SCI And Environmental Accessibility

For persons living with a spinal cord injury (SCI) or other types of physical disabilities, accessibility is key to successful community reintegration and vitally important for overall life satisfaction.

Mr. Wun fell asleep while driving without a safey belt, resulting in a serious motor vehicle accident and a spinal cord injury (SCI).

To enable appropriate planning of Mr. Wun's second period of rehabilitation, the rehabilitation team had to gain an accurate picture of his functioning.

With the assessment results in mind, the second part of the Rehab-Cycle^® assessment phase involved identifying the goals and targets to achieve with rehabilitation interventions.

In the Rehab-Cycle^® intervention phase, a range of interventions were undertaken to address the goals set for each of Mr. Wun's intervention targets i.e. the ICF category for which a goal was set and for which interventions were planned.

Although the re-assessment of Mr. Wun’s functioning status at the end of the Rehab-Cycle^® revealed only modest improvements, the goals related to the prevention of secondary conditions and to mobility were achieved.

Accessibility is a broad term encompassing many elements, including physical, socio-cultural and technological aspects. This case study of Mr. Wun highlighted how difficult it is to overcome environmental inaccessibility, despite rehabilitation efforts to increase a person's independence in mobility.

Example of book: Jones M, Rivett D. Introduction to clinical reasoning. In: Jones M, Rivett D. Clinical reasoning for manual therapists. Edinburgh, UK: Butterworth Heinemann. 2004.

1. United Nations (UN). Convention on the Rights of Persons with Disabilities (CRPD). Geneva, Switzerland: United Nations; 2006.
2. United Nations (UN). UN Enable Newsletter January 2016. [Internet] 2002. Available from: https://www.un.org/development/desa/disabilities/news.html. Access February 2016.
3. United Nations Economic and Social Commission for Asia and the Pacific (UNESCAP). Disability at a glance 2012: Strengthening the evidence base in Asia and the Pacific. Bangkok, Thailand: United Nations; 2012.
4. Ito N. Convention on the rights of persons with disabilities and perspectives of development assistance: A case study of Thai disability policy. Asia Pacific Disability Rehabilitation Journal. 2010; 21(1): 43-59.
5. National Office for Empowerment of Persons with Disabilities. Persons with Disabilities Empowerment Act B.E.2550. Bangkok, Thailand: National Office for Empowerment of Persons with Disabilities; 2007.
6. National Committee for Empowerment of Persons with Disabilities. The 4th National Plan on the Empowerment of Persons with Disabilities B.E. 2555-2559. Bangkok, Thailand: National Office for Empowerment of Persons with Disabilities; 2011.
7. Noreau L, Fougeyrollas P, Boschen K. Perceived influence of the environment on social participation among individuals with spinal cord injury. Top Spinal Cord Inj Rehabil. 2002; 7(3): 56-72.
8. Boschen KA, Tonack M, Gargaro J. Long-term adjustment and community reintegration following spinal cord injury. Int J Rehab Res. 2003; 26(3): 157-164.
9. Bickenbach J, Officer A, Shakespeare T, von Groote P. (eds.) International perspectives on spinal cord injury (IPSCI). Geneva, Switzerland: World Health Organization; 2013.
10. Venter C, Savill T, Rickert T, Bogopane H, Venkatesh A, Camba J, Mulikita N, Khaula C, Stone J, Maunder D. Enhanced accessibility for people with disabilities living in urban areas (an unpublished project report, PR/INT/248/02). United Kingdom Department for International Development (DFID), Research for Development Project R8016. [Internet] 2002. Available from: http://r4d.dfid.gov.uk/Project/5322/. Accessed February 2016.
11. Venter C, Rickert T, Maunder D. From basic rights to full access: Elements of current accessibility practice in developing countries. Paper presented at the 82nd Transportation Research Board Annual Conference, Washington, DC (USA) on 12-16 January 2003.
12. Richards JS, Bombardier CH, Tate D, Dijkers M, Gordon W, Shewchuk R, DeVivo MJ. Access to the environment and life satisfaction after spinal cord injury. Arch Phys Med Rehabil. 1999; 80(11):1501-1506.
13. Whiteneck G, Meade MA, Dijkers M, Tate DG, Bushnik T, Forchheimer MB. Environmental factors and their role in participation and life satisfaction after spinal cord injury. Arch Phys Med Rehabil 85(11): 1793-1803.
14. Scelza WM, Kirshblum SC, Wuermser LA, Ho CH, Priebe MM, Chiodo AE. Spinal cord injury medicine. 4. Community reintegration after spinal cord injury. Arch Phys Med Rehabil. 2007; 88(3)Suppl.1: S71-S75.
15. World Health Organization. International Classification of Functioning, Disability and Health (ICF). Geneva: World Health Organization; 2001.
16. European Conference of Ministers of Transport (ECMT). Improving transport accessibility for all. Guide to good practice. [Internet] 2006. Available from: http://www.internationaltransportforum.org/IntOrg/ecmt/accessibility/accessibility.html. Accessed February 2016.
17. World Health Organization. Guidelines on the provision of manual wheelchairs in less resourced settings. [Internet] 2008. Available from: http://www.who.int/violence_injury_prevention/publications/services/en. Accessed February 2016.
18. World Health Organization (WHO), International Society for Prosthetics and Orthotics (ISPO), US Agency for International Development (USAID). Sheldon S, Jacobs N. (eds.) Report of a consensus conference on wheelchairs for developing countries. [Internet] 2006. Available from: http://www.who.int/disabilities/technology/WCGconcensusconf/en/. Accessed February 2016.

Download as PDF