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Sundrasegaran P, Engkasan JP. Upper Extremity Functional Status in Patients with Chronic Tetraplegia in Universiti Malaya Medical Centre. Malays J Med Sci 2023; 30:79-90. [PMID: 38239256 PMCID: PMC10793124 DOI: 10.21315/mjms2023.30.6.9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 03/31/2023] [Indexed: 01/22/2024] Open
Abstract
Background Persons with tetraplegia rank improved upper extremity (UE) function as the most important rehabilitation outcome because it allows them greater independence in activities of daily living (ADL). The aim of this study was to describe UE status in patients with tetraplegia using the International Spinal Cord Injury Upper Extremity Basic Data Set version 1.1 (ISCI-UE 1.1) and to determine differences in UE status between tetraplegic individuals with traumatic and non-traumatic SCIs. Methods This cross-sectional study was conducted among patients with tetraplegia who attended the SCI rehabilitation clinic of a tertiary hospital from September 2021 to August 2022. Both upper limbs were assessed using ISCI-UE 1.1. Results One hundred patients were included in this study, of whom 80 were men. The mean (SD) age of the patients was 54.30 (16.95) years old. In these patients, most SCIs (62%) were of traumatic origin. Two hundred UEs were evaluated, of which 109 showed good hand function (level 5) and 10 had the poorest hand function (level 1). Meanwhile, 130 UEs showed good shoulder function (level D) and 10 had the poorest shoulder function (level A). A statistically significant association with UE status (reach-and-grasp ability and shoulder function) was found in both the non-traumatic and traumatic SCI groups, with better hand and shoulder functions in the non-traumatic SCI group (right-hand, P = 0.004 and left hand, P = 0.001; right shoulder, P < 0.001 and left shoulder, P = 0.002). Conclusion ISCI-UE 1.1 is a feasible tool for documenting UE function in patients with tetraplegia. Compared with the individuals with traumatic SCI in this study, those with non-traumatic SCI demonstrated better upper extremity functionality.
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Anne Sinnott Jerram K, Dunn JA, Smaill RP, Middleton JW. International Classification of Function, Disability and Health (ICF) Word Mapping to Determine the Human Functioning Associated with Upper Extremity Surgery for Tetraplegia. J Patient Exp 2023; 10:23743735231211886. [PMID: 38026063 PMCID: PMC10631323 DOI: 10.1177/23743735231211886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2023] Open
Abstract
Understanding human functioning and disablement, the contributing factors and their interactions in individuals with tetraplegia is important since elective upper extremity (UE) reconstructive surgery is now offered earlier after injury prior to full recognition of what lies ahead. Qualitative and quantitative data were available from a prior series of mixed methods studies, including a case series design capturing the patients' lived-experience perspectives of nerve or tendon transfer surgery, or not as the case may be. The objective of this study was to perform secondary data analysis to determine whether the recommended outcome tools being used by clinicians reflect the all important domains of functioning identified by people with tetraplegia who were considering UE reconstructive procedures. The original 18 candidate themes derived from qualitative analysis were reviewed in retrospect, along with a content analysis of the tools' questions, undertaking word mapping links to the ICF taxonomy. The outcomes tools included in the content analysis were the Canadian Occupational Performance Measure, the Capabilities of Upper Extremity Questionnaire, The Personal Wellbeing Index, and the Grasp and Release Test. Comparison between clinical outcomes tools and the patient lived-experience data uniquely identified links to Chapter1 (b) Mental functions, which include consciousness, orientation, temperament/personality, energy/drive, and higher-level cognition.
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Affiliation(s)
- K Anne Sinnott Jerram
- John Walsh Centre for Rehabilitation Research, Kolling Institute, St Leonards, NSW, Australia
- Sydney Medical School-Northern, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
- Burwood Academy of Trust, Christchurch, New Zealand
| | - Jennifer A Dunn
- Department of Orthopedic Surgery & Musculoskeletal Medicine, University of Otago, Christchurch, New Zealand
| | | | - James W Middleton
- John Walsh Centre for Rehabilitation Research, Kolling Institute, St Leonards, NSW, Australia
- Sydney Medical School-Northern, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
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Moulaei K, Sheikhtaheri A, Haghdoost AA, Nezhadd MS, Bahaadinbeigy K. A data set for the design and implementation of the upper limb disability registry. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2023; 12:130. [PMID: 37397108 PMCID: PMC10312779 DOI: 10.4103/jehp.jehp_721_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 07/14/2022] [Indexed: 07/04/2023]
Abstract
BACKGROUND If the data elements needed for patient registries are not identified, designing and implementing them can be very challenging. Identifying and introducing a Data Set (DS) can help solve this challenge. The aim of this study was to identify and present a DS for the design and implementation of the upper limb disability registry. MATERIALS AND METHODS This cross-sectional study was conducted in two phases. In the first phase, to identify the administrative and clinical data elements required for registry, a comprehensive study was conducted in PubMed, Web of Science, and Scopus databases. Then, the necessary data elements were extracted from the studies and a questionnaire was designed based on them. In the second phase, in order to confirm the DS, the questionnaire was distributed to 20 orthopedic, physical medicine and rehabilitation physicians and physiotherapists during a two-round Delphi. In order to analyze the data, the frequency and mean score of each data element were calculated. Data elements that received an agreement more than 75% in the first or two-round Delphi were considered for the final DS. RESULTS A total of 81 data elements in five categories of "demographic data", "clinical presentation", "past medical history", "psychological issues", and "pharmacological and non-pharmacological treatments" were extracted from the studies. Finally, 78 data elements were approved by experts as essential data elements for designing a patient registry for upper limb disabilities. CONCLUSION In this study, the data elements necessary for the design and implementation of the upper limb disability registry were suggested. This DS can help registry designers and health data administrators know what data needs to be included in the registry system in order to have a successful design and implementation. Moreover, this standardized DS can be effective for integrating and improving the information management of people with upper limb disabilities and used to accurately gather the upper limb disabilities data for research and policymaking purposes.
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Affiliation(s)
- Khadijeh Moulaei
- Medical Informatics Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Abbas Sheikhtaheri
- Department of Health Information Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Ali A. Haghdoost
- HIV/STI Surveillance Research Center and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Mansour S. Nezhadd
- Department of Physical Therapy, Faculty of Allied Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Kambiz Bahaadinbeigy
- Medical Informatics Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
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Independence and upper extremity functioning after spinal cord injury: a cross-sectional study. Sci Rep 2023; 13:3148. [PMID: 36823179 PMCID: PMC9950049 DOI: 10.1038/s41598-023-29986-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 02/14/2023] [Indexed: 02/25/2023] Open
Abstract
Upper extremity functioning is important for achieving independence in activities of daily living (ADL). A better understanding of relationships between different aspects of independence in ADL after spinal cord injury (SCI) and upper extremity functioning is required to guide rehabilitation practices. To determine which aspects of independence in ADL are correlated with upper extremity functioning in individuals with cervical or thoracic SCI. A total of 25 adults (mean age 58.4 years, 72% men) with established cervical or thoracic SCI were recruited. Independence in ADL was assessed by Spinal Cord Independence Measure (SCIM-III) and upper extremity functioning by kinematic measures (movement time, smoothness, and wrist angle during drinking task), grip strength, Upper Extremity Motor and Sensory Score, Box and Block Test (BBT), Action Research Arm Test (ARAT), and Upper Extremity Basic Data Set (ISCI-Hand and ISCI-Shoulder). Spearman correlation coefficients were used for data analyses. The SCIM-self-care subscale, particularly the feeding and dressing items, correlated moderately (r ≥ 0.5) with movement time and smoothness, grip strength, ARAT, BBT, and ISCI-Hand. The SCIM-respiration/sphincter subscale and the SCIM-mobility showed very low and low correlations with upper extremity assessments. However, at item level, respiration and bed/wheelchair mobility showed moderate correlations. Independence in self-care as domain and feeding/dressing, respiration and bed/wheelchair mobility as separate items were dependent on upper extremity functioning in individuals with cervical or thoracic SCI. Movement time and smoothness along with BBT, grip strength, ARAT, and ISCI-Hand can be used as indicators of independence in ADL. These findings can provide guidance to clinical practice in selection of upper extremity assessments in the context for ADL in individuals with SCI.
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Lili L, Sunnerhagen KS, Rekand T, Alt Murphy M. Quantifying an Upper Extremity Everyday Task With 3D Kinematic Analysis in People With Spinal Cord Injury and Non-disabled Controls. Front Neurol 2021; 12:755790. [PMID: 34721277 PMCID: PMC8555709 DOI: 10.3389/fneur.2021.755790] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 09/13/2021] [Indexed: 11/23/2022] Open
Abstract
Objectives: Upper extremity function after spinal cord injury (SCI) is an important factor for performance of activities of daily living. An objective assessment of upper extremity function preferably in purposeful daily tasks is essential in understanding its impact on real-life activities. This study aimed to identify which movement parameters of upper extremity, measured by kinematic analysis during a purposeful daily task, are impaired in people with cervical or thoracic SCI. Materials and Methods: The study included 29 adults (mean 59.5 years, 9 women and 20 men) with cervical (n = 19) or thoracic (n = 10) established complete (n = 15) or incomplete (n = 14) SCI, and 54 non-disabled controls with commensurable age and sex (mean 59 years, 15 women, 39 men). The 3D kinematic data were captured with a five-camera system during a standardized unilateral daily task (drinking from a glass). In SCI, the upper extremity functioning of each arm was assessed with Action Research Arm Test (ARAT). Having a full score in ARAT indicated full functioning; a score of <57 points indicated limited functioning. Kinematic data from full functioning arms (n = 27) and limited functioning arms (n = 30) in SCI were compared with the non-dominant arms (n = 54) in controls. Results: In the limited upper extremity functioning group, movement time, smoothness, arm abduction, wrist angle, trunk displacement, and inter-joint coordination, but not peak velocity of the hand, angular velocity of elbow, and relative time to peak velocity, all differed from controls. In the full upper extremity functioning group, arm abduction alone was significantly different from controls. Conclusions: The findings demonstrate that apart from measures of peak velocity, kinematic measures of movement quality including movement time, smoothness, trunk displacement, and joint angles are impaired in people with limited upper extremity functioning after SCI. The study provides robust results applicable to a representative population of individuals with established cervical or thoracic SCI. The results suggest that kinematic analysis might be useful for those with limited functioning in order to get a better understanding of the specific movement impairments in daily tasks after SCI.
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Affiliation(s)
- Lamprini Lili
- Institute of Neuroscience and Physiology, Clinical Neuroscience, Rehabilitation Medicine, University of Gothenburg, Sahlgrenska Academy, Gothenburg, Sweden.,Department of Neurocare, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Katharina S Sunnerhagen
- Institute of Neuroscience and Physiology, Clinical Neuroscience, Rehabilitation Medicine, University of Gothenburg, Sahlgrenska Academy, Gothenburg, Sweden.,Department of Neurocare, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Tiina Rekand
- Department of Neurology, Haukeland University Hospital, Bergen, Norway
| | - Margit Alt Murphy
- Institute of Neuroscience and Physiology, Clinical Neuroscience, Rehabilitation Medicine, University of Gothenburg, Sahlgrenska Academy, Gothenburg, Sweden.,Department of Occupational Therapy and Physiotherapy, Sahlgrenska University Hospital, Gothenburg, Sweden
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Lili L, Sunnerhagen KS, Rekand T, Alt Murphy M. Associations between upper extremity functioning and kinematics in people with spinal cord injury. J Neuroeng Rehabil 2021; 18:147. [PMID: 34565401 PMCID: PMC8474732 DOI: 10.1186/s12984-021-00938-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 09/08/2021] [Indexed: 11/30/2022] Open
Abstract
Introduction More knowledge of the relationships between kinematic measures and clinical assessments is required to guide clinical decision making and future research. Objectives To determine which kinematic variables obtained during a drinking task were associated with clinical assessments of upper extremity functioning in people with spinal cord injury (SCI). Methods In total, 25 individuals with chronic cervical (n = 17) or thoracic (n = 8) complete (n = 14) or motor incomplete (n = 11) SCI (mean age 58.4, SD 13.8) were included. Kinematic data, including movement time, smoothness and joint angles was captured with a 5-camera optoelectronic system during a unimanual drinking task. Action Research Arm Test (ARAT), Sollerman Hand Function Test (SHFT) and basic hand classification of the Upper Extremity Data Set (ISCI-Hand) were used as clinical assessments. Multiple regression analysis was used to identify kinematic variables associated with clinical assessments after controlling for potential confounding factors, such as, age, severity of SCI, sensory function, and hand surgery. Results Movement time, smoothness and movement pattern kinematics including trunk displacement, elbow and wrist joint angles were correlated (p < 0.05) with all three clinical scales while the velocity-related kinematics and inter-joint coordination showed low correlations. Multiple regression analysis revealed that wrist angle combined with movement time or smoothness explained 82% and 77% of the total variance in ARAT and SHFT, respectively. Wrist angle alone explained 59% of the variance in ISCI-Hand. The proprioception of the hand increased the explanatory power in the models of ARAT and SHFT. Associations between kinematics and clinical assessments in the subgroup with cervical SCI were equivalent to the whole group analyses. The number of participants in the subgroup with thoracic SCI was small and only allowed limited analysis. Conclusions Wrist angle, movement time, movement smoothness are the most important kinematic variables associated with upper extremity clinical assessments in people with SCI. The results are most valid for individuals with cervical SCI. All three assessments are appropriate for SCI. Further research with larger representative sample of thoracic SCI needed. Supplementary Information The online version contains supplementary material available at 10.1186/s12984-021-00938-9.
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Affiliation(s)
- Lamprini Lili
- Institute of Neuroscience and Physiology, Clinical Neuroscience, Rehabilitation Medicine, Sahlgrenska Academy, University of Gothenburg, Per Dubbsgatan 14, 3rd Floor, 41345, Göteborg, Sweden. .,Department of Neurological Rehabilitation, Sahlgrenska University Hospital, Göteborg, Sweden.
| | - Katharina S Sunnerhagen
- Institute of Neuroscience and Physiology, Clinical Neuroscience, Rehabilitation Medicine, Sahlgrenska Academy, University of Gothenburg, Per Dubbsgatan 14, 3rd Floor, 41345, Göteborg, Sweden.,Department of Neurological Rehabilitation, Sahlgrenska University Hospital, Göteborg, Sweden
| | - Tiina Rekand
- Institute of Neuroscience and Physiology, Clinical Neuroscience, Rehabilitation Medicine, Sahlgrenska Academy, University of Gothenburg, Per Dubbsgatan 14, 3rd Floor, 41345, Göteborg, Sweden.,Department of Neurology, Haukeland University Hospital, Bergen, Norway
| | - Margit Alt Murphy
- Institute of Neuroscience and Physiology, Clinical Neuroscience, Rehabilitation Medicine, Sahlgrenska Academy, University of Gothenburg, Per Dubbsgatan 14, 3rd Floor, 41345, Göteborg, Sweden.,Department of Occupational Therapy and Physiotherapy, Sahlgrenska University Hospital, Göteborg, Sweden
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Dunn JA, Koch-Borner S, Johanson ME, Wangdell J. Toward Consensus in Assessing Upper Limb Muscle Strength and Pinch and Grip Strength in People With Tetraplegia Having Upper Limb Reconstructions. Top Spinal Cord Inj Rehabil 2021; 27:70-82. [PMID: 34456548 DOI: 10.46292/sci20-00012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Objectives To reach agreement on standardized protocols for assessing upper limb strength and grip and pinch force for upper limb reconstructive surgery for tetraplegia. Methods Selected members of an expert panel composed of international therapists formed at the 2018 International Congress for Upper Limb Surgery for Tetraplegia conducted a literature review of current practice that identified gaps and inconsistencies in measurement protocols and presented to workshop attendees. To resolve discrepancies, a set of questions was presented to workshop attendees who voted electronically. Consensus was set at 75% agreement. Results For manual muscle testing, consensus was reached for using the Medical Research Council scale, without plus or minus, and the use of resistance through range when testing grade 4 and grade 5 strength. Pectoralis major and serratus anterior should be routinely tested, however there was no consensus on other shoulder muscles. Grip and pinch strength should be tested according to the American Society of Hand Therapists positioning. For grip strength, either the Jamar or Biometrics dynamometer expressed in kilograms should be used. For grip and pinch strength, three measurements should be performed at each testing. No consensus was reached on a device for pinch strength. Conclusion This work is an important step to enable comparable data in the future. Further consensus methods will work toward developing more comprehensive guidelines in this population. Building international consensus for pre- and postoperative measures of function supports objective evaluation of novel therapies and interpretation of multicenter studies.
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Affiliation(s)
- Jennifer A Dunn
- Department of Orthopaedic Surgery and Musculoskeletal Medicine, University of Otago Christchurch, Christchurch, New Zealand
| | | | - M Elise Johanson
- VA Palo Alto Health Care System, Research and Spinal Cord Injury/Disability Services, Palo Alto, California
| | - Johanna Wangdell
- Center of Advanced Reconstruction of Extremities, Sahlgrenska University Hospital, Gothenburg, Sweden.,Department of Hand Surgery, Institute of Clinical Sciences, The Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
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Frye SK, Geigle PR. Current U.S. splinting practices for individuals with cervical spinal cord injury. Spinal Cord Ser Cases 2020; 6:49. [PMID: 32555151 PMCID: PMC7298624 DOI: 10.1038/s41394-020-0295-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 03/23/2020] [Accepted: 05/13/2020] [Indexed: 11/10/2022] Open
Abstract
STUDY DESIGN Survey research design. OBJECTIVE To understand current splinting practices of occupational therapists working with individuals with spinal cord injury. SETTING The United States. METHODS An online survey was emailed to occupational therapists working in U.S. inpatient spinal cord rehabilitation facilities. The survey included questions about hand splinting practices in their patients with cervical spinal cord injury. RESULTS Sixty-five occupational therapists in 21 different states completed the survey. They reported that current and predicted hand function was the primary principle guiding splint decision making. Across all levels of cervical SCI, resting hand splints are commonly prescribed for night use, and 64.6% of respondents stated they typically recommend them for individuals without active arm movement. Most respondents (73.8%) also report prescribing wrist splints for day use for individuals without active wrist movement. Survey results indicate that therapists are using splints less frequently overall for all levels of injury. The long-opponens splint is no longer being used regularly in SCI and the MCP block splint is being used more frequently. CONCLUSION Survey responses indicated that splinting is standard care for individuals with cervical spinal cord injury and that the level of SCI dictates specific recommendations. Splint practice guidelines are a framework for intervention mediated by case-specific clinical reasoning and client input.
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Affiliation(s)
- Sara Kate Frye
- University of Maryland Rehabilitation & Orthopaedic Institute, Baltimore, MD, USA.
- Thomas Jefferson University Hospital, Philadelphia, PA, USA.
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Azadmanjir Z, Jazayeri SB, Habibi Arejan R, Ghodsi Z, Sharif-Alhoseini M, Kheiri G, Zendehdel K, Safdarian M, Sadeghian F, Khazaeipour Z, Naghdi K, Arab Kheradmand J, Saadat S, Pirnejad H, Fazel MR, Fakharian E, Mohammadzadeh M, Sadeghi-Naini M, Saberi H, Derakhshan P, Sabour H, Benzel EC, Oreilly G, Noonan V, Vaccaro AR, Emami-Razavi SH, Rahimi-Movaghar V. The data set development for the National Spinal Cord Injury Registry of Iran (NSCIR-IR): progress toward improving the quality of care. Spinal Cord Ser Cases 2020; 6:17. [PMID: 32210224 PMCID: PMC7093542 DOI: 10.1038/s41394-020-0265-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Revised: 02/29/2020] [Accepted: 02/29/2020] [Indexed: 12/17/2022] Open
Abstract
STUDY DESIGN Descriptive study. OBJECTIVES The aim of this manuscript is to describe the development process of the data set for the National Spinal Cord Injury Registry of Iran (NSCIR-IR). SETTING SCI community in Iran. METHODS The NSCIR-IR data set was developed in 8 months, from March 2015 to October 2015. An expert panel of 14 members was formed. After a review of data sets of similar registries in developed countries, the selection and modification of the basic framework were performed over 16 meetings, based on the objectives and feasibility of the registry. RESULTS The final version of the data set was composed of 376 data elements including sociodemographic, hospital admission, injury incidence, prehospital procedures, emergency department visit, medical history, vertebral injury, spinal cord injury details, interventions, complications, and discharge data. It also includes 163 components of the International Standards for the Neurologic Classification of Spinal Cord Injury (ISNCSCI) and 65 data elements related to quality of life, pressure ulcers, pain, and spasticity. CONCLUSION The NSCIR-IR data set was developed in order to meet the quality improvement objectives of the registry. The process was centered around choosing the data elements assessing care provided to individuals in the acute and chronic phases of SCI in hospital settings. The International Spinal Cord Injury Data Set was selected as a basic framework, helped by comparison with data from other countries. Expert panel modifications facilitated the implementation of the registry process with the current clinical workflow in hospitals.
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Affiliation(s)
- Zahra Azadmanjir
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Department of Health Information Management, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Behzad Jazayeri
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Department of Urology, University of Florida, Jacksonville, FL, USA
| | - Roya Habibi Arejan
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Ghodsi
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahdi Sharif-Alhoseini
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Ghazaleh Kheiri
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Student's Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran
| | - Kazem Zendehdel
- Cancer Research Center, Cancer Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahdi Safdarian
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Farideh Sadeghian
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Center for Health Related Social and Behavioral Science Research, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Zahra Khazaeipour
- Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Khatereh Naghdi
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Soheil Saadat
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Habibollah Pirnejad
- Health Information Technology Department, Urmia University of Medical Sciences, Urmia, Iran
| | | | - Esmail Fakharian
- Trauma Research Center, Kashan University of Medical Sciences, Kashan, Iran
| | | | - Mohsen Sadeghi-Naini
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
- Shahid Beheshti University of Medical Science, Tehran, Iran
| | - Houshang Saberi
- Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Neurosurgery Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Pegah Derakhshan
- Student Research Committee, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Hadis Sabour
- Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Edward C Benzel
- Department of Neurosurgery, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Gerard Oreilly
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Vanessa Noonan
- Rick Hansen Institute, University of British Columbia, Vancouver, BC, Canada
| | - Alexander R Vaccaro
- Department of Orthopedic Surgery, Rothman Institute, Thomas Jefferson University, Philadelphia, PA, USA
| | - Seyed Hassan Emami-Razavi
- Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Vafa Rahimi-Movaghar
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran.
- Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.
- Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
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Biering-Sørensen F, Cohen S, Rodriguez GM, Tausk K, Martin J. Electronic medical record: data collection and reporting for spinal cord injury. Spinal Cord Ser Cases 2018; 4:70. [PMID: 30109135 PMCID: PMC6081412 DOI: 10.1038/s41394-018-0106-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 06/01/2018] [Accepted: 06/01/2018] [Indexed: 11/09/2022] Open
Abstract
STUDY DESIGN Presentation of implementation of International Spinal Cord Injury (SCI) Data Sets, International Standards for Neurological Classification of SCI (ISNCSCI), and other structured SCI tools in to the Electronic Medical Record (EMR) Epic. OBJECTIVES To describe the implementation of SCI tools in Epic at Rigshospitalet, University of Hospital, Capital Region of Denmark, and the ambitions for the future development of SCI related structured data and their reporting in the Epic EMR to be able to standardize data collection to facilitate research within institutions and collaboratively with other institutions locally and globally. SETTING Denmark and United States of America. METHODS The general content of the EMR Epic and the SCI-specific structured data implemented are described as well as the tools for reporting. RESULTS The ISNCSCI is made available via access to http://isncscialgorithm.azurewebsites.net/. After filling in the test data on the website, one can save the completed form as an image within the patient's chart. The International SCI Core Data Set and 13 International SCI Basic Data Sets (Table 1) are nearly completely implemented in the Danish version of Epic as SmartForms. In addition, 14 functional measures, including the Spinal Cord Independence Measure III, are implemented as flowsheets (Table 2). CONCLUSIONS The possibility of entering international recognized structured data into the EMR gives better possibility for data sharing across SCI centers worldwide. SPONSORSHIP Gianna Maria Rodriguez, Stacey Cohen, and Fin Biering-Sørensen are users of Epic, but have no economic relationship with Epic. Kelly Tausk and Josh Martin are employees of Epic.
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Affiliation(s)
- Fin Biering-Sørensen
- Clinic for Spinal Cord Injuries, Neuroscience Center, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Stacey Cohen
- Clinical Informatics, Mount Sinai Health System, New York, NY USA
| | - Gianna Maria Rodriguez
- Physical Medicine and Rehabilitation, University of Michigan Hospital System, Ann Arbor, MI USA
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11
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Reliability of the International Spinal Cord Injury Upper Extremity Basic Data Set. Spinal Cord 2018; 56:913-918. [PMID: 29895877 DOI: 10.1038/s41393-018-0154-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2017] [Revised: 04/27/2018] [Accepted: 04/27/2018] [Indexed: 11/08/2022]
Abstract
STUDY DESIGN It is a psychometrics study. OBJECTIVE To assess the inter-rater reliability of the International Spinal Cord Injury Upper Extremity Basic Data Set (ISCI-UE). SETTING Maharaj Nakorn Chiang Mai Hospital, Chiang Mai, Thailand. METHODS Individuals with subacute and chronic cervical spinal cord injury (SCI) were recruited. One examiner rated five parts of the ISCI-UE, including the ability to reach and grasp, the shoulder function classification, utilization of adaptive devices used to enhance upper-extremity function, complications affecting upper-extremity function, and upper extremity/hand reconstructive surgery. A second blinded examiner repeated the procedures within 1 day. Quadratic weighted kappa was calculated to determine the inter-rater reliability. RESULTS Sixty participants were included in the study. Fifty-two patients were men, and the mean (SD) age of participants was 42.9 (14.3) years. The median (interquartile range) time since injury was 9.5 (1-53) months. A total of 117 upper limbs were assessed. The inter-rater reliability was substantial, with almost perfect agreement in all items (ability to reach and grasp = 0.98; shoulder function classification = 0.97; use of assistive devices = 0.89; complications = 0.74; and surgery = 1). CONCLUSION The International Spinal Cord Injury Upper Extremity Basic Data Set (ISCI-UE) has very good inter-rater reliability for evaluating individuals with cervical SCI.
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Wäckerlin S, Gemperli A, Sigrist-Nix D, Arnet U. Need and availability of assistive devices to compensate for impaired hand function of individuals with tetraplegia. J Spinal Cord Med 2018; 43:77-87. [PMID: 29863967 PMCID: PMC7006670 DOI: 10.1080/10790268.2018.1479054] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Context/Objective: To evaluate the availability and self-declared unmet need of assistive devices to compensate for impaired hand function of individuals with tetraplegia in Switzerland.Design: Cross-sectional survey.Setting: Community.Participants: Individuals with tetraplegia, aged 16 years or older, living in Switzerland.Interventions: not applicable.Outcome Measures: The self-report availability and unmet need of 18 assistive devices for impaired hand function was analyzed descriptively. The availability of devices was further evaluated stratified by sex, age, SCI severity, independence in grooming, time since injury, living situation, working status, and income. Associations between availability of devices and person characteristics were investigated using logistic regression analysis.Results: Overall 32.7% of participants had any assistive device for impaired hand function at their disposal. The most frequent devices were adapted cutlery (14.8%), type supports (14.1%), environmental control systems (11.4%), and writing orthosis (10.6%). In the bivariate analysis several factors showed significant associations with at least one assistive device. Nevertheless, when controlling for potential confounding in multivariate analysis only independence in grooming (adapted cutlery, environmental control systems, type support, speech recognition software), SCI severity (writing orthosis, type support), and sex (adapted kitchenware) remained significantly associated with the availability of the mentioned assistive devices. The self-declared unmet need was generally low (0.7% - 4.3%), except for adapted kitchenware with a moderate unmet need (8.9%).Conclusion: This study indicates that most individuals with tetraplegia in Switzerland are adequately supplied with assistive devices to compensate for impaired hand function. The availability depends mainly on SCI severity and independence in grooming.
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Affiliation(s)
- Stephanie Wäckerlin
- Swiss Paraplegic Research, Nottwil, Switzerland,Department of Health Sciences and Health Policy, University of Lucerne, Lucerne
| | - Armin Gemperli
- Swiss Paraplegic Research, Nottwil, Switzerland,Department of Health Sciences and Health Policy, University of Lucerne, Lucerne
| | | | - Ursina Arnet
- Swiss Paraplegic Research, Nottwil, Switzerland,Department of Health Sciences and Health Policy, University of Lucerne, Lucerne,Correspondence to: Ursina Arnet, Swiss Paraplegic Research, Guido A. Zäch Strasse 4, CH-6207 Nottwil, Switzerland.
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Relevance of the international spinal cord injury basic data sets to youth: an Inter-Professional review with recommendations. Spinal Cord 2017; 55:875-881. [DOI: 10.1038/sc.2017.14] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Revised: 12/29/2016] [Accepted: 01/06/2017] [Indexed: 01/22/2023]
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Biering-Sørensen F, Noonan VK. Standardization of Data for Clinical Use and Research in Spinal Cord Injury. Brain Sci 2016; 6:E29. [PMID: 27529284 PMCID: PMC5039458 DOI: 10.3390/brainsci6030029] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Revised: 07/22/2016] [Accepted: 08/03/2016] [Indexed: 11/25/2022] Open
Abstract
Increased survival after spinal cord injury (SCI) worldwide has enhanced the need for quality data that can be compared and shared between centers, countries, as well as across research studies, to better understand how best to prevent and treat SCI. Such data should be standardized and be able to be uniformly collected at any SCI center or within any SCI study. Standardization will make it possible to collect information from larger SCI populations for multi-center research studies. With this aim, the international SCI community has obtained consensus regarding the best available data and measures for use in SCI clinical practice and research. Reporting of SCI data is likewise standardized. Data elements are continuously updated and developed using an open and transparent process. There are ongoing internal, as well as external review processes, where all interested parties are encouraged to participate. The purpose of this review paper is to provide an overview of the initiatives to standardize data including the International Spinal Cord Society's International SCI Data Sets and the National Institutes of Health, National Institute of Neurological Disorders and Stroke Common Data Elements Project within SCI and discuss future opportunities.
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Affiliation(s)
- Fin Biering-Sørensen
- Clinic for Spinal Cord Injuries, Rigshospitalet (2081), University of Copenhagen, Copenhagen DK-2100, Denmark.
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Sinnott KA, Dunn JA, Wangdell J, Johanson ME, Hall AS, Post MW. Measurement of Outcomes of Upper Limb Reconstructive Surgery for Tetraplegia. Arch Phys Med Rehabil 2016; 97:S169-81. [DOI: 10.1016/j.apmr.2015.10.110] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Revised: 09/18/2015] [Accepted: 10/20/2015] [Indexed: 10/21/2022]
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Harvey LA. Physiotherapy rehabilitation for people with spinal cord injuries. J Physiother 2016; 62:4-11. [PMID: 26701156 DOI: 10.1016/j.jphys.2015.11.004] [Citation(s) in RCA: 88] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2015] [Revised: 11/11/2015] [Accepted: 11/13/2015] [Indexed: 01/13/2023] Open
Affiliation(s)
- Lisa A Harvey
- John Walsh Centre for Rehabilitation Research, Kolling Institute, Sydney Medical School/Northern, University of Sydney, Australia
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Biering-Sørensen F, Alai S, Anderson K, Charlifue S, Chen Y, DeVivo M, Flanders AE, Jones L, Kleitman N, Lans A, Noonan VK, Odenkirchen J, Steeves J, Tansey K, Widerström-Noga E, Jakeman LB. Common data elements for spinal cord injury clinical research: a National Institute for Neurological Disorders and Stroke project. Spinal Cord 2015; 53:265-77. [PMID: 25665542 PMCID: PMC4393777 DOI: 10.1038/sc.2014.246] [Citation(s) in RCA: 79] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Revised: 12/04/2014] [Accepted: 12/25/2014] [Indexed: 01/08/2023]
Abstract
OBJECTIVES To develop a comprehensive set of common data elements (CDEs), data definitions, case report forms and guidelines for use in spinal cord injury (SCI) clinical research, as part of the CDE project at the National Institute of Neurological Disorders and Stroke (NINDS) of the US National Institutes of Health. SETTING International Working Groups. METHODS Nine working groups composed of international experts reviewed existing CDEs and instruments, created new elements when needed and provided recommendations for SCI clinical research. The project was carried out in collaboration with and cross-referenced to development of the International Spinal Cord Society (ISCoS) International SCI Data Sets. The recommendations were compiled, subjected to internal review and posted online for external public comment. The final version was reviewed by all working groups and the NINDS CDE team before release. RESULTS The NINDS SCI CDEs and supporting documents are publically available on the NINDS CDE website and the ISCoS website. The CDEs span the continuum of SCI care and the full range of domains of the International Classification of Functioning, Disability and Health. CONCLUSION Widespread use of CDEs can facilitate SCI clinical research and trial design, data sharing and retrospective analyses. Continued international collaboration will enable consistent data collection and reporting, and will help ensure that the data elements are updated, reviewed and broadcast as additional evidence is obtained.
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Affiliation(s)
- Fin Biering-Sørensen
- Department of Spinal Cord Injuries, Rigshospitalet and Glostrup Hospital, University of Copenhagen, Copenhagen, Denmark
| | | | - Kim Anderson
- Miami Project to Cure Paralysis, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | | | - Yuying Chen
- University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Michael DeVivo
- University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Adam E. Flanders
- Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | - Linda Jones
- Craig H. Neilsen Foundation, Encino, California, USA
| | | | - Aria Lans
- The EMMES Corporation, Rockville, Maryland, USA
| | | | - Joanne Odenkirchen
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland, USA
| | - John Steeves
- University of British Columbia and Vancouver Coastal Health, Vancouver, BC, Canada
| | - Keith Tansey
- Emory University and Atlanta VA Medical Center, Atlanta, Georgia, USA
| | - Eva Widerström-Noga
- Miami Project to Cure Paralysis, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Lyn B. Jakeman
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland, USA
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