Running head: SPINAL CORD INJURY

Spinal Cord Injury and the Importance of Hydration Michelle Ashley Touro University Nevada

SPINAL CORD INJURY Occupational Profile Diagnosis The client suffered an incomplete T1 spinal cord injury, due to a motorcycle accident. After suffering the spinal cord injury, he decided to move in with his parents because his house was no longer functional for him and he was unable to independently care for himself. Prior to

the injury, the client would go boating and fishing with friends. He has been unable to participate in these activities and would like to work on returning to these activities. Currently he uses a wheelchair for mobility, in his house and in the community. He is optimistic that with therapy he will regain more functional use of his body, and perform the activities that are meaningful to him. Performance Limitations Disruption of the spinal cord secondary to a traumatic event that results in the loss of motor and sensory function below the level where the injury was sustained (Gregorio-Torres, Laredo & Andrews, 2011). SCI often results in an overwhelming loss of function, interfering with every aspect of occupational performance and quality of life (Gregorio-Torres, Laredo & Andrews, 2011). The client is unable to perform activities of daily living (ADLs) and instrumental activities of daily living (IADLs) independently, and currently requires the help of a family member to complete daily activities. The client has a four year old son that he enjoys spending time with; unfortunately, due to the pain he experiences throughout the day he is unable to interact with him at the level he did prior to the injury. He also has a hard time regulating his body temperature and continually complains of feeling cold. The client exhibits weakness in his upper extremities and a lack of trunk control, as well as limited range of motion in his upper

SPINAL CORD INJURY extremities. Additionally, the client worked two jobs, one as a bartender and the other as a

manager at a local gym. After sustaining the T1 spinal cord injury he has been unable to return to either job. Purpose of Device Hydration is important, especially in regards to individuals that have suffered a spinal cord injury. Depending on the level of injury, a spinal cord injury can alter the bodys ability to regulate temperature, and blood pressure, as well as other physiological changes. Normally it is recommended that nondisabled individuals consume between eight and 12 eight-ounce glasses of water a day. Individuals who have suffered a spinal cord injury actually need to consume even more water (Craig Hospital, n.d.). This is due to injury affecting their bodys ability to actually sense the thirst sensation. The speed in which an individual with a spinal cord injury senses the sensation is quite a bit slower, which can be devastating to their health. Staying properly hydrated aid in helping an individual with a spinal cord injury to normalize their temperature, flush their kidneys and bladder, and keep skin conditions to a minimum (Craig Hospital, n.d.). The current device was fabricated to ensure that someone with an injury such as a spinal cord injury or any other injury that causes weakness or paralysis in one or both arms still has the ability to hydrate themselves with minimal assistance. Alternate population that would benefit from this device include clients who have suffered a stroke, amputees, or older adults that have limited range of motion in their upper extremity due to osteoarthritis. The Talan, a wheelchair and desk cup holder can be attached to various surfaces allowing the individual to always have water or their beverage of choice within close proximity. This will ensure the individual stays properly hydrated, even if a caregiver is not around because it is a hands-free device. Similar Devices

SPINAL CORD INJURY The following chart provides a list of similar devices to The Talan, which provides

easy access to hydration. A unique aspect of the The Talan is that it is a hands-free device. The gooseneck allows the caregiver to attach the device to a wheelchair or desk and position it so the individual can easily access their drink with minimal movement involved. Similar devices attach to the wheelchair but the individual would still need to have upper extremity function and strength to grasp the drinking container and bring it to their mouth. Item Retailer Cost

$20.99 1800WHEELCHAIR.com

Liquid Caddy Drink Holder

$39.95 Amazon.com

Heavy Duty Handlebar Drink Holder

Amazon.com

$12.99

Wheelchair Armrest Tray

SPINAL CORD INJURY

Amazon.com

$10.03

Clamp-On Wheelchair Drink Holder

Amazon.com

$29.99

Wheelchair Drink/Cup Holder

Cost Analysis Item Clip-on Desk Lamp Copper Wire Retailer WalMart Walmart Cost $10.98 $3.99

Cup

Pre-owned

N/A

Foam

Pre-owned

N/A

Straw

Pre-owned

N/A

Literature Review When reviewing the literature it was evident to see the importance of hydration and the impact it has on individuals with a spinal cord injury. Ditunno and Formal (1994), discussed the

SPINAL CORD INJURY different signs and symptoms to be aware of when working with a client who has sustained a spinal cord injury. One of the common medical problems discussed throughout the paper centered on the occurrence of urinary tract problems (Ditunno & Formal, 1994). Without proper hydration, urinary problems increase which then lead to additional medical concerns. Due to the damage that occurred during the injury, the nerve signals that notify the body to drink are weaken and the individual does not increase their fluid intake. Additionally, another important topic that was discussed throughout the literature review was thermoregulation issues exhibited in the spinal cord injury population. Attia and Engel (1983), discussed how spinal cord damage affects an individuals ability to regulate their own temperature. This causes issues with their ability to sweat and maintain a normalized core body temperature, due to irregular vasoconstriction and vasodilation. Staying hydrated can aid in an individuals ability to neutralize their thermoregulatory set point (Attia & Engel, 1983). Based on the literature review, it is evident that individuals with a spinal cord injury need to be cognizant of their hydration levels and be aware of the changes that are taking place throughout their body.

SPINAL CORD INJURY References Attia, M. & Engel, P. (1983). Thermoregulatory set point in patients with spinal cord injuries (spinal man). Paraplegia, 21, 233-248. Craig Hospital. (n.d.). http://www.craighospital.org/Left-Nav/Craig-Programs/Spinal-CordInjury--SCI--Rehab/Health-and-Wellness-Information/EducationalBrochures/H2O:%20Hydration Ditunno, J.F., & Formal, C.S. (1994). Chronic spinal cord injury. The New England Journal of Medicine, 330(8), 550-556. Gregorio-Torres, T., Laredo, R., & Andrews, S. K. (2011). Enabling performance and

participation following spinal cord injury. In C. H. Christiansen & K. M. Matuska (Eds.). Ways of living intervention strategies to enable participation (4th ed., pp. 239-280). Bethesda: American Occupational Therapy Association, Inc.