What should be included in occupational therapy for cauda equina and conus medullaris syndrome?

Updated: Jun 14, 2018
  • Author: Segun Toyin Dawodu, JD, MD, MS, MBA, LLM, FAAPMR, FAANEM; Chief Editor: Nicholas Lorenzo, MD, MHA, CPE  more...
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Answer

Conduct the following:

  • Wheelchair training, especially for advanced wheelchair activities

  • Transfer training

  • Activities of daily living program with assistive devices for dressing, feeding, grooming, bathing, and toileting

  • Motor coordination skills training

  • Shower program

  • Upper extremities training to increase strength for the increased demands of wheelchair propulsion and walking with assistive devices

  • Home evaluation

  • Family training

  • A home exercise program

Orthotic/assistive devices may be needed for functional household ambulation and, if possible, community ambulation. This entails prescribing and training in proper use of knee-ankle-foot orthoses (KAFO) with forearm crutches for support; for lower lesions, KAFOs or AFOs with canes or crutches may be needed. In addition to the above, bathtub bench, transfer boards, pressure-relieving seats, and wheelchairs are devices that may be needed. The patient should be assessed for these needs prior to discharge from the acute rehabilitation setting.


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