Do you know where the injury site is? Is it a complete or incomplete spinal cord injury? This will dictate the affected areas and what will be possible.
You have to consider what this individual’s goal are and ultimately if you can help them. Considering they are a paraplegic, you could certainly work on strength and flexibility of the upper body musculature. If they are WC bound and don’t use a power chair, you can work on strengthening potentially weak muscles that oppose the prime movers for wheelchair mobility. This will hopefully lead to a decreased chance of injury.
The ACSM Guidelines for Exercise Testing and Prescription outline some considerations for spinal cord injuries if you have that text available.
As you do your complete assessment, I would be looking at the way the client maneuvers and how the client is responding to you in general. You want to be very thorough and ask frank questions so that you can design a realistic and accommodating program.
I would also survey the studio, gym, home, that you will be training in and make sure it is conducive to this client and that you have wheel chair access if that’s the case.
Also, if this is a new found injury I would discuss all physical endeavors with their doctor first.
Also there are organizations such as ACSM offering certifications for Special Populations.
I work with a para that has been in her chair from age 10, she is 53. She can do everything I give her. The TRX is excellent as well as a BOSU. I work core strength with her and use the seated Elliptical trainer when we are not outside riding our bikes together. She loves to snow and water ski, swim and travel so her work outs are imperative to her lifestyle. Enjoy the challange and most of all learn from your client~
I would first ask your client the nature of his/her injury. Only do seated prone leg raises, if she is capable. Does she have any lower body function?
I would work on her upper body–chest press, shoulder abduction, biceps curl, triceps extension, and abdominal work as she can tolerate, as well as low back.
Take care, Danny