Milestone Continuing Education

1. Discuss common neurological level of injury when assessing the cervical region
2. Differentiate between the ascending and descending pathways of the spinal tracts.
3. List the three divisions of the autonomic nervous system and the functions associated with each division.
4. Explain the required elements of the neurological examination as well as the optional elements.
5. Differentiate between tetraplegia and paraplegia.
6. Discuss central cord syndrome.
7. Explain determinants of recovery for spinal cord injury patients.
8. Discuss management of spinal stability with the use of orthoses.
9. Recognize signs and symptoms associated with orthostatic hypotension and treatment options.
10. Identify the risk of respiratory complications after spinal cord injuries.
11. Define spasticity.
12. List possible underlying issues that could contribute to the development of spasticity.
13. Explain different types of pain associated with spinal cord injuries.
14. Differentiate between environmental factors, personal factors and the combination of the two.
15. Discuss emotional reactions associated with spinal cord injuries and the implications of each on the patient.
16. Identify the benefits of counseling for patients who have a spinal cord injury.
17. Explain the importance of the initial evaluation and the role it plays in therapeutic intervention.
18. Discuss the importance of effectively interviewing both the patient and the family following a spinal cord injury.
19. Discuss pain and effects of pain on the patient.
20. Explain appropriate methods to evaluate bed mobility.
21. Discuss the effects of aging on the spinal cord patient.
22. Identify signs and symptoms associated with the decrease in skin resilience associated with the spinal cord injury patient.
23. Define fatigue.
24. Discuss the importance of implementing bracing and splinting as the spinal cord patient adjusts to aging.
25. Discuss psychological distress to health and functioning

Included in Module 1:  Medical Management, Psychological Adjustment and Evaluation
Chapter 1:  Understanding Spinal cord Injury and Advances in Recovery
Chapter 2:  Medical Management and Complications of Spinal Cord Injury
Chapter 5:  Psychological adjustment to Spinal Cord Injury
Chapter 6:  Evaluation
Chapter 22:  Functional and Psychosocial Aspects of Aging with Spinal Cord Injury
Chapter 23:  Quality of Life After Spinal Cord Injury 

1. Discuss the role of intervention programs for patients with spinal cord injuries.
2. Identify the importance of patient education as well as that of caregiver education.
3. List the three classes of levers in the human body and differentiate between the three.
4. Explain the importance of range of motion after a spinal cord injury.
5. Define tenodesis.
6. Differentiate between the long sitting position and the short sitting position.
7. List the psychosocial considerations that play a role in transfer techniques.
8. Discuss transfer techniques for patients with spinal cord injuries.
9. Identify those at higher risk for development of upper limb pain and injury following a spinal cord injury.
10. Explain the importance of the level of injury and its role in rehabilitation.
11. Discuss the importance of teaching proper weight shifts.
12. Discuss paralytic scoliosis.
13. Recognize factors that influence the development of paralytic scoliosis.
14. Identify Scapulothoracic instability.
15. Identify the appropriate considerations for upper limb orthotic intervention.
16. Define serial casting.
17. Discuss the considerations for choosing between a manual and power wheelchair for patients with spinal cord injuries.
18. Identify the importance of correct seating and positioning in the wheelchair.
19. Discuss the role of the cushion and factors to consider when choosing an appropriate cushion for a wheelchair.
20. List postural deformities observed in clients with spinal cord injuries.
21. Differentiate between the advantages and disadvantages when observing hanger angle of leg rest.
22. List different types of power wheelchairs and the advantages to each.
23. Identify the wheel locations of power wheel chairs and how they benefit the patient.
24. Discuss input devices for power wheel chairs.
25. Define shear strain.
26. Identify components used to promote postural support while seated in a wheelchair.

Included in Module 2:  Position Changes, Transfer Techniques and ADL’s 
Chapter 7:  Intervention Principles and Position Changes
Chapter 8:  Transfer Techniques
Chapter 9:  Activities of Daily Living
Chapter 10:  Management of Upper Limb in Individuals with Tetraplegia
Chapter 11:  Seating and Positioning 

1. List the categories of assistive technology and the functional level of each.
2. Discuss the Matching Person and Technology process of selecting appropriate technology for a patient.
3. Identify barriers to acquiring assistive technology devices and services.
4. Differentiate between momentary, latched and proportional switches and how they function as an alternative means to execute a command in an electronic device.
5. Explain the importance of mainstream technology and how it benefits an individual with a spinal cord injury.
6. Discuss the percentage of individuals with spinal cord injuries that do not return to their home environment following a spinal cord injury
7. Explain universal design.
8. Identify programs available to help with funding for home modifications for spinal cord injury patients.
9. Demonstrate knowledge in home modifications and the appropriate rooms to consider for modification.
10. Discuss the level of injury and the role it plays in home modifications.
11. List appropriate doorway measurements to accommodate for wheelchair dependent patients.
12. Explain bed/mattress options and selections appropriate to meet the needs of spinal cord injury patients.
13. List wheelchair design options.
14. Identify the appropriate axle placement to meet the needs of each individual.
15. List propulsion techniques and differentiate between each.
16. Explain the role wheelies play in gaining independence in wheelchair mobility.
17. Discuss ascending and descending ramps in a wheelchair.
18. Discuss ascending and descending a curb in a wheelchair.
19. Identify prerequisites to negotiating stairs in a wheelchair.
20. List all methods of maneuvering steps.
21. Explain the parastance position and when it is appropriate to assume this position.
22. Demonstrate knowledge in implementing the Berg Balance Test.
23. Define conventional rehabilitation.
24. Differentiate between conventional gait rehabilitation and locomotor training.
25. Differentiate between swing-through, swing-to and drag-to gait patterns.
26. Discuss the role functional electrical stimulation plays in rehabilitation of muscle bulk and reducing spasticity.

Included in Module 3:  Assistive Technology, Home Modifications, Wheelchair Skills and Ambulation
Chapter 12:  Assessment and Match for Effective Assistive Technology
Chapter 13:  Using Assistive Technology
Chapter 14:  Accessible Home Modification and Durable Medical Equipment
Chapter 15:  Wheelchair Skills
Chapter 16:  Ambulation 

1. Discuss the applications of functional electrical stimulation in spinal cord injury.
2. Explain the role of muscle fibers in functional electrical stimulation
3. Explain the contraindication and precautions for functional electrical stimulation.
4. List the factors that affect muscular response to functional electrical stimulation.
5. Differentiate between pulse amplitude, pulse width and pulse frequency.
6. Define impedance
7. Differentiate between asymmetrical biphasic current and monophasic pulsatile current.
8. Discuss cardiovascular and pulmonary adaptation to spinal cord injury and the reasons ventilation is significantly impaired.
9. Explain the two major roles that the sensory components of functional electrical stimulation are responsible for.
10. List types of electrodes available for functional electrical stimulation.
11. List factors that may effectiveness and success of stimulation programs.
12. Differentiate between the Freehand system, Bionic Glove, Handmaster and FESMate and how a patient may benefit from each.
13. Differentiate between the ParaWalker and the Parastem.
14. Define autonomic dysreflexia.
15. Explain the rate of perceived exertion and how it is implemented to prescribe exercise intensity for individuals with tetraplegia and high paraplegia.
16. Discuss training programs for athletes with spinal cord injuries
17. Identify sports available to individuals with spinal cord injuries
18. Differentiate between periodization, speed training, skill training and plyometrics.
19. List workout strategies to avoid over training.
20. Explain sprint training.
21. Define plyometrics.
22. Discuss advantages and disadvantages of free weights versus machine weights.
23. Explain the number of sets and repetitions appropriate during weight training exercises.
24. List the four common training routines used by athletes.
25. Discuss third-party add-on equipment used to safely transport individuals while seated in their wheelchairs.
26. Differentiate between four-point tie down systems, docking systems, clamping systems, and rim pin systems identify both functionality and advantages or disadvantages of each.
27. Discuss standards implemented to evaluate safety for those traveling in wheelchairs.
28. Differentiate between fixed-route transportation and demand-responsive transportation.
29. Discuss goals of Diver rehabilitation programs.
30. Explain how the level of injury helps determine the appropriate choice of vehicle transportation.

Included in Module 4:  Exercise, Fitness and Transportation
Chapter 17:  Functional Electrical Stimulation
Chapter 18:  Exercise and Fitness with Spinal Cord Injury
Chapter 19:  Sports and Recreation for People with Spinal Cord Injury
Chapter 20:  Wheelchair Transportation
Chapter 21:  Transportation, Driving and Community Access