Spinal Cord Injury Rehabilitation THERAPY IN PRACTICE SERIES Edited by Jo Campling This series of books is aimed at 'therapists' concerned with rehabili tation in a very broad sense. The intended audience particularly in cludes occupational therapists, physiotherapists and speech therapists, but many titles will also be of interest to nurses, psychologists, medical staff, social workers, teachers or voluntary workers. Some volumes are interdisciplinary, others are aimed at one particular profession. All titles will be comprehensive but concise, and practical but with due reference to relevant theory and evidence. They are not research mono graphs but focus on professional practice, and will be of value to both students and qualified personnel. 1. Occupational Therapy for Children with Disabilities Dorothy E. Penso 2. Living Skills for Mentally Handicapped People Christine Peck and Chia Swee Hong 3. Rehabilitation of the Older Patient Edited by Amanda J. Squires 4. Physiotherapy and the Elderly Patient Paul Wagstaff and Davis Coakley 5. Rehabilitation of the Severely Brain-Injured Adult Edited by Ian Fussey and Gordon Muir Giles 6. Communication Problems in Elderly People Rosemary Gravell 7. Occupational Therapy Practice in Psychiatry Linda Finlay 8. Working with Bilingual Language Disability Edited by Deirdre M. Duncan 9. Counselling Skills for Health Professionals Philip Burnard 10. Teaching Interpersonal Skills A handbook of experiential learning for health professionals Philip Burnard 11. Occupational Therapy for Stroke Rehabilitation Simon B.N. Thompson and Maryanne Morgan 12. Assessing Physically Disabled People at Home Kathy Maczka 13. Acute Head Injury Practical management in rehabilitation Ruth Garner 14. Practical Physiotherapy with Older People Lucinda Smyth et al. 15. Keyboard, Graphic and Handwriting Skills Helping people with motor disabilities Dorothy E. Penso 16. Community Occupational Therapy with Mentally Handicapped Adults Debbie Isaac 17. Autism Professional perspectives and practice Edited by Kathryn Ellis 18. Multiple Sclerosis Approaches to management Edited by Lorraine De Souza 19. Occupational Therapy in Rheumatology An holistic approach Lynne Sandles 20. Breakdown of Speech Causes and remediation Nancy R. Milloy 21. Coping with Stress in the Health Professions A practical guide Philip Burnard 22. Speech and Communication Problems in Psychiatry Rosemary Gravell and Jenny France 23. Limb Amputation From aetiology to rehabilitation Rosalind Ham and Leonard Cotton 24. Management in Occupational Therapy Zielfa B. Maslin 25. Rehabilitation in Parkinson's Disease Edited by Francis I. Caird 26. Exercise Physiology for Health Professionals Stephen R. Bird 27. Therapy for the Bum Patient Annette Leveridge 28. Effective Communication Skills for Health Professionals Philip Burnard 29. Ageing, Healthy and in Control An alternative approach to maintaining the health of older people Steve Scrutton 30. The Early Identification of Language Impairment in Children Edited by James Law 31. An Introduction to Communication Disorders Diana Syder 32. Writing for Health Professionals A manual for writers Philip Burnard 33. Brain Injury Rehabilitation A neuro-functional approach Gordon Muir Giles and Jo Clark-Wilson 34. Living with Continuing Perceptuo-motor Difficulties Theory and strategies to help children, adolescents and adults Dorothy E. Penso 35. Psychology and Counselling for Health Professionals Edited by Rowan Bayne and Paula Nicholson 36. Occupational Therapy for Orthopaedic Conditions Dina Penrose 37. Teaching Students in Clinical Settings Jackie Stengelhofen 38. Groupwork in Occupational Therapy Linda Finlay 39. Elder Abuse Concepts, theories and interventions Gerald Bennett and Paul Kingston 40. Teamwork in Neurology Ruth Nieuwenhuis 41. Eating Disorders A guide for health professionals Simon B.N. Thompson 42. Community Mental Health Practical approaches to long-term problems Steve Morgan 43. Acupuncture in Clinical Practice A guide for health professionals Nadia Ellis 44. Child Sexual Abuse A guide for health professionals Celia Doyle Forthcoming titles Forensic Psychiatry for Health Professionals Chris Lloyd Research Methods for Therapists Avril Drummond Speech and Language Problems in Children A practical guide Dilys A. Treharne Spinal Cord Injury Rehabilitation Karen Whalley Hammell Occupational Therapist, Saskatchewan, Canada SPRINGER-SCIENCE+BUSINESS MEDIA, B.V. First edition 1995 © Springer Science+Business Media Dordrecht 1995 OriginalIy published by Chapman & HalI in 1995 Typeset in 1O/12pt Palatino by Florencetype Ltd, Stoodleigh, Devon ISBN 978-0-412-47680-8 ISBN 978-1-4899-4451-1 (eBook) DOI 10.1007/978-1-4899-4451-1 Apart from any fair dealing for the purposes of research or private study, or criticism or review, as permitted under the UK Copyright Designs and Patents Act, 1988, this publication may not be reproduced, stored, or transmitted, in any form or by any means, without the prior permission in writing of the publishers, or in the case of reprographic reproduction only in accordance with the terms of the licences issued by the Copyright Licensing Agency in the UK, or in accordance with the terms of licences issued by the appropriate Reproduction Rights Organization outside the UK. Enquiries concemirtg reproduction outside the terms stated here should be sent to the publishers at the London address printed on this page. The publisher makes no representation, express or implied, with regard to the accuracy of the information contained in this book and cannot accept any legal responsibility or liability for any errors or omissions that may be made. A catalogue record for this book is available from the British Library Library of Congress Catalog Card Number: 94-71813 § Printed on permanent acid-free text paper, manufactured in accordance with ANSIINISO Z39 48-1992 (Permanence of Paper). To Ike Contents Preface xiii Acknowledgements XV Author's note xvi Introduction 1 Client-centred practice 1 International Classification of Impairments, Disabilities and Handicaps 2 Canadian model of occupational performance 2 Independence 3 References 4 1 Rehabilitation and self-determination 5 Introduction 5 Medical model of rehabilitation 7 Educational approach to rehabilitation 9 Model of occupational performance and the assessment process 10 Goal setting 13 Establishing objectives 15 Identifying attainment of objectives 17 Accountability 18 Compliance and control 19 Active participation: the activated patient and empowerment in rehabilitation 20 Learned/taught helplessness 22 Locus of control 22 Motivation 24 Relationship between client and therapist 26 Conclusion 29 Acknowledgement 30 Contents X References 30 Further reading 32 2 Education as the key to rehabilitation 33 Introduction 33 Learning process 34 Theories of learning 35 How do people 'learn best'? 36 Application of learning theory in rehabilitation 37 Compliance and control 38 Learning and empowerment 39 Problem-solving and learning 40 Peer learning 42 Barriers to learning 43 Learning needs and Maslow's hierarchy 45 Setting goals 47 Family involvement in the learning process 48 Summary 49 References 50 3 Spinal cord injury: aetiology, incidence and impairments 52 Historical perspective 52 Incidence and prevalence 53 Aetiology of traumatic injury 54 Prevention of traumatic injury 56 Impairment 60 Emergency management 69 Specialized spinal injury units 71 References 72 4 Acute care and reduction of disability 74 Acute care 75 Disability reduction: acute and long-term management 93 Survival and mortality 111 References 113 5 Engagement in self-care activities 118 Introduction 118 Functional levels 119