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Cao Y, Clark JMR, Krause JS. Difficulty Obtaining Daily Necessities and Difficulty Obtaining SCI Services During the COVID-19 Pandemic Among People With Spinal Cord Injury. Arch Phys Med Rehabil 2024; 105:82-87. [PMID: 37598832 DOI: 10.1016/j.apmr.2023.08.002] [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: 06/06/2023] [Revised: 08/02/2023] [Accepted: 08/03/2023] [Indexed: 08/22/2023]
Abstract
OBJECTIVE To describe the self-reported difficulties during the COVID-19 pandemic on the lives of persons with traumatic spinal cord injury (SCI), and to identify the factors measured prior the pandemic that predict the number of difficulties obtaining daily necessities and difficulties obtaining SCI services during the pandemic. DESIGN Cohort study. SETTING A state SCI outcomes follow-up database in the southeastern United States. PARTICIPANTS 297 participants (N=297) met the following eligibility criteria: (1) ≥18 years of age, (2) traumatic SCI, (3) minimum of 1-year post-injury, and (4) having completed a longitudinal study questionnaire immediately prior to the pandemic (between 12/1/2019 and 03/11/2020). INTERVENTIONS N/A. MAIN OUTCOME MEASURE(S) The outcome measures were the self-reported number of difficulties obtaining daily necessities (difficulties to get food, medication, and routine medical/dental care) and difficulties obtaining SCI services during the pandemic (difficulties to get treatment for SCI-related problems, to maintain regular SCI equipment, and to get SCI supplies). RESULTS Among 297 eligible participants, 247 (83%) have completed the follow-up during the pandemic between December 2020 and December 2021. There were 22% participants having at least 1 difficulty obtaining daily necessities and 19% participants having at least 1 difficulty obtaining SCI services. Younger, ambulatory participants, cervical 1-4 injury level, lower household income, more health conditions, and no routine health care access prior to the pandemic were associated with greater number of difficulties obtaining daily necessities. Women, non-ambulatory participants, marital relation, having need for physical assistance, more health conditions, and no routine health care access prior to the pandemic related to greater number of difficulties obtaining SCI services. CONCLUSIONS People with SCI have experienced living difficulties during the COVID-19 pandemic. Of particular importance, no routine health care access and more health conditions are related to more difficulties obtaining both daily necessities and SCI services after controlling the socio-demographics and injury characteristics.
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Affiliation(s)
- Yue Cao
- College of Health Professions, Medical University of South Carolina, Charleston, SC
| | - Jillian M R Clark
- College of Health Professions, Medical University of South Carolina, Charleston, SC; Mental Health Service, VA San Diego Healthcare System, San Diego, CA
| | - James S Krause
- College of Health Professions, Medical University of South Carolina, Charleston, SC.
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Cole S, Wang Z, Chen Z, Hua C, Chen Y, Evans D. Is Spending Nights Away From Home Associated With Participation and Life Satisfaction After Spinal Cord Injury? A Longitudinal Perspective. Top Spinal Cord Inj Rehabil 2023; 29:73-85. [PMID: 38076499 PMCID: PMC10704217 DOI: 10.46292/sci22-00020] [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] [Indexed: 12/18/2023]
Abstract
Background Community reintegration after SCI rehabilitation consists of readjustment not only to the home setting but also to the social and occupational spheres, which often require people to spend nights away from home. Because community reintegration contributes to life satisfaction after SCI, it is necessary to investigate how travel participation is related to occupational and social participation and life satisfaction. Additionally, better management of the long-term effects of SCI requires better understanding of the changes in participation and life satisfaction over time. Objectives To examine how participation and life satisfaction change over time following SCI, and to investigate whether spending nights away from home is associated with occupational and social participation and life satisfaction over time. Methods This is a longitudinal analysis of data extracted from the publicly available database of Spinal Cord Model Systems from 1996 to 2016. A generalized linear mixed model was developed to examine the changes of outcome variables over time while controlling demographic variables. Results Travel and social participation declined while life satisfaction increased as people lived longer with SCI, controlling for confounders. No significant change was identified in occupational participation. Spending nights away from home was significantly and positively associated with social and occupational participation and life satisfaction over time. Although travel participation of people with SCI declined over time, its association with social participation strengthened as the number of postinjury years increased. Conclusion Travel participation plays an important role in successful community reintegration. Rehabilitation services and travel services should provide training and resources on travel after SCI for improved participation and life satisfaction.
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Affiliation(s)
- Shu Cole
- Indiana University School of Public Health-Bloomington, Bloomington, Indiana
| | - Zikun Wang
- Indiana University School of Public Health-Bloomington, Bloomington, Indiana
| | - Zhongxue Chen
- Indiana University School of Public Health-Bloomington, Bloomington, Indiana
| | - Chenggang Hua
- Indiana University School of Public Health-Bloomington, Bloomington, Indiana
| | - Yuying Chen
- Department of Physical Medicine and Rehabilitation, The University of Alabama at Birmingham, Birmingham, Alabama
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Clark JMR, Cao Y, Krause JS. Pain interference and depressive symptom severity across 10 years in individuals with long-term spinal cord injury. J Spinal Cord Med 2023:1-8. [PMID: 37982813 DOI: 10.1080/10790268.2023.2263940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2023] Open
Abstract
OBJECTIVE To examine change in pain interference and depression over a 10-year time period in individuals with long-term traumatic spinal cord injury (SCI) and to identify the extent to which changes in pain interference over time predicts change in depressive symptoms. DESIGN Longitudinal analyses of self-report assessment data. SETTING Specialty and university hospitals in the Southeastern and Midwestern United States. PARTICIPANTS Adults with a history of traumatic SCI (n = 504) who responded to the three most recent data collection periods of the SCI Longitudinal Aging Study (2008 [Time 1], 2013 [Time 2], and 2018 [Time 3]). The participants averaged 59 years of age and 32 years since injury onset at Time 3. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Patient Health Questionnaire (PHQ-9) assessed depressive symptom severity. The 7-item Pain Interference scale from the Brief Pain Inventory assessed pain interference. RESULTS Over the three study timepoints, the sample averaged moderate levels of pain interference and mild depressive symptom severity. Unconditional linear growth models, reflecting changes in central tendency, indicated that pain interference significantly decreased and depressive symptom severity significantly increased over time. Multiple independent variables random coefficient modeling based on correlations suggested that change in pain interference was positively associated with change in depressive symptom severity over the 10-year study follow-up. CONCLUSION Average depressive symptom severity worsened over time. Change in pain interference was positively associated with change in depressive symptom severity. These results point to the complexity of aging related changes in depressive symptoms and pain interference. They further support the need for continued assessment of mood and pain experiences, particularly among individuals reaching aging milestones with SCI.
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Affiliation(s)
- Jillian M R Clark
- College of Health Professions, Medical University of South Carolina, Charleston, South Carolina, USA
- Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, San Diego, California, USA
- Department of Psychiatry, University of California, San Diego, La Jolla, California, USA
| | - Yue Cao
- College of Health Professions, Medical University of South Carolina, Charleston, South Carolina, USA
| | - James S Krause
- College of Health Professions, Medical University of South Carolina, Charleston, South Carolina, USA
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Li Y, Khan N, Ritzel RM, Lei Z, Allen S, Faden AI, Wu J. Sexually dimorphic extracellular vesicle responses after chronic spinal cord injury are associated with neuroinflammation and neurodegeneration in the aged brain. J Neuroinflammation 2023; 20:197. [PMID: 37653491 PMCID: PMC10469550 DOI: 10.1186/s12974-023-02881-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 08/27/2023] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND Medical advances have made it increasingly possible for spinal cord injury (SCI) survivors to survive decades after the insult. But how SCI affects aging changes and aging impacts the injury process have received limited attention. Extracellular vesicles (EVs) are recognized as critical mediators of neuroinflammation after CNS injury, including at a distance from the lesion site. We have previously shown that SCI in young male mice leads to robust changes in plasma EV count and microRNA (miR) content. Here, our goal was to investigate the impact of biological sex and aging on EVs and brain after SCI. METHODS Young adult age-matched male and female C57BL/6 mice were subjected to SCI. At 19 months post-injury, total plasma EVs were isolated by ultracentrifugation and characterized by nanoparticle tracking analysis (NTA). EVs miR cargo was examined using the Fireplex® assay. The transcriptional changes in the brain were assessed by a NanoString nCounter Neuropathology panel and validated by Western blot (WB) and flow cytometry (FC). A battery of behavioral tests was performed for assessment of neurological function. RESULTS Transcriptomic changes showed a high number of changes between sham and those with SCI. Sex-specific changes were found in transcription networks related to disease association, activated microglia, and vesicle trafficking. FC showed higher microglia and myeloid counts in the injured tissue of SCI/Female compared to their male counterparts, along with higher microglial production of ROS in both injured site and the brain. In the latter, increased levels of TNF and mitochondrial membrane potential were seen in microglia from SCI/Female. WB and NTA revealed that EV markers are elevated in the plasma of SCI/Male. Particle concentration in the cortex increased after injury, with SCI/Female showing higher counts than SCI/Male. EVs cargo analysis revealed changes in miR content related to injury and sex. Behavioral testing confirmed impairment of cognition and depression at chronic time points after SCI in both sexes, without significant differences between males and females. CONCLUSIONS Our study is the first to show sexually dimorphic changes in brain after very long-term SCI and supports a potential sex-dependent EV-mediated mechanism that contributes to SCI-induced brain changes.
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Affiliation(s)
- Yun Li
- Department of Anesthesiology and Center for Shock, Trauma and Anesthesiology Research (STAR), University of Maryland School of Medicine, 685 W. Baltimore Street, MSTF, Room 6-034D, Baltimore, MD, 21201, USA
| | - Niaz Khan
- Department of Anesthesiology and Center for Shock, Trauma and Anesthesiology Research (STAR), University of Maryland School of Medicine, 685 W. Baltimore Street, MSTF, Room 6-034D, Baltimore, MD, 21201, USA
| | - Rodney M Ritzel
- Department of Anesthesiology and Center for Shock, Trauma and Anesthesiology Research (STAR), University of Maryland School of Medicine, 685 W. Baltimore Street, MSTF, Room 6-034D, Baltimore, MD, 21201, USA
| | - Zhuofan Lei
- Department of Anesthesiology and Center for Shock, Trauma and Anesthesiology Research (STAR), University of Maryland School of Medicine, 685 W. Baltimore Street, MSTF, Room 6-034D, Baltimore, MD, 21201, USA
| | - Samantha Allen
- Department of Anesthesiology and Center for Shock, Trauma and Anesthesiology Research (STAR), University of Maryland School of Medicine, 685 W. Baltimore Street, MSTF, Room 6-034D, Baltimore, MD, 21201, USA
| | - Alan I Faden
- Department of Anesthesiology and Center for Shock, Trauma and Anesthesiology Research (STAR), University of Maryland School of Medicine, 685 W. Baltimore Street, MSTF, Room 6-034D, Baltimore, MD, 21201, USA
| | - Junfang Wu
- Department of Anesthesiology and Center for Shock, Trauma and Anesthesiology Research (STAR), University of Maryland School of Medicine, 685 W. Baltimore Street, MSTF, Room 6-034D, Baltimore, MD, 21201, USA.
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Araneda OF, Rosales-Antequera C, Contreras-Briceño F, Tuesta M, Rossi-Serrano R, Magalhães J, Viscor G. Systemic and Pulmonary Inflammation/Oxidative Damage: Implications of General and Respiratory Muscle Training in Chronic Spinal-Cord-Injured Patients. BIOLOGY 2023; 12:828. [PMID: 37372113 DOI: 10.3390/biology12060828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 06/03/2023] [Accepted: 06/05/2023] [Indexed: 06/29/2023]
Abstract
Chronic spinal cord injury affects several respiratory-function-related parameters, such as a decrease in respiratory volumes associated with weakness and a tendency to fibrosis of the perithoracic muscles, a predominance of vagal over sympathetic action inducing airway obstructions, and a difficulty in mobilizing secretions. Altogether, these changes result in both restrictive and obstructive patterns. Moreover, low pulmonary ventilation and reduced cardiovascular system functionality (low venous return and right stroke volume) will hinder adequate alveolar recruitment and low O2 diffusion, leading to a drop in peak physical performance. In addition to the functional effects described above, systemic and localized effects on this organ chronically increase oxidative damage and tissue inflammation. This narrative review describes both the deleterious effects of chronic spinal cord injury on the functional effects of the respiratory system as well as the role of oxidative damage/inflammation in this clinical context. In addition, the evidence for the effect of general and respiratory muscular training on the skeletal muscle as a possible preventive and treatment strategy for both functional effects and underlying tissue mechanisms is summarized.
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Affiliation(s)
- Oscar F Araneda
- Integrative Laboratory of Biomechanics and Physiology of Effort (LIBFE), Kinesiology School, Faculty of Medicine, Universidad de los Andes, Monseñor Álvaro del Portillo, Las Condes, Santiago 12455, Chile
| | - Cristián Rosales-Antequera
- Physical Medicine and Rehabilitation Unit, Clínica Universidad de los Andes, Santiago 8320000, Chile
- Physiology Section, Department of Cell Biology, Physiology, and Immunology, Faculty of Biology, Universitat de Barcelona, 08028 Barcelona, Spain
| | - Felipe Contreras-Briceño
- Laboratory of Exercise Physiology, Department of Health Science, Faculty of Medicine, Pontificia Universidad Católica de Chile, Av. Vicuña Mackenna #4860, Santiago 7820436, Chile
- Millennium Institute for Intelligent Healthcare Engineering, Av. Vicuña Mackenna #4860, Santiago 7820436, Chile
| | - Marcelo Tuesta
- Exercise and Rehabilitation Sciences Institute, School of Physical Therapy, Faculty of Rehabilitation Sciences, Universidad Andres Bello, Santiago 7591538, Chile
| | - Rafael Rossi-Serrano
- Physical Medicine and Rehabilitation Unit, Clínica Universidad de los Andes, Santiago 8320000, Chile
| | - José Magalhães
- Laboratory of Metabolism and Exercise (LaMetEx), Research Centre in Physical Activity, Health and Leisure (CIAFEL), Laboratory for Integrative and Translational Research in Population Health (ITR), Faculty of Sport, University of Porto, 4200-450 Porto, Portugal
| | - Ginés Viscor
- Physiology Section, Department of Cell Biology, Physiology, and Immunology, Faculty of Biology, Universitat de Barcelona, 08028 Barcelona, Spain
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Waller M, Jörgensen S, Lexell J. Changes over 6 years in secondary health conditions and activity limitations in older adults aging with long-term spinal cord injury. PM R 2023; 15:157-167. [PMID: 35092167 DOI: 10.1002/pmrj.12776] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 11/19/2021] [Accepted: 12/28/2021] [Indexed: 11/11/2022]
Abstract
BACKGROUND The number of individuals aging with long-term spinal cord injury (SCI) is increasing. Still, there is limited knowledge about changes in secondary health conditions (SHCs) and activity limitations over time. OBJECTIVES To determine changes in SHCs and activity limitations in older adults aging with long-term SCI over 6 years, and to investigate how changes in SHCs and activity limitations are associated with gender, age, and injury characteristics. DESIGN Longitudinal cohort study from the Swedish Aging with Spinal Cord Injury Study (SASCIS). SETTING Community settings, Sweden. PARTICIPANTS From the initial 123 participants in the SASCIS: 78 individuals (32% women); mean age 68 years; mean time since injury 31 years; injury levels C1-L3, AIS A-D. INTERVENTIONS Not applicable MAIN OUTCOME MEASURE: Bowel and bladder function and problems, pain, spasticity, and the Spinal Cord Independence Measure (SCIM III). RESULTS Over 6 years, bowel-related problems increased (31% to 47%, p = .015) and the occurrence of constipation doubled to 24% (p = .013). There were increases in frequent urinary tract infections (10% to 26%, p = .004), use of indwelling urinary catheters (15% to 23%, p = .031), and other bladder-related problems (4% to 22%, p < .001). The occurrence of pain was high (85%), with no significant change. Spasticity increased from 41% to 62% (p < .001). Activity limitations increased (SCIM III total score mean 67 to 61, p < .001, with significant decreases in all subscales). The increase in bowel-related problems was greater in males, and the deterioration in self-care was greater in participants with longer time since injury and with traumatic injuries. CONCLUSIONS These findings support the notion that SHCs and activity limitations increase over time in older adults aging with long-term SCI. The results can inform clinicians and call for a proactive, holistic approach in the long-term follow-up to support healthy and active aging.
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Affiliation(s)
- Mikael Waller
- Department of Health Sciences, Lund University, Lund, Sweden.,Department of Rehabilitation Medicine, Sunderby Hospital, Norrbotten County Council, Luleå, Sweden
| | - Sophie Jörgensen
- Department of Health Sciences, Lund University, Lund, Sweden.,Department of Rehabilitation Medicine, Skåne University Hospital, Lund, Sweden
| | - Jan Lexell
- Department of Health Sciences, Lund University, Lund, Sweden.,Department of Rehabilitation Medicine, Skåne University Hospital, Lund, Sweden
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Krause JS, Dismuke-Greer CE, Reed K. Characteristics Associated With Perceived Underemployment Among Participants With Spinal Cord Injury. Arch Rehabil Res Clin Transl 2022; 4:100230. [PMID: 36545525 PMCID: PMC9761249 DOI: 10.1016/j.arrct.2022.100230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Objective To identify job characteristics related to perceived underemployment among people with spinal cord injury (SCI), while controlling for demographic, injury, and educational factors. Design Cross-sectional, logistic regression with predicted probabilities of underemployment. Setting Medical University in the Southeastern United States. Participants 952 were adults with traumatic SCI, all of whom were a minimum of 1-year post-injury and employed at the time of the study. They averaged 46.7 years of age, the majority were male (70.5%), and over half (52%) were ambulatory (N=952). Interventions Not applicable. Main Outcome Measures Perceived underemployment was defined and measured by a dichotomous variable (yes/no). Results Demographic, injury, and educational factors explained only 4.8% of the variance in underemployment, whereas the full model explained 21.8%. Underemployment was significantly lower for women (odds ratio [OR]=0.66, 95% confidence interval [CI; .44, .98]), those who were either married or in a nonmarried couple (OR=0.63, 95% CI [.42, .93]), those with health benefits (OR=0.58, 95% CI [.37, .91]) and higher for those with lower earnings and occupations in the category of sales, professional/managerial. Postsecondary educational milestones, having received a promotion or recognition, and working full time were not identified as significant predictors in the multivariate model, although each was significantly related to a lower likelihood of underemployment when using a restricted model that controls only for demographics, SCI, and educational status (rather than all variables simultaneously). Age, years since injury, and injury severity were not significant. Conclusion Underemployment is a concern among people with SCI and is more prevalent in low-paying jobs, without benefits, and opportunities for recognition and promotion. Vocational counseling strategies need to promote quality employment, including jobs with recognition and benefits.
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Affiliation(s)
- James S. Krause
- College of Health Professions, Medical University of South Carolina, Charleston, SC
- Corresponding author James S. Krause, PhD, College of Health Professions, Medical University of South Carolina, 151-B Rutledge Ave, MSC 962, Charleston, SC 29425.
| | | | - Karla Reed
- Spartanburg Methodist College, Spartanburg, SC
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Jörgensen S, Lennman E, Lexell J. Sense of coherence and changes over six years among older adults aging with long-term spinal cord injury. Spinal Cord 2021; 59:1278-1284. [PMID: 34593987 DOI: 10.1038/s41393-021-00713-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 09/17/2021] [Accepted: 09/17/2021] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN Cross-sectional and longitudinal. OBJECTIVES To (i) describe sense of coherence (SOC) and changes over six years in older adults aging with long-term spinal cord injury (SCI) and (ii) investigate how changes in SOC are associated with injury characteristics and changes in sociodemographics and secondary health conditions (SHCs; bowel-related and bladder-related problems, pain and spasticity). SETTING Community in Southern Sweden. METHODS From the initial 123 participants in the Swedish Aging with Spinal Cord Injury Study (SASCIS), 76 individuals (33% women, median age 66 years, median time since injury 30 years, AIS A-D, 30% complete) responded to the 13-item SOC scale (range 13-91) twice with a 6-year interval. Data were analyzed with multivariable hierarchical regression. RESULTS The participants rated a strong SOC at both assessments (median 73 and 76.5, respectively) which significantly increased over time. Overall, their marital status and vocational situation remained stable whereas SHCs increased. A change from not having a partner to having one was the only significant explanatory factor for a positive change in SOC. CONCLUSIONS The present study describes, for the first time, changes in SOC over time and associated factors in older adults aging with long-term SCI. They generally maintain a strong ability to understand, handle, and being motivated when dealing with stressful events arising in their lives as a result of their SCI. The associations emphasize the importance of the social context for successful adaptation to living with SCI along the aging process.
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Affiliation(s)
- Sophie Jörgensen
- Department of Health Sciences, Lund University, Lund, Sweden. .,Department of Rehabilitation Medicine, Skåne University Hospital, Lund, Sweden.
| | - Elsa Lennman
- Department of Health Sciences, Lund University, Lund, Sweden
| | - Jan Lexell
- Department of Health Sciences, Lund University, Lund, Sweden.,Department of Rehabilitation Medicine, Skåne University Hospital, Lund, Sweden
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Jörgensen S, Hedgren L, Sundelin A, Lexell J. Global and domain-specific life satisfaction among older adults with long-term spinal cord injury. J Spinal Cord Med 2021; 44:322-330. [PMID: 31099721 PMCID: PMC7952060 DOI: 10.1080/10790268.2019.1610618] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVE Although life expectancy after spinal cord injury (SCI) has increased, knowledge of life satisfaction and associated factors among older adults with long-term SCI is still very limited. The objective of this study was, therefore, to assess global and domain-specific life satisfaction among older adults with long-term SCI and investigate the association with sociodemographics, injury characteristics and secondary health conditions. DESIGN Cross-sectional cohort study. Data from the Swedish Aging with Spinal Cord Injury Study (SASCIS). SETTING Community settings in southern Sweden. PARTICIPANTS Seventy-eight individuals (32% women, injury levels C1-L3, American Spinal Injury Association Impairment Scale (AIS) A-D) mean age 68 years, mean time since injury 31 years. INTERVENTIONS Not applicable. OUTCOME MEASURES The Life Satisfaction Questionnaire (LiSat-11). RESULTS The participants were at least rather satisfied with most of the 11 life domains. They rated the lowest satisfaction with sexual life, activities of daily living and somatic health. Having a partner and being vocationally active was associated with greater satisfaction with life as a whole and with several other life domains. Participants with AIS D injuries were less satisfied with their somatic health than those with tetraplegia AIS A-C and paraplegia AIS A-C injuries. More secondary health conditions were negatively associated with satisfaction in five life domains. CONCLUSION Life satisfaction can be affected many years after SCI. The social context, participation in meaningful activities and minimizing secondary health conditions seem to be important for maintaining life satisfaction in older adults with a long-term injury.
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Affiliation(s)
- Sophie Jörgensen
- Department of Health Sciences, Lund University, Lund, Sweden
- Department of Neurology and Rehabilitation Medicine, Skåne University Hospital, Lund, Sweden
| | - Linn Hedgren
- Department of Health Sciences, Lund University, Lund, Sweden
| | - Anna Sundelin
- Department of Health Sciences, Lund University, Lund, Sweden
| | - Jan Lexell
- Department of Health Sciences, Lund University, Lund, Sweden
- Department of Neurology and Rehabilitation Medicine, Skåne University Hospital, Lund, Sweden
- Department of Neuroscience, Rehabilitation Medicine, Uppsala University, Uppsala, Sweden
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Byra S. Associations between post-traumatic growth and wisdom in people with long-term paraplegia - the role of disability appraisals and participation. Disabil Rehabil 2021; 44:3510-3517. [PMID: 33417504 DOI: 10.1080/09638288.2020.1867903] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE The number of people with long-term spinal cord injury (SCI) is growing but our knowledge about their successful functioning is still limited. The goal of this study was to investigate the correlations between posttraumatic growth (PTG) and wisdom in people with long-term paraplegia, exploring the mediating effect of disability appraisals, and participation/autonomy (P/A). METHODS One-hundred and sixty-six persons with paraplegia completed a set of questionnaires, which included: The three-dimensional Wisdom Scale; The Post-traumatic Growth Inventory; Appraisals of Disability Primary and Secondary Scale; Impact on Participation and Autonomy Questionnaire. Mediation was tested using bootstrapping and a multiple mediation model with two mediators. RESULTS Positive and significant correlations between PTG, disability appraisals (as determined resilience), P/A, and wisdom were found. PTG is associated with wisdom when disability appraisals and P/A are mediators. Higher PTG was related to higher determined resilience and smaller restrictions in participation, both of which were associated with higher wisdom. CONCLUSIONS The relationship between PTG and wisdom is complex and indirect in people with long-term paraplegia. The mediating variables of disability appraisals and P/A explained the variance in PTG, with P/A playing a more significant role. Findings suggest that long-term SCI may correlate with experiencing high levels of PTG and wisdom, and more positive disability appraisals.Implications for rehabilitationPTG is associated with life wisdom in people with long-term SCI, with a significant contribution of disability appraisal and P/A.Therapists can increase these people's awareness about the possibility of experiencing PTG and maintaining positive changes, despite long-term SCI.Therapists can support people with long-term SCI in maintaining or extending the possibilities of participation and autonomous decision-making about their daily activities, which in consequence may be important for increasing their life wisdom.
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Affiliation(s)
- Stanisława Byra
- Faculty of Education and Psychology, Institute of Pedagogy, Maria Curie-Skłodowska University, Lublin, Poland
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11
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Li C, Clark JMR, Krause JS. Twenty-Five-Year Cross-sequential Analysis of Self-reported Problems: Findings From 5 Cohorts From the Spinal Cord Injury Longitudinal Aging Study. Arch Phys Med Rehabil 2020; 102:888-894. [PMID: 33373601 DOI: 10.1016/j.apmr.2020.11.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 10/14/2020] [Accepted: 11/05/2020] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To evaluate how self-reported problems change over time among people with spinal cord injury (SCI). DESIGN Cross-sequential analysis. SETTING Medical university in the Southeastern United States. PARTICIPANTS Participants included 1997 individuals with traumatic SCI of at least 1-year duration who were identified from participation in the SCI Longitudinal Aging Study from 1993-2018. INTERVENTIONS None. MAIN OUTCOME MEASURES The outcomes analyzed were 6 problem factors defined as health, social isolation, emotional distress, environmental barriers, money, and lack of opportunities. A series of cross-sequential models, using PROC MIXED procedure, were developed to evaluate the initial and change of the 6 problem factors over the 6 times of measurements in 25 years. RESULTS Years post injury was negatively associated with initial status of problems of social isolation, emotional distress, environmental barriers, and lack of opportunities because participants with more years post injury at baseline reported lower scores on each factor. Longitudinally, with increased years post injury, higher scores were observed on the health problem factor. However, problems of social isolation, emotional distress, environmental barriers, money, and lack of opportunities decreased over time with increasing years post injury. CONCLUSIONS Participants had more health problems with increasing years after SCI, but fewer problems of social isolation, emotional distress, environmental barriers, money, and lack of opportunities.
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Affiliation(s)
- Chao Li
- College of Health Professions, Medical University of South Carolina, Charleston, South Carolina
| | - Jillian M R Clark
- College of Health Professions, Medical University of South Carolina, Charleston, South Carolina; Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, San Diego, California; Department of Psychiatry, University of California, San Diego, La Jolla, California
| | - James S Krause
- College of Health Professions, Medical University of South Carolina, Charleston, South Carolina.
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12
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Jörgensen S, Costa Andersson MV, Lexell J. Changes in health-related quality of life among older adults aging with long-term spinal cord injury. Spinal Cord 2020; 59:769-776. [PMID: 33184513 PMCID: PMC8257479 DOI: 10.1038/s41393-020-00579-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 10/22/2020] [Accepted: 10/26/2020] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN Cross-sectional and longitudinal. OBJECTIVES To (i) describe health-related quality of life (HRQoL) and changes over 6 years in older adults aging with long-term spinal cord injury (SCI) and (ii) investigate how changes in HRQoL are associated with age, gender, and injury characteristics. SETTING Community in southern Sweden. METHODS From the initial 123 participants (years 2011-2012) in the Swedish Aging with Spinal Cord Injury Study (SASCIS), 77 individuals (32% women, C1-L3, AIS A-D, median age 66 years, median time since injury 31 years, 30% complete injuries) were assessed 6 years later. HRQoL was rated with the Spinal Cord Injury Quality of Life Questionnaire (SCI QL-23). Associations were investigated using multivariable linear regression analyses. RESULTS The median rating of global QoL (scale range 0-100) was relatively high at both assessments (67 and 83, respectively). There was a large variability in all HRQoL-domains and no significant changes over 6 years. As compared to an AIS D injury, a tetraplegia AIS A-C injury and tetraplegia and paraplegia AIS A-C injuries were associated with positive change in depressive symptoms and global QoL, respectively. CONCLUSIONS Older adults aging with long-term SCI show large variations in all HRQoL-domains and have the potential to maintain a high and stable level of HRQoL over time. Persons with AIS D injuries may need increased attention to mitigate negative changes in depressive symptoms and global QoL. Further studies are needed to identify modifiable factors associated with changes in HRQoL in older adults aging with long-term SCI.
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Affiliation(s)
- Sophie Jörgensen
- Department of Health Sciences, Lund University, Lund, Sweden. .,Department of Rehabilitation Medicine, Skåne University Hospital, Lund, Sweden.
| | | | - Jan Lexell
- Department of Health Sciences, Lund University, Lund, Sweden.,Department of Rehabilitation Medicine, Skåne University Hospital, Lund, Sweden
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Krause JS, Iwanaga K, Reed KS, Chan F. Importance of intangible and tangible job considerations among participants with spinal cord injury: Factor analysis and scale development. JOURNAL OF VOCATIONAL REHABILITATION 2020. [DOI: 10.3233/jvr-201086] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- James S. Krause
- College of Health Professions, Medical University of South Carolina, Charleston, SC, USA
| | - Kanako Iwanaga
- College of Health Professions, Virginia Commonwealth University, Richmond, VA, USA
| | - Karla S. Reed
- College of Health Professions, Medical University of South Carolina, Charleston, SC, USA
| | - Fong Chan
- School of Education, University of Wisconsin-Madison, Madison, WI, USA
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Li C, Clark JMR, DiPiro N, Roesler J, Krause JS. Trends in nonroutine physician visits and hospitalizations: findings among five cohorts from the Spinal Cord Injury Longitudinal Aging Study. Spinal Cord 2020; 58:658-666. [DOI: 10.1038/s41393-019-0407-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 12/11/2019] [Accepted: 12/12/2019] [Indexed: 11/09/2022]
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Krause JS, Dismuke-Greer CE, Jarnecke M, Reed KS. Differential Odds of Employment and Estimation of Earnings Among Those With Spinal Cord Injury. REHABILITATION COUNSELING BULLETIN 2019. [DOI: 10.1177/0034355219848493] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Our purpose was to identify demographic, educational, and injury-related characteristics associated with odds of employment and estimates of differential earnings among participants with spinal cord injury (SCI). Self-report assessments were obtained from 1,983 participants who had traumatic SCI, were 18+ years old, and less than 65 years of age. All were recruited into the current cross-sectional study from previous studies of health and aging from the Midwestern and Southeastern United States. Midwestern participants had 2.41 higher odds of employment. Older age at injury was associated with lower odds of employment. There were no sex differences in the odds of employment, but women had an estimated US$19,431 lower conditional earnings. Non-Hispanic Blacks had 69% lower odds of employment, and those working had an estimated US$12,058 lower earnings. Ambulatory participants had higher odds of employment (odds ratio [OR] = 4.66) and higher conditional earnings (US$17,277) than those with the most severe SCI. Those with 4-year or postgraduate degrees had substantially higher odds of employment (OR = 4.15, OR = 5.72, respectively) and higher conditional earnings (US$29,990, US$44,580, respectively) compared with those with a high school certificate or less. These findings underscore the importance of policies to promote the optimal quality employment outcomes for people with SCI.
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Affiliation(s)
| | | | | | - Karla S. Reed
- Medical University of South Carolina, Charleston, USA
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Survival in 222 Patients With Severe CSCI: An 8-Year Epidemiologic Survey in Western China. Arch Phys Med Rehabil 2019; 100:1872-1880. [PMID: 30684486 DOI: 10.1016/j.apmr.2018.12.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 12/03/2018] [Accepted: 12/10/2018] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To assess the survival and the predictors of mortality in patients with severe cervical spinal cord injuries (CSCI). DESIGN Retrospective study. PARTICIPANTS From January 1, 2010, to May 31, 2018, patients who suffered from severe CSCIs in Western China were enrolled in this study (N=222). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Survival rates and mortality risk factors. Measures were calculated by the product-limit method (Kaplan-Meier) and the Cox model. RESULTS The overall 1-year, 3-year, 5-year, and 8-year postoperative mortalities were 24.4%, 30.6%, 33.3%, 36.2%, and 39.0%, respectively. Most deaths occurred within 36 months after the injury. According to the Cox proportional hazards model, the significant predictors of survival were as follows: (1) age; (2) neurologic level; (3) treatment options (surgical or conservative); (4) ventilator support (P<.05). The 8-year mortality for older patients (>50y) was 50.2%, which was significantly higher than that for younger patients (32.4%, <50y). The risk of death was 2.053 times higher in higher levels of injury (C1-C4) than in lower levels of injury (C5-C8) (P<.05). Compared with conservative treatment, patients who received surgical treatment (either anterior or posterior decompression) had a lower risk of death (P<.05). No significant difference was detected in the risk of death between early surgery (<3d) and mid-term surgery (3-7d) (P>.05). However, patients who received late-term surgery (>7d) had a higher mortality risk (P<.05). The overall 8-year mortality risk of patients who needed ventilator support was much higher than those who did not need ventilator support (P<.05). CONCLUSIONS Age, neurologic level, ventilator dependence, treatment options, and timing to surgery were main risk factors for mortality in patients with severe CSCIs. Better understanding of the predictors for survival could possibly contribute to the improvement of survival rates.
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Silveira SL, Ledoux TA, Johnston CA, Kalpakjian C, O'Connor DP, Cottingham M, McGrath R, Tate D. Well on wheels intervention: Satisfaction with life and health for adults with spinal cord injuries. J Spinal Cord Med 2018; 43:60-68. [PMID: 30557093 PMCID: PMC7006815 DOI: 10.1080/10790268.2018.1554333] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
Objective/Background: To examine how demographic and injury characteristics identify satisfaction with life (SWL), and assess the differential effects of a wellness intervention by baseline SWL groups.Design: Baseline and longitudinal analysis of a randomized controlled pilot intervention using decision tree regression and linear mixed models.Setting: Community based.Participants: Seventy-two individuals with spinal cord injury (SCI) were randomized to an intervention group (n = 39) or control group (n = 33). Participants were aged 44.1 ± 13.0 years and 13.1 ± 10.6 years post-injury. Most participants were male (n = 50; 69.4%) and had paraplegia (n = 38; 52.7%). Participants were classified as high versus low SWL at baseline using a cutoff score of 20.Interventions: The intervention aimed to increase self-efficacy, and in turn, increase engagement in health-promoting behaviors related to SWL. Six 4-hour in-person workshops were conducted over a 3-month period led by experts and peer-mentors who were available for support.Outcome measure(s): Self-efficacy for health practices, secondary condition severity, health-promoting behaviors, perceived stress, and SWL.Results: At baseline, participants with low SWL were recently injured (<4.5 years), while persons with high SWL were married and younger (<49 years old). Intervention participants with low SWL at baseline significantly improved SWL over time compared to those with high SWL (P = 0.02).Conclusion: Certain injury and demographic characteristics were associated with SWL, and intervention participants with low SWL at baseline improved their SWL over 2 years. Healthcare providers should consider time post-injury, marital status, and age in identifying individuals at risk for low SWL that may benefit from wellness interventions.
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Affiliation(s)
- Stephanie L. Silveira
- Department of Health and Human Performance, University of Houston, Houston, Texas, USA,Department of Physical Therapy, University of Alabama at Birmingham, Birmingham, Alabama, USA,Correspondence to: Stephanie L. Silveira, Department of Physical Therapy, University of Alabama at Birmingham, 1720 2nd Avenue South, SHPB 360X, Birmingham, Alabama 35294-1212, USA; Ph: 205-975-9321.
| | - Tracey A. Ledoux
- Department of Health and Human Performance, University of Houston, Houston, Texas, USA
| | - Craig A. Johnston
- Department of Health and Human Performance, University of Houston, Houston, Texas, USA
| | - Claire Kalpakjian
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, Michigan, USA
| | - Daniel P. O'Connor
- Department of Health and Human Performance, University of Houston, Houston, Texas, USA
| | - Michael Cottingham
- Department of Health and Human Performance, University of Houston, Houston, Texas, USA
| | - Ryan McGrath
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, North Dakota, USA
| | - Denise Tate
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, Michigan, USA
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Participation restriction and assistance needs in people with spinal cord injuries of more than 40 year duration. Spinal Cord Ser Cases 2018; 4:28. [PMID: 29619249 DOI: 10.1038/s41394-018-0056-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Revised: 02/10/2018] [Accepted: 02/11/2018] [Indexed: 11/08/2022] Open
Abstract
Study design Prospective observational. Objectives Examine changes in participation restriction and assistance needs in a sample of people with long-standing spinal cord injuries (SCIs). Setting Two British spinal centres. Methods The sample consisted of British ageing with SCI study participants who were seen at baseline (1990 or 1993) and in the final follow-up (2010). Outcome measures were the Craig Handicap Assessment and Reporting Technique-Short Form (CHART-SF) and interview questions about assistance needs. Results Eighty-five Ageing study participants took part in 2010; their mean age was 67.65 years and the mean time since injury was 46.26 years. The mean CHART-SF physical independence subscore decreased from 97.44 in 1990 to 91.26 in 2010, mobility from 95.58 to 82.10, occupation from 86.82 to 64.49 and social integration from 96.29 to 88.68 (all p < 0.05). Increasing assistance needs were reported by 10.1% of participants in 1990, by 36.6% in 2010 (p < 0.05) and by 62.4% over the entire 20-year study period. Persons requiring more assistance were older and injured longer, had a more severe SCI and lower self-reported quality of life and life satisfaction (p < 0.05). In the multivariate logistic regression, the strongest predictor of needing more assistance was injury severity (p < 0.05). Conclusions An increase in participation restriction and in assistance needs was reported over the 20 year follow-up in persons injured more than 40 years ago. SCI severity was the main risk factor for needing more assistance. Clinical awareness of how participation changes with age may help provide timely intervention and offset declines.
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Zhang D, Wang F, Zhai X, Li XH, He XJ. Lithium promotes recovery of neurological function after spinal cord injury by inducing autophagy. Neural Regen Res 2018; 13:2191-2199. [PMID: 30323152 PMCID: PMC6199946 DOI: 10.4103/1673-5374.241473] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Lithium promotes autophagy and has a neuroprotective effect on spinal cord injury (SCI); however, the underlying mechanisms remain unclear. Therefore, in this study, we investigated the effects of lithium and the autophagy inhibitor 3-methyladenine (3-MA) in a rat model of SCI. The rats were randomly assigned to the SCI, lithium, 3-MA and sham groups. In the 3-MA group, rats were intraperitoneally injected with 3-MA (3 mg/kg) 2 hours before SCI. In the lithium and 3-MA groups, rats were intraperitoneally injected with lithium (LiCl; 30 mg/kg) 6 hours after SCI and thereafter once daily until sacrifice. At 2, 3 and 4 weeks after SCI, neurological function and diffusion tensor imaging indicators were remarkably improved in the lithium group compared with the SCI and 3-MA groups. The Basso, Beattie and Bresnahan locomotor rating scale score and fractional anisotropy values were increased, and the apparent diffusion coefficient value was decreased. Immunohistochemical staining showed that immunoreactivities for Beclin-1 and light-chain 3B peaked 1 day after SCI in the lithium and SCI groups. Immunoreactivities for Beclin-1 and light-chain 3B were weaker in the 3-MA group than in the SCI group, indicating that 3-MA inhibits lithium-induced autophagy. Furthermore, NeuN+ neurons were more numerous in the lithium group than in the SCI and 3-MA groups, with the fewest in the latter. Our findings show that lithium reduces neuronal damage after acute SCI and promotes neurological recovery by inducing autophagy. The neuroprotective mechanism of action may not be entirely dependent on the enhancement of autophagy, and furthermore, 3-MA might not completely inhibit all autophagy pathways.
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Affiliation(s)
- Duo Zhang
- Department of Orthopedics, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Fang Wang
- Department of Orthopedics, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, China
| | - Xu Zhai
- Department of Emergency, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, China
| | - Xiao-Hui Li
- Department of Radiology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, China
| | - Xi-Jing He
- Department of Orthopedics, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi Province, China
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Generating Rasch-based activity of daily living measures from the Spinal Cord Injury Longitudinal Aging Study. Spinal Cord 2017; 56:14-21. [PMID: 28895574 DOI: 10.1038/sc.2017.99] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Revised: 06/27/2017] [Accepted: 07/11/2017] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN Retrospective Longitudinal Study. OBJECTIVES (1) To determine whether the Spinal Cord Injury Activities of Daily Living (SCI_ADL) measure shows adequate item-level and precision psychometrics; (2) to investigate whether the SCI_ADL measure effectively detects ADL changes across time; (3) to describe self-care task(s) participants can and cannot do across time. SETTING Two Midwestern hospitals and 1 Southeastern specialty hospital in 1993. METHODS All participants were adults with traumatic SCI of at least 1-year duration at enrollment. We used 20-year (1993-2013) retrospective longitudinal data and categorized participants into three injury levels: C1-C4 (cervical; n=50), C5-C8 (n=126) and T1-S5 (thoracic, lumbar and sacral; n=168). We first examined psychometrics of the SCI_ADL with factor and Rasch analyses; then we investigated longitudinal change of SCI_ADL scores at three time points over 20 years (1993, 2003 and 2013) using generalized linear mixed modeling and post hoc analyses. RESULTS The SCI_ADL measure demonstrated unidimensionality, person strata of 2.9, high Cronbach's α (0.93) and fair person reliability (0.76). T1-S5 had the highest measures, following C5-C8 and C1-C4 at three time points (P<0.05). The C1-C4 and T1-S5 groups showed significant decreases from 2003 to 2013; however, none of the three groups showed significant differences from 1993 to 2003 (P<0.05). CONCLUSIONS The SCI_ADL measure could detect longitudinal ADL changes of the population with SCI across time. The C1-C4 group decreased the most in ADLs, indicating higher need of long-term services and rehabilitation.
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Xia Y, Xia H, Chen D, Liao Z, Yan Y. Mechanisms of autophagy and apoptosis mediated by JAK2 signaling pathway after spinal cord injury of rats. Exp Ther Med 2017; 14:1589-1593. [PMID: 28781630 PMCID: PMC5526089 DOI: 10.3892/etm.2017.4674] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Accepted: 05/04/2017] [Indexed: 01/01/2023] Open
Abstract
The aim of this study was to investigate the pathogenesis of autophagy and apoptosis mediated by Janus kinase 2/signal transducer and activator of transcription 3 (JAK2/STAT3) signal pathway after the onset of acute spinal cord injury (ASCI). A total of 45 Sprague-Dawley adult rats of either sex were selected for this study. The age of rats ranged from 8 to 10 weeks, and the average weight was 245 g. These rats were randomly divided into three groups, i.e. sham-operated group, model group, and the AG-490 intervention group (AG-490 is an inhibitor of JAK2). Each group contained 15 rats. Models were prepared using the modified Allen method. Five rats in each group were sacrificed at 6, 12 and 24 h, respectively, and the expression levels of p-JAK2 and p-STAT3 were detected in spinal cord tissue via western blot analysis. The levels of proinflammatory cytokines interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) were detected via ELISA, positive expression of light chain 3 (LC3)-II of microtubule-associated protein 1 via immunofluorescence labeling method, and mRNA expression levels of caspase-3 and Bax/Bcl-2 via RT-PCR. In the model group, the expression levels of p-JAK2, p-STAT3, IL-6, TNF-α and LC3-II, and the mRNA expression levels of caspase-3 and Bax/Bcl-2 at all time-points were significantly higher than those in the AG-490 intervention group, and the levels in the sham-operated group were the lowest (p<0.05). In the model group, peak levels of p-JAK2 and p-STAT3 were attained at 12 h, but a decline was seen at 24 h; while increasing trend was seen in other indicators. In conclusion, JAK2/STAT3 signal pathway can mediate the activity of autophagy and apoptosis in an early stage after the onset of ASCI of rat.
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Affiliation(s)
- Yongzhi Xia
- Department of Neurosurgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, P.R. China
| | - Haijian Xia
- Department of Neurosurgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, P.R. China
| | - Dan Chen
- Department of Neurosurgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, P.R. China
| | - Zhengbu Liao
- Department of Neurosurgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, P.R. China
| | - Yi Yan
- Department of Neurosurgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, P.R. China
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