The recent series of presentations by Rosie Bartlett, and hosted by BABICM, highlighted questions around the possible correlation of combined diagnoses of Spinal Cord Injury (SCI) and Acquired Brain Injury (ABI) in relation to poor outcomes around postural care and pressure management. Anecdotal case information from participants raised the hypothesis that cognitive and executive impairment in people who had sustained mild to moderate brain injuries were significant factors in maintaining good postural management and also increased the risks associated with development of and treatment of pressure ulcers. BABICM are now raising this survey to explore this hypothesis and to attempt to gain further insight into the extent to which this is considered a factor of significance by case managers working with people over longer periods, with a view to potentially exploring this hypothesis further with research partners.
Please take a few minutes to answer this brief survey. We value your opinion and thank you for your time.
“How many of your clients have a diagnosis of spinal cord injury
ASIA Impairment Scale
The ASIA Impairment Scale is another helpful guide to understanding an injury. It was developed by doctors at the American Spinal Injury Association (ASIA) to categorize the extent of an injury in terms of the degree of damage to the spinal cord. If the injury is “complete,” (ASIA A) it means that no messages can travel across the location of the injury to the brain. However, “incomplete” injuries, which mean that some messages can still get through, are classified as ASIA B, ASIA C or ASIA D, depending on amount of movement and feeling that remain below the level of the injury.
Here are the classifications:
ASIA A: Complete, no motor or sensory function is preserved below the level of the injury, including the sacral segments S4 – S5 ASIA B: Incomplete Sensory, but not motor function is preserved below the neurological level of injury, and includes the sacral segments S4 – S5 ASIA C: Incomplete, motor function is preserved below the neurological level of injury, but more than half of the key muscles below the level have a muscle grade less than 3 (i.e. unable to move against gravity) ASIA D: Incomplete, motor function is preserved below the neurological level of injury, and at least half the key muscles below the injury level have a muscle grade of 3 or more (i.e. joints can be moved against gravity. ASIA E: Normal, motor and sensory functions are normal
Please indicate below the number of clients/patients at each grade of injury
Please only enter numbers.
How many of your SCI clients attended a specialist centre for their rehabilitation?
How many attended an alternative secondary rehabilitation centre before discharge into the community?
How many of your client base have a confirmed dual diagnosis of Acquired Brain Injury alongside Spinal Cord Injury?
Was this diagnosis recognised pre/post discharge into the community?
How many of your client base do you believe have a dual diagnosis of Acquired Brain Injury alongside Spinal Cord Injury that has not been recognised?
What is the incidence of pressure injury in your client base? %
Please indicate whether this has been a difficulty in: (please indicate all that apply)
You can select multiple options.
In your opinion, is the diagnosis of ABI likely to increase or diminish the likelihood of difficulties?
In your experience, how relevant do you think that cognitive, executive and insight difficulties are in impacting on ability of people to manage their postural and pressure care following a SCI?
Why do you think that this might be the case?
Please provide any brief examples of where this has been a particular issue?
What strategies have you found helpful in supporting clients with ABI and SCI to manage their postural and pressure care? How else might we help?