COMMUNITY TRIPS
Community trips, which help the patient to plan, problem
solve, transfer therapy skills, and cope with real-life situations, include:
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Movies, theater, spectator sports, sightseeing tours, museums, and concerts
-
Shopping, restaurants, and clubs
SPORTS
Vigorous, physical exercise
is highly beneficial for SCI patients. It stimulates circulation,
helps prevent skin breakdown, increases fluid intake, promotes
self-worth and mental health, improves the immune system and
overall health, and supports the patient's construction of an
identity following the injury (Taylor
and McGruder, 1996), including the necessary first step
of reconnecting with a past self (Lee,
et al 1996). Sports also enhance physical performance
and induce positive physiological adaptations (Schmid,
et al 1998) and are important for their social aspects
(Wu & Williams, 2001). Athletes
score significantly higher on the CHART, indicating greater
levels of community integration than nonathletes (Hanson,
et al 2001). Standard exercise tests are advocated for
the evaluation of training and for rehabilitation progress (van
der Woude, et al 2002).
Exercise can impact brain circuitry by promoting neuronal repair and can enhance learning and memory by increasing neurotrophic support. Exercise may be a powerful lifestyle implementation that could be used to augment synaptic plasticity, promote behavioral rehabilitation, and counteract the deleterious effect of aging. (Vaynman & Gomez-Pinilla, 2005).
SCI patients who participate in sports are usually younger,
less likely to have a cervical-level injury, and report higher incomes. There
is no apparent correlation between post-injury sports participation with
psychological adjustment (Foreman, et al 1997)
or with a pre-injury history of sports involvement
(Kirkby, et al 1996). However, many
SCI patients who participate in competitive sports were active prior to the
injury and were motivated by other physically disabled people
(Furst, et al 1993)
Wheelchair sports include basketball,
bowling, track and field, swimming, archery, table tennis, softball,
football, marathons, and rugby. There are organizations
throughout the world that support recreational activities
for people with disabilities. Many have sites on the web.
Wheelchair racers with SCI should follow recommendations for
able-bodied individuals to minimize their risks of hyperthermia
during competition (Bhambhani, 2002).
A classification scheme places participants in 1 of 3
groups:
-
Class I - Complete motor loss at T-7 level or above
-
Class II - Complete motor loss originating at T-8 and descending through
L-2
-
Class III - All other disabilities originating at or below L-3
Training for wheelchair sports can begin prior to discharge.
The benefit of sea kayaking and aquatic therapy classes have also been reported
for SCI patients (Taylor & McGruder, 1996; Broach,
et al 1997).
INDEPENDENT LIVING
Recent trends to discharge patients more quickly than
in the past place more emphasis on:
-
Integrating previous hospital-based recreational therapy programs into the
growing independent living movement (McAweeney, et
al 1997)
-
Social contacts to facilitate community integration and the value of leisure
as a context for the establishment of social contacts
(Dattilo, et al 1998)
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