UMass Amherst KIN 460 - Team project SCI case studies - Fall 2018 (2 pages)

Total number of points 30 Spinal cord Injury Case Studies Morgan s Story SCI Case Study Here s What Happened Morgan was a cheerleader in 10th grade very social and considered one of the nicest people at school Just like every other morning Morgan was heading to school in the SUV her parents had helped her buy just three months ago She was still in her quiet neighborhood where there was virtually no traffic at this early hour Morgan was in the habit of buckling her seat belt just before she left the residential streets to pull onto the four lane road outside her neighborhood It was Friday and Morgan and her friends had plans to attend the football game after school She remembered that they had not yet figured out where they would meet up immediately after school It was a tradition with her circle of friends that they grab a bite to eat at a local fast food restaurant before the game She would see her friends once she arrived at school but was excited and wanted to make the plans This was the perfect time to send off a quick text to her friends to nail down a place to meet Morgan s parents her driver s education instructor the local billboards and television commercials had all warned her about the dangers of texting and driving but Morgan knew she was an amazingly fast texter She smiled as she thought about how painfully slow her mother was at this mindless task As she approached the intersection a lawn maintenance truck pulling a trailer overloaded with mowers and leaf blowers came careening around the corner wandering over into her lane But Morgan was looking at her phone so she did not see what was coming toward her The vehicles collided Although she was not going that fast the sudden impact made her SUV swerve and roll over Morgan was thrown from her vehicle The lawn maintenance truck was damaged and the workers who had been belted in were shaken up but not severely injured As soon as they realized what had happened they called 911 and went to help Morgan as best they could Morgan was breathing but dazed and just barely able to speak Her body lay twisted in an unnatural pose Even to the medically untrained lawn crew it seemed obvious that this beautiful young girl s life was to be forever changed Morgan s Condition What The Doctors Found 1 Morgan had a fracture at her T 9 vertebra and had significant swelling of her spinal cord She required surgery on her spine to stabilize her from T7 to T12 2 Morgan was able to breathe on her own 3 Morgan could not feel or move anything below her belly button the location of T9 4 Morgan could not control her bowels or bladder Task 1 Injury assessment and outcome prediction for Morgan s case 8 points Note For Task 1 questions use Reference 1 as resource but also use additional resources Clearly identify these resources in your answer a Based on the described level of injury would you classify this patient as paraplegic or tetra quadriplegic Explain your choice b Record the patient s ASIA American Spinal Injury Association scale score Explain what this score means c Summarize the key components of the neurological exam that the Doctors performed after Morgan entered the hospital Use the report by Maynard on International Standards for Neurological and Functional Classification of Spinal Cord Injury in the Journal Spinal Cord reference 4 d What improvement in motor and sensory function can be predicted after extensive rehabilitation also include possible ASIA level for Morgan based on the early examination and results from the doctors assessment Clearly indicate why you predict the stated ASIA level outcome after rehabilitation e What imaging methods can be used to gain more insight into the possible damage in the cord Explain what these imaging methods can help diagnose Total number of points 30 Spinal cord Injury Case Studies Task 2 Design your own case study and do the following 12 points 1 Write the case study Here s What Happened 2 Write the patient s condition What the doctors found 3 Address the following question Note For Task 2 3 questions use Reference 1 as resource but also use additional resources Clearly identify these resources in your answer a Based on the described level of injury would you classify this patient as paraplegic or tetra quadriplegic Explain your choice b Record the patient s ASIA scale score Explain what this score means c What improvement in motor and sensory function can be predicted after extensive rehabilitation also include possible ASIA level for your SCI injured patient in the case study based on the early examination and results from the doctors assessment Clearly indicate why you predict the stated ASIA level outcome after rehabiliation Task 3 Spinal Cord retraining of sensorimotor function 10 points Note for 1 and 2 use Reference 1 as resource but also use additional resources Clearly identify these resources in your answer For 3 find the paper online and for 3 d use references 2 primary and 3 1 List the different movement physical therapy treatment options that therapists PT OT etc have to improve sensorimotor function in Morgan s case and provide a rationale for why these treatments may work for Morgan 2 List the different movement physical therapy treatment options that therapists PT OT etc have to improve sensorimotor function in your case study in Task 2 and provide a rationale for why these treatments may work for your patient 3 A very recent study in the New England Journal of Medicine reference 5 below has allowed people with serious spinal cord lesions to stand and walk again using epidural stimulation and gait and balance training a what is epidural stimulation and how is it given to the patient b describe the main improvements in all 4 study participants and how that is reflected in their AIS American Spinal Injury Association Impairment Scale AIS grade as well as Motor and sensory scores c provide a coherent argument based on the basic knowledge of spinal cord function from section 2 in class why this epidural stimulation can improve walking in SCI patients References 1 McDonald J W Sadowsky C 2002 Spinal cord injury The Lancet 359 9304 417 425 2 Bradbury E J McMahon S B 2006 Spinal cord repair strategies why do they work Nature Reviews Neuroscience 7 8 644 653 3 Horner P J Gage F H 2000 Regenerating the damaged central nervous system Nature 407 6807 963 970 4 Maynard F M Bracken M B Creasey G J F D Ditunno J F Donovan W H Ducker T B Young W 1997 International standards for neurological and