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Kondo H, Koyama S, Otaka Y, Kumazawa N, Furuzawa S, Kanada Y, Tanabe S. Kinematic analysis of preparation for transferring from wheelchair to bed. Assist Technol 2024; 36:309-318. [PMID: 38446111 DOI: 10.1080/10400435.2024.2315410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/11/2024] [Indexed: 03/07/2024] Open
Abstract
This study aimed to clarify the kinematics, particularly of the shoulder and hip joints, during preparation for manual wheelchair-to-bed transfer (i.e. when flipping up the arm and foot supports). This cross-sectional study included 32 able-bodied individuals. The kinematics of the shoulder and hip joints when the arm and foot supports were flipped up of manual wheelchair, were evaluated using a markerless inertial sensor-based motion capture system. We found that flipping the arm support upwards involved a large amount of abduction, internal and external rotation, flexion, and extension at the shoulder joint, whereas flipping the foot support upwards involved a large amount of flexion at the hip joint. The findings suggest that it is necessary to consider the range of motion required to flip up the arm and foot supports of manual wheelchairs, particularly in those with limited shoulder and hip range of motion such as older people, neuromuscular disorders, and orthopedic disorders.
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Affiliation(s)
- Hikaru Kondo
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
- Department of Rehabilitation, Fujita Health University Hospital, Toyoake, Japan
- Graduate School of Health Sciences, Fujita Health University, Toyoake, Japan
| | - Soichiro Koyama
- Graduate School of Health Sciences, Fujita Health University, Toyoake, Japan
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Japan
| | - Yohei Otaka
- Department of Rehabilitation Medicine I, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Nobuhiro Kumazawa
- Department of Rehabilitation, Fujita Health University Hospital, Toyoake, Japan
| | - Shotaro Furuzawa
- Department of Rehabilitation, Fujita Health University Hospital, Toyoake, Japan
| | - Yoshikiyo Kanada
- Graduate School of Health Sciences, Fujita Health University, Toyoake, Japan
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Japan
| | - Shigeo Tanabe
- Graduate School of Health Sciences, Fujita Health University, Toyoake, Japan
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Japan
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Holm NJ, Møller T, Schou LH, Biering-Sørensen F. Monitoring outcome measures for cardiometabolic disease during rehabilitation and follow-up in people with spinal cord injury. Spinal Cord 2024; 62:125-132. [PMID: 38326463 DOI: 10.1038/s41393-023-00956-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 10/16/2023] [Accepted: 12/20/2023] [Indexed: 02/09/2024]
Abstract
STUDY DESIGN Controlled pragmatic intervention with follow-up. OBJECTIVES To describe cardiometabolic risk outcomes after a pragmatic intervention implemented into standard spinal cord injury (SCI) rehabilitation. SETTING Inpatient SCI rehabilitation in East-Denmark. PARTICIPANTS Inpatients, >18 years, having sustained a SCI within the last 12 months at admission to rehabilitation, regardless of etiology, neurological level or completeness of the lesion or mobility status. METHODS Patient education on health promotion was guided by evidence and included feedback on peak oxygen uptake (VO2peak) (primary outcome measure), body mass index (BMI), Dual energy X-ray absorptiometry and metabolic profile (secondary outcome measures). Paired t-tests, non-parametric tests and Analysis of Variance (ANOVA) were used for analyzes. VO2peak and BMI were compared to historical data. RESULTS VO2peak increased significantly from admission to discharge but did not exceed historical data despite a minimal clinical important difference. BMI decreased significantly during rehabilitation (p < 0.001) followed by a significant increase after discharge (p = 0.006). There was a trend that people with American Spinal Injury Association Impairment Scale (AIS) D SCI increased lean mass to nearly normal values. Criteria for pre-diabetes or diabetes were present in 28.5% and dyslipidemia in 45% of the participants 44.2 days after time of injury. CONCLUSIONS Despite improvements during rehabilitation, outcome measures were worse than recommended, and most outcome measures worsened at follow up, even in people with an AIS D SCI. Meaningful support regarding exercise and diet when tackling altered life circumstances is needed after discharge.
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Affiliation(s)
- Nicolaj J Holm
- Rigshospitalet, Neuroscience Center, Department for Spinal Cord and Brain Injuries, Hornbæk, Denmark.
| | - Tom Møller
- University Hospitals Centre for Health Care Research, University hospital Copenhagen, Rigshospitalet, Denmark
| | - Lone H Schou
- University College Copenhagen, Department of Nursing and Nutrition, Copenhagen, Denmark
| | - Fin Biering-Sørensen
- Rigshospitalet, Neuroscience Center, Department for Spinal Cord and Brain Injuries, Hornbæk, Denmark
- Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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Butler Forslund E, Löfvenmark I. Effects of the SmartDrive on mobility, activity, and shoulder pain among manual wheelchair users with spinal cord injury - a prospective long-term cohort pilot study. Disabil Rehabil Assist Technol 2024; 19:397-406. [PMID: 35793399 DOI: 10.1080/17483107.2022.2091670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 06/14/2022] [Indexed: 10/17/2022]
Abstract
PURPOSE to investigate long-term effects of SmartDrive on mobility, everyday activity, and shoulder pain among spinal cord injured manual wheelchairs users. MATERIAL AND METHODS A prospective pilot intervention study was conducted at Spinalis/Aleris Rehab Station, Sweden. Participants were consecutively invited when evaluated for SmartDrive prescription. Assessments were done at baseline, intervention (use of SmartDrive), and after six months. A smartwatch registered wheelchair utilization including push intensity and pushes/day. Wheelchair Outcome Measure, pain rating instruments including Wheelchair User's Shoulder Pain Index, a wheelchair test, and semi-structured interviews were used. Descriptive statistics and content analysis approach were used. RESULTS Twenty-five persons were screened, six of 14 included completed the study. Drop-out reasons were not related to SmartDrive for five of the eight persons. After intervention, there was a tendency of decreased pain (median (IQR) 5/10 (2.6-6.6) vs 2.5 (2-3.2). All participants reported increased satisfaction of performance when "taking a walk", from median (IQR) 45/100 (27-70) at baseline to 95 (80-100) at 6 months. Two persons who could not ascend a slope at baseline could manage using the SmartDrive. Interviews revealed that the in general positive response persisted at six months. Also, with the SmartDrive the participants could go out despite pain, providing a sense of freedom and independence. Three incidents were reported. CONCLUSION This long-term pilot study indicates that a SmartDrive might be a valuable assistive device to promote mobility despite of shoulder pain. All participants considered it easy to use and experienced increased independence, however skills training and follow-ups are necessary. IMPLICATIONS FOR REHABILITATIONA Rear Drive Power Assist Device (RD-PAD) could increase satisfaction with self-selected activities.A RD-PAD could increase functional mobility by facilitating propelling longer distances and steeper slopes.A RD-PAD could improve perseverance of daily activities in spite of shoulder pain.A RD-PAD could be a valuable assistive aid for persons with paraplegia with different level of wheelchair skills but with good self-awareness regarding their abilities.Thorough assessment of initial wheelchair skills, training, and follow-up are important to enhance safety and maximize performance when using the RD-PAD.
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Affiliation(s)
- Emelie Butler Forslund
- Spinalis Aleris Rehab Station, Solna, Sweden
- Department of Neurogeriatrics, Karolinska Institute, Stockholm, Sweden
| | - Inka Löfvenmark
- Spinalis Aleris Rehab Station, Solna, Sweden
- Department of Neurogeriatrics, Karolinska Institute, Stockholm, Sweden
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Post MWM, Forchheimer M, Charlifue S, D'Andréa Greve J, New P, Tate DG. Responsiveness of the International Spinal Cord Injury Quality of Life Basic Data Set V2.0: An international longitudinal study. J Spinal Cord Med 2023; 46:760-768. [PMID: 37133305 PMCID: PMC10446793 DOI: 10.1080/10790268.2023.2197820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/04/2023] Open
Abstract
CONTEXT/OBJECTIVE Examine the sensitivity of the International Spinal Cord Injury Quality of Life Basic Data Set V2.0 (QoL-BDS V2.0) to reflect changes in mobility and secondary health conditions (SHCs) between inpatient rehabilitation and one-year follow-up. DESIGN International longitudinal study. Questionnaires were administered at baseline (Median 6 weeks, inter-quartile range 4-10 weeks post-onset) and after 12 months. SETTING Spinal cord rehabilitation institutions in the US, Brazil, Australia and the Netherlands. PARTICIPANTS : Individuals with recent onset of spinal cord injury or disease (SCI/SCD) admitted to inpatient rehabilitation. OUTCOME MEASURES The QoL-BDS V2.0, comprises four items on satisfaction with 'life as a whole', 'physical health', 'psychological health', and 'social life'. Mobility level was measured with a single item and SHCs with the SCI Secondary Conditions Scale (SCI-SCS). RESULTS Of the 160 participants, 61% had SCI, 48% had tetraplegia and 82% were wheelchair-users. Scores on 'life as a whole', 'physical health' and the total scale were significantly higher at follow-up compared to baseline in the total sample and the SCD subgroup, but not in the SCI subgroup. Increases in 'physical health', 'psychological health', 'social life' and the total score were significantly associated with improvements in the SCI-SCS or mobility scores. Participants with improved SCI-SCS and mobility at follow-up showed significantly more improvement in satisfaction with social life and the total score compared to participants without such favorable changes. CONCLUSION The results of this study provide partial evidence of responsiveness of the QoL-BDS V2.0 total score as a measure of QoL among individuals with SCI/SCD.
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Affiliation(s)
- Marcel W. M. Post
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, the Netherlands
- University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, the Netherlands
| | - Martin Forchheimer
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, Michigan, USA
| | | | - Julia D'Andréa Greve
- Orthopedic Department Medical School, University of São Paulo, São Paulo, Brazil
| | - Peter New
- Spinal Rehabilitation Service, Caulfield Hospital, Alfred Health, Melbourne, Victoria, Australia
- Epworth-Monash Rehabilitation Medicine Unit, Monash University, Melbourne, Victoria, Australia
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Denise G. Tate
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, Michigan, USA
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Aaby A, Ravn SL, Elfström ML, Kasch H, Andersen TE. Does the Danish version of the Spinal Cord Lesion-related Coping Strategies Questionnaire measure what we think it measures? A triangulated mixed-methods validation approach. Spinal Cord 2022; 60:1080-1086. [PMID: 35717550 DOI: 10.1038/s41393-022-00825-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 06/08/2022] [Accepted: 06/09/2022] [Indexed: 11/10/2022]
Abstract
STUDY DESIGN Triangulated mixed-methods validation study. OBJECTIVES To validate the Danish version of the Spinal Cord Lesion-related Coping Strategies Questionnaire (SCL-CSQ). SETTING Community in Denmark. METHODS Participants were invited via a patient organization and its specialized hospital. Eligibility criteria were having a spinal cord injury (SCI), being 18 years or older, and able to understand and respond in Danish. Quantitative data were collected to determine internal consistency and criterion validity of the three subscales of SCL-CSQ, i.e., acceptance, fighting spirit, and social reliance. The Three-Step Test-Interview approach was employed to determine whether items measured what they were intended to measure (i.e., construct validity based on response processes). RESULTS The quantitative sample consisted of 107 participants, and the interview sample comprised 11 participants. The acceptance and fighting spirit subscales showed adequate internal consistency (Cronbach's alpha of 0.72 and 0.76 respectively) and satisfactory criterion validity (expected correlations with quality of life and depression). The social reliance subscale showed inadequate internal consistency (Cronbach's alpha of 0.58) and criterion validity. All fighting spirit items and all but one acceptance items were interpreted congruently by most participants. Conversely, two social reliance items were only interpreted congruently by 9 and 27%. CONCLUSION The acceptance and fighting spirit subscales of the Danish version of the SCL-CSQ showed good psychometric properties, while the social reliance subscale showed serious issues and should be revised. Researchers and clinicians are urged to reflect on these findings when revising the SCL-CSQ or adapting it to other languages, cultural contexts, and rehabilitation settings.
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Affiliation(s)
- Anders Aaby
- Specialized Hospital for Polio and Accident Victims, Roedovre, Denmark. .,InCoRE, Department of Psychology, University of Southern Denmark, Odense, Denmark.
| | - Sophie L Ravn
- Specialized Hospital for Polio and Accident Victims, Roedovre, Denmark.,InCoRE, Department of Psychology, University of Southern Denmark, Odense, Denmark.,ThRIVE, Department of Psychology, University of Southern Denmark, Odense, Denmark
| | - Magnus L Elfström
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
| | - Helge Kasch
- Department of Neurology, Aarhus University Hospital, Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Tonny E Andersen
- InCoRE, Department of Psychology, University of Southern Denmark, Odense, Denmark
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Kasch H, Løve US, Jønsson AB, Severinsen KE, Possover M, Elmgreen SB, Forman A. Effect of pelvic laparoscopic implantation of neuroprosthesis in spinal cord injured subjects: a 1-year prospective randomized controlled study. Spinal Cord 2022; 60:251-255. [PMID: 34429511 PMCID: PMC8904257 DOI: 10.1038/s41393-021-00693-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 08/10/2021] [Accepted: 08/11/2021] [Indexed: 02/06/2023]
Abstract
STUDY DESIGN 1-year prospective RCT. OBJECTIVE Examine the effect of implantable pulse generator and low-frequency stimulation of the pelvic nerves using laparoscopic implantation of neuroprosthesis (LION) compared with neuromuscular electrical stimulation (NMES) in SCI. METHODS Inclusion criteria: traumatic spinal cord injury (SCI), age 18-55 years, neurological level-of-injury Th4-L1, time-since-injury >1 year, and AIS-grades A-B. Participants were randomized to (A) LION procedure or (B) control group receiving NMES. PRIMARY OUTCOME MEASURE Walking Index for Spinal Cord Injury (WISCI-II), which is a SCI specific outcome measure assessing ability to ambulate. SECONDARY OUTCOME MEASURES Spinal Cord Independence Measure III (SCIM III), Patient Global Impression of Change (PGIC), Penn Spasm Frequency Scale (PSFS), severity of spasticity measured by Numeric Rating Scale (NRS-11); International Spinal Cord Injury data sets-Quality of Life Basic Data Set (QoLBDS), and Brief Pain Inventory (BPI). RESULTS Seventeen SCI individuals, AIS grade A, neurological level ranging from Th4-L1, were randomized to the study. One individual was excluded prior to intervention. Eight participants (7 males) with a mean age (SD) of 35.5 (12.4) years were allocated to the LION procedure, 8 participants (7 males) with age of 38.8 (15.1) years were allocated to NMES. Significantly, 5 LION group participants gained 1 point on the WISCI II scale, (p < 0.013; Fisher´s exact test). WISCI II scale score did not change in controls. No significant changes were observed in the secondary outcome measures. CONCLUSION The LION procedure is a promising new treatment for individuals with SCI with significant one-year improvement in walking ability.
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Affiliation(s)
- Helge Kasch
- grid.416838.00000 0004 0646 9184Spinal Cord Injury Centre of Western Denmark, Department of Neurology, Viborg Regional Hospital, Viborg, Denmark ,grid.7048.b0000 0001 1956 2722Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Uffe Schou Løve
- grid.416838.00000 0004 0646 9184Department of Surgery, Viborg Regional Hospital, Viborg, Denmark
| | - Anette Bach Jønsson
- grid.416838.00000 0004 0646 9184Spinal Cord Injury Centre of Western Denmark, Department of Neurology, Viborg Regional Hospital, Viborg, Denmark ,grid.7048.b0000 0001 1956 2722Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Kaare Eg Severinsen
- grid.416838.00000 0004 0646 9184Spinal Cord Injury Centre of Western Denmark, Department of Neurology, Viborg Regional Hospital, Viborg, Denmark ,grid.7048.b0000 0001 1956 2722Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Marc Possover
- Possover International Medical Centre, Zürich, Switzerland
| | | | - Axel Forman
- grid.7048.b0000 0001 1956 2722Department of Clinical Medicine, Aarhus University, Aarhus, Denmark ,grid.154185.c0000 0004 0512 597XDepartment of Obstetrics and Gynecology, Aarhus University Hospital, Aarhus, Denmark
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Treatment of shoulder pain in people with spinal cord injury who use manual wheelchairs: a systematic review and meta-analysis. Spinal Cord 2021; 60:107-114. [PMID: 34373591 DOI: 10.1038/s41393-021-00673-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 07/12/2021] [Accepted: 07/14/2021] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN Systematic review and meta-analysis OBJECTIVES: The objective was to summarise prior research regarding the efficacy of active physiotherapy interventions and prevention strategies on shoulder pain, decreased physical function and quality of life in people with a spinal cord injury (SCI). METHODS A systematic literature search was conducted in CENTRAL, EMBASE (via Ovid), CINAHL and MEDLINE (via Ovid). Randomised controlled trials investigating effects of active physiotherapy interventions on shoulder pain, physical function and quality of life were included. Further, prospective cohort studies investigating effects of active physiotherapy interventions in prevention of shoulder pain and reduced physical function were included. Mean difference (MD) for pain (15 items on a 0-10 scale) and standardised mean difference (SMD) for physical function were summarised in a random effects meta-analysis. RESULTS Four studies on treatment (totalling 167 participants), and no studies on prevention were included. Significant and clinically meaningful improvements on shoulder pain (MD 19.06, 95% CI 5.72-32.40; I2 = 65%) (scale 0-150) and physical function (SMD 0.61, 95% CI 0.27-0.94; I2 = 0%) were found for active physiotherapy interventions. Only one study included quality of life, making meta-analysis inappropriate. CONCLUSIONS Evidence from a sparse number of studies supports active physiotherapy interventions to decrease shoulder pain and increase physical function in people with SCI who use a manual wheelchair. No studies met the criteria for prevention, highlighting a lack of research investigating prevention of shoulder pain and decreased physical function and quality of life.
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