The Effects Of Employment Status At 2 Years ' Post Discharge From Spinal Cord Injury Rehabilitation

Nerves from each segment of the spinal cord connect to specific regions of the body. The cervical region or neck are referred to as C1 through C8; they control signals to the neck, arms, and hands. The segments in thoracic or upper back region T1 through T12 relay signals to the torso and some parts of the arms. The segments in the upper lumbar or mid-back region just below the ribs, L1 through L5, control signals to the hips and legs. Last, the sacral segments S1 through S5 lie just below the lumbar segments in the mid-back and control signals to the groin, toes, and some parts of the legs. The effects of spinal cord injury at different segments reflect this organization.(SC-Basic Anatomy of Spine-http://www.goes.com/billr/html/_anatomy_of_a_spinal_cord.html)

The cervical spinal nerve C3-5 innervate the phrenic nerve. These are the lower motor neurons.

The central nervous system is what connects the brain to the muscles of the body. When a patient has an injury to the spinal cord, movements in certain parts of the body will be affected based on the location of the injury. If the injury affects hand motion then many day to day tasks are affected. This literature review seeks to understand how an injury to the spinal cord impacts movement, and what has been done so far to help those affected by spinal cord injuries.

Physiotherapists at a specialist centre in London are helping people with spinal cord injuries to get fit, achieve personal rehab goals and receive life-long care.

This information is collected through the use of standardized procedures so that every participant is asked the same questions in the same way. It involves asking people for information in some structured format. Depending on what is being analyzed, the participants being surveyed may be representing themselves, their employer, or some organization to which they belong. A survey can be administered in a couple of different ways. In a survey research, the researcher selects a sample of respondents from a population and administers a standardized questionnaire to them.

There are a number of methods of collecting data, some of them are – questionnaire, surveys, checklists, interviews, observations, focus group etc (Cordray, 1986; Einhorn and Hogarth, 1986).

The scale is broken up into classifications A, B, C, D, and E. Classification “A” represents the most severe impairment indicating a complete lesion with no signs of sensory or motor function in the sacral segments. Classification “B” represents an incomplete lesion. Some sensory function is present but motor function is lost below the neurological level. Classification “C” represents an incomplete lesion. Motor function is present in this classification and more than half of the muscles below the point of injury have a muscle grade less than 3. Classification “D” represents an incomplete lesion, motor function is present, and at least half the muscles below the point of injury have a muscle grade of 3 or greater. Classification “E” represents the best outcome and indicates that all sensory and motor functions are intact (p.

To evaluate the effectiveness of psychological interventions on spinal cord injury (SCI) rehabilitation outcomes, Heinermann et al. (2012) recruited 1032 participants from six SCI rehab facilities across the U.S. Heinermann et al. (2012) provided, “usual rehabilitation care” (p.578) to treat the participants. This care focused primarily on teaching patients how to process emotions, navigate adjustment issues, manage family dynamics and develop new coping skills. The rehab psychologists also provided psychoeducational services, which also focused on coping and adjusting to life after their injury (Heinermann et al., 2012). Heinermann et al. (2012) recorded outcome measures immediately after the participants were released from the facility and again after one year. Specifically, at each interval, participants were required to complete multiple objective scales including, but not limited to, the Satisfaction With Life Scale, Patient Health Questionnaire, and the Craig Handicap Assessment and Reporting Technique (Heinermann et al., 2012).

Online scholarly article that provides general information about spinal cord injuries. The article describes what a spinal cord injury is and treatment methods that may be beneficial for individuals who have sustained a spinal cord injury. The article states that individuals with high level injuries will usually require respiratory support, and individuals will benefit from rehabilitation programs and skill-building exercises. The article provides the prognosis for complete and incomplete spinal cord injuries and briefly discusses research that is being conducted in regard to spinal cord injuries.

After 27 physical therapy visits post surgeries in a period of 6 months the patient reported no perceived disability to work after 52 weeks. Although, some functional disability was experienced when it came to general activities and sports between 4 to 13 percent based on the QuickDASH. Pain levels reported by the VAS remained considerable low. The subject reported pain level between 0-4 on a 10 scale; pain decreased to zero by week 10.

A study titled Effects of FES-Ambulation Training on Locomotor Function and Health-Related Quality of Life in Individuals With Spinal Cord Injury, found that those with Asia D Spinal Cord injuries showed significant improvement in the 6 minute walk test, and body weight support training. ASIA is a spinal cord impairment scale and those who are ASIA D are classified with motor function preserved below neurological level and more than half of key muscles below the level have a grade of 3 or more.7 The study also showed a non-significant increase with 10 meter walk test for walking speed. Patients showed an increase with the Walking Index for Spinal Cord Injury II (WISCI II) and in the Short Term Form -36 pain score. The WISCI II is used to look at the amount of assistance needed with walking and assistive devices used with those who have an SCI. There were 6 participants in the study with an average of 9.3 years post injury. They excluded those that took part in FES training within 3 months, those with a history of heart disease, current pressure ulcers, unpredictable autonomic dysreflexia, fractures, and other musculoskeletal issues that would make it unsafe to exercise. They took measurements 24-48 hours before the first exercise program and then 48-72 hours after the last exercise

Research technique gathering information from a sample of people using questionnaires (which will be utilized later for primary data).

After 27 physical therapy visits post surgeries in a period of 6 months the patient reported no perceived work disability after 52 weeks. Nonetheless, some functional disability was experienced when it came to general activities and sports between 4 to 13 percent based on the QuickDASH. Pain levels reported by the VAS remained considerable low. The subject reported the pain level between 0-4 on a 10 scale; pain decreased to zero by week 10.

A literature review illustrates how vital job placement services have been found to be in the job employment assistance endeavors. The review of previous studies reveals the “receipt of placement services” to be the “strongest predictor of employment outcomes” (Fleming et al., 2014, p. 7). A 2006 study characterized job placement as “the driving force behind the vocational rehabilitation program” (Fleming et al., 2014, p. 7). According to the researchers, the public Vocational Rehabilitation (VR) services have attained the status of “the most important vocational programs for persons with disabilities” (Fleming et al., 2014, p. 7). The authors cite the number of “new applicants [registered] nationally” as 564,908, in the 2011 Fiscal Year alone, as proof of the organization’s heavy caseload of new clients (Fleming et al., 2014, p. 7). These numbers indicate that rehabilitation services have been in high demand. Considering the importance of the vocational programs in assisting the disabled clients who are in need of employment, the authors determined that it was appropriate to examine the different ways these services can be rendered.

In survey method research, participants answer questions administered through interviews or questionnaires. After participants answer the questions, researchers describe the responses given. In order for the survey to be both reliable and valid it is important that the questions are constructed properly. Questions should be written so they are clear and easy to comprehend.