1
|
Crul TC, Hacking EC, Visser-Meily JMA, Post MWM, Stolwijk-Swüste JM. Choosing non-pharmacological treatments for neuropathic pain in spinal cord injury: a qualitative study. Disabil Rehabil 2024:1-7. [PMID: 38840332 DOI: 10.1080/09638288.2024.2362402] [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: 10/26/2023] [Accepted: 05/28/2024] [Indexed: 06/07/2024]
Abstract
PURPOSE The aims of this study were to explore (1) the considerations of people with spinal cord injury (SCI) in choosing to use non-pharmacological treatments (N-PTs) for neuropathic pain (NP), (2) which factors influence their decision and who is involved in this choice. MATERIALS AND METHODS Eleven individuals with SCI and NP were interviewed. Interviews were transcribed verbatim, transcripts were analysed through thematic coding, following an inductive content analysis approach. RESULTS A journey towards finding and choosing N-PTs emerged. Key phases in this journey were: motives, strategy and practical considerations. Pain and its impact on their life led participants to consider N-PTs. Motives were participants' negative attitudes towards regular medication, willingness to try everything and disappointment and frustration with the guidance from their health care provider (HCP). The search strategies often involved third parties and the internet. This led them to choose a specific N-PT. The journey was influenced by one's attitude, previous personal experience, experience of HCPs, financial considerations, availability and convenience of the treatment. CONCLUSIONS The journey individuals with SCI and NP go through to find N-PTs to manage pain is difficult and often lonely. Findings highlight the importance of HCPs accompanying people with SCI in finding N-PTs.
Collapse
Affiliation(s)
- T C Crul
- Centre of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Centre, University Medical Centre Utrecht, and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - E C Hacking
- Centre of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Centre, University Medical Centre Utrecht, and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - J M A Visser-Meily
- Centre of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Centre, University Medical Centre Utrecht, and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
- Department of Rehabilitation, Physical Therapy Science & Sports, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - M W M Post
- Centre of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Centre, University Medical Centre Utrecht, and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
- Centre for Rehabilitation, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - J M Stolwijk-Swüste
- Centre of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Centre, University Medical Centre Utrecht, and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
- Department of Spinal Cord Injury and Orthopedics, De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| |
Collapse
|
2
|
Keightley JGA, Haagman B, Magner JD, Debenham JR. Models of care for musculoskeletal shoulder pain in spinal cord injury: A scoping review. J Spinal Cord Med 2024; 47:327-344. [PMID: 36913538 PMCID: PMC11044743 DOI: 10.1080/10790268.2023.2183335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/15/2023] Open
Abstract
CONTEXT Spinal cord injury (SCI) is a neurological condition that significantly impacts a person's lifestyle, health and well-being. Many individuals with SCI experience secondary musculoskeletal shoulder pain. This scoping review examines the current research on the diagnosis and management of shoulder pain in SCI. OBJECTIVE The aim of this Scoping Review was (1) to chart peer-reviewed literature regarding the diagnosis and management of shoulder pain as it relates to SCI and (2) identify gaps in this body of literature to inform future research priorities. METHODS Six electronic databases were searched from inception until April 2022. In addition, reviewers scanned the reference lists of identified articles. Articles from peer-reviewed sources that reported diagnostic or management procedures for musculoskeletal shoulder conditions within the SCI population were considered and 1679 articles were identified. Title and abstract screening, full text review, and data extraction were undertaken by two independent reviewers. RESULTS Eighty seven articles were included, covering diagnosis or management of shoulder pain in SCI. CONCLUSION Whilst the most commonly reported diagnostic procedures and management strategies reflect contemporary practice for shoulder pain, the entire body of literature demonstrates inconsistencies in methodologies. In places, the literature continues to perceive value in procedures inconsistent with best practice. These findings encourage researchers to pursue the development of robust models of care for musculoskeletal shoulder pain in SCI using a collaborative and integrated approach, combining best practice for musculoskeletal shoulder pain alongside clinical expertise in the management of SCI.
Collapse
Affiliation(s)
- Jordan G. A. Keightley
- National School of Nursing, Midwifery, Health Sciences and Physiotherapy, The University of Notre Dame Australia, Fremantle, Western Australia, Australia
- Active Linc (Home Based Services), Innaloo, Western Australia, Australia
| | - Bianca Haagman
- National School of Nursing, Midwifery, Health Sciences and Physiotherapy, The University of Notre Dame Australia, Fremantle, Western Australia, Australia
- Active Linc (Home Based Services), Innaloo, Western Australia, Australia
| | - Julie D. Magner
- Active Linc (Home Based Services), Innaloo, Western Australia, Australia
| | - James R. Debenham
- National School of Nursing, Midwifery, Health Sciences and Physiotherapy, The University of Notre Dame Australia, Fremantle, Western Australia, Australia
- Active Linc (Home Based Services), Innaloo, Western Australia, Australia
- Majarlin Kimberley Centre for Remote Health, The University of Notre Dame Australia, Broome, Western Australia, Australia
| |
Collapse
|
3
|
Fell JD, Medina-Aguiñaga D, Burke DA, Hubscher CH. Impact of Activity-Based Training on Bowel Function in a Rat Model of Spinal Cord Injury. J Neurotrauma 2024; 41:1181-1195. [PMID: 38117145 DOI: 10.1089/neu.2023.0486] [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: 12/21/2023] Open
Abstract
Significant bowel-related issues after spinal cord injury (SCI) that affect morbidity and quality of life (QOL) include diminished bowel motility, loss of sphincter control, gastric ulcers, autonomic dysreflexia, pain, diarrhea, constipation, and fecal incontinence. Clinical diagnoses and research in humans have largely relied on anorectal manometry (ARM) procedures to increase understanding of the functional effects of SCI on colorectal motility and defecation physiology. Recent pre-clinical rodent studies have also used ARM to further our understanding of bowel-related dysfunctions post-SCI. In the present study, the benefits of different activity-based training (ABT) durations on bowel function were examined. Six groups of male rats including two non-training (NT; uninjured and SCI) and four ABT (quadrupedal [Quad or Q] stepping on a treadmill) groups. All ABT animals received 4 weeks of 1-h daily stepping beginning 2 weeks post-SCI followed by variable amounts for 4 additional weeks (none; daily; once a week; daily for final 4th week only). Outcome measures included fecal output (home cage; metabolic cage) throughout the study and terminal measurements (post 8-week ABT) of external anal sphincter (EAS) electromyography, resting anorectal pressure, and giant contraction (GC) activation under urethane anesthesia. The results indicate that treadmill training normalized defecation amount based on feces weight and food intake, as well as GC frequency, EAS latency and amplitude during fecal expulsion, and resting pressure in specific areas within the colorectum. The two intermittent training groups consistently showed recorded metrics comparable to the non-injured group. The results demonstrate bowel dysfunction in the rodent SCI contusion model with improvements in functional outcomes following ABT. Importantly, the benefits to bowel-related functions with versus without intermittent ABT illustrate the need for periodic therapy to maintain the functional gains of ABT.
Collapse
Affiliation(s)
- Jason D Fell
- Department of Anatomical Sciences and Neurobiology, University of Louisville School of Medicine, Louisville, Kentucky, USA
| | - Daniel Medina-Aguiñaga
- Department of Anatomical Sciences and Neurobiology, University of Louisville School of Medicine, Louisville, Kentucky, USA
| | - Darlene A Burke
- Kentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, Kentucky, USA
| | - Charles H Hubscher
- Department of Anatomical Sciences and Neurobiology, University of Louisville School of Medicine, Louisville, Kentucky, USA
- Kentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, Kentucky, USA
| |
Collapse
|
4
|
Rana S, Alom F, Martinez RC, Fuller DD, Mickle AD. Acute ampakines increase voiding function and coordination in a rat model of SCI. eLife 2024; 12:RP89767. [PMID: 38451184 PMCID: PMC10962400 DOI: 10.7554/elife.89767] [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] [Indexed: 03/08/2024] Open
Abstract
Neurogenic bladder dysfunction causes urological complications and reduces the quality of life in persons with spinal cord injury (SCI). Glutamatergic signaling via AMPA receptors is fundamentally important to the neural circuits controlling bladder voiding. Ampakines are positive allosteric modulators of AMPA receptors that can enhance the function of glutamatergic neural circuits after SCI. We hypothesized that ampakines can acutely stimulate bladder voiding that has been impaired due to thoracic contusion SCI. Adult female Sprague-Dawley rats received a unilateral contusion of the T9 spinal cord (n = 10). Bladder function (cystometry) and coordination with the external urethral sphincter (EUS) were assessed 5 d post-SCI under urethane anesthesia. Data were compared to responses in spinal-intact rats (n = 8). The 'low-impact' ampakine CX1739 (5, 10, or 15 mg/kg) or vehicle (2-hydroxypropyl-beta-cyclodextrin [HPCD]) was administered intravenously. The HPCD vehicle had no discernible impact on voiding. In contrast, following CX1739, the pressure threshold for inducing bladder contraction, voided volume, and the interval between bladder contractions were significantly reduced. These responses occurred in a dose-dependent manner. We conclude that modulating AMPA receptor function using ampakines can rapidly improve bladder-voiding capability at subacute time points following contusion SCI. These results may provide a new and translatable method for therapeutic targeting of bladder dysfunction acutely after SCI.
Collapse
Affiliation(s)
- Sabhya Rana
- Department of Physical Therapy, University of FloridaGainesvilleUnited States
- McKnight Brain Institute, University of FloridaGainesvilleUnited States
- Breathing Research and Therapeutics CenterGainesvilleUnited States
| | - Firoj Alom
- Department of Physiological Sciences, College of Veterinary Medicine, University of FloridaGainesvilleUnited States
- Department of Veterinary and Animal Sciences, University of RajshahiRajshahiBangladesh
| | - Robert C Martinez
- Department of Physical Therapy, University of FloridaGainesvilleUnited States
- McKnight Brain Institute, University of FloridaGainesvilleUnited States
- Breathing Research and Therapeutics CenterGainesvilleUnited States
| | - David D Fuller
- Department of Physical Therapy, University of FloridaGainesvilleUnited States
- McKnight Brain Institute, University of FloridaGainesvilleUnited States
- Breathing Research and Therapeutics CenterGainesvilleUnited States
| | - Aaron D Mickle
- McKnight Brain Institute, University of FloridaGainesvilleUnited States
- Department of Physiological Sciences, College of Veterinary Medicine, University of FloridaGainesvilleUnited States
- Department of Veterinary and Animal Sciences, University of RajshahiRajshahiBangladesh
- J. Crayton Pruitt Family Department of Biomedical Engineering, College of Engineering, University of FloridaGainesvilleUnited States
| |
Collapse
|
5
|
Morgan KA, Paton S, Patten A, Tucker S, Walker K. Community-based exercise goals of persons with spinal cord injury: Interpreted using the International Classification of Functioning, Disability, and Health. J Spinal Cord Med 2024; 47:229-238. [PMID: 34698620 PMCID: PMC10885771 DOI: 10.1080/10790268.2021.1970896] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
OBJECTIVE To identify goals for exercising among community-dwelling persons with spinal cord injury (PwSCI). DESIGN Qualitative descriptive study. SETTING Community-based exercise facility for persons with a disability. PARTICIPANTS Fifty-five PwSCI identified their exercise goals prior to participation in a community-based exercise intervention. INTERVENTIONS None. OUTCOME MEASURES A modified version of the Canadian Occupational Performance Measure was used to ask about exercise goals. The International Classification of Functioning, Disability, and Health (ICF) was used to code the goals for themes. RESULTS The participants were predominantly male (76%) and Black (56%) with thoracic-level injury (51%) and a mean age of 39.44 (standard deviation [SD] 13.62). A total of 231 goals (mean 4.2 goals per participant; SD 1.25) were identified. Participants rated their performance and satisfaction with their goals as 4.256 (SD 1.55) and 3.57 (SD 1.67), respectively. Participants most frequently reported goals related to endurance, muscle strengthening, weight loss, activities of daily living, transferring, and home and community mobility. The most commonly reported goals fell into five ICF domains: Functions of Cardiovascular, Hematological, Immunological, and Respiratory Systems; Neuromusculoskeletal and Movement-Related Functions; Structures Related to Movement; Mobility; and Self-Care. CONCLUSION PwSCI have goals they would like to achieve through participation in exercise. The goals are multifaceted and encompass improving health and fitness as well as improving performance in everyday activities such as transferring and mobility. Identifying themes of goals for PwSCI to achieve through exercise is an important step in developing programs and interventions needed to support PwSCI living in the community.
Collapse
Affiliation(s)
- Kerri A. Morgan
- Washington University in St. Louis, School of Medicine, St. Louis, Missouri, USA
| | - Samantha Paton
- Washington University in St. Louis, School of Medicine, St. Louis, Missouri, USA
| | - Anna Patten
- Washington University in St. Louis, School of Medicine, St. Louis, Missouri, USA
| | - Susan Tucker
- Washington University in St. Louis, School of Medicine, St. Louis, Missouri, USA
| | - Kimberly Walker
- Washington University in St. Louis, School of Medicine, St. Louis, Missouri, USA
| |
Collapse
|
6
|
Mashola MK, Korkie E, Mothabeng DJ. Exploring the Experience of Living with Pain after Spinal Cord Injury: A Qualitative Study. Behav Neurol 2024; 2024:9081530. [PMID: 38343899 PMCID: PMC10857878 DOI: 10.1155/2024/9081530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 12/28/2023] [Accepted: 01/20/2024] [Indexed: 02/15/2024] Open
Abstract
A spinal cord injury is a life-changing experience that results in functional limitations and an increased risk of secondary health conditions. People with spinal cord injury identify pain as the most devastating health problem following their injury that not only affects their social life but their mental well-being as well. This study is aimed at exploring the lived experience of living with pain by community-dwelling manual wheelchair users with spinal cord injuries. An explorative qualitative design was used to explore their experiences. In-depth interviews were recorded and transcribed, and the data were analysed using inductive thematic content analysis in the MAXQDA v2020. Fifteen manual wheelchair users with paraplegia participated in this study, and four themes were identified from their experience of living with pain: pain constantly lurks, pain is worse than the direct consequences of the SCI, pain is restrictive, and life continues despite the pain. Categories and subcategories included the participants being one with the pain; pain interfering with sleep; feelings of anger, isolation, and suicidal ideation; and uncertainties about what the future holds living with pain. Living with pain after SCI is a challenging feat, and effective management of pain is necessary to improve not only functioning and mobility but also mental health and life satisfaction.
Collapse
Affiliation(s)
- Mokgadi Kholofelo Mashola
- Department of Physiotherapy, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Elzette Korkie
- Department of Physiotherapy, School of Healthcare Sciences, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Diphale Joyce Mothabeng
- Department of Physiotherapy, School of Healthcare Sciences, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| |
Collapse
|
7
|
Wallen ES, Sippel JL, Park ME, Etingen B, Weaver FM, Hogan TP, Smith BM, Bokhour BG, Wickremasinghe IM. Utilization of whole health services among veterans with spinal cord injuries and disorders (SCI/D): Early insights from the VA SCI/D system of care. J Spinal Cord Med 2024; 47:100-109. [PMID: 37249362 PMCID: PMC10795622 DOI: 10.1080/10790268.2023.2183325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
Abstract
CONTEXT/OBJECTIVE Our objective was to describe early participation in Whole Health programs across the Veterans Health Administration (VHA) Spinal Cord Injuries and Disorders (SCI/D) System of Care. DESIGN Retrospective analysis of VHA administrative data. SETTING The VHA SCI/D System of Care. PARTICIPANTS Veterans with SCI/D included in the FY2019 cumulative VHA SCI/D Registry cohort with living status during FY2017, FY2018, and FY2019. INTERVENTIONS N/A. OUTCOME MEASURES We assessed the number of encounters and unique Veterans with SCI/D, and the percent of Veterans with SCI/D, who utilized each Whole Health (WH) program available in VA. RESULTS Utilization of WH Pathway and well-being Programs increased from 62 encounters to 1703 encounters between FY2017 and FY2019 (representing 0.09% to 3.13% of Veterans with SCI/D). Utilization of chiropractic care rose from 130 encounters to 418 encounters during the same time period. Similarly, utilization of complementary and integrative health programs increased from 886 encounters to 2655 encounters (representing 1.09% to 3.11% of Veterans; FY2017 to 2019). We also report utilization of specific WH programs. CONCLUSION Participation in WH services has been increasing among Veterans with SCI/D who receive health care from the VHA SCI/D System of Care. However, utilization among Veterans with SCI/D remains low overall, and targeted efforts to increase WH program reach are needed. Additional information about the relative effectiveness of different strategies to support WH implementation is also needed, to ensure strategies likely to have the most impact are prioritized.
Collapse
Affiliation(s)
- Erik S. Wallen
- Spinal Cord Injuries and Disorders National Program Office, Veterans Health Administration, Washington, DC, USA
| | - Jennifer L. Sippel
- Spinal Cord Injuries and Disorders National Program Office, Veterans Health Administration, Washington, DC, USA
| | - Meaghan E. Park
- Spinal Cord Injuries and Disorders National Program Office, Veterans Health Administration, Washington, DC, USA
| | - Bella Etingen
- Center of Innovation for Complex Chronic Healthcare (CINCCH), Edward Hines Jr. VA Hospital, Hines, Illinois, USA
| | - Frances M. Weaver
- Center of Innovation for Complex Chronic Healthcare (CINCCH), Edward Hines Jr. VA Hospital, Hines, Illinois, USA
- Public Health Sciences, Parkinson School of Health Sciences and Public Health, Loyola University, Maywood, Illinois, USA
| | - Timothy P. Hogan
- Center for Healthcare Organization and Implementation Research (CHOIR), VA Bedford Healthcare System, Bedford, Massachusetts, USA
- Department of Population and Data Sciences, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Bridget M. Smith
- Center of Innovation for Complex Chronic Healthcare (CINCCH), Edward Hines Jr. VA Hospital, Hines, Illinois, USA
- Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Barbara G. Bokhour
- Center for Healthcare Organization and Implementation Research (CHOIR), VA Bedford Healthcare System, Bedford, Massachusetts, USA
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Itala M. Wickremasinghe
- Spinal Cord Injuries and Disorders National Program Office, Veterans Health Administration, Washington, DC, USA
| |
Collapse
|
8
|
Patsakos EM, Bailey KA, Ditor DS. Exploring the Lived Experiences of Individuals With Spinal Cord Injury During the COVID-19 Pandemic. INQUIRY : A JOURNAL OF MEDICAL CARE ORGANIZATION, PROVISION AND FINANCING 2024; 61:469580241226827. [PMID: 38263725 PMCID: PMC10807388 DOI: 10.1177/00469580241226827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 12/09/2023] [Accepted: 01/02/2024] [Indexed: 01/25/2024]
Abstract
The global spread of severe acute respiratory syndrome coronavirus 2019 (COVID-19) has affected over 100 countries and has led to the tragic loss of life, overwhelmed health care systems and severely impacted the global economy. Specifically, individuals living with spinal cord injury (SCI) are particularly vulnerable during the COVID-19 pandemic as they often face adverse impacts on their health, emotional well-being, community participation, and life expectancy. The objective of this study was to investigate the lived experience of individuals with SCI during the COVID-19 pandemic in Ontario, Canada. An exploratory design with a qualitative descriptive approach was used to address the study objective. Nine semi-structured interviews were conducted with individuals with traumatic and non-traumatic SCI (37-69 years, C3-L5, AIS A-D, and 5-42 years post-injury). Using reflexive thematic analysis, the following themes were created: (1) Caregiver exposure to COVID-19; (2) Staying physically active in quarantine; (3) Living in social isolation; (4) Difficulty obtaining necessary medical supplies; (5) Access to health services and virtual care during COVID-19; and (6) Fighting COVID-19 misinformation. This is one of the first studies to explore the impact of COVID-19 on individuals living with SCI in Ontario. This study contributes to a greater understanding of the challenges faced by individuals living with SCI and provides insight into how to better support and respond to the specific and unique needs of individuals with SCI and their families during a national emergency or pandemic.
Collapse
Affiliation(s)
| | | | - David S. Ditor
- Brock University, St. Catharines, ON, Canada
- Brock-Niagara Centre for Health and Well-being, St. Catharines, ON, Canada
| |
Collapse
|
9
|
Tijsse Klasen J, van Diemen T, Langerak NG, van Nes IJW. Effects of Adaptations in an Interdisciplinary Follow-Up Clinic for People with Spinal Cord Injury in the Chronic Phase: A Prospective Cohort Study. J Clin Med 2023; 12:7572. [PMID: 38137640 PMCID: PMC10744320 DOI: 10.3390/jcm12247572] [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: 11/01/2023] [Revised: 11/30/2023] [Accepted: 12/03/2023] [Indexed: 12/24/2023] Open
Abstract
People with spinal cord injury (SCI) often experience secondary health conditions (SHCs), which are addressed during interdisciplinary follow-up clinics. We adapted the design of our clinic, by introducing a questionnaire concerning functioning and SHCs, additional measurements of blood pressure and saturation, and participants were seen by either a specialized nurse or rehabilitation physician. In this study, we investigated the effects of these adaptations and the experienced satisfaction of the participants. The results showed an increased number of recommendations in the adapted design, compared to the initial design. Further, the nature of the recommendations shifted from somatic issues to recommendations regarding psychosocial functioning and regarding (the use of) devices. The added measurements revealed an average high systolic blood pressure, which led to more referrals to the general practitioner. The clinical weight and pulmonary functions stayed stable over time. The current adaptations in design expanded and optimized the number and nature of recommendations regarding SHCs to participants. The questionnaire helps the participant to prepare for the clinic and the professionals to tailor their recommendations, resulting in highly satisfied participants.
Collapse
Affiliation(s)
- Julia Tijsse Klasen
- Department of Rehabilitation Medicine, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands; (J.T.K.); (I.J.W.v.N.)
| | - Tijn van Diemen
- Department of Spinal Cord Injury Rehabilitation, Sint Maartenskliniek, 6500 GM Nijmegen, The Netherlands
- Department of Research, Sint Maartenskliniek, 6500 GM Nijmegen, The Netherlands;
| | - Nelleke G. Langerak
- Department of Research, Sint Maartenskliniek, 6500 GM Nijmegen, The Netherlands;
| | - Ilse J. W. van Nes
- Department of Rehabilitation Medicine, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands; (J.T.K.); (I.J.W.v.N.)
- Department of Spinal Cord Injury Rehabilitation, Sint Maartenskliniek, 6500 GM Nijmegen, The Netherlands
| |
Collapse
|
10
|
Rana S, Alom F, Martinez RC, Fuller DD, Mickle AD. Acute ampakines increase voiding function and coordination in a rat model of SCI. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.05.26.542339. [PMID: 37293023 PMCID: PMC10245998 DOI: 10.1101/2023.05.26.542339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Neurogenic bladder dysfunction causes urological complications and reduces the quality of life in persons with spinal cord injury (SCI). Glutamatergic signaling via AMPA receptors is fundamentally important to the neural circuits controlling bladder voiding. Ampakines are positive allosteric modulators of AMPA receptors that can enhance the function of glutamatergic neural circuits after SCI. We hypothesized that ampakines can acutely stimulate bladder voiding that has been impaired due to thoracic contusion SCI. Adult female Sprague Dawley rats received a unilateral contusion of the T9 spinal cord (n=10). Bladder function (cystometry) and coordination with the external urethral sphincter (EUS) were assessed five days post-SCI under urethane anesthesia. Data were compared to responses in spinal intact rats (n=8). The "low impact" ampakine CX1739 (5, 10, or 15 mg/kg) or vehicle (HPCD) was administered intravenously. The HPCD vehicle had no discernable impact on voiding. In contrast, following CX1739, the pressure threshold for inducing bladder contraction, voided volume, and the interval between bladder contractions were significantly reduced. These responses occurred in a dose-dependent manner. We conclude that modulating AMPA receptor function using ampakines can rapidly improve bladder voiding capability at sub-acute time points following contusion SCI. These results may provide a new and translatable method for therapeutic targeting of bladder dysfunction acutely after SCI.
Collapse
Affiliation(s)
- Sabhya Rana
- Department of Physical Therapy, University of Florida, Gainesville, FL, 32610
- McKnight Brain Institute, University of Florida, Gainesville, FL, 32610
- Breathing Research and Therapeutics Center, Gainesville, FL, 32610
| | - Firoj Alom
- Department of Physiological Sciences, College of Veterinary Medicine, University of Florida
- Department of Veterinary and Animal Sciences, University of Rajshahi, Rajshahi
| | - Robert C Martinez
- Department of Physical Therapy, University of Florida, Gainesville, FL, 32610
- McKnight Brain Institute, University of Florida, Gainesville, FL, 32610
- Breathing Research and Therapeutics Center, Gainesville, FL, 32610
| | - David D Fuller
- Department of Physical Therapy, University of Florida, Gainesville, FL, 32610
- McKnight Brain Institute, University of Florida, Gainesville, FL, 32610
- Breathing Research and Therapeutics Center, Gainesville, FL, 32610
| | - Aaron D Mickle
- McKnight Brain Institute, University of Florida, Gainesville, FL, 32610
- Department of Physiological Sciences, College of Veterinary Medicine, University of Florida
- Department of Veterinary and Animal Sciences, University of Rajshahi, Rajshahi
- J. Crayton Pruitt Family Department of Biomedical Engineering, College of Engineering, University of Florida
| |
Collapse
|
11
|
Poublon CG, Scholten EWM, Wyndaele MIA, Post MWM, Stolwijk-Swüste JM. Changes in bladder emptying during inpatient rehabilitation after spinal cord injury and predicting factors: data from the Dutch Spinal Cord Injury Database. Spinal Cord 2023; 61:624-631. [PMID: 37608226 DOI: 10.1038/s41393-023-00925-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 07/24/2023] [Accepted: 08/02/2023] [Indexed: 08/24/2023]
Abstract
STUDY DESIGN Secondary analysis of multicentre prospective observational data. OBJECTIVES To describe methods of bladder emptying at admission and discharge in patients with recently acquired spinal cord injury (SCI) and to describe predictors of bladder emptying methods at discharge. SETTING First inpatient rehabilitation in specialised rehabilitation centres in the Netherlands. METHODS Data from the Dutch Spinal Cord Injury Database collected between 2015 and 2019 were used. McNemar-Bowker test was used to evaluate if bladder emptying methods differed over time; One-Way ANOVA and Chi-Square tests to see if bladder emptying methods differed by demographic and injury-related characteristics. Binary logistic regression was used to predict the type of bladder emptying at discharge with demographic and injury-related characteristics measured at admission. RESULTS Of 1403 patients, 44.1% had cervical, 38.4% thoracic and 17.5% lumbosacral lesions at admission. AIS classification was mostly D (63.8%). The method of bladder emptying changed significantly (p < 0.001) from admission to discharge: decrease of clean intermittent assisted catheterisation (17.1% to 4.1%) and indwelling catheter (33.4% to 16.3%) and increase in clean intermittent self-catheterisation (CISC, 7.8% to 22.2%) and normal voiding (40.2% to 56.1%). Age, sex, SCI level, AIS classification and level of independence predicted the method of bladder emptying at discharge (all p < 0.001). CONCLUSIONS During first inpatient rehabilitation, the method of bladder emptying changed resulting in more patients discharged with normal voiding and CISC. Age, sex, SCI level, AIS classification and level of independence in self-care were all confirmed as factors playing a role in this change.
Collapse
Affiliation(s)
- Claire G Poublon
- Centre of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Centre, University Medical Centre Utrecht, and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Eline W M Scholten
- Centre of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Centre, University Medical Centre Utrecht, and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Michel I A Wyndaele
- Department of Urology, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Marcel W M Post
- Centre of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Centre, University Medical Centre Utrecht, and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
- University of Groningen, University Medical Centre Groningen, Department of Rehabilitation Medicine, Groningen, the Netherlands
| | - Janneke M Stolwijk-Swüste
- Centre of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Centre, University Medical Centre Utrecht, and De Hoogstraat Rehabilitation, Utrecht, The Netherlands.
| |
Collapse
|
12
|
Vos-Draper TL, Morrow MMB, Ferguson JE, Mathiowetz VG. Effects of Real-Time Pressure Map Feedback on Confidence in Pressure Management in Wheelchair Users With Spinal Cord Injury: Pilot Intervention Study. JMIR Rehabil Assist Technol 2023; 10:e49813. [PMID: 37824188 PMCID: PMC10603555 DOI: 10.2196/49813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 08/31/2023] [Accepted: 09/08/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND Wheelchair users with a spinal cord injury (SCI) are at a high risk for developing pressure injuries (PIs). Performing weight shifts is a primary method of pressure management for PI prevention; however, individuals with SCI may lack confidence in their abilities to perform adequate pressure relief due to their lack of sensation. Real-time seat interface pressure mapping feedback may provide partial substitution for sensory feedback such that an individual's confidence is improved. OBJECTIVE We aim to examine how confidence for pressure management by wheelchair users with SCI was impacted by providing access to real-time, on-demand seat interface pressure mapping feedback. METHODS Adults with SCI (N=23) completed self-efficacy questions addressing confidence around 4 factors related to performing weight shifts in this longitudinal, repeated-measures study. We evaluated the impact of providing standard PI prevention education and access to live pressure map feedback on confidence levels for performing weight shifts. RESULTS Access to live pressure map feedback while learning how to perform weight shifts resulted in significantly higher confidence about moving far enough to relieve pressure at high-risk areas. Confidence for adhering to the recommended weight shift frequency and duration was not significantly impacted by in-clinic education or use of pressure map feedback. Confidence that performing weight shifts reduces PI risk increased most following education, with slight additional increase when pressure map feedback was added. CONCLUSIONS Access to live pressure mapping feedback improves confidence about performing weight shifts that relieve pressure when provided in the clinical setting and demonstrates potential for the same in the home. This preliminary exploration of a smartphone-based pressure mapping intervention highlights the value of access to continuous pressure mapping feedback to improve awareness and confidence for managing pressure. TRIAL REGISTRATION ClinicalTrials.gov NCT03987243; https://clinicaltrials.gov/study/NCT03987243.
Collapse
Affiliation(s)
- Tamara L Vos-Draper
- Center for Allied Health Professions, Program in Occupational Therapy, University of Minnesota, Minneapolis, MN, United States
- Division of Rehabilitation Science, Department of Rehabilitation Medicine, University of Minnesota, Minneapolis, MN, United States
| | - Melissa M B Morrow
- School of Health Professions, Center for Health Promotion, Performance, and Rehabilitation Research, University of Texas Medical Branch, Galveston, TX, United States
| | - John E Ferguson
- Division of Rehabilitation Science, Department of Rehabilitation Medicine, University of Minnesota, Minneapolis, MN, United States
- Division of Physical Medicine & Rehabilitation, Department of Rehabilitation Medicine, University of Minnesota, Minneapolis, MN, United States
- Minneapolis Veterans Affairs Health Care System, Minneapolis, MN, United States
| | - Virgil G Mathiowetz
- Center for Allied Health Professions, Program in Occupational Therapy, University of Minnesota, Minneapolis, MN, United States
- Division of Rehabilitation Science, Department of Rehabilitation Medicine, University of Minnesota, Minneapolis, MN, United States
| |
Collapse
|
13
|
Hong HA, Fallah N, Wang D, Cheng CL, Humphreys S, Parsons J, Noonan VK. Multimorbidity in persons with non-traumatic spinal cord injury and its impact on healthcare utilization and health outcomes. Spinal Cord 2023; 61:483-491. [PMID: 37604933 DOI: 10.1038/s41393-023-00915-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 05/24/2023] [Accepted: 07/12/2023] [Indexed: 08/23/2023]
Abstract
STUDY DESIGN Cross-sectional survey in Canada. OBJECTIVES To explore multimorbidity (the coexistence of two/more health conditions) in persons with non-traumatic spinal cord injury (NTSCI) and evaluate its impact on healthcare utilization (HCU) and health outcomes. SETTING Community-dwelling persons. METHODS Data from the Spinal Cord Injury Community Survey (SCICS) was used. A multimorbidity index (MMI) consisting of 30 secondary health conditions (SHCs), the 7-item HCU questionnaire, the Short Form-12 (SF-12), Life Satisfaction-11 first question, and single-item Quality of Life (QoL) measure were administered. Additionally, participants were grouped as "felt needed healthcare was received" (Group 1, n = 322) or "felt needed healthcare was not received" (Group 2, n = 89) using the HCU question. Associations among these variables were assessed using multivariable analysis. RESULTS 408 of 412 (99%) participants with NTSCI reported multimorbidity. Constipation, spasticity, and fatigue were the most prevalent self-reported SHCs. Group 1 had a higher MMI score compared to Group 2 (p < 0.001). A higher MMI score correlated with the feeling of not receiving needed care (OR 1.4, 95% CI 1.08-1.21), lower SF-12 (physical/mental component summary scores), being unsatisfied with life, and lower QoL (all p < 0.001). Additionally, Group 1 had more females (p < 0.001), non-Caucasians (p = 0.034), and lower personal annual income (p = 0.025). CONCLUSIONS Persons with NTSCI have multimorbidity, and the MMI score was associated with increased HCU and worse health outcomes. This work emphasizes the critical need for improved healthcare and monitoring. Future work determining specific thresholds for the MMI could be helpful for triage screening to identify persons at higher risk of poor outcomes.
Collapse
Affiliation(s)
- Heather A Hong
- Praxis Spinal Cord Institute, Vancouver, British Columbia, Canada
| | - Nader Fallah
- Praxis Spinal Cord Institute, Vancouver, British Columbia, Canada
- Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Di Wang
- Praxis Spinal Cord Institute, Vancouver, British Columbia, Canada
| | | | | | - Jessica Parsons
- Praxis Spinal Cord Institute, Vancouver, British Columbia, Canada
| | - Vanessa K Noonan
- Praxis Spinal Cord Institute, Vancouver, British Columbia, Canada.
- International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, British Columbia, Canada.
| |
Collapse
|
14
|
Ejtehadi M, Amrein S, Hoogland IE, Riener R, Paez-Granados D. Learning Activities of Daily Living from Unobtrusive Multimodal Wearables: Towards Monitoring Outpatient Rehabilitation. IEEE Int Conf Rehabil Robot 2023; 2023:1-6. [PMID: 37941240 DOI: 10.1109/icorr58425.2023.10304743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
Monitoring activities of daily living (ADLs) for wheelchair users, particularly spinal cord injury individuals is important for understanding the rehabilitation progress, customizing treatment plans, and observing the onset of secondary health conditions. This work proposes an innovative sensory system for measuring and classifying ADLs relevant to secondary health conditions. We systematically evaluated multiple wearable sensors such as pressure distribution mats on the wheelchair seat, accelerometer data from the ear and wrists, and IMU data from the wheelchair wheels to achieve the best unobtrusive combination of sensors that successfully distinguished ADLs. Our work resulted in an XGBoost classifier with a 20-second window size and extracted features in statistical, time, frequency, and wavelet domains, with an average class-wise F1 score of 82% (with only 3 out of 12 classes being mislabeled). Our study results demonstrate that the newly investigated modality of the bottom pressure mat emerges as the most relevant information source for recognizing ADLs, while heart and respiratory rates did not provide added value for the selected set of ADLs. The proposed sensory system and methodology proved high quality in most classes and easily extendable for long-term monitoring in outpatient rehabilitation, with the need for an extended database of activities.
Collapse
|
15
|
Nuechterlein A, Feng L, Yehia A, Illes J. Strengths, gaps, and future directions on the landscape of ethics-related research for spinal cord injury. Spinal Cord 2023; 61:477-482. [PMID: 37072509 PMCID: PMC10495258 DOI: 10.1038/s41393-023-00897-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: 11/15/2022] [Revised: 03/24/2023] [Accepted: 03/30/2023] [Indexed: 04/20/2023]
Abstract
Spinal cord injury (SCI) affects between 250,000-500,000 people globally each year. While the medical aspects of SCI have received considerable attention in the academic literature, discourse pertaining to its ethical implications is more limited. The experience of SCI is shaped by intersecting demographic and identity factors such as gender, race, and culture that necessitate an intersectional and value-based approach to ethics-related research that is properly situated in context. Given this background, we conducted a content analysis of academic studies exploring the perspectives and priorities of individuals with SCI published in peer-reviewed journals in the decade between 2012-2021. Terms pertaining to SCI and ethics were combined in a search of two major publication databases. We documented overall publication patterns, recruitment and research methods, reporting of demographic variables, and ethics-related discourse. Seventy (70) papers met inclusion criteria and were categorized by their major foci. Findings reveal a gap in reporting of participant demographics, particularly with respect to race and ethnicity, geographic background, and household income. We discuss these person-centered themes and gaps that must be closed in the reporting and supporting of SCI research.
Collapse
Affiliation(s)
- Anna Nuechterlein
- Neuroethics Canada, Division of Neurology, Department of Medicine, University of British Columbia, 2211 Wesbrook Mall, Koerner S124, Vancouver, BC, V6T 2B5, Canada
| | - Lydia Feng
- Neuroethics Canada, Division of Neurology, Department of Medicine, University of British Columbia, 2211 Wesbrook Mall, Koerner S124, Vancouver, BC, V6T 2B5, Canada
| | - Alaa Yehia
- Neuroethics Canada, Division of Neurology, Department of Medicine, University of British Columbia, 2211 Wesbrook Mall, Koerner S124, Vancouver, BC, V6T 2B5, Canada
| | - Judy Illes
- Neuroethics Canada, Division of Neurology, Department of Medicine, University of British Columbia, 2211 Wesbrook Mall, Koerner S124, Vancouver, BC, V6T 2B5, Canada.
| |
Collapse
|
16
|
de Vries WHK, van der Slikke RMA, van Dijk MP, Arnet U. Real-Life Wheelchair Mobility Metrics from IMUs. SENSORS (BASEL, SWITZERLAND) 2023; 23:7174. [PMID: 37631711 PMCID: PMC10458841 DOI: 10.3390/s23167174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 08/02/2023] [Accepted: 08/09/2023] [Indexed: 08/27/2023]
Abstract
Daily wheelchair ambulation is seen as a risk factor for shoulder problems, which are prevalent in manual wheelchair users. To examine the long-term effect of shoulder load from daily wheelchair ambulation on shoulder problems, quantification is required in real-life settings. In this study, we describe and validate a comprehensive and unobtrusive methodology to derive clinically relevant wheelchair mobility metrics (WCMMs) from inertial measurement systems (IMUs) placed on the wheelchair frame and wheel in real-life settings. The set of WCMMs includes distance covered by the wheelchair, linear velocity of the wheelchair, number and duration of pushes, number and magnitude of turns and inclination of the wheelchair when on a slope. Data are collected from ten able-bodied participants, trained in wheelchair-related activities, who followed a 40 min course over the campus. The IMU-derived WCMMs are validated against accepted reference methods such as Smartwheel and video analysis. Intraclass correlation (ICC) is applied to test the reliability of the IMU method. IMU-derived push duration appeared to be less comparable with Smartwheel estimates, as it measures the effect of all energy applied to the wheelchair (including thorax and upper extremity movements), whereas the Smartwheel only measures forces and torques applied by the hand at the rim. All other WCMMs can be reliably estimated from real-life IMU data, with small errors and high ICCs, which opens the way to further examine real-life behavior in wheelchair ambulation with respect to shoulder loading. Moreover, WCMMs can be applied to other applications, including health tracking for individual interest or in therapy settings.
Collapse
Affiliation(s)
| | - Rienk M. A. van der Slikke
- Department of Biomechanical Engineering, Delft University of Technology, 2628 Delft, The Netherlands; (R.M.A.v.d.S.); (M.P.v.D.)
- Human Kinetic Technology, The Hague University of Applied Sciences, 2521 The Hague, The Netherlands
| | - Marit P. van Dijk
- Department of Biomechanical Engineering, Delft University of Technology, 2628 Delft, The Netherlands; (R.M.A.v.d.S.); (M.P.v.D.)
| | - Ursina Arnet
- Swiss Paraplegic Research, Guido A. Zächstrasse 4, 6207 Nottwil, Switzerland;
| |
Collapse
|
17
|
Ciardi G, Lamberti G, Tidona A. Italian translation and reliability of Fist-Sci Scale for chronic paraplegic patients: an observational study. ACTA BIO-MEDICA : ATENEI PARMENSIS 2023; 94:e2023131. [PMID: 37326268 PMCID: PMC10308477 DOI: 10.23750/abm.v94i3.14154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 05/19/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND AND AIM Lack of trunk control following spinal cord injury implicates a worse quality of life and a higher dependence on caregivers; literature proposes several evaluation scales, but studies show poor methodological quality. This study aimed to translate and explore the significance of the Italian version of the FIST-SCI scale for chronic spinal cord injury patients. METHODS A longitudinal cohort study was conducted at Fiorenzuola D'Arda Hospital. After a forward/backward translation of the FIST-SCI scale in Italian content and face translational validity, intervalutator reliability was assessed. Patients were recruited by historical tracking of patients who received acute rehabilitation care at the Villanova D'Arda Spinal Unit. Two researchers administered the FIST-SCI scale to the same patients at the follow-up. RESULTS Ten patients took part in the study; results showed that higher inter-rater correlation coefficient (Pearson's R= 0.89, p= 0.01 Intra-class correlation coefficient= 0.94, p=0.000). Content validity was also excellent (Scale Content Validity Index = 0.91); some experts suggested future scale developments. DISCUSSION Italian FIST-SCI scale for assessing trunk control in chronic spinal patients appears to be an excellent assessment tool concerning intervalutator reliability. Content validity further confirms the validity of the instrument.
Collapse
Affiliation(s)
- Gianluca Ciardi
- Physiotherapy degree course- University of Parma/ Azienda Usl Piacenza .
| | | | - Alessia Tidona
- Physiotherapy degree course student- University of Parma.
| |
Collapse
|
18
|
Desai RH, Kiserow R, Mullings A, Smith M, Tucker S, Eyler A, Stark S, Morgan K. Exploring the Perspectives of Adults Aging With Long-Term Physical Disabilities on Physical Activity: A Qualitative Study. Am J Health Promot 2023; 37:654-663. [PMID: 36624040 PMCID: PMC10468916 DOI: 10.1177/08901171221151123] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND Adults aging with long-term physical disabilities (AAwPD) face personal and environmental barriers to living independently, but little is known about their perspectives on and experiences with physical activity (PA). PURPOSE The purpose of this study was to explore the perspectives of AAwPD on PA. RESEARCH DESIGN Qualitative semi-structured interviews with AAwPD were conducted virtually via phone or videoconference. STUDY SAMPLE A convenience sample of AAwPD aged 45-65 and living with a physical disability for at least 5 years was recruited through aging organizations, disability organizations, and social media in St. Louis, Missouri until thematic saturation was reached (n = 20). DATA COLLECTION AND ANALYSIS Participants were asked semi-structured interview questions about their perspectives and experiences with PA following an interview guide developed by disability, aging, and qualitative research experts. Data were analyzed using text analysis in NVivo 12. Codes were developed into themes by the research team and validated using member checking methods. RESULTS Four themes emerged from the data: barriers and facilitators to engaging in PA, motivations and beliefs regarding PA, benefits of PA, and PA routines and habits. Participants reported a desire to engage in more PA but described barriers such as pain and fatigue symptoms, secondary health conditions, lack of social support, and fear of falling. Accessibility of facilities and equipment (eg, lack of ramps or equipment not at wheelchair height) and transportation barriers (eg, inconvenient schedules or excessive wait times) were specifically described as major environmental barriers. CONCLUSION Most participants' reported PA routines did not meet the quantity or intensity levels recommended by current guidelines. These results may help inform healthcare providers, community programs, and future interventions to improve PA levels for AAwPD, an underserved but growing demographic.
Collapse
Affiliation(s)
- Rachel Heeb Desai
- Washington University School of Medicine, Program in Occupational Therapy, St. Louis, MO
| | - Rachel Kiserow
- Washington University School of Medicine, Program in Occupational Therapy, St. Louis, MO
| | - Alicia Mullings
- Washington University School of Medicine, Program in Occupational Therapy, St. Louis, MO
| | - Megan Smith
- Washington University School of Medicine, Program in Occupational Therapy, St. Louis, MO
| | - Susan Tucker
- Washington University School of Medicine, Program in Occupational Therapy, St. Louis, MO
| | - Amy Eyler
- Washington University in St. Louis, Brown School of Public Health, St. Louis, MO
| | - Susan Stark
- Washington University School of Medicine, Program in Occupational Therapy, St. Louis, MO
| | - Kerri Morgan
- Washington University School of Medicine, Program in Occupational Therapy, St. Louis, MO
| |
Collapse
|
19
|
Joseph C, Thurston C, Nizeyimana E, Scriba E, Conradsson DM, Rhoda A. Prevalence of secondary health conditions and mental status in persons with long-term spinal cord injury in South Africa: Comparison between public and private healthcare sectors. S Afr Med J 2023; 113:46-53. [PMID: 37170601 DOI: 10.7196/samj.2023.v113i5.16791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Indexed: 05/13/2023] Open
Abstract
BACKGROUND Spinal cord injuries typically result in a range of negative health outcomes and health states, which impacts overall functioning, health and well-being. It remains important to establish the prevalence (burden) of health outcomes to help with the development of optimal treatment strategies. OBJECTIVES To determine the prevalence and treatment rates of secondary health conditions (SHCs) and mental health states in persons with long-term spinal cord injury (SCI) receiving public compared with private healthcare services in South Africa. METHODS A cross-sectional survey included 200 community-dwelling persons with long-term SCI, 60% with paraplegia, 53% with complete injuries and 156 from the public and 44 from private healthcare sectors. The following modules of the International Spinal Cord Injury (InSCI) community survey were used: (i) demographic and injury characteristics; (ii) SHCs and treatment rates; and (iii) vitality and emotional well-being. All statistical analyses were stratified according to healthcare sector. RESULTS Pain (47% v. 57), sexual dysfunction (59% v. 41%) and muscle spasms (54% v. 43%) were the most common SHCs in both cohorts, and the period prevalence was significantly higher for sleeping problems (41% v. 25%), sexual dysfunction (59% v. 41%) and contractures (42% v. 20%) in the public compared with the private cohort. Persons with SCI in the private cohort received treatment more often for sleeping problems (100% v. 45%), autonomic dysreflexia (75% v. 27%) and pain (56% v. 33%) than their counterparts with public insurance. Negative mental health states were prevalent in both groups. CONCLUSION SHCs and negative mental health were common in persons with SCI in South Africa, while those with public insurance reporter a higher occurrence of sleep problems and contractures, as well as lower treatment rates. Overall, a need exists to better support persons with SCI in the long-term context to facilitate improved functioning and wellbeing.
Collapse
Affiliation(s)
- C Joseph
- Department of Health and Rehabilitation Sciences; Division of Physiotherapy; Stellenbosch University; Cape Town.
| | - C Thurston
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, Sweden.
| | - E Nizeyimana
- Department of Health and Rehabilitation Sciences, Division of Physiotherapy, Stellenbosch University, Cape Town, South Africa.
| | - E Scriba
- Spescare Medical Facility, Stellenbosch, Cape Town.
| | - D M Conradsson
- Women's Health and Allied Health Professionals Theme, Medical Unit Occupational Therapy and Physiotherapy, Karolinska University Hospital, Stockholm, Sweden.
| | - A Rhoda
- Deanery, Faculty of Community and Health Sciences, University of the Western Cape, Cape Town, South Africa.
| |
Collapse
|
20
|
Brinkemper A, Grasmücke D, Yilmaz E, Reinecke F, Schildhauer TA, Aach M. Influence of Locomotion Therapy With the Wearable Cyborg HAL on Bladder and Bowel Function in Acute and Chronic SCI Patients. Global Spine J 2023; 13:668-676. [PMID: 33858209 DOI: 10.1177/21925682211003851] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
STUDY DESIGN Retrospective survey. OBJECTIVES Purpose of this study was to explore whether bowel and bladder management can be influenced by locomotion therapy with HAL Robot Suit. METHODS 35 subjects with acute (< one year since injury, n = 13) or chronic (> one year since injury, n = 22) incomplete paraplegia (American Spinal Injury Association Impairment Scale (AIS) B, n = 1 / AIS C, n = 22 / AIS D, n = 7) or complete paraplegia (AIS A, n = 5) with zones of partial preservation (ZPP) participated. A retrospective survey was carried out asking for bowel incontinence (Wexner Score), constipation (Cleveland Clinic Constipation Scoring System (CCCS)) and bladder function (self-developed questionnaire) before and after completing a training period of 12 weeks with HAL. RESULTS Wexner Score over all patients and for group of chronic patients decreased significantly. For group of acute patients Wexner Score decreased insignificantly. Patients from both groups with higher baseline scores could decrease significantly. CCCS was insignificantly reduced for all patients, group of acute and group of chronic patients. For subgroup of chronic patients with higher baseline scores, CCCS decreased at end of training period missing out significance. The self-developed questionnaire showed an improvement in bladder function in 28.24% of all patients, 31.43% of chronic patients, and 23.08% of acute patients. CONCLUSIONS Our findings show trends of enhanced bladder and bowel function following exoskeleton training. Patients with higher baseline scores in Wexner Score and CCCS seem to benefit more than those with mild to moderate scores.
Collapse
Affiliation(s)
- Alexis Brinkemper
- Department of General and Trauma Surgery, BG University Hospital Bergmannsheil, Bochum, Germany
- *Shared first authorship
| | - Dennis Grasmücke
- Department of Spinal Cord Injuries, BG University Hospital Bergmannsheil, Bochum, Germany
- *Shared first authorship
| | - Emre Yilmaz
- Department of General and Trauma Surgery, BG University Hospital Bergmannsheil, Bochum, Germany
| | - Felix Reinecke
- Department for Trauma, Hand and Reconstructive Surgery, University Hospital Essen Germany, Berlin, Germany
| | | | - Mirko Aach
- Department of Spinal Cord Injuries, BG University Hospital Bergmannsheil, Bochum, Germany
| |
Collapse
|
21
|
Espindula PAV, de Carvalho Bastone A, Paula Santos A. Construct validity and reliability of the participation scale (P-scale) in individuals with spinal cord injury. J Spinal Cord Med 2023:1-8. [PMID: 36913535 DOI: 10.1080/10790268.2023.2183327] [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: 03/15/2023] Open
Abstract
OBJECTIVES To investigate the reliability and the construct validity of the Participation Scale (P-scale) in adults with Spinal Cord Injury (SCI). DESIGN A cross-sectional study. SETTING : SARAH Network of Rehabilitation Hospitals, Brazil. PARTICIPANTS : One hundred individuals with SCI. INTERVENTIONS : Not applicable. OUTCOME MEASURES : Sociodemographic and clinical characteristics were investigated. To assess reliability the P-scale was applied twice with a one-week interval. To assess construct validity the Functional Independence Measure, the Beck Depression Inventory, and the Accessibility Perception Questionnaire were administered. RESULTS The mean age of the participants was 38.9 ± 12.80 years. The majority were male (70%) and had traumatic injuries (74%). The P-scale showed significant correlations with the Functional Independence Measure motor domain (rs = -0.280) and cognitive domain (rs = -0.520); with the Beck Depression Inventory score (rs = 0.610); with the Accessibility Perception Questionnaire displacement domain (rs = -0.620) and psycho-affective domain (rs = 0.530). Mean scores obtained on the P-scale differed significantly between the groups with and without depressive symptoms (P = 0.001), neuropathic pain (P = 0.033), and functional dependence (P = 0.001). There was no difference between the paraplegic and quadriplegic groups. The P-scale had adequate internal consistency (Cronbach's alpha = 0.873), excellent test-retest reliability (ICC2,1 = 0.992; 95% CI = 0.987-0.994), and in the Bland-Altman plot analysis, only six values fell outside the limits of agreement. CONCLUSION Our results support the use of the P-scale to assess the participation of individuals with SCI in research and clinical practice.
Collapse
Affiliation(s)
- Patrícia Avelar Viana Espindula
- SARAH Network of Rehabilitation Hospitals, Belo Horizonte, Minas Gerais, Brazil.,Postgraduate Program in Reabilitation and Functional Performance (PPGReab), Federal University of the Jequitinhonha and Mucuri Valleys, Diamantina, Minas Gerais, Brazil
| | - Alessandra de Carvalho Bastone
- Postgraduate Program in Reabilitation and Functional Performance (PPGReab), Federal University of the Jequitinhonha and Mucuri Valleys, Diamantina, Minas Gerais, Brazil.,Physiotherapy Department, Faculty of Biological Sciences and Health, Federal University of the Jequitinhonha and Mucuri Valleys, Diamantina, Minas Gerais, Brazil
| | - Ana Paula Santos
- Postgraduate Program in Reabilitation and Functional Performance (PPGReab), Federal University of the Jequitinhonha and Mucuri Valleys, Diamantina, Minas Gerais, Brazil.,Physiotherapy Department, Faculty of Biological Sciences and Health, Federal University of the Jequitinhonha and Mucuri Valleys, Diamantina, Minas Gerais, Brazil
| |
Collapse
|
22
|
Herrity AN, Castillo C, Isakov RV, Anele UA, Wang D, Boakye M, Ugiliweneza B. Health Care Utilization and Cost Associated With Urinary Tract Infections in a Privately Insured Spinal Cord Injury Population. Top Spinal Cord Inj Rehabil 2023; 29:108-117. [PMID: 36819926 PMCID: PMC9936897 DOI: 10.46292/sci22-00022] [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: 02/17/2023]
Abstract
Background Urinary tract infections (UTIs) are the most common secondary medical complication following spinal cord injury (SCI), significantly impacting health care resource utilization and costs. Objectives To characterize risk factors and health care utilization costs associated with UTIs in the setting of SCI. Methods IBM's Marketscan Database from 2000-2019 was utilized to identify individuals with traumatic SCI. Relevant ICD-9 and ICD-10 codes classified individuals into two analysis groups: having ≥ 1 UTI episode or no UTI episodes within 2 years following injury. Demographics (age, sex), insurance type, comorbidities, level of injury (cervical, thoracic, lumbar/sacral), and health care utilization/payments were evaluated. Results Of the 6762 individuals retained, 1860 had ≥ 1 UTI with an average of three episodes (SD 2). Younger age, female sex, thoracic level of injury, noncommercial insurance, and having at least one comorbidity were associated with increased odds of UTI. Individuals with a UTI in year 1 were 11 times more likely to experience a UTI in year 2. As expected, those with a UTI had a higher rate and associated cost of hospital admission, use of outpatient services, and prescription refills. UTIs were associated with 2.48 times higher cumulated health care resource use payments over 2 years after injury. Conclusions In addition to bladder management-related causes, several factors are associated with an increased risk of UTIs following SCI. UTI incidence substantially increases health care utilization costs. An increased understanding of UTI-associated risk factors may improve the ability to identify and manage higher risk individuals with SCI and ultimately optimize their health care utilization.
Collapse
Affiliation(s)
- April N. Herrity
- Kentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, Kentucky
- Department of Neurological Surgery, University of Louisville, Louisville, Kentucky
- Department of Physiology, University of Louisville, Louisville, Kentucky
- University of Louisville School of Medicine, Louisville, Kentucky
| | - Camilo Castillo
- Department of Neurological Surgery, University of Louisville, Louisville, Kentucky
- University of Louisville School of Medicine, Louisville, Kentucky
- Division of Physical Medicine and Rehabilitation, University of Louisville, Louisville, Kentucky
| | - Roman V. Isakov
- University of Louisville School of Medicine, Louisville, Kentucky
| | - Uzoma A. Anele
- University of Louisville School of Medicine, Louisville, Kentucky
- Department of Urology, University of Louisville, Louisville, Kentucky
| | - Dengzhi Wang
- Kentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, Kentucky
- Department of Neurological Surgery, University of Louisville, Louisville, Kentucky
- University of Louisville School of Medicine, Louisville, Kentucky
| | - Maxwell Boakye
- Kentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, Kentucky
- Department of Neurological Surgery, University of Louisville, Louisville, Kentucky
- University of Louisville School of Medicine, Louisville, Kentucky
| | - Beatrice Ugiliweneza
- Kentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, Kentucky
- Department of Neurological Surgery, University of Louisville, Louisville, Kentucky
- University of Louisville School of Medicine, Louisville, Kentucky
- Department of Health Management and Systems Sciences, University of Louisville, Louisville, Kentucky
| |
Collapse
|
23
|
Leung T, Toatley S, Rodgers MD, Qanungo S, Mueller M, Denny B, Rodriguez A. Feasibility of a Community-Based, Online, Peer-Supported Spinal Cord Injury Self-management Intervention: Protocol for a Pilot Wait-Listed Randomized Trial. JMIR Res Protoc 2023; 12:e42688. [PMID: 36749612 PMCID: PMC9944143 DOI: 10.2196/42688] [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: 09/13/2022] [Revised: 11/27/2022] [Accepted: 11/30/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND People with spinal cord injury (SCI) report feeling unprepared to manage their disability upon discharge to the community. This situation is exacerbated when they return to settings where self-management support and resources are sparse, thus increasing the risk of costly secondary conditions and rehospitalizations. These factors make a compelling case for implementing innovative community-based SCI self-management programs that empower and engage individuals with SCI. Using a community-engaged research (CEnR) approach, we developed a peer-supported SCI self-management intervention, known as PHOENIX (Peer-supported Health Outreach, Education, and Information Exchange), which integrates online educational content and support from peer navigators (PNs) through telehealth, to promote health and community participation after SCI. OBJECTIVE The objective of this pilot study is to evaluate the feasibility and acceptability of PHOENIX and the study design, and to obtain estimates of the variability of relevant outcome measures. METHODS We conducted a pilot randomized waitlist-controlled trial (n=30) in collaboration with the South Carolina Spinal Cord Injury Association (SCSCIA), our long-standing community-based nonprofit organization research partner. We recruited 4 PNs through our SCSCIA collaboration using its existing network of trained peer mentors. Our study design supported comparison of the following 2 randomly assigned groups: PHOENIX intervention group and waitlist enhanced usual care (EUC) group. The PHOENIX intervention was administered online by PNs over 16 weeks through scheduled "video visits." The EUC group participated in the study for 16 weeks with usual community services and no navigation, and received 4 monthly newsletters from the SCSCIA on a variety of SCI-relevant topics. At the end of the waitlist period, the waitlist EUC group received the full PHOENIX intervention. Measures of feasibility included PN and participant recruitment and retention, PN workload, protocol adherence, and incidence of technical issues. We conducted qualitative interviews with participants and PNs to evaluate the acceptability of PHOENIX and the study design. Outcome measures, including community participation, quality of life, and the occurrence and subjective impact of medically serious secondary conditions and rehospitalizations, were assessed at baseline after randomization and at subsequent time points to allow between-group comparisons. RESULTS PN hiring and training were completed in August 2018. Recruitment began in November 2018. A total of 30 participants were recruited across South Carolina, and 28 participants completed follow-up by August 2020. An analysis of the results is being finalized, and the results are expected to be published in 2023. CONCLUSIONS This study will provide valuable information to guide future research seeking to address unmet self-management needs and improve outcomes in individuals with SCI. Feasibility findings of this study will provide evidence from CEnR guided by people with SCI and SCI service providers to inform further development, testing, and dissemination of effective and scalable self-management strategies for people with SCI. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR1-10.2196/42688.
Collapse
Affiliation(s)
| | - Sherwood Toatley
- South Carolina Spinal Cord Injury Association, Columbia, SC, United States
| | - Marka Danielle Rodgers
- Center for Spinal Cord Injury, Roper Rehabilitation Hospital, Charleston, SC, United States
| | - Suparna Qanungo
- College of Nursing, Medical University of South Carolina, Charleston, SC, United States
| | - Martina Mueller
- College of Nursing, Medical University of South Carolina, Charleston, SC, United States
| | - Brian Denny
- South Carolina Spinal Cord Injury Association, Columbia, SC, United States
| | - Angela Rodriguez
- South Carolina Spinal Cord Injury Association, Columbia, SC, United States
| |
Collapse
|
24
|
Liu Y, Hasimu M, Jia M, Tang J, Wang Y, He X, Yan T, Xie S, Li K. The Effects of APP-Based Intervention for Depression Among Community-Dwelling Individuals With Spinal Cord Injury: A Randomized Controlled Trial. Arch Phys Med Rehabil 2023; 104:195-202. [PMID: 36332676 DOI: 10.1016/j.apmr.2022.10.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 09/28/2022] [Accepted: 10/03/2022] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To assess the effect of a self-management intervention delivered by mobile application (APP) for depression among community-dwelling individuals with spinal cord injury (SCI). DESIGN Randomized controlled trial. SETTINGS General communities in China. PARTICIPANTS Community-dwelling individuals with SCI who were diagnosed within 2 years were recruited in this study (N=98). It was a convenience sample with an average age of 41.71, 82.7% participants were men. INTERVENTIONS Participants in the intervention group (n=49) received 5 sessions on self-management training provided by nurse-led multidisciplinary team via APP at the second, fourth, sixth, eighth, and 12th weeks, respectively, after they discharge from hospitals. Participants in the control group (n=49) received routine telephone counselling provided by follow-up nurses at the 12th week after they discharge. OUTCOME MEASURE The outcome of this study is depression, which is not the primary outcomes in the registration of this program. Depression was measured by version 2 of Beck Depression Inventory at discharge (T0), the 12th week after discharge from hospitals (T1), and the 24th week after discharge from hospitals (T2). RESULTS There were 98 participants (49 in the intervention group and 49 in the control group) completing the intervention and data collection. Compared with the control group, the intervention group had lower level of depression at T2 (B=-5.76; 95% CI=-9.97, -1.54; P=.007). Small to moderate effect sizes on depression favoring the intervention were demonstrated at T1 (Cohen's d=-.178) and T2 (Cohen's d=-.535). CONCLUSIONS APP-based self-management support can be a potential intervention to reduce depression among community-dwelling individuals with SCI.
Collapse
Affiliation(s)
- Yinnan Liu
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| | | | - Mengmeng Jia
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| | - Jie Tang
- Department of Spinal Cord Injury Rehabilitation, Affiliated Sichuan Provincial Rehabilitation Hospital of Chengdu University of TCM, Chengdu, China
| | - Yingmin Wang
- Department of Rehabilitation Medicine, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Xiaokuo He
- Department of Rehabilitation Medicine, The Fifth Hospital of Xiamen, Xiamen, China
| | - Tiebin Yan
- Department of Rehabilitation Medicine, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Sumei Xie
- Department of Nursing, Guangdong Provincial Work Injury Rehabilitation Hospital, Guangzhou, China
| | - Kun Li
- School of Nursing, Sun Yat-sen University, Guangzhou, China.
| |
Collapse
|
25
|
Jeon M, Kim O, Lee BS, Kim W, Kim JH, Kim EJ, Kim J. Influence of Sociodemographic Factors, Health Conditions, and Activity on Participation in People With Spinal Cord Injury in South Korea. Arch Phys Med Rehabil 2023; 104:52-62. [PMID: 36028101 DOI: 10.1016/j.apmr.2022.08.004] [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: 03/11/2022] [Revised: 08/02/2022] [Accepted: 08/08/2022] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To verify the causal relationship between sociodemographic factors, health conditions, and activities that influence the participation of people with spinal cord injury (SCI) using International Spinal Cord Injury (InSCI) Survey data and to investigate the moderation effects of environmental restrictions and health care system concerns. DESIGN Cross-sectional community survey and structural equation model. SETTING SCI databases of the Korea National Rehabilitation Center and Korea Spinal Cord Injury Association. PARTICIPANTS Community-dwelling adults (N=890) with SCI. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES The InSCI questionnaire domains included sociodemographic factors, health conditions, activity, participation, environmental restrictions, and health system concerns. Sociodemographic factors included age, education, and income. Health conditions included bowel dysfunction, respiratory problems, and pain, among others. Activity included "daily routine" and "using hands," among others. Participation included "interacting with people" and "intimate relationships," among others. Environmental restrictions included "public places" and "negative attitudes," among others. Health care system concerns included "nursing care" and "experience of being treated," among others. RESULTS The hypothesis that health conditions would have a significant effect on activity was supported because 51% of the total variance in activity factors was explained by health condition factors. The hypothesis that activity would have a significant effect on participation was also supported because 63.4% of total variance in participation factors was explained by activity factors. The moderation effect tests supported the hypotheses that health conditions, activity, and participation would differ depending on the extent of environmental restrictions as well as the extent of health system concerns. CONCLUSIONS When formulating policies and recommendations to promote the participation of people with SCI living in the South Korean community, the influence of environmental restrictions and health systems as well as the causal influence of health conditions and activity should be considered.
Collapse
Affiliation(s)
- Minjae Jeon
- Department of Healthcare and Public Health Research, Rehabilitation Research Institute, Korea National Rehabilitation Center, Seoul
| | - Onyoo Kim
- Department of Rehabilitation Medicine, Rehabilitation Hospital, Korea National Rehabilitation Center, Seoul.
| | - Bum-Suk Lee
- Department of Rehabilitation Medicine, Rehabilitation Hospital, Korea National Rehabilitation Center, Seoul.
| | - Wanho Kim
- Department of Rehabilitation Medicine, Rehabilitation Hospital, Korea National Rehabilitation Center, Seoul
| | - Jung Hwan Kim
- Department of Rehabilitation Medicine, Rehabilitation Hospital, Korea National Rehabilitation Center, Seoul
| | - Eun-Joo Kim
- Department of Rehabilitation Medicine, Rehabilitation Hospital, Korea National Rehabilitation Center, Seoul
| | - Jiin Kim
- Department of Community Reintegration Service, Rehabilitation Hospital, Korea National Rehabilitation Center, Seoul, Republic of Korea
| |
Collapse
|
26
|
Korkmaz N, Yardimci G, Ülgen E, Köroğlu Ö, Yilmaz B. Evaluation of secondary complication awareness among individuals with spinal cord injury. Int J Rehabil Res 2022; 45:311-318. [PMID: 36083580 DOI: 10.1097/mrr.0000000000000544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Secondary complications (SCs) are common and cause high morbidity and mortality in individuals with spinal cord injury (SCI). There is no information or a satisfactory scale of measurement for evaluating the opinions of individuals with SCI on whether they have sufficient knowledge about these complications. This study aimed to evaluate the opinions of individuals with SCI about whether they have sufficient information on SCI-related SCs. Demographic and clinical characteristics of 64 SCI individuals were recorded. A questionnaire was applied to evaluate the opinions of the participants and whether they have sufficient information about SCs before and after a multidisciplinary rehabilitation for SCI. A test was performed to measure the knowledge level at admission to the hospital and discharge. The mean value of the total questionnaire score, which was 6.2 at admission, increased to 7.91 at discharge ( P < 0.001). All subgroup scores of the questionnaire were higher at discharge than at admission (all P < 0.05). Total, neurogenic bladder, neurogenic bowel and spasticity test scores increased at discharge compared to admission (all P < 0.05). There is a relationship between the change in questionnaire scores and some demographic and injury characteristics. The opinions of the individuals with SCI on having sufficient information about SCs and their knowledge levels increased after a multidisciplinary rehabilitation program. Applying such a questionnaire and test at admission may have increased the awareness of the participants about SCs and contributed to a higher level of knowledge and opinion.
Collapse
Affiliation(s)
- Nurdan Korkmaz
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Gaziler Physical Medicine and Rehabilitation Training and Research Hospital and
| | - Gokhan Yardimci
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Gaziler Physical Medicine and Rehabilitation Training and Research Hospital and
| | - Esra Ülgen
- Department of Physical Medicine and Rehabilitation, University of Health Sciences, Gaziler Physical Medicine and Rehabilitation Training and Research Hospital and
| | - Özlem Köroğlu
- Department of Physical Medicine and Rehabilitation, Gulhane School of Medicine, University of Health Sciences, Gaziler Training and Research Hospital, Ankara, Turkey
| | - Bilge Yilmaz
- Department of Physical Medicine and Rehabilitation, Gulhane School of Medicine, University of Health Sciences, Gaziler Training and Research Hospital, Ankara, Turkey
| |
Collapse
|
27
|
LaVela SL, Motl RW, Gonzalez B, Tarlov E, Aguina K, Bombardier CH. Randomised controlled trial of the Caring Connections intervention to reduce loneliness and perceived social isolation in persons with spinal cord injuries and disorders: study protocol. BMJ Open 2022; 12:e063246. [PMID: 36400737 PMCID: PMC9677023 DOI: 10.1136/bmjopen-2022-063246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION Perceived social isolation and loneliness are understudied in individuals with spinal cord injuries and disorders (SCI/D). The few existing studies reported that they are common, yet poorly treated, in persons with SCI/D. We developed an intervention called Caring Connections (CC) aimed at reducing loneliness and perceived social isolation in persons with SCI/D. CC is a peer-based, recurrent letter writing programme designed to provide moments of positivity. We will conduct and evaluate a randomised controlled trial (RCT) to assess changes in loneliness and social isolation outcomes between the CC intervention and control conditions in community-dwelling individuals with SCI/D. METHODS AND ANALYSIS RCT to compare outcomes of community-dwelling individuals with SCI/D undergoing the CC intervention to an attention control group (receiving informational materials on life domains important to a good quality of life). Eligible participants include adults with chronic SCI/D who have been injured for >1 year. The primary outcome is loneliness, measured using the UCLA (University of California, Los Angeles) 3-item Loneliness Scale. Other outcomes include perceived social isolation and social support. A post-trial process evaluation will assess perceived benefits, negative impacts and satisfaction with the intervention, and areas for improvement. We will test the hypotheses of reduced loneliness and perceived social isolation in the CC intervention arm from baseline to 6 months and will also measure the magnitude of effect (difference between CC arm and attention control arm). We will use generalised linear models for repeated measures. We will assume a one-tailed, α=0.05 level of significance for comparisons. Process outcomes will be analysed using mixed methods, including frequencies for the rating items and thematic analysis for open-ended item responses. ETHICS AND DISSEMINATION This study has received Hines Veterans Affairs Institutional Review Board approval (#1673654). Findings will be disseminated widely through healthcare organisations, peer-reviewed publications and conferences. TRIAL REGISTRATION NUMBER NCT05295108.
Collapse
Affiliation(s)
- Sherri L LaVela
- Center of Innovation for Complex Chronic Healthcare (CINCCH), US Department of Veterans Affairs, Edward Hines Jr. VA Hospital, Hines, Illinois, USA
- Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Robert W Motl
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Beverly Gonzalez
- Center of Innovation for Complex Chronic Healthcare (CINCCH), US Department of Veterans Affairs, Edward Hines Jr. VA Hospital, Hines, Illinois, USA
| | - Elizabeth Tarlov
- Center of Innovation for Complex Chronic Healthcare (CINCCH), US Department of Veterans Affairs, Edward Hines Jr. VA Hospital, Hines, Illinois, USA
- Population Health Nursing Science, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Keith Aguina
- Veterans Engagement Committee, US Department of Veterans Affairs, Edward Hines Jr. VA Hospital, Hines, Illinois, USA
| | - Charles H Bombardier
- Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, USA
| |
Collapse
|
28
|
Bjork JM, Perrin PB, Plonski PE, Vassileva J, Goetz LL. Impulsivity and reduced quality of life in persons with paraplegia. NeuroRehabilitation 2022; 51:489-497. [DOI: 10.3233/nre-220115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND: Low Quality of Life (QoL) in persons with paraplegia may stem from impulsive behaviors. Impulsivity in persons with paraplegia and persistently low QoL has seldom been probed but could be targeted with cognitive behavioral therapies. OBJECTIVE: Determine how task-assessed and self-report impulsivity relate to quality of life (QoL) in adults with paraplegia. METHODS: In a preliminary study, 33 adults with paraplegia after traumatic SCI were administered verbal interviews on QoL from the PROMIS item bank at baseline and at six-month follow-up, along with several computerized metrics of impulsivity at baseline. RESULTS: A cluster of (n = 10) participants characterized by high levels of negative affect and low levels of resilience and life satisfaction across both baseline and follow-up showed significantly greater negative urgency impulsivity (p = 0.007) as well as significantly lower mindfulness and self-care in some domains (all p = 0.05), compared to the cluster of participants (n = 23) who showed higher life satisfaction and resilience. Behavioral metrics of delay discounting and rapid-response (motoric) impulsivity did not significantly differ (all p > 0.05) between the two clusters of participants. CONCLUSIONS: These data suggest that novel interventions that reduce trait impulsivity in other disorders could be applied to potentially reduce risk for reduced self-care and QoL in individuals with paraplegia.
Collapse
Affiliation(s)
- James M. Bjork
- Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, VA, USA
- HunterHolmes McGuire Veterans Affairs Medical Center, Richmond, VA, USA
| | - Paul B. Perrin
- HunterHolmes McGuire Veterans Affairs Medical Center, Richmond, VA, USA
- Department of Psychology, Virginia CommonwealthUniversity, Richmond, VA, USA
| | - Paul E. Plonski
- HunterHolmes McGuire Veterans Affairs Medical Center, Richmond, VA, USA
- Department of Psychology, Tufts University, Medford, MA, USA
| | - Jasmin Vassileva
- Institute for Drug and Alcohol Studies, Virginia Commonwealth University, Richmond, VA, USA
| | - Lance L. Goetz
- HunterHolmes McGuire Veterans Affairs Medical Center, Richmond, VA, USA
| |
Collapse
|
29
|
Goodwin BM, Olney CM, Ferguson JE, Hansen AH, Eddy B, Goldish G, Morrow MM, Vos-Draper TL. Visualization of user interactions with a pressure mapping mobile application for wheelchair users at risk for pressure injuries. Assist Technol 2022; 34:444-453. [PMID: 33395558 PMCID: PMC8433259 DOI: 10.1080/10400435.2020.1862938] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Pressure injuries for individuals with spinal cord injuries (SCI) are correlated with mortality and are a leading cause for rehospitalizations. The Assisted Weight Shift (AW-Shift©) is a mobile pressure mapping application designed to provide users with a live map view and reminders to perform weight shifts. Novel visualization techniques were used to understand daily distributions of user interaction wit h AW-Shift©. The date and time of system interactions were recorded for six participants with SCI over 7 days (five males/one female, five manual users/one power user, 55.3 ± 17.3 years old, 10.6 ± 6.5 years since injury). Circular frequency plots were created to visualize the time and frequency participants brought the app to the foreground of their phone and received alerts and reminders to complete weight shifts. While some participants used the system regularly throughout the day, others primarily used it before 8am; highlighting the system's importance for regular spot checks and morning wheelchair setup. Participant adherence to weight shift reminders was low suggesting the live pressure map may be more useful. Circular frequency plots can be used by clinicians to more easily review large amounts of patient data. Future work will investigate raw pressure mat data and create a closed-loop weight shift detection algorithm.
Collapse
Affiliation(s)
- Brianna M. Goodwin
- Division of Health Care Policy and Research, Department of Health Sciences Research Mayo Clinic, Rochester, Minnesota, USA,Kern Center for the Science of Health Care Delivery, Rochester, Minnesota, USA
| | - Christine M. Olney
- Minneapolis Veterans Affairs Health Care System, Minneapolis, Minnesota, USA,College of Design, University of Minnesota, Minneapolis, Minnesota, USA
| | - John E. Ferguson
- Minneapolis Veterans Affairs Health Care System, Minneapolis, Minnesota, USA,Department of Rehabilitation Medicine, University of Minnesota, Minneapolis, Minnesota, USA
| | - Andrew H. Hansen
- Minneapolis Veterans Affairs Health Care System, Minneapolis, Minnesota, USA,Department of Rehabilitation Medicine, University of Minnesota, Minneapolis, Minnesota, USA
| | - Byron Eddy
- Minneapolis Veterans Affairs Health Care System, Minneapolis, Minnesota, USA,Department of Rehabilitation Medicine, University of Minnesota, Minneapolis, Minnesota, USA
| | - Gary Goldish
- Minneapolis Veterans Affairs Health Care System, Minneapolis, Minnesota, USA,Department of Rehabilitation Medicine, University of Minnesota, Minneapolis, Minnesota, USA
| | - Melissa M. Morrow
- Division of Health Care Policy and Research, Department of Health Sciences Research Mayo Clinic, Rochester, Minnesota, USA,Kern Center for the Science of Health Care Delivery, Rochester, Minnesota, USA
| | - Tamara L. Vos-Draper
- Department of Rehabilitation Medicine, University of Minnesota, Minneapolis, Minnesota, USA,Center for Allied Health Professions, Program in Occupational Therapy, University of Minnesota, Minneapolis, Minnesota, USA
| |
Collapse
|
30
|
Herrity AN, Aslan SC, Mesbah S, Siu R, Kalvakuri K, Ugiliweneza B, Mohamed A, Hubscher CH, Harkema SJ. Targeting bladder function with network-specific epidural stimulation after chronic spinal cord injury. Sci Rep 2022; 12:11179. [PMID: 35778466 PMCID: PMC9249897 DOI: 10.1038/s41598-022-15315-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 06/22/2022] [Indexed: 11/20/2022] Open
Abstract
Profound dysfunctional reorganization of spinal networks and extensive loss of functional continuity after spinal cord injury (SCI) has not precluded individuals from achieving coordinated voluntary activity and gaining multi-systemic autonomic control. Bladder function is enhanced by approaches, such as spinal cord epidural stimulation (scES) that modulates and strengthens spared circuitry, even in cases of clinically complete SCI. It is unknown whether scES parameters specifically configured for modulating the activity of the lower urinary tract (LUT) could improve both bladder storage and emptying. Functional bladder mapping studies, conducted during filling cystometry, identified specific scES parameters that improved bladder compliance, while maintaining stable blood pressure, and enabled the initiation of voiding in seven individuals with motor complete SCI. Using high-resolution magnetic resonance imaging and finite element modeling, specific neuroanatomical structures responsible for modulating bladder function were identified and plotted as heat maps. Data from this pilot clinical trial indicate that scES neuromodulation that targets bladder compliance reduces incidences of urinary incontinence and provides a means for mitigating autonomic dysreflexia associated with bladder distention. The ability to initiate voiding with targeted scES is a key step towards regaining volitional control of LUT function, advancing the application and adaptability of scES for autonomic function.
Collapse
Affiliation(s)
- April N Herrity
- Kentucky Spinal Cord Injury Research Center, Department of Neurological Surgery, The University of Louisville, 220 Abraham Flexner Way, Suite 1518, Louisville, KY, 40202, USA. .,Department of Neurological Surgery, University of Louisville, Louisville, KY, USA. .,Department of Physiology, University of Louisville, Louisville, KY, USA.
| | - Sevda C Aslan
- Kentucky Spinal Cord Injury Research Center, Department of Neurological Surgery, The University of Louisville, 220 Abraham Flexner Way, Suite 1518, Louisville, KY, 40202, USA.,Department of Neurological Surgery, University of Louisville, Louisville, KY, USA
| | - Samineh Mesbah
- Kentucky Spinal Cord Injury Research Center, Department of Neurological Surgery, The University of Louisville, 220 Abraham Flexner Way, Suite 1518, Louisville, KY, 40202, USA.,Department of Neurological Surgery, University of Louisville, Louisville, KY, USA
| | - Ricardo Siu
- Kentucky Spinal Cord Injury Research Center, Department of Neurological Surgery, The University of Louisville, 220 Abraham Flexner Way, Suite 1518, Louisville, KY, 40202, USA.,Department of Neurological Surgery, University of Louisville, Louisville, KY, USA
| | - Karthik Kalvakuri
- Kentucky Spinal Cord Injury Research Center, Department of Neurological Surgery, The University of Louisville, 220 Abraham Flexner Way, Suite 1518, Louisville, KY, 40202, USA
| | - Beatrice Ugiliweneza
- Kentucky Spinal Cord Injury Research Center, Department of Neurological Surgery, The University of Louisville, 220 Abraham Flexner Way, Suite 1518, Louisville, KY, 40202, USA.,Department of Neurological Surgery, University of Louisville, Louisville, KY, USA.,Department of Health Sciences, University of Louisville, Louisville, KY, USA
| | - Ahmad Mohamed
- Department of Urology, University of Louisville, Louisville, KY, USA
| | - Charles H Hubscher
- Kentucky Spinal Cord Injury Research Center, Department of Neurological Surgery, The University of Louisville, 220 Abraham Flexner Way, Suite 1518, Louisville, KY, 40202, USA.,Department of Anatomical Sciences and Neurobiology, University of Louisville, Louisville, KY, USA
| | - Susan J Harkema
- Kentucky Spinal Cord Injury Research Center, Department of Neurological Surgery, The University of Louisville, 220 Abraham Flexner Way, Suite 1518, Louisville, KY, 40202, USA.,Department of Neurological Surgery, University of Louisville, Louisville, KY, USA
| |
Collapse
|
31
|
Piatt JA, Simic Stanojevic I, Stanojevic C, Zahl ML, Richmond MA, Herbenick D. Sexual Health and Women Living With Spinal Cord Injury: The Unheard Voice. FRONTIERS IN REHABILITATION SCIENCES 2022; 3:853647. [PMID: 36189068 PMCID: PMC9397743 DOI: 10.3389/fresc.2022.853647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 04/15/2022] [Indexed: 11/13/2022]
Abstract
Women's sexual health within the context of sexual function and psychosocial dimensions while living with a spinal cord injury (SCI) has rarely been discussed separately from men living with a SCI or from a collective with other chronic conditions. To date, over 64,000 women in the U.S. are currently living with SCI, with total numbers increasing each year, as well as the demographics shifting to include more diversity in race and incidences occurring later in life. On average, SCI tends to be acquired during the childbearing years (~30–50 years old), as well as when women experience other health concerns associated with aging, including perimenopause and menopause. Additionally, women's sexual health is often conceptualized from the position of the absence of disease and dysfunction. However, consistent with definitions furthered by the World Health Organization (WHO) and World Association of Sexual Health (WAS), we believe women's sexual health is multifaceted, moving beyond a focus on reproduction to also encompass sexual function and the psychosocial dimensions of sexual health both living with and without disabling conditions and diseases. Within this lens, we present prior research that has been conducted, conclusions from these studies, implications for practice, and recommendations for future research. Thus, the paper will expand the understanding of both sexual function and psychosocial dimensions for women living with SCI.
Collapse
Affiliation(s)
- Jennifer Ann Piatt
- Department of Health and Wellness Design, School of Public Health, Indiana University, Bloomington, IN, United States
- *Correspondence: Jennifer Ann Piatt
| | - Ivanka Simic Stanojevic
- Department of Health and Wellness Design, School of Public Health, Indiana University, Bloomington, IN, United States
| | - Cedomir Stanojevic
- Department of Health and Wellness Design, School of Public Health, Indiana University, Bloomington, IN, United States
| | - Melissa L. Zahl
- Department of Occupational and Recreational Therapies, College of Health, University of Utah, Salt Lake City, UT, United States
| | - Mary Ann Richmond
- Veterans Affairs Northeast Ohio Health Care, Cleveland, OH, United States
| | - Debra Herbenick
- Department of Applied Health Sciences, School of Public Health, Indiana University, Bloomington, IN, United States
| |
Collapse
|
32
|
Berger A, Goldstine J, Hofstad C, Inglese GW, Kirschner-Hermanns R, MacLachlan S, Shah S, Vos-van der Hulst M, Weiss J. Incidence of urinary tract infection following initiation of intermittent catheterization among patients with recent spinal cord injury in Germany and the Netherlands. J Spinal Cord Med 2022; 45:461-471. [PMID: 33054606 PMCID: PMC9135430 DOI: 10.1080/10790268.2020.1829416] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Objective: To assess incidence of urinary tract infection (UTI) among patients with recent spinal cord injury (SCI) who initiated intermittent catheterization (IC).Design: Retrospective chart review.Setting: Two European SCI rehabilitation centers.Participants: Seventy-three consecutive patients with recent SCI who initiated IC.Outcome measures: Incidence of UTI, using six different definitions, each based on microbiology ± symptomatology ± mention of UTI . Rates were expressed in terms of numbers of UTIs per 100 patient-months (PMs). Attention was focused on first-noted UTI during the three-month follow-up, as assessed with each of the six definitions.Results: Fifty-eight percent of patients (n = 33) met ≥1 definitions for UTI during follow-up (rate: 31.5 UTIs per 100 PMs), ranging from 14% (5.3 per 100 PMs; definition requiring bacteriuria, pyuria, and presence of symptoms) to 45% (22.7 per 100 PMs; definition requiring "mention of UTI"). Ten cases were identified using the definition that required bacteriuria, pyuria, and symptoms, whereas definitions that required bacteriuria and either pyuria or symptoms resulted in the identification of 20-25 cases. Median time to UTI ranged from 42 days ("mention of UTI") to 81 days (definition requiring bacteriuria and ≥100 leukocytes/mm3).Conclusion: Depending on definition, 14% to 45% of patients with recent SCI experience UTI within three months of initiating IC. Definitions requiring bacteriuria and either pyuria or symptoms consistently identified about twice as many cases as those that required all three conditions. Standardizing definitions may help improve detection, treatment, and prevention of UTI within this vulnerable population.
Collapse
Affiliation(s)
- Ariel Berger
- Real-World Evidence, Evidera Inc., Waltham, Massachusetts, USA,Correspondence to: Ariel Berger, Real-World Evidence, Evidera Inc., 500 Totten Pond Road, 5th Floor, Waltham, Massachusetts02451, USA.
| | - Jimena Goldstine
- Global Market Access, Hollister Inc., Libertyville, Illinois, USA
| | - Cheriel Hofstad
- Department of Research, Sint Maartenskliniek, Ubbergen, Netherlands
| | - Gary W. Inglese
- Global Market Access, Hollister Inc., Libertyville, Illinois, USA
| | - Ruth Kirschner-Hermanns
- Neuro-Urology, Neurological Rehabilitation Center Godeshoehe e.V., Bonn, Germany,Neuro-Urology/Clinic of Urology, University Clinic, Bonn, Germany
| | | | - Surbhi Shah
- Real-World Evidence, Evidera Inc., Waltham, Massachusetts, USA
| | - Marije Vos-van der Hulst
- Department of Research, Sint Maartenskliniek, Ubbergen, Netherlands,Rehabilitation Spinal cord Injury, Sint Maartenskliniek, Nijmegen, Netherlands
| | - Jerome Weiss
- Neuro-Urology, Neurological Rehabilitation Center Godeshoehe e.V., Bonn, Germany
| |
Collapse
|
33
|
Shang Z, Li D, Chen J, Wang R, Wang M, Zhang B, Wang X, Wanyan P. What Is the Optimal Timing of Transplantation of Neural Stem Cells in Spinal Cord Injury? A Systematic Review and Network Meta-Analysis Based on Animal Studies. Front Immunol 2022; 13:855309. [PMID: 35371014 PMCID: PMC8965614 DOI: 10.3389/fimmu.2022.855309] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 02/15/2022] [Indexed: 01/13/2023] Open
Abstract
Objective The optimal transplantation timing of neural stem cells in spinal cord injury is fully explored in animal studies to reduce the risk of transformation to clinical practice and to provide valuable reference for future animal studies and clinical research. Method Seven electronic databases, namely, PubMed, Web of Science, Embase, Wanfang, Chinese Scientific Journal Database (CSJD-VIP), China Biomedical Literature Database (CBM), and China National Knowledge Infrastructure (CNKI), were searched. The studies were retrieved from inception to November 2021. Two researchers independently screened the literature, extracted data, and evaluated the methodological quality based on the inclusion criteria. Results and Discussion Thirty-nine studies were incorporated into the final analyses. Based on the subgroup of animal models and transplantation dose, the results of network meta-analysis showed that the effect of transplantation in the subacute phase might be the best. However, the results of traditional meta-analysis were inconsistent. In the moderate-dose group of moderate spinal cord injury model and the low-dose group of severe spinal cord injury model, transplantation in the subacute phase did not significantly improve motor function. Given the lack of evidence for direct comparison between different transplantation phases, the indirectness of our network meta-analysis, and the low quality of evidence in current animal studies, our confidence in recommending cell transplantation in the subacute phase is limited. In the future, more high-quality, direct comparative studies are needed to explore this issue in depth.
Collapse
Affiliation(s)
- Zhizhong Shang
- The First Clinical Medical School of Lanzhou University, Lanzhou, China
| | - Dongliang Li
- The First Clinical Medical School of Lanzhou University, Lanzhou, China
| | - Jinlei Chen
- The First Clinical Medical School of Lanzhou University, Lanzhou, China
| | - RuiRui Wang
- The First Clinical Medical School of Lanzhou University, Lanzhou, China
| | - Mingchuan Wang
- The First Clinical Medical School of Lanzhou University, Lanzhou, China
| | - Baolin Zhang
- The First Clinical Medical School of Lanzhou University, Lanzhou, China
| | - Xin Wang
- The First Clinical Medical School of Lanzhou University, Lanzhou, China.,Chengren Institute of Traditional Chinese Medicine, Lanzhou, China.,Department of Spine, Changzheng Hospital, Naval Medical University, Shanghai, China
| | - Pingping Wanyan
- Basic Medical College, Gansu University of Chinese Medicine, Lanzhou, China.,Department of Nephrology, The Second Hospital of Lanzhou University, Lanzhou, China
| |
Collapse
|
34
|
Effects of sacral nerve stimulation on neuronal nitric oxide synthase in the colon and sacral cord of rats with defecation disorder after spinal cord injury. World Neurosurg 2022; 164:e214-e223. [DOI: 10.1016/j.wneu.2022.04.080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 04/19/2022] [Indexed: 11/18/2022]
|
35
|
Mashola MK, Korkie E, Mothabeng DJ. The presence of pain in community-dwelling South African manual wheelchair users with spinal cord injury. SOUTH AFRICAN JOURNAL OF PHYSIOTHERAPY 2022; 78:1600. [PMID: 35281780 PMCID: PMC8905372 DOI: 10.4102/sajp.v78i1.1600] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 11/23/2021] [Indexed: 11/15/2022] Open
Abstract
Background Pain after spinal cord injury (SCI) is common and is likely to continue throughout life with varying levels of severity. Objective To determine the presence of pain, the sociodemographic and injury profile of community-dwelling manual wheelchair users. Method This quantitative correlational study used a sociodemographic and injury profile sheet and the Douleur Neuropathique 4 Questions (DN4) questionnaire to document demographic, SCI profiles as well as pain characteristics. Pain severity was determined using the Numeric Rating Scale. Data were analysed using the Statistical Package for the Social Sciences (SPSS) v27 at 0.05 level of significance. Results The pain rate was 104; 85% of 122 participants and mainly in those with complete SCI (77.9%). Neuropathic pain was more common (76; 62.5%) and significantly associated (p < 0.05) with higher pain severity. Pain was mainly in one area of the body (59; 48.4%) but occurring in up to five areas. The most painful area had a mean severity of 6.7/10; was more common in the lower limbs below the injury level (48; 39.4%); and was burning in nature (40; 32.7%). Conclusions Pain after SCI is as problematic in the South African context as it is globally. With the rising SCI prevalence in the country, understanding pain and its presentation is important for holistic management of a person with SCI. Clinical implications In-depth assessment of pain should be conducted and appropriate management interventions for specific pain types be prescribed to effectively reduce pain.
Collapse
Affiliation(s)
- Mokgadi K Mashola
- Department of Physiotherapy, Faculty of Health Science, University of the Witwatersrand, Johannesburg, South Africa
- Department of Physiotherapy, Faculty of Health Science, University of Pretoria, Pretoria, South Africa
| | - Elzette Korkie
- Department of Physiotherapy, Faculty of Health Science, University of Pretoria, Pretoria, South Africa
| | - Diphale J Mothabeng
- Department of Physiotherapy, Faculty of Health Science, University of Pretoria, Pretoria, South Africa
| |
Collapse
|
36
|
Retrospective trends in length of stay and bowel management at discharge from inpatient rehabilitation among individuals with spinal cord injury. Spinal Cord 2022; 60:674-678. [DOI: 10.1038/s41393-022-00753-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 01/07/2022] [Accepted: 01/11/2022] [Indexed: 11/08/2022]
|
37
|
Chronic physical health conditions following injury: a comparison of prevalence and risk in people with orthopaedic major trauma and other types of injury. Arch Phys Med Rehabil 2022; 103:1738-1748. [DOI: 10.1016/j.apmr.2021.12.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 11/17/2021] [Accepted: 12/13/2021] [Indexed: 11/19/2022]
|
38
|
Jeyathevan G, Jaglal SB, Hitzig SL, Linassi G, Mills S, Noonan VK, Anzai K, Clarke T, Wolfe D, Bayley M, Aslam L, Farahani F, Alavinia SM, Omidvar M, Craven BC. Conception and development of Self-Management indicators to advance the quality of spinal cord injury rehabilitation: SCI-High Project. J Spinal Cord Med 2021; 44:S94-S117. [PMID: 34779736 PMCID: PMC8604486 DOI: 10.1080/10790268.2021.1961054] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
CONTEXT Although self-management is linked to reduced secondary health complications (SHCs) and enhanced overall quality of life post-spinal cord injury or disease (SCI/D), it is poorly integrated into the current rehabilitation process. Promoting self-management and assuring equity in care delivery is critical. Herein, we describe the selection of Self-Management structure, process and outcome indicators for adults with SCI/D in the first 18 months after rehabilitation admission. METHODS Experts in self-management across Canada completed the following tasks: (1) defined the Self-Management construct; (2) conducted a systematic search of available outcomes and their psychometric properties; and (3) created a Driver diagram summarizing available evidence related to Self-Management. Facilitated meetings allowed development and selection following rapid-cycle evaluations of proposed structure, process and outcome indicators. RESULTS The structure indicator is the proportion of staff with appropriate education and training in self-management principles. The process indicator is the proportion of SCI/D inpatients who have received a self-management assessment related to specific patient self-management goal(s) within 30 days of admission. The outcome indicator is the Skill and Technique Acquisition, and Self-Monitoring and Insight subscores of the modified Health Education Impact Questionnaire. CONCLUSION The structure indicator will heighten awareness among administrators and policy makers regarding the need to provide staff with ongoing training related to promoting self-management skill acquisition. Successful implementation of the Self-Management process and outcome indicators will promote self-management education and skill acquisition as a rehabilitation priority, allow for personalization of skills related to the individual's self-management goal(s), and empower individuals with SCI/D to manage their health and daily activities while successfully integrating into the community.
Collapse
Affiliation(s)
- Gaya Jeyathevan
- KITE Research Institute, Toronto Rehabilitation Institute – University Health Network, Toronto, Ontario, Canada
| | - Susan B. Jaglal
- KITE Research Institute, Toronto Rehabilitation Institute – University Health Network, Toronto, Ontario, Canada,Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Ontario, Canada,Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Sander L. Hitzig
- St. John’s Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada,Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada,Rehabilitation Sciences Institute, Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Gary Linassi
- Department of Physical Medicine and Rehabilitation, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Sandra Mills
- Brain and Spinal Cord Rehabilitation Program, Toronto Rehabilitation Institute – University Health Network, Toronto, Ontario, Canada
| | | | - Karen Anzai
- GF Strong Rehab Centre, Vancouver, British Columbia, Canada
| | | | - Dalton Wolfe
- Parkwood Institute Research, Lawson Health Research Institute, London, Ontario, Canada,School of Health Studies, Western University, London, Ontario, Canada
| | - Mark Bayley
- KITE Research Institute, Toronto Rehabilitation Institute – University Health Network, Toronto, Ontario, Canada,Brain and Spinal Cord Rehabilitation Program, Toronto Rehabilitation Institute – University Health Network, Toronto, Ontario, Canada,Division of Physical Medicine and Rehabilitation, Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Lubna Aslam
- Spinal Cord Injury Ontario, Toronto, Ontario, Canada
| | - Farnoosh Farahani
- KITE Research Institute, Toronto Rehabilitation Institute – University Health Network, Toronto, Ontario, Canada
| | - S. Mohammad Alavinia
- KITE Research Institute, Toronto Rehabilitation Institute – University Health Network, Toronto, Ontario, Canada
| | - Maryam Omidvar
- KITE Research Institute, Toronto Rehabilitation Institute – University Health Network, Toronto, Ontario, Canada
| | - B. Catharine Craven
- KITE Research Institute, Toronto Rehabilitation Institute – University Health Network, Toronto, Ontario, Canada,Brain and Spinal Cord Rehabilitation Program, Toronto Rehabilitation Institute – University Health Network, Toronto, Ontario, Canada,Division of Physical Medicine and Rehabilitation, Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada,Correspondence to: B. Catharine Craven, KITE Research Institute, Toronto Rehabilitation Institute – University Health Network, 206-H 520 Sutherland Drive, Toronto, ON, M4G3V9, Canada; Ph: 416-597-3422x6122.
| |
Collapse
|
39
|
Dietz N, Sarpong K, Ugiliweneza B, Wang D, Aslan SS, Castillo C, Boakye M, Herrity AN. Longitudinal Trends and Prevalence of Bowel Management in Individuals With Spinal Cord Injury. Top Spinal Cord Inj Rehabil 2021; 27:53-67. [PMID: 34866888 DOI: 10.46292/sci21-00008] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Background: Neurogenic bowel dysfunction (NBD) following spinal cord injury (SCI) represents a major source of morbidity, negatively impacting quality of life and overall independence. The long-term changes in bowel care needs are not well-reported, preventing consensus on the natural course and optimal management of NBD following injury. Objectives: To understand the changes in bowel management needs over time following SCI. Methods: A retrospective observational study using the National Spinal Cord Injury Model Systems database evaluated the degree of independence with bowel management at discharge from inpatient rehabilitation across time (1988-2016). The prevalence and consecutive trajectory of bowel management was also evaluated at discharge and at each 5-year follow-up period, for 25 years. Results: The majority of individuals discharged from inpatient rehabilitation (n = 17,492) required total assistance with bowel management, a trend that significantly increased over time. However, by 5-years post injury, there was a significant shift in bowel management needs from total assistance to modified independence. In those with consecutive 25-year follow-up data (n = 11,131), a similar shift in bowel management to a less dependent strategy occurred even at chronic time points post injury, primarily in individuals with paraplegia and classified as motor and sensory complete. Conclusion: The findings of this study highlight the need for providing continued multipronged interventions (e.g., rehabilitative, educational, psycho-social) at the different stages of SCI to support individuals not only in the immediate years after discharge but also well into the chronic stages after injury.
Collapse
Affiliation(s)
- Nicholas Dietz
- Department of Neurological Surgery, University of Louisville, Louisville, Kentucky
| | - Kwadwo Sarpong
- School of Medicine, Georgetown University, Washington, DC
| | - Beatrice Ugiliweneza
- Department of Neurological Surgery, University of Louisville, Louisville, Kentucky.,Kentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, Kentucky.,Department of Health Management and Systems Science, University of Louisville, Louisville, Kentucky
| | - Dengzhi Wang
- Department of Neurological Surgery, University of Louisville, Louisville, Kentucky.,Kentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, Kentucky
| | - Sevda S Aslan
- Department of Neurological Surgery, University of Louisville, Louisville, Kentucky.,Kentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, Kentucky
| | - Camilo Castillo
- Department of Neurological Surgery, University of Louisville, Louisville, Kentucky.,Division of Physical Medicine and Rehabilitation, University of Louisville, Louisville, Kentucky
| | - Maxwell Boakye
- Department of Neurological Surgery, University of Louisville, Louisville, Kentucky.,Kentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, Kentucky
| | - April N Herrity
- Department of Neurological Surgery, University of Louisville, Louisville, Kentucky.,Kentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, Kentucky.,Department of Physiology, University of Louisville, Louisville, Kentucky
| |
Collapse
|
40
|
Pilusa S, Myezwa H, Potterton J. Exploring prevention and management of secondary health conditions in people with spinal cord injury in South Africa. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2021. [DOI: 10.12968/ijtr.2021.0005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background/Aims Preventative care for people with spinal cord injury is neglected, even though secondary health conditions are prevalent among this group. There is limited information on preventative care for secondary health conditions among people with spinal cord injury. This study aimed to explore how people with spinal cord injury prevent and manage secondary health conditions. Methods A total of 17 individuals with spinal cord injury attending an outpatients clinic at a public rehabilitation hospital were interviewed face to face. All the interviews were transcribed verbatim and analysed using thematic content analysis. Results The participants used different strategies to prevent and manage secondary health conditions, such as medication, assistive devices, self-management, resilience coping strategies and therapeutic approaches. The participants found prevention of secondary health conditions ‘challenging’ and some of the strategies were ineffective. Conclusions Although many strategies are used by people with spinal cord injury to prevent and manage secondary health conditions, the experience is difficult. To minimise the occurrence and the consequence of secondary health conditions among people with spinal cord injury, health professionals must promote and support preventative care for secondary health conditions.
Collapse
Affiliation(s)
- Sonti Pilusa
- Department of Physiotherapy, Faculty of Therapeutic Sciences, University of the Witswatersrand, Johannesburg, South Africa
| | - Hellen Myezwa
- School Faculty of Therapeutic Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Joanne Potterton
- Department of Physiotherapy, Faculty of Therapeutic Sciences, University of the Witswatersrand, Johannesburg, South Africa
| |
Collapse
|
41
|
Chen X, Wang Y, Zhou G, Hu X, Han S, Gao J. The combination of nanoscaffolds and stem cell transplantation: Paving a promising road for spinal cord injury regeneration. Biomed Pharmacother 2021; 143:112233. [PMID: 34649357 DOI: 10.1016/j.biopha.2021.112233] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 09/05/2021] [Accepted: 09/19/2021] [Indexed: 12/14/2022] Open
Abstract
Spinal cord injury (SCI), one of the most devastating traumas, has caused long-term disability in millions of people worldwide. The pathophysiology of SCI primarily occurs in two stages classified as primary injury and secondary injury. Due to the rupture of axons and the apoptosis of neurons, patients lose their motor, sensory, and reflex functions, which also imposes a huge burden on families and society. However, traditional surgery does not facilitate neuronal regeneration. Although neural stem cells (NSCs) have the potential for multidirectional differentiation, the probability of differentiation into neurons and survival are still low. Surprisingly, the unique properties of nanotechnologies enable targeted drug delivery while reducing adverse reactions, assisting NSCs in differentiating into neurons. Here, recent studies on promising nanoscaffolds are highlighted, and their strengths and drawbacks are evaluated. Although the treatment of SCI remains fraught with challenges, the combination of nanoscaffolds and NSCs pave a promising road for SCI regeneration.
Collapse
Affiliation(s)
- Xiaokun Chen
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yiyang Wang
- School of Medicine, Tsinghua University, Haidian District, Beijing, China
| | - Gang Zhou
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xianghui Hu
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shiyuan Han
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jun Gao
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
| |
Collapse
|
42
|
Learning self-care skills after spinal cord injury: a qualitative study. BMC Psychol 2021; 9:155. [PMID: 34627397 PMCID: PMC8501583 DOI: 10.1186/s40359-021-00659-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 09/22/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND People with a recent spinal cord injury (SCI) often follow intensive rehabilitation. Learning appropriate self-care, deal with their impairments and prevent secondary health conditions (SHCs), is highly important during rehabilitation. To date it is not clear how self-care skills are taught to people with SCI. The objective of this study was to understand how people with SCI experienced the learning of appropriate self-care skills during inpatient rehabilitation, including the role of the rehabilitation team. METHODS Individual semi-structured interviews were conducted with 15 people with SCI, recently discharged from initial inpatient rehabilitation. Interviews were audio-taped, transcribed and analyzed thematically. RESULTS Two main themes and seven sub-themes were identified. Participants stated that the contribution of the rehabilitation team to learning self-care, including prevention of SHCs, was mostly made by optimizing opportunities to learn through experience. For preventing SHCs, education and lessons learned from the professionals during therapy and the formal educational program, was experienced as especially important. Further, the motivational attitude of the professionals which participants found stimulating and was based on respect, combined with their positive contribution as one team, were seen as essentials elements for learning appropriate self-care. However participants did not recognize the contribution of the nursing staff as part of their rehabilitation, although it was seen as very important. An important aspect of the participants' own contribution was challenging oneself to learn self-care. This was done in different ways by the participants. Further, their own mental adjustment was considered important in the learning process. The gaining of confidence was by most participants seen as personal characteristic, although they also recognized the importance of the team effort and the experiences they underwent. CONCLUSIONS Learning appropriate self-care was mostly done through experience, by challenging themselves, and making use of the opportunities given by the members of the rehabilitation team. The same strategies used by the rehabilitation team to teach people with SCI to perform appropriate self-care, were also helpful for the participants to gain confidence. Explicit attention for self-care training as an important goal in SCI rehabilitation may strengthen the nursing staff's role and stimulate interdisciplinary working.
Collapse
|
43
|
Gao J, Khang M, Liao Z, Detloff M, Lee JS. Therapeutic targets and nanomaterial-based therapies for mitigation of secondary injury after spinal cord injury. Nanomedicine (Lond) 2021; 16:2013-2028. [PMID: 34402308 PMCID: PMC8411395 DOI: 10.2217/nnm-2021-0113] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 06/29/2021] [Indexed: 12/31/2022] Open
Abstract
Spinal cord injury (SCI) and the resulting neurological trauma commonly result in complete or incomplete neurological dysfunction and there are few effective treatments for primary SCI. However, the following secondary SCI, including the changes of microvasculature, inflammatory response and oxidative stress around the injury site, may provide promising therapeutic targets. The advances of nanomaterials hold promise for delivering therapeutics to alleviate secondary SCI and promote functional recovery. In this review, we highlight recent achievements of nanomaterial-based therapy, specifically targeting blood-spinal cord barrier disruption, mitigation of the inflammatory response and lightening of oxidative stress after spinal cord injury.
Collapse
Affiliation(s)
- Jun Gao
- Department of Bioengineering, Drug Design, Development & Delivery (4D) Laboratory, Clemson University, Clemson, SC 29634, USA
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China
| | - Minkyung Khang
- Department of Bioengineering, Drug Design, Development & Delivery (4D) Laboratory, Clemson University, Clemson, SC 29634, USA
| | - Zhen Liao
- Department of Bioengineering, Drug Design, Development & Delivery (4D) Laboratory, Clemson University, Clemson, SC 29634, USA
| | - Megan Detloff
- Department of Neurobiology & Anatomy, Drexel University, Philadelphia, PA 19129, USA
| | - Jeoung Soo Lee
- Department of Bioengineering, Drug Design, Development & Delivery (4D) Laboratory, Clemson University, Clemson, SC 29634, USA
| |
Collapse
|
44
|
Kuzu D, Troost JP, Carlozzi NE, Ehde DM, Molton IR, Kratz AL. How Do Fluctuations in Pain, Fatigue, Anxiety, Depressed Mood, and Perceived Cognitive Function Relate to Same-Day Social Participation in Individuals With Spinal Cord Injury? Arch Phys Med Rehabil 2021; 103:385-393. [PMID: 34454899 DOI: 10.1016/j.apmr.2021.07.809] [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] [Received: 01/06/2021] [Revised: 06/02/2021] [Accepted: 07/24/2021] [Indexed: 11/02/2022]
Abstract
OBJECTIVE This study aimed to examine same-day associations of pain, fatigue, depressed mood, anxiety, and perceived cognitive function with social participation in the daily lives of adults with spinal cord injury (SCI). DESIGN Observational study used a combination of baseline surveys and 7 end-of-day (EOD) diaries. SETTING General community. PARTICIPANTS Individuals with SCI (N=168; mean age, 49.8y; 63% male, 37% female). MAIN OUTCOME MEASURES Patient-Reported Outcomes Measurement Information System short form measures (Ability to Participate in Social Roles and Activities, Pain Intensity, Depression, Anxiety, Cognitive Function Abilities) were adapted for daily administrations as EOD diaries. RESULT Results of multivariable model showed that daily increases in fatigue (B=-0.10; P=.004) and depressive symptoms (B=-0.25; P=<.001) and decreases in perceived cognitive function (B=0.11; P=<.001) were significantly related to worse same-day social participation. Daily fluctuations in anxiety and pain were unrelated to same-day social participation. CONCLUSIONS This is the first study that shows within-person associations of common SCI symptoms with social participation in the daily lives of adults with SCI. Results from the current study may help to develop more effective individualized treatments of symptoms and symptom effect aimed at improving social participation.
Collapse
Affiliation(s)
- Duygu Kuzu
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI.
| | - Jonathan P Troost
- Michigan Institute for Clinical and Health Research, University of Michigan, Ann Arbor, MI
| | - Noelle E Carlozzi
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI
| | - Dawn M Ehde
- Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, WA
| | - Ivan R Molton
- Department of Rehabilitation Medicine, University of Washington School of Medicine, Seattle, WA
| | - Anna L Kratz
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI
| |
Collapse
|
45
|
Herrity AN, Hubscher CH, Angeli CA, Boakye M, Harkema SJ. Impact of long-term epidural electrical stimulation enabled task-specific training on secondary conditions of chronic paraplegia in two humans. J Spinal Cord Med 2021; 44:513-514. [PMID: 34270394 PMCID: PMC8288117 DOI: 10.1080/10790268.2021.1918967] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Affiliation(s)
- April N. Herrity
- Kentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, Kentucky, USA,Department of Neurological Surgery, University of Louisville, Louisville, Kentucky, USA,Correspondence to: April N. Herrity. E-mail:
| | - Charles H. Hubscher
- Kentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, Kentucky, USA,Department of Anatomical Sciences and Neurobiology, University of Louisville, Louisville, Kentucky, USA
| | - Claudia A. Angeli
- Kentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, Kentucky, USA,Department of Bioengineering, University of Louisville, Louisville, Kentucky, USA
| | - Maxwell Boakye
- Kentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, Kentucky, USA,Department of Neurological Surgery, University of Louisville, Louisville, Kentucky, USA
| | - Susan J. Harkema
- Kentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, Kentucky, USA,Department of Neurological Surgery, University of Louisville, Louisville, Kentucky, USA
| |
Collapse
|
46
|
van der Scheer JW, Goosey-Tolfrey VL, Valentino SE, Davis GM, Ho CH. Functional electrical stimulation cycling exercise after spinal cord injury: a systematic review of health and fitness-related outcomes. J Neuroeng Rehabil 2021; 18:99. [PMID: 34118958 PMCID: PMC8196442 DOI: 10.1186/s12984-021-00882-8] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 05/19/2021] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVES The objective of this review was to summarize and appraise evidence on functional electrical stimulation (FES) cycling exercise after spinal cord injury (SCI), in order to inform the development of evidence-based clinical practice guidelines. METHODS PubMed, the Cochrane Central Register of Controlled Trials, EMBASE, SPORTDiscus, and CINAHL were searched up to April 2021 to identify FES cycling exercise intervention studies including adults with SCI. In order to capture the widest array of evidence available, any outcome measure employed in such studies was considered eligible. Two independent reviewers conducted study eligibility screening, data extraction, and quality appraisal using Cochranes' Risk of Bias or Downs and Black tools. Each study was designated as a Level 1, 2, 3 or 4 study, dependent on study design and quality appraisal scores. The certainty of the evidence for each outcome was assessed using GRADE ratings ('High', 'Moderate', 'Low', or 'Very low'). RESULTS Ninety-two studies met the eligibility criteria, comprising 999 adults with SCI representing all age, sex, time since injury, lesion level and lesion completeness strata. For muscle health (e.g., muscle mass, fiber type composition), significant improvements were found in 3 out of 4 Level 1-2 studies, and 27 out of 32 Level 3-4 studies (GRADE rating: 'High'). Although lacking Level 1-2 studies, significant improvements were also found in nearly all of 35 Level 3-4 studies on power output and aerobic fitness (e.g., peak power and oxygen uptake during an FES cycling test) (GRADE ratings: 'Low'). CONCLUSION Current evidence indicates that FES cycling exercise improves lower-body muscle health of adults with SCI, and may increase power output and aerobic fitness. The evidence summarized and appraised in this review can inform the development of the first international, evidence-based clinical practice guidelines for the use of FES cycling exercise in clinical and community settings of adults with SCI. Registration review protocol: CRD42018108940 (PROSPERO).
Collapse
Affiliation(s)
- Jan W van der Scheer
- Peter Harrison Centre for Disability Sport, School for Sport, Exercise and Health Sciences, Loughborough University, Epinal Way, Loughborough, LE11 3TU, UK
- The Healthcare Improvement Studies (THIS) Institute, Department of Public Health and Primary Care, School of Clinical Medicine, University of Cambridge, Cambridge Biomedical Campus, Clifford Allbutt Building, Cambridge, CB2 OAH, UK
| | - Victoria L Goosey-Tolfrey
- Peter Harrison Centre for Disability Sport, School for Sport, Exercise and Health Sciences, Loughborough University, Epinal Way, Loughborough, LE11 3TU, UK
| | - Sydney E Valentino
- Department of Kinesiology, McMaster University, Room IWC EG115, 1280 Main St. W., Hamilton, ON, L8S 4K1, Canada
| | - Glen M Davis
- Discipline of Exercise and Sport Sciences, Faculty of Medicine and Health, Sydney School of Health Sciences, University of Sydney, Sydney, NSW, 2006, Australia
| | - Chester H Ho
- Division of Physical Medicine & Rehabilitation, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, AB, T6G 2R3, Canada.
| |
Collapse
|
47
|
STOICA SI, TĂNASE I, ONOSE G. Influences and consequences resulting in addictions in general and to chronic alcoholism, especially for patients with spinal cord injury. BALNEO AND PRM RESEARCH JOURNAL 2021. [DOI: 10.12680/balneo.2021.432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Introduction: Spinal cord injury can be a cause of severe disability, with important consequences at the individual and social levels. Causes are often produced by falls or road accidents; and addictions (particularly chronic ethylism) also increase the risk of vertebral-medullary lesions.
Materials and Methods: With with the approval of the TEHBA Ethics Commission (no.17464/14.06.2019), we used specific tests (DASS-21, MOS SF-36, SMAST, AUDIT, CAGE, AIS) and we questioned a group of patients admitted to the THEBA Neuro-Muscle Recovery Clinic after being treated in the Spinal Neurosurgery Service for acute and subacute vertebral medullary trauma.
Results: We evaluated the link between addictions (especially ethanol), the risk of spinal cord injury, and the underlying subacute evolution of patients with this pathology.
Conclusions: Substance abuse (especially ethanol) increases the risk of spinal cord injury and is a serious public health problem.
Keywords: SCI, DASS-21, MOS SF-36, AUDIT, CAGE, SMAST, Neuromuscular Recovery
Collapse
Affiliation(s)
- Simona-Isabelle STOICA
- 1. University of Medicine and Pharmacy “Carol Davila” (UMPCD), in Bucharest, Romania 2 Teaching Emergency Hospital “Bagdasar-Arseni” (TEHBA), Bucharest, Romania
| | - Ioana TĂNASE
- 2 Teaching Emergency Hospital “Bagdasar-Arseni” (TEHBA), Bucharest, Romania
| | - Gelu ONOSE
- 1. University of Medicine and Pharmacy “Carol Davila” (UMPCD), in Bucharest, Romania 2 Teaching Emergency Hospital “Bagdasar-Arseni” (TEHBA), Bucharest, Romania
| |
Collapse
|
48
|
Coker J, Berliner J, Botticello A, Bryce TN, Charlifue S, Chen D, Estrada D, Monden KR, Taylor H, Zafonte R, Zanca JM. Utilization of Complementary and Integrative Health Care by People With Spinal Cord Injury in the Spinal Cord Injury Model Systems: A Descriptive Study. Arch Phys Med Rehabil 2021; 103:755-763. [PMID: 34058154 DOI: 10.1016/j.apmr.2021.04.023] [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: 12/30/2020] [Revised: 04/01/2021] [Accepted: 04/29/2021] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To characterize the use of complementary and integrative health care (CIH) by people with spinal cord injury. DESIGN Cross-sectional self-report study. SETTING Participants were recruited from 5 Spinal Cord Injury Model Systems (SCIMS) centers across the United States. INTERVENTIONS Not applicable. PARTICIPANTS A total of 411 persons enrolled in the SCIMS completing their SCIMS follow-up interview between January 2017 and July 2019 (N = 411). MAIN OUTCOME MEASURES Participants completed a survey developed for this study that included questions about types of CIH currently and previously used, reasons for current and previous use, reasons for discontinuing use of CIH, and reasons for never using CIH since injury. RESULTS Of the 411 respondents, 80.3% were current or previous users of CIH; 19.7% had not used CIH since injury. The most commonly used current types of CIH were multivitamins (40.0%) and massage (32.6%), whereas the most common previously used type of CIH was acupuncture (33.9%). General health and wellness (61.4%) and pain (31.2%) were the most common reasons for using CIH. The primary reason for discontinuing CIH was that it was not helpful (42.1%). The primary reason for not using CIH since injury was not knowing what options are available (40.7%). CONCLUSIONS These results point to the importance for rehabilitation clinicians to be aware that their patients may be using 1 or more CIH approaches. Providers should be open to starting a dialogue to ensure the health and safety of their patients because there is limited information on safety and efficacy of CIH approaches in this population. These results also set the stage for further analysis of this data set to increase our knowledge in this area.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | - Heather Taylor
- Texas Institute for Rehabilitation Research, Houston, TX
| | - Ross Zafonte
- Spaulding Rehabilitation Hospital, Charlestown, MA
| | | |
Collapse
|
49
|
Pilusa SI, Myezwa H, Potterton J. Experiences of secondary health conditions amongst people with spinal cord injury in South Africa: A qualitative study. SOUTH AFRICAN JOURNAL OF PHYSIOTHERAPY 2021; 77:1530. [PMID: 33937547 PMCID: PMC8063775 DOI: 10.4102/sajp.v77i1.1530] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 01/26/2021] [Indexed: 01/04/2023] Open
Abstract
Background Secondary health conditions (SHCs) such as pain, pressure sores, sexual problems, bowel and bladder problems are prevalent throughout the lifespan of people with spinal cord injury (SCI). Studies have reported that SHCs decrease life expectancy and increase health care costs. Studies on the lived experience of SHCs are, however, limited. Objectives To explore the experiences of SHCs amongst people with SCI in a public rehabilitation hospital in South Africa. Method Face-to-face semi-structured interviews were conducted with people with SCI from August 2018 to July 2019. All interviews were transcribed verbatim and analysed using a content analysis approach. Results Seventeen people with SCI were interviewed. Participants experienced a range of SHCs. The most common experienced SHC was pain (94%). The main theme that emerged from the analysis was 'the impact of secondary health conditions on health and well-being'. The categories linked to the impact were SHCs co-occurrence and how SHCs limit function, restrict participation, affect mental health and disrupt lives. Conclusion We found that SHCs were enormously impactful on our participants' lives and health, as illustrated by their stories of fear, embarrassment and shame. Understanding people with SCI experiences of SHCs can enhance communication between people with SCI and health professionals and may help develop prevention strategies. Clinical implications To enhance patient-centred care, health professionals are encouraged to actively listen to patients' experiences of illness and the impact on health and wellbeing.
Collapse
Affiliation(s)
- Sonti I Pilusa
- Department of Physiotherapy, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, Parktown, South Africa
| | - Hellen Myezwa
- Department of Physiotherapy, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, Parktown, South Africa
| | - Joanne Potterton
- Department of Physiotherapy, School of Therapeutic Sciences, Faculty of Health Sciences, University of the Witwatersrand, Parktown, South Africa
| |
Collapse
|
50
|
Gong D, Wang Y, Zhong L, Jia M, Liu T, Li K. Excretory dysfunction and quality of life after a spinal cord injury: A cross-sectional study. J Clin Nurs 2021; 30:1394-1402. [PMID: 33528879 DOI: 10.1111/jocn.15689] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 12/14/2020] [Accepted: 01/22/2021] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES To determine the aspects of excretory dysfunction most influential in determining the quality of life of survivors of spinal cord injury. BACKGROUND Excretory dysfunction is one of the most common and troublesome sequelae of spinal cord injury. Previous studies have shown that it can restrict social participation restriction, cause readmission and generally influence quality of life substantially. DESIGN A cross-sectional survey of hospital inpatients following STOBE guidelines. METHODS A convenience sample of 101 patients with traumatic or non-traumatic spinal cord injury were asked about their experiences of excretory dysfunction, and management and their self-perceived quality of life. Univariate analysis and multiple linear regression were performed to isolate the most important relationships. RESULTS Only 2 of the 101 subjects professed to be unaffected by excretion dysfunction. Bladder-related dysfunction was the most frequently mentioned type of problem. Quality of life impairment was found to be most often associated with bladder accidents, bowel accidents and having more than one bladder complications. CONCLUSIONS Excretory dysfunction substantially impacts quality of life after a spinal cord injury. Bladder accidents, bowel accidents and more than one bladder complication are factors independently influencing the quality of life of spinal cord injury survivors. RELEVANCE TO CLINICAL PRACTICE To improve excretion-related QOL, patients' bladder and bowel self-management training should be strengthened seeking to prevent complications and reduce the risk of bladder and bowel accidents.
Collapse
Affiliation(s)
- De Gong
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| | - Yingmin Wang
- Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Lirong Zhong
- Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Mengmeng Jia
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| | - Ting Liu
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| | - Kun Li
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| |
Collapse
|