**5.5 Physiotherapist**

The scope of profession of Physiotherapy spans from intensive in-hospital care, orthopedics, non-communicable diseases, neurology, obstetrics and gynecology rehabilitation [2, 38]. Physiotherapists can manage a variety of concerns of spinal cord injured individual that include diminished respiratory functioning, muscle weakness and contractures, poor somatosensation, reduced mobility, misaligned posture, and deteriorating fitness [35, 39, 40]. The physiotherapists will prescribe physical activity starting from post-surgery confirmed to bed, then bed mobility, transfers maneuvers (from bed to chair, bed to standing and return manoeuvers to bed), assisted gait movement, wheelchair mobility, and upper limb functioning and strengthening. Although a physiotherapist can perform these important tasks other specialists are requested to assist with physical activity and exercise therapy. The physiotherapist may enlist the assistance of a biokineticist (South Africa and Namibia) or kinesiotherapist (United States of America and Canada) to prescribe and monitor stretch, strengthening and aerobic exercises.

**113**

*The Interprofessional Clinical and Therapeutic Team Strategy to Manage Spinal Cord Injuries*

In larger spinal cord rehabilitation centers, different movement therapists such biokineticist, kinesiotherapist and recreational therapist may form part of the multi-disciplinary team. Ellapen *et al.* (2018) reported that biokineticists are rehabilitation exercise expertise because their formative tertiary education is Exercise Science and Exercise Physiology [41]. Strydom *et al* and Lawrason *et al* reported that many patients prefer recreational therapeutic physical activities such as sport, games, fishing, gardening, arts and crafts instead of clinical exercise therapy regimes, which on occasion necessitates the referral to recreational therapists [42, 43]. Harvey recommends that physiotherapists should concentrate their efforts to assist spinal cord injured individual to walk with and without assistance, push a manual wheelchair and being able to independently transfer or relocate themselves from one position to another to re-acclimatize themselves to

Pillanstrini *et al* describe the profession of Occupational Therapy as the skilled paramedical treatment, which helps the person to accomplish independence and success in all aspects of their daily lifestyle [44]. The occupational therapist assist spinal cord injured people to re-adjust to their social and physical living environments [44]. De Wit *et al* suggest that the fundamental focus of occupational therapist is the re-acclimatization of activities of daily living through home-based activities, sensory, perceptual and cognitive exercises [45]. Occupational therapists can also assist spinal cord injured individuals who want to return to their careers by re-acclimatizing them to their work-environments, which an aspect that warrants

Kinesiotherapy is an American and Canadian exercise therapy profession that subscribes to the solicitation of scientific, evidence based human movement physical activity and exercise principles aimed to recover the individual's muscular strength and endurance and movement capabilities of patients with functional kinesiological limitations, and individuals who need protracted physical conditioning [46, 47]. A kinesiotherapist functions within the professional association of the American Kinesiotherapy Association. These exercise therapists can assist persons

A biokineticist is a specialized exercise therapist who functions within the professional association of Health Professions Council of South Africa (HPCSA) and/or the Namibian Health Professions Council (NHPC) [48, 49]. This profession is concerned with final-phase rehabilitation and preventative exercise therapy in the pathogenic healthcare paradigm and the promotion of health and wellbeing in the fortogenic healthcare paradigm [50]. Through individualized physical activity and exercise programme prescription a biokineticist is able to improve the health and wellbeing of a spinal cord injured individual. A biokineticist intends to enhance the physical and physiological status and wellbeing of a patient through an exercise regime in dual context of clinical pathology as well as performance enhancement [42]. Due to the host of non-communicable diseases co-morbidities that affect spinal cord injured individuals the expertise of biokineticists is extremely valuable

in both the pathogenic and fortogenic healthcare paradigms.

*DOI: http://dx.doi.org/10.5772/intechopen.94850*

daily living [39].

more emphasizes.

**5.8 Biokineticist**

to curtail their pathogenesis.

**5.7 Kinesiotherapist**

**5.6 Occupational therapist**

*The Interprofessional Clinical and Therapeutic Team Strategy to Manage Spinal Cord Injuries DOI: http://dx.doi.org/10.5772/intechopen.94850*

In larger spinal cord rehabilitation centers, different movement therapists such biokineticist, kinesiotherapist and recreational therapist may form part of the multi-disciplinary team. Ellapen *et al.* (2018) reported that biokineticists are rehabilitation exercise expertise because their formative tertiary education is Exercise Science and Exercise Physiology [41]. Strydom *et al* and Lawrason *et al* reported that many patients prefer recreational therapeutic physical activities such as sport, games, fishing, gardening, arts and crafts instead of clinical exercise therapy regimes, which on occasion necessitates the referral to recreational therapists [42, 43]. Harvey recommends that physiotherapists should concentrate their efforts to assist spinal cord injured individual to walk with and without assistance, push a manual wheelchair and being able to independently transfer or relocate themselves from one position to another to re-acclimatize themselves to daily living [39].

### **5.6 Occupational therapist**

*Therapy Approaches in Neurological Disorders*

**5.2 Rehabilitation nurse**

practitioners [35].

**5.3 Nutritionist**

body fat.

**5.4 Pharmacist**

**5.5 Physiotherapist**

person and medication prescription [37].

and a rehabilitation medicine specialist is needed. The aforementioned medical doctors all have significant roles to play in the successful management of spinal cord injured individuals, who needs to comply with their directives [34]. The consulting medical doctor and/or physician general serves as the source of referrals for physio-

The rehabilitation nurse has many responsibilities covering a range of clinical and therapeutic functions, such as patient personal hygiene care, person compliance to short; intermediate and long terms healthcare goals which overlaps with many of the therapeutic practitioners scope of professions. Many rehabilitation nurses are present 24 hours, seven days a week, thereby placing them the most admirable position to serve as the coordinators of the interprofessional clinical and therapeutic team because they interact all the clinical and rehabilitative

The significance of good nutritional advice is of paramount value because of the increased risks associated; both malnutrition, (during early post-injury period) and, later obesity that becomes common co-morbidity among spinal cord injured people. Good nutritional choices and habits play a fundamental role to achieve and maintain body mass control, bladder and bowel management, augment immune system function and skin integrity [36]. Collaborative regular monitoring of body mass, body mass index, lean muscle mass and percent body fat mass between the exercise therapist (biokineticist and/or kinesiotherapist) and dietary intake by the nutritionist significantly contribute to assist the spinal cord injured individual maintain optimal body, lean muscle mass and percent

Pharmacist input into the management of spinal cord injured individuals involves medication review of risks that medication can produce to the health of the

The scope of profession of Physiotherapy spans from intensive in-hospital care, orthopedics, non-communicable diseases, neurology, obstetrics and gynecology rehabilitation [2, 38]. Physiotherapists can manage a variety of concerns of spinal cord injured individual that include diminished respiratory functioning, muscle weakness and contractures, poor somatosensation, reduced mobility, misaligned posture, and deteriorating fitness [35, 39, 40]. The physiotherapists will prescribe physical activity starting from post-surgery confirmed to bed, then bed mobility, transfers maneuvers (from bed to chair, bed to standing and return manoeuvers to bed), assisted gait movement, wheelchair mobility, and upper limb functioning and strengthening. Although a physiotherapist can perform these important tasks other specialists are requested to assist with physical activity and exercise therapy. The physiotherapist may enlist the assistance of a biokineticist (South Africa and Namibia) or kinesiotherapist (United States of America and Canada) to prescribe and monitor stretch, strengthening and aerobic exercises.

therapy and exercise therapy (biokinetics and kinesiotherapy).

**112**

Pillanstrini *et al* describe the profession of Occupational Therapy as the skilled paramedical treatment, which helps the person to accomplish independence and success in all aspects of their daily lifestyle [44]. The occupational therapist assist spinal cord injured people to re-adjust to their social and physical living environments [44]. De Wit *et al* suggest that the fundamental focus of occupational therapist is the re-acclimatization of activities of daily living through home-based activities, sensory, perceptual and cognitive exercises [45]. Occupational therapists can also assist spinal cord injured individuals who want to return to their careers by re-acclimatizing them to their work-environments, which an aspect that warrants more emphasizes.

### **5.7 Kinesiotherapist**

Kinesiotherapy is an American and Canadian exercise therapy profession that subscribes to the solicitation of scientific, evidence based human movement physical activity and exercise principles aimed to recover the individual's muscular strength and endurance and movement capabilities of patients with functional kinesiological limitations, and individuals who need protracted physical conditioning [46, 47]. A kinesiotherapist functions within the professional association of the American Kinesiotherapy Association. These exercise therapists can assist persons in both the pathogenic and fortogenic healthcare paradigms.

### **5.8 Biokineticist**

A biokineticist is a specialized exercise therapist who functions within the professional association of Health Professions Council of South Africa (HPCSA) and/or the Namibian Health Professions Council (NHPC) [48, 49]. This profession is concerned with final-phase rehabilitation and preventative exercise therapy in the pathogenic healthcare paradigm and the promotion of health and wellbeing in the fortogenic healthcare paradigm [50]. Through individualized physical activity and exercise programme prescription a biokineticist is able to improve the health and wellbeing of a spinal cord injured individual. A biokineticist intends to enhance the physical and physiological status and wellbeing of a patient through an exercise regime in dual context of clinical pathology as well as performance enhancement [42]. Due to the host of non-communicable diseases co-morbidities that affect spinal cord injured individuals the expertise of biokineticists is extremely valuable to curtail their pathogenesis.

## **5.9 Psychologist**

Clinical psychologists focus their efforts to prevent and rehabilitate a variety of psychological problems affecting individuals and families post spinal injury. The psychologist may select various psychological counseling techniques, intended to enhance their spinal cord injured individuals sense of control over these problems, as well as become acquaint with resources that they may employ to overcome their problems. The psychologist also assists the spinal cord injured individuals family to deal with the traumatic event. On occasion the attending psychologist may refer the patient to a neuropsychologist and/or psychiatrist when traditional psychological counseling is inadequate to manage the individuals' psychological problems [35]. Neuropsychologists can play a pivotal role in helping spinal cord injured individuals to address cognition dysfunction that only surface once rehabilitation begins [51].
