Sport, free time and hobbies in people with spinal cord injury

Analysis of sedentariness in women from a gender and equity perspective

ABSTRACTThis cross-sectional study aimed to analyse the social and gender-related factors influencing sedentariness in women, including occupation and family size (FS). We included women aged 45-70 years participating in the Breast Cancer Screening Programme of the Valencia Region (BCSP-VR) between November 2018 and October 2019 (n = 121,988). The response variable was sedentariness measured by sitting time in hours/day (h/day) (<3 h/day and ≥3 h/day). The explanatory variables were age, educational level, country of origin, living alone, childcare responsibilities, FS, disability, body mass index (BMI) and smoking status. Logistic regression models were adjusted for the whole sample and were stratified by occupation and FS. The variables that increased the odds of sedentariness were age ≥65 years (OR = 1.28; CI = 1.20-1.36), high educational level (OR = 1.39; CI = 1.31-1.47), non-manual occupation (OR = 2.38; CI = 2.27-2.48), living alone (OR = 1.11; CI = 1.05-1.17), disability (OR = 1.37; CI = 1.20-1.56) and BMI ≥ 30 (OR = 1.33; CI = 1.28-1.38). The variables decreasing the odds were large (OR = 0.90; CI = 0.87-0.96) and medium FS (OR = 0.93; CI = 0.90-0.97). Older age, high educational level and high BMI conferred a higher odd of sedentary lifestyle, independently of occupation and FS with statistical differences. Protective factors were childcare responsibilities in non-working women (OR = 0.86; CI = 0.74-0.99), large FS in women with manual occupations (OR = 0.88; CI = 0.80-0.97) and medium FS in housewives (OR = 0.91; CI = 0.86-0.97). This study identified social and gender-related inequalities in the factors influencing sedentariness, which were related to the type of occupation and FS.

Quality of life, concern of falling and satisfaction of the sit-ski aid in sit-skiers with spinal cord injury: observational study

STUDY DESIGN

Observational study.

OBJECTIVE

To describe (1) user satisfaction, (2) the Quality of Life (QoL) and (3) fear of falling in individuals with tetraplegia or paraplegia who used a mono-ski for sit-skiing.

SETTING

Spinal units and Sport associations.

METHODS

An observational study of people with spinal cord injury (SCI) who used a sit-ski. Participants were recruited in various SCI rehabilitation centers and sport associations. Participants completed three assessment tools: the Quebec User Evaluation of Satisfaction with assistive Technology (QUEST 2.0); the World Health Organization Quality of Life (WHOQoL-BREF); the Spinal Cord Injury Fall Concern Scale (SCI-FCS). Results were evaluated with chi-squared test and Kolmogorov-Smirnov's test and the significance was set for p values < 0.05.

RESULTS

Fifteen participants were included. Results showed positive and statistically significant values for all the items of the SCI-FCS related to fear of falling, and for most of the items of the WHOQoL-BREF related to QoL and the QUEST 2.0 related to satisfaction with the device.

CONCLUSIONS

This study highlights that sit skiing is correlated with high levels of satisfaction with the mono-ski, increases in QoL, and low levels of fear of falling. In adding these findings to the existent literature, it can be stated with more certainty that sit-skiing is a sport that can be recommended in rehabilitation and sports therapy programs.

Training for mobility with exoskeleton robot in spinal cord injury patients: a pilot study

BACKGROUND

Wearable robots are people-oriented robots designed to be worn all day, thus helping in the daily activities. They can assist in walking, running, jumping higher or even lifting objects too heavy in normal conditions.

AIM

The aim of this report was to investigate the changes in gait pattern through 3D gait analysis of subjects with spinal cord injury (SCI) undergoing an adaptive training with a wearable exoskeletal device (ESD). The change in the quality of life was also investigate together with the possibility to wear these devices all day, to improve the mobility.

DESIGN

Prospective quasi-experimental study, pre- and post-design.

SETTING

Outpatient SCI patients.

POPULATION

On a voluntary basis, eight SCI patients who had never used any ESD device were recruited.

METHODS

Subjects underwent a three-dimensional gait analysis (3D GA) while wearing the ESD at baseline (inclusion) (T0) and after 20 sessions of training over an expected average of 5/6 weeks (T1). The secondary outcome measures were: Participant Satisfaction Questionnaire, 6-Minute Walking Test (6MWT), Borg Scale (the test was administered in indoor and outdoor conditions) and Timed Up-and-Go test (TUG). Spatiotemporal and kinematic parameters were assessed and their change from the beginning to the end of the training was the secondary outcome.

RESULTS

No dropouts were recorded during the training and all subjects were able to terminate the protocol (compliant subjects: N.=8). After the training, all person showed some significant improvements for TUG, 6MWT and 10 MWT (Z=-2.521; P=0.008) and for the spatiotemporal and kinematics parameters.

CONCLUSIONS

This paper confirms that the adaptive training with ESD is safe and feasible in a heterogeneous sample of persons with SCI, especially in ameliorating the interaction between the patients and the device with an improvement of spatiotemporal and kinematics parameters.

CLINICAL REHABILITATION IMPACT

Since the training has been proven safe and the hypothesis that the subjects with spinal cord injury improving their performance over time and being able to adapt at the use of device in full autonomy at home during all the activities of the daily living has strengthened.

IL-1β-induces NF-κB and upregulates microRNA-372 to inhibit spinal cord injury recovery

Excessive inflammation including IL-1β-initiated signaling is among the earlies reactions that can cause neuronal damage following spinal cord injury (SCI). It has been suggested that microRNAs may participate in stem cell repair to facilitate functional recovery following SCI. In this study we have shown that in cultured human neural stem cells (hNSC), IL-1β reduced the expression of both KIF3B (kinesin family member 3B) and NOSIP (nitric oxide synthase-interacting protein), two key modulators for restricting inflammation and promoting neuronal regeneration. The induction of microRNA-372 (miR-372) by IL-1β is specifically responsible for the inhibition of KIF3B and NOSIP. The 3'-untranslated regions (UTRs) of both KIF3B and NOSIP contain targeting sequences to miR-372 that directly inhibit their expression. Moreover, we found that the expression of miR-372 was stimulated in hNSC by IL-1β through an NF-κB binding site at its promoter region. Finally, stable overexpression of miR-372 inhibitor in hNSC rescued the IL-1β-induced impairment as shown by significant improvements in tissue water content, myeloperoxidase activity, and behavioral assessments in SCI rats. These findings suggest a critical role of miR-372 in inflammatory signaling and pinpoint a novel target for the treatment of acute SCI.NEW & NOTEWORTHY Our data demonstrate that IL-1β can impair the functional recovery of neural stem cell transplant therapy for spinal cord injury (SCI) treatment in rats. This effect is dependent on microRNA-372 (miR-372)-dependent gene repression of KIF3B and NOSIP. Therefore, specific knockdown of miR-372 may provide benefits for SCI treatments.

Effects on mobility training and de-adaptations in subjects with Spinal Cord Injury due to a Wearable Robot: a preliminary report

Background

Spinal cord injury (SCI) is a severe neurological disorder associated not only with ongoing medical complications but also with a significant loss of mobility and participation. The introduction of robotic technologies to recover lower limb function has been greatly employed in the rehabilitative practice. The aim of this preliminary report were to evaluate the efficacy, the feasibility and the changes in the mobility and in the de-adaptations of a new rehabilitative protocol for EKSO™ a robotic exoskeleton device in subjects with SCI disease with an impairment of lower limbs assessed by gait analysis and clinical outcomes.

Method

This is a pilot single case experimental A-B (pre-post) design study. Three cognitively intact voluntary participants with SCI and gait disorders were admitted. All subjects were submitted to a training program of robot walking sessions for 45 min daily over 20 sessions. The spatiotemporal parameters at the beginning (T0) and at the end of treatment (T1) were recorded. Other clinical assessments (6 min walking test and Timed Up and Go test) were acquired at T0 and T1.

Results

Robot training were feasible and acceptable and all participants completed the training sessions. All subjects showed improvements in gait spatiotemporal indexes (Mean velocity, Cadence, Step length and Step width) and in 6 min Walking Test (T0 versus T1).

Conclusions

Robot training is a feasible form of rehabilitation for people with SCI. Further investigation regarding long term effectiveness of robot training in time is necessary.

Trial registration

ClinicalTrials.gov NCT02065830.

Do people with spinal cord injury meet the WHO recommendations on physical activity?

OBJECTIVES

To describe physical activity (PA) levels in persons with spinal cord injury (SCI) and to investigate associated factors.

METHODS

PA behavior of people with SCI in Switzerland was assessed in a community survey with four items from the Physical Activity Scale for individuals with physical disabilities (PA of light, moderate, and strenuous intensity and muscle-strengthening exercises). In addition to descriptive analyses, the odds of performing PA according to the WHO recommendations (at least 2.5 h/week of at least moderate intensity) were analyzed by multivariable logistic regression.

RESULTS

Participants (n = 485; aged 52.9 ± 14.8; 73.6 % male) carried out PA a total of 6.0 h/week (median). 18.6 % were physically inactive, 50.3 % carried out muscle-strengthening exercises, and 48.9 % fulfilled the WHO recommendations. Regression analyses showed that women, people aged 71+, and people with complete tetraplegia had significantly lower odds of fulfilling the WHO recommendations than participants in the respective reference category (men, ages 17-30, incomplete paraplegia).

CONCLUSIONS

PA levels of people with SCI in Switzerland are rather high. However, some subgroups need special consideration when planning interventions to increase PA levels.