water, sand or general purpose conditions. The Wheelchair Motorcycle Association (WMA) tests many of these vehicles and advises both manufacturers and ATVers with disabilities on modifications and accessories.
Archery: Wheelchair archery is a sport easily adapted for people who use a wheelchair. It is organized by Wheelchair Sports USA in accordance with International Archery Federation rules. Competitive rounds are composed of arrows shot at various distances. Archers with upper extremity weakness may use adaptive equipment. The National Archery Association also permits wheelchair archers to compete with non-disabled archers in its programs.
Basketball: Wheelchair basketball, a physically demanding team sport, is the oldest competitive wheelchair sport. It continues to be one of the most popular. The National Wheelchair Basketball Association (NWBA), which organizes the sport nationally, currently consists of 180 teams competing in 21 conferences. Conference play culminates in annual men's, women's, juniors', and intercollegiate national tournaments held each spring. Wheelchair basketball rules are a slightly modified form of the National Collegiate Athletic Association rules.
Bicycling/Handcycling: Recently, the bicycle has undergone adaptations enabling a person to propel it using hand power. There are cycles for children, tandem cycles, units that attach to a wheelchair and some that are truly bicycles. Sports 'n Spokes magazine annually compiles a list of bicycle and handcycle manufacturers.
Bowling: Wheelchair bowling is regulated by the American Wheelchair Bowling Association (AWBA), using modified American Bowling Congress rules. The AWBA hosts an annual national tournament and sanctions numerous other tournaments and local league play.
Football: Although it is a fledgling sport in terms of national organization, wheelchair football has been played for many years. Only a few modifications of the National Collegiate Athletic Association rules have been made for the sport. These include a 60-yard hard-surface playing field with 8-yard end zones, 6-man teams, 2-hand touch tackles, down-field throws to simulate kicks and 15 yards for a first down.
Golf: Golf is easily adapted for people with disabilities through the use of modified golf equipment. Interested golf professionals have begun to conduct clinics and develop teaching methods for individuals with disabilities. The National Amputee Golf Association is the sport's guiding force in this country.
Power Soccer: With the growth of wheelchair sports, power chair users now have a competitive sport of their own. Power soccer is played with four players on a team trying to push an 18" physio-ball over the end line of a regulation basketball court for a score. Thick plexiglas guards protect the players' feet and wheelchair and allow the player to control the ball. The features of this game are that it is exclusively for power chair users and it is competitive.
Quad Rugby: Quad Rugby is a unique, competitive sport for quadriplegics. The game is played on a basketball court by four-member teams using a volleyball. The objective is to carry the ball across the opponent's goal line. Players are classified according to the USQRA classification system, which rates players' level of disabilities as 0.5 through 3.5. Each class has a point value, and teams are balanced by limiting the number of points allowed on the court to eight. Although the game is not an adaptation of non-disabled rugby, the name was chosen because it best describes the game's spirit. Quad Rugby is governed by the U.S. Quad Rugby Association, which sanctions regional and sectional competitions and a national championship each spring.
Racquetball: Wheelchair racquetball was formally established in 1983. Because of the lively ball and relatively small court, it is an exciting, fast-paced and highly competitive wheelchair sport. The U.S. Racquetball Association governs and organizes competitions.
Road Racing/Long Distance Racing: Wheelchair road racing has become a very popular and rapidly growing sport since the first wheelchair athlete entered the Boston Marathon in 1975. Generally, wheelchair competition is run in conjunction with established road races, and wheelchair athletes compete in a separate division against other wheelchair athletes. Wheelchair divisions are regularly organized in large, nationally prominent races as well as in hundreds of smaller, community-sponsored races throughout the United States. Wheelchair Athletics of the USA/WSUSA is the guiding force of wheelchair road racing.
Rowing: Rowing shells modified for stability, which are lightweight and easily propelled, accommodate people with a broad range of mobility impairments. Devices for securing hands to oars provide the precise degree of support needed to allow the rower's power to be harnessed efficiently. Rowing offers access to the water for recreation, aerobic conditioning and competition.
Sailing: New designs in sailboats and adaptive equipment allow sailors with disabilities to get on and off and maneuver around sailboats with no or minimal assistance, enabling a sailor with a disability to handle a boat much as a non-disabled person would. Sailing is an ideal way to enjoy the excitement and freedom of open waters. The National Ocean Access Project (NOAP) is the leading national organization promoting sailing for people with disabilities.
Scuba Diving: Recently scuba diving has become more readily available to people with disabilities as instructors become more aware of these divers' capabilities. The Handicapped Scuba Association (HSA) trains divers with disabilities to scuba dive.
Skiing: Both competitive and recreational skiing is available. Through competitions organized by Disabled Sports USA (DSUSA) and sanctioned by the United States Ski Association, an athlete can compete in downhill racing, slalom and giant slalom. Amputees compete standing up in either three- or four-track (i.e., with outrigger skis) competition, depending on their disability, and those with spinal cord injuries or similar disabilities affecting both lower extremities use a sit-ski or mono-ski. A new, more stable version of the mono-ski, called a bi-ski, has been developed for people with higher level injuries.
Slalom: Slalom is a unique wheelchair sport that does not parallel an established able-bodied sport. It is a timed test of speed, dexterity and maneuverability in which competitors follow an obstacle course clearly marked by arrows, flags and gates. The course is required to have minimum specifications but gives meet directors flexibility with design. Slalom competition is governed by Wheelchair Athletics of the USA/WSUSA.
Sled Hockey: Sled hockey, which is governed in the United States by the American Sled Hockey Association, began 30 years ago in Norway. It is played at the regional, sectional, national, international, and Paralympic levels. Teams are developing for men and women as well as juniors. Able-bodied athletes are also welcome to participate.
Softball: Competitive wheelchair softball is governed by the National Wheelchair Softball Association (NWSA) and is played under the official rules of 16-inch, slow-pitch softball as approved by the Amateur Softball Association. All member teams are eligible to enter post-season competition that culminates in the National Wheelchair Softball Tournament each September.
Swimming: Competitive and recreational swimming easily can be enjoyed with friends and family. Swimmers compete in a variety of distances in the standard strokes of freestyle, backstroke, butterfly and breaststroke. Competitive swimming for people with disabilities is organized nationally by U.S. Wheelchair Swimming/ WSUSA, which bases its rules on U.S. Swimming rules.
Table Tennis: Singles and doubles competition for men and women is played regionally, nationally and internationally and is organized by the American Wheelchair Table Tennis Association/ WSUSA in accordance with U.S. Table Tennis Association rules. A ranking system of all competitive wheelchair table tennis players has been established. Quadriplegics and others with impaired hand function play table tennis by strapping or taping the paddle to their hand.
Tennis: Wheelchair tennis can readily be enjoyed with non-disabled family and friends. Organized by the National Foundation of Wheelchair Tennis (NFWT), the sport follows the rules of the U.S. Tennis Association with one exception: the wheelchair tennis player is allowed two bounces instead of one. Athletes are classified according to their performance in competition, so a player may start in any of the five divisions offered for men or three divisions offered for women. Divisions are also offered for quadriplegics and juniors. wheelchair tennis players often obtain introductory lessons at community tennis programs.
Track and Field: Track events are run on a hard surface, 400-meter oval track, ranging from 100 meters to 10,000 meters depending on the athlete's classification. The front wheel constitutes the start and finish of the race. Field events include the javelin, shot put and discus. The club throw is organized for quadriplegics. Equipment size and weight vary according to the athlete's classification. Competitors may use throwing chairs (platforms) or tie-downs to secure their chair for maximum performance. These events are governed by Wheelchair Athletics of the USA/WSUSA.
Waterskiing: People with disabilities who have the desire to learn how to water ski may do so using a modified ski that resembles a thin, tapered toboggan with a seat. The rope is held by the skier or attached to the ski, depending on upper body strength. For more information, contact the Disabled Ski Committee of the American Waterski Association.
Weight Training: People with disabilities can benefit from an individualized weight training program that enables them to acquire fitness skills that are transferable to other sports and recreational activities. Community health spas and YMCAs across the country are beginning to modify fitness equipment to meet the needs of those with disabilities. In addition, a number of manufacturers offer weight training equipment designed to accommodate people with disabilities.
Wheelchair Fencing: Through the sport of wheelchair fencing, athletes practice the centuries-old art of swordsmanship. Requiring a combination of agility, strength, and concentration, fencers compete in one or more of the three weapons: foil, epee, or saber. This fast-paced sport has been a part of the Paralympic Games since 1960. Wheelchair fencers also have many other opportunities to display their skills. In America, the U.S. Fencing Association organizes wheelchair fencing tournaments and training clinics.
Reference:
Links
Information on this sheet contains only suggested guidelines. Each person must be considered individually, and in many cases, a physician's written consent should be obtained.
This page on Spinal Cord Injuries was written by Martin Kudlacek when he was a Ph.D. student at Texas Woman's University. Dr. Kudlacek is now teaching at Palackky University in the Czech Republic.