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Bhattarai M, Shigemoto Y, Huang YC, Islam MT, Sorenson M. Mindfulness for health and wellbeing in adults with spinal cord injury: A scoping review. J Spinal Cord Med 2024:1-15. [PMID: 39007686 DOI: 10.1080/10790268.2024.2374130] [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: 07/16/2024] Open
Abstract
CONTEXT Individuals with spinal cord injury (SCI) require resources to prevent or self-manage complications in order to maintain optimum functioning and well-being. Rehabilitation literature suggests that mindfulness as an internal psychological resource can play a crucial role in promoting self-management and improving health and well-being. OBJECTIVES We sought to identify and synthesize existing evidence on the role of mindfulness and mindfulness-based interventions in health and well-being outcomes among adults with SCI. METHODS We conducted a scoping review, searching evidence across four electronic databases, CINAHL, PubMed, PsycINFO, and Web of Science, for articles published between 2000 and 2023. Additional articles were searched from the reference list of identified articles. RESULTS Of 354 articles identified in the search, 20 were included in the scoping review. Thirteen studies were interventional in design, while the other seven included cross-sectional and qualitative designs. Some interventional studies examined mindfulness as the major component of the interventions, whereas other studies integrated mindfulness as one component of the intervention program. Overall, mindfulness and mindfulness-based interventions were associated with a range of health and well-being outcomes among individuals with SCI. CONCLUSIONS Mindfulness and mindfulness-based interventions appear to positively impact health and well-being in adults with SCI. However, mindfulness interventions were inconsistent in terms of content, delivery frequency, and duration. It is essential to develop multifaceted, tailored mindfulness interventions utilizing a consumer-based approach and established theories of mindfulness and mindfulness-based practices for adults with SCI.
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Affiliation(s)
- Muna Bhattarai
- College of Nursing, Texas A&M University, College Station, TX, USA
| | - Yuki Shigemoto
- Department of Psychology, Prairie View A&M University, Prairie View, TX, USA
| | - Ya-Ching Huang
- College of Nursing, Texas A&M University, College Station, TX, USA
| | | | - Matthew Sorenson
- College of Nursing, Texas A&M University, College Station, TX, USA
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Li Y, Li M, Bressington D, Li K, Wong AY, Chung WM, Molassiotis A, Ma CZH, Kor PPK, Yeung WF. Effect of a Mindfulness and Motivational Interviewing-Oriented Physical-Psychological Integrative Intervention for Community-Dwelling Spinal Cord Injury Survivors: A Mixed-Methods Randomized Controlled Trial. Arch Phys Med Rehabil 2024:S0003-9993(24)01006-2. [PMID: 38782232 DOI: 10.1016/j.apmr.2024.05.017] [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: 12/14/2023] [Revised: 05/13/2024] [Accepted: 05/14/2024] [Indexed: 05/25/2024]
Abstract
OBJECTIVE To evaluate the feasibility, acceptability, and efficacy of a mindfulness and motivational interviewing-oriented physical-psychological integrated intervention in community-dwelling spinal cord injury (SCI) survivors. DESIGN A mixed-methods randomized controlled trial. SETTING Local organizations for handicapped in Hong Kong. PARTICIPANTS Community-dwelling adults with SCI (N=72). INTERVENTIONS Participants in the intervention group (n=36) received video-guided exercise for daily practice and online group psychological (mindfulness and motivational interviewing-oriented) weekly sessions for 8 weeks. Participants in the control group (n=36) received an 8-week online group didactic education on lifestyle discussions and general health suggestions. MAIN OUTCOMES MEASURES Primary outcomes included quality of life, physical activity, depression, and chronic pain. Secondary outcomes included exercise self-efficacy and mindfulness. Outcomes were measured at baseline, postintervention, and 3-month follow-up. Focus-group interviews were conducted postintervention. RESULTS The recruitment, retention, and adherence rates were 84.7%, 100%, and 98.6%, respectively. The intervention showed significant positive effects on preventing declines in quality of life at 3-month follow-up (Cohen d=0.70, 95% CI=0.22-1.18). Positive trends manifested in physical activity, depression, chronic pain, and exercise self-efficacy. Three qualitative categories were identified: subjective improvements in exercise, physical, and social well-being; perceived changes in mindfulness and mental well-being; and intervention facilitators and barriers. CONCLUSIONS The mindfulness and motivational interviewing-oriented physical-psychological integrated intervention is feasible and acceptable. The significant prolonged effect in maintaining quality of life and positive effects on physical and psychosocial well-being indicate its value to address major health challenges of community-dwelling SCI survivors.
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Affiliation(s)
- Yan Li
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Mengqi Li
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China.
| | | | - Kun Li
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| | - Arnold Yl Wong
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China; Research Institute for Smart Ageing, The Hong Kong Polytechnic University, Hong Kong, China
| | | | - Alex Molassiotis
- College of Arts, Humanities and Education, University of Derby, Derby, United Kingdom
| | - Christina Zong-Hao Ma
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | | | - Wing Fai Yeung
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
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Hoekstra S, Ettema F, van der Bijll M, van der Sterren V, van Binsbergen E, van Orsouw L, Achterberg W, Daanen H, Janssen T, de Groot S. The effect of breathing exercises and mindset with or without cold exposure on mental and physical health in persons with a spinal cord injury-a protocol for a three-arm randomised-controlled trial. Spinal Cord 2024; 62:237-240. [PMID: 38491303 DOI: 10.1038/s41393-024-00976-9] [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: 04/27/2023] [Revised: 03/04/2024] [Accepted: 03/06/2024] [Indexed: 03/18/2024]
Abstract
STUDY DESIGN A three-arm randomized controlled trial. OBJECTIVES To investigate the effects of the Wim Hof Method (WHM), with (WHM-C) and without cold exposure (WHM-NC), on mental and physical health in persons with chronic spinal cord injury (SCI). SETTING Rehabilitation centre (assessments and once-weekly intervention sessions) and home-based (daily intervention sessions). METHODS Sixty adults with chronic SCI will be randomised (1:1:1) to one of three groups: participants in the intervention groups (i.e., WHM-C and WHM-NC) will engage in a 7-week intervention, with one weekly practice session at the rehabilitation centre and a daily WHM session at home. WHM-NC will consist of breathing exercises and mindset, while participants in WHM-C will partake in breathing exercises, mindset and cold exposure. Participants allocated to usual care (UC) will not receive the WHM intervention. The primary outcome is mental health reported via the Mental Health Inventory (MHI)-5, while secondary outcomes include circulating inflammatory and metabolic marker concentration, pulmonary function, body composition, sleep quality, spasticity, chronic pain and psychological stress. ETHICS AND DISSEMINATION Ethics approval has been obtained from the medical ethics committee of the Máxima Medical Centre (Veldhoven, the Netherlands; identifier: w22.069). If shown efficacious in improving mental health, as well as physical health, in persons with chronic SCI, the low cost and accessibility of the WHM allows it to be directly implemented in SCI rehabilitation. TRIAL REGISTRATION NUMBER NCT05704322.
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Affiliation(s)
- Sven Hoekstra
- Department of Rehabilitation Medicine, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Frank Ettema
- Reade Center for Rehabilitation & Rheumatology, Amsterdam, The Netherlands
| | - Max van der Bijll
- Reade Center for Rehabilitation & Rheumatology, Amsterdam, The Netherlands
| | | | | | - Ludwine van Orsouw
- Reade Center for Rehabilitation & Rheumatology, Amsterdam, The Netherlands
| | - Wendy Achterberg
- Reade Center for Rehabilitation & Rheumatology, Amsterdam, The Netherlands
| | - Hein Daanen
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
| | - Thomas Janssen
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
- Amsterdam Rehabilitation Research Center Reade, Amsterdam, The Netherlands
| | - Sonja de Groot
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands.
- Amsterdam Rehabilitation Research Center Reade, Amsterdam, The Netherlands.
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Perret C, Käch M, Hertig-Godeschalk A, Ammann F. Strength and power adaptations of the upper body following 20 training sessions on an eccentric arm-crank ergometer. Eur J Appl Physiol 2024:10.1007/s00421-024-05486-3. [PMID: 38656379 DOI: 10.1007/s00421-024-05486-3] [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: 01/12/2024] [Accepted: 04/04/2024] [Indexed: 04/26/2024]
Abstract
PURPOSE Eccentric strength training is an innovative and promising approach to improve exercise performance. However, most eccentric training studies in the past were performed with a focus on the lower extremities. The present study aimed to test the feasibility and effects on strength and power adaptations of a structured upper-body eccentric training program. METHODS Fourteen (median age (Q1-Q3) 29 years (27-32); 9 females, 5 males) healthy, regularly exercising individuals performed 20 progressive training sessions (2-3 sessions/week at 20-50% peak power for 8-14 min) on a symmetric eccentric arm-crank ergometer. Before and after the intervention, anaerobic peak power (PP) and maximal concentric aerobic power output (POmax) on an arm-crank ergometer as well as the one repetition maximum (1RM) for bench press were determined as main outcome parameters. A p-value ≤ 0.05 was considered statistically significant. RESULTS Significant improvements in PP (+ 4% (1-8), p = 0.007), POmax (+ 6% (0-8); p = 0.01), and 1RM (+ 12% (10-17); p < 0.001) were found. Exercise intensity was relatively low at 64% (55-70) of maximum heart rate. CONCLUSIONS Twenty progressive training sessions on a symmetric arm-crank ergometer are effective in inducing significant aerobic and anaerobic performance and strength improvements in the upper body. This intervention is safe and feasible, and can be performed at relatively low cardiovascular intensities. Therefore, this training method offers an interesting approach from elite sports to rehabilitation.
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Affiliation(s)
- Claudio Perret
- Swiss Paraplegic Research, Guido A. Zaech-Strasse 4, 6207, Nottwil, Switzerland
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Matheo Käch
- Institute of Human Movement Sciences and Sports, ETH Zurich, Zurich, Switzerland
- Institute of Sports Medicine, Swiss Paraplegic Centre, Nottwil, Switzerland
| | | | - Fabian Ammann
- Institute of Sports Medicine, Swiss Paraplegic Centre, Nottwil, Switzerland
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Choukas NR, Mace RA, Rochon EA, Brewer JR, Vranceanu AM. Exploring mechanisms of improvement in the Active Brains intervention for older adults with chronic pain and early cognitive decline. Arch Gerontol Geriatr 2024; 118:105290. [PMID: 38056101 PMCID: PMC11056800 DOI: 10.1016/j.archger.2023.105290] [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: 09/26/2023] [Revised: 11/11/2023] [Accepted: 11/26/2023] [Indexed: 12/08/2023]
Abstract
OBJECTIVES We iteratively developed, optimized, and established the feasibility of a virtual, group-based, mind-body activity program (Active Brains, AB), supported by Fitbit for older adults with chronic pain (CP) and early cognitive decline (ECD). Guided by the principles of the NIH stage model we 1) explore signals of improvement in AB outcomes and hypothesized mechanisms of action and 2) explore relationships between changes in outcomes with changes in mechanisms. METHODS Participants were N = 15 older adults (age ≥ 60) with CP-ECD from two NIH stage 1 pilot studies of AB. We conducted paired t-tests to explore pre-post improvements, and correlations to investigate associations between changes in outcomes and mechanisms. RESULTS We observed small to large improvements across co-primary and secondary outcomes (d = 0.24-1.09). We observed small to medium improvements in 4 out of 5 hypothesized mechanisms (d = 0.23-0.47). Overall, improvements in outcomes had moderate to large associations with improvements in hypothesized mechanisms. CONCLUSION AB was associated with improvements across several co-primary and secondary outcomes, and hypothesized mechanisms. Pain-specific coping and general coping skills are promising treatment targets to address the CP-ECD comorbidity among older adults.
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Affiliation(s)
- Nathaniel R Choukas
- Center for Health Outcomes and Interdisciplinary Research (CHOIR), Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Ryan A Mace
- Center for Health Outcomes and Interdisciplinary Research (CHOIR), Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
| | - Elizabeth A Rochon
- Center for Health Outcomes and Interdisciplinary Research (CHOIR), Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Julie R Brewer
- Center for Health Outcomes and Interdisciplinary Research (CHOIR), Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Ana-Maria Vranceanu
- Center for Health Outcomes and Interdisciplinary Research (CHOIR), Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
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Wiles MD, Benson I, Edwards L, Miller R, Tait F, Wynn-Hebden A. Management of acute cervical spinal cord injury in the non-specialist intensive care unit: a narrative review of current evidence. Anaesthesia 2024; 79:193-202. [PMID: 38088443 DOI: 10.1111/anae.16198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/23/2023] [Indexed: 01/11/2024]
Abstract
Each year approximately one million people suffer spinal cord injury, which has significant physical, psychosocial and economic impacts on patients and their families. Spinal cord rehabilitation centres are a well-established part of the care pathway for patients with spinal cord injury and facilitate improvements in functional independence and reductions in healthcare costs. Within the UK, however, there are a limited number of spinal cord injury centres, which delays admission. Patients and their families often perceive that they are not receiving specialist care while being treated in non-specialist units. This review aimed to provide clinicians who work in non-specialist spinal injury centres with a summary of contemporary studies relevant to the critical care management of patients with cervical spinal cord injury. We undertook a targeted literature review including guidelines, systematic reviews, meta-analyses, clinical trials and randomised controlled trials published in English between 1 June 2017 and 1 June 2023. Studies involving key clinical management strategies published before this time, but which have not been updated or repeated, were also included. We then summarised the key management themes: acute critical care management approaches (including ventilation strategies, blood pressure management and tracheostomy insertion); respiratory weaning techniques; management of pain and autonomic dysreflexia; and rehabilitation.
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Affiliation(s)
- M D Wiles
- Academic Department of Anaesthesia and Peri-operative Medicine, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
- Centre for Applied Health and Social Care Research, Sheffield Hallam University, Sheffield, UK
| | - I Benson
- National Spinal Injuries Centre, Buckinghamshire Hospitals NHS Trust, Stoke Mandeville, UK
| | - L Edwards
- University of Nottingham, Nottingham, UK
| | - R Miller
- Critical Care Department, Northampton General Hospital, Northampton, UK
| | - F Tait
- Critical Care Department, Northampton General Hospital, Northampton, UK
| | - A Wynn-Hebden
- Department of Anaesthesia and Critical Care, University Hospitals of Leicester NHS Trust, Leicester, UK
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Bhattarai M, McDaniels B, Jin Y, Smedema SM. Pain and quality of life in persons with spinal cord injury: Mediating effects of mindfulness, self-efficacy, social support, and functional independence. J Clin Psychol 2024; 80:406-420. [PMID: 37864835 DOI: 10.1002/jclp.23616] [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: 03/07/2023] [Revised: 10/05/2023] [Accepted: 10/13/2023] [Indexed: 10/23/2023]
Abstract
OBJECTIVE To identify mediating roles of mindfulness, self-efficacy, social support, and functional independence in the relationship between pain and quality of life (QOL) in persons with spinal cord injury (SCI). METHODS A cross-sectional descriptive study was conducted using a sample of 272 persons with SCI living in the United States. The participants completed self-report standardized questionnaires on a Qualtrics survey. A parallel mediation analysis adjusting for covariates was performed to test the hypotheses. RESULTS Findings showed significant direct effects of pain on functional independence, self-efficacy, mindfulness, and social support. Self-efficacy, mindfulness, and social support had significant direct effects on QOL. In the mediation analysis, mindfulness, self-efficacy, and social support significantly mediated the relationship between pain and QOL, controlling for other variables in the model. CONCLUSIONS This study adds to the extant literature by providing evidence that mindfulness, self-efficacy, and social support not only directly contribute to QOL but are likely to mitigate the negative effect of pain on QOL in persons with SCI. Identifying these potential factors that can assuage the adverse effects of pain on QOL is a first step toward active intervention to facilitate the adjustment of persons with SCI.
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Affiliation(s)
- Muna Bhattarai
- School of Nursing, Texas A&M University, Bryan, Texas, USA
| | - Bradley McDaniels
- College of Health and Public Service, University of North Texas, Denton, Texas, USA
| | - Yuanyuan Jin
- School of Nursing, Soochow University, Suzhou, China
| | - Susan M Smedema
- Department of Rehabilitation Psychology and Special Education, University of Wisconsin, Madison, Wisconsin, USA
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Mashola MK, Korkie E, Mothabeng DJ. Pain medication misuse in the South African spinal cord injury context. Health SA 2024; 29:2377. [PMID: 38322368 PMCID: PMC10839206 DOI: 10.4102/hsag.v29i0.2377] [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: 03/02/2023] [Accepted: 10/31/2023] [Indexed: 02/08/2024] Open
Abstract
Background Pain after spinal cord injury (SCI) is debilitating and has been reported to be difficult to treat, despite pharmacological interventions. Pain medication misuse (PMM) and associated individual factors among people with spinal cord injury (PWSCI) are scarce. Aim To determine PMM and the associated factors in PWSCI. Setting Homes of community-dwelling manual wheelchair users with SCI in South Africa. Methods Community-dwelling PWSCI (n = 122) were consecutively sampled and the Pain Medication Questionnaire (PMQ) was used to determine PMM. Descriptive statistics, Fisher's exact test, independent t-tests, and simple linear regression tests were performed using SPSS v27. Testing was conducted at the 0.05 level of significance. Results Eighty-five per cent of the participants reported the presence of pain and 48.1% of them used pain medication. Forty-four percent of people who used pain medication scored ≥ 30, indicative of serious aberrant drug-taking behaviours. Opioids were mainly used for neuropathic pain and in combination with other types of medications such as anticonvulsants and non-steroidal anti-inflammatories (44.0%). Pain severity and the type of pain medication were found to be predictors of PMM (p < 0.01 respectively). Conclusion Pain relief after SCI remains difficult to achieve, with an evident high risk of PMM, which may lead to long-lasting side effects, dependency, or overdose. Contribution This study has shown the need for the assessment of the potential risk of dependency before prescribing pain medication, particularly opioids to PWSCI.
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Affiliation(s)
- Mokgadi K Mashola
- Department of Physiotherapy, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Department of Physiotherapy, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Elzette Korkie
- Department of Physiotherapy, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Diphale J Mothabeng
- Department of Physiotherapy, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
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Gérard M, Charvier K, Leduc H, Courtois F. Looking Beyond the Chair: Psycho-Perceptual Predictors of Sexual Distress and Sexual Satisfaction in Individuals with Spinal Cord Injury. JOURNAL OF SEX RESEARCH 2023:1-18. [PMID: 37819254 DOI: 10.1080/00224499.2023.2260816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/13/2023]
Abstract
Despite a large body of biomedical research, little is known about the psychological and perceptual predictors of sexual satisfaction (SS) and sexual distress (SD) post spinal cord injury (SCI). Guided by a bio-psycho-perceptual framework, this cross-sectional research aimed at assessing SS and SD in a large SCI sample using validated patient-reported outcome measures (PROM). Significant correlates and predictors of SS and SD were also identified. Ninety-one men and women with SCI completed PROMs of SS and SD, as well as psychological (mood, sexual and body esteem) and perceptual (interoceptive awareness, trait mindfulness, sexual mindfulness) factors. Neurological profiles were also assessed, along with experience of orgasm. Correlates of SS and SD were first identified using Pearson's correlations, then multiple hierarchical regression models were computed to isolate predictors. Orgasm experience and psychological factors emerged as moderate correlates of both SS and SD, while neurological factors did not. Interoceptive awareness and trait mindfulness showed weak associations with SD and none with SS. Among the tested predictors, experience of orgasm emerged as the strongest for SS (β = -.29, p < .01), followed by mood, which predicted SS and SD. Sexual and body esteem was predictive of SD only. In sexually active participants, sexual mindfulness predicted both SS (β = 0.55, p < .001) and SD (β = -0.56, p < .001) above and beyond all other variables. This study reveals unique aspects of SS and SD postinjury and supports further consideration of psychological and perceptual dimensions of SCI sexuality in rehabilitation research.
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Affiliation(s)
- Marina Gérard
- Psychology Department, Université du Québec à Montréal
| | | | - Hugues Leduc
- Psychology Department, Université du Québec à Montréal
| | - Frédérique Courtois
- Sexology Department, Université du Québec à Montréal
- CIUSSS du Centre-Sud-de-l'Île-de-Montréal (CCSMTL), Gingras Lindsay Montreal Rehabilitation Institute (IRGLM)
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de Groot S, Ettema FWL, van Leeuwen CMC, Achterberg WJ, Janssen TWJ, Hoekstra SP. The Effect of Mindset and Breathing Exercises on Physical and Mental Health in Persons with Spinal Cord Injury-A Pilot Feasibility Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6784. [PMID: 37754643 PMCID: PMC10531230 DOI: 10.3390/ijerph20186784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 09/12/2023] [Accepted: 09/16/2023] [Indexed: 09/28/2023]
Abstract
This study investigated the feasibility and efficacy of mindset and breathing exercises (Wim Hof Method (WHM)) on physical and mental health in persons with spinal cord injury (SCI). Ten individuals with SCI participated in this pilot study. These ten participants followed a 4-week WHM intervention, with one weekly group session in the rehabilitation center and daily practice at home using the WHM app. An in-person exit-interview was conducted post-intervention to collect qualitative information on participants' experiences, regarding the feasibility and effects of the intervention. Furthermore, tests and questionnaires were administered pre- and post-intervention to assess physical and mental health outcomes. Adherence to the weekly in-person meetings was excellent and no adverse events occurred. Physical and mental health outcomes in this small sample size showed some pre-post differences. This pilot feasibility study provides preliminary evidence supporting the feasibility and efficacy of the WHM, including mindset and breathing exercises, on physical and mental health of people with SCI. These results warrant a randomized-controlled trial, including cold exposure, of this novel intervention in people with SCI.
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Affiliation(s)
- Sonja de Groot
- Amsterdam Rehabilitation Research Center, Reade, 1054 HW Amsterdam, The Netherlands;
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, 1081 BT Amsterdam, The Netherlands
| | - Frank W. L. Ettema
- Reade Center for Rehabilitation & Rheumatology, 1054 HW Amsterdam, The Netherlands; (F.W.L.E.); (W.J.A.)
| | - Christel M. C. van Leeuwen
- Centre of Excellence for Rehabilitation Medicine, University Medical Centre Utrecht Brain Centre, University Medical Centre Utrecht, 3583 TM Utrecht, The Netherlands;
- Department of Spinal Cord Injury and Orthopedics, De Hoogstraat Rehabilitation, 3583 TM Utrecht, The Netherlands
| | - Wendy J. Achterberg
- Reade Center for Rehabilitation & Rheumatology, 1054 HW Amsterdam, The Netherlands; (F.W.L.E.); (W.J.A.)
| | - Thomas W. J. Janssen
- Amsterdam Rehabilitation Research Center, Reade, 1054 HW Amsterdam, The Netherlands;
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, 1081 BT Amsterdam, The Netherlands
| | - Sven P. Hoekstra
- Department of Rehabilitation Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX 78229-3900, USA;
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough LE11 3TU, UK
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Mandloi S, Syed M, Shoraka O, Ailes I, Kang KC, Sathe A, Heller J, Thalheimer S, Mohamed FB, Sharan A, Harrop J, Krisa L, Matias C, Alizadeh M. The role of the insula in chronic pain following spinal cord injury: A resting-state fMRI study. J Neuroimaging 2023; 33:781-791. [PMID: 37188633 DOI: 10.1111/jon.13117] [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: 03/20/2023] [Revised: 04/23/2023] [Accepted: 05/04/2023] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND AND PURPOSE Spinal cord injury (SCI) results in the loss of motor and sensory function from disconnections between efferent and afferent pathways. Most SCI patients are affected with chronic neuropathic pain, but there is a paucity of data concerning neuroplastic changes following SCI. Chronic pain disrupts default networks and is associated with abnormal insular connectivity. The posterior insula (PI) is associated with the degree of pain and intensity of pain. The anterior insula (AI) is related to signal changes. Comprehension of SCI pain mechanisms is essential to elucidate effective treatment options. METHODS This study examines the insular gyri functional connectivity (FC) of seven (five male, two female) SCI participants with moderate-severe chronic pain compared to 10 (five male, five female) healthy controls (HC). All subjects had 3-Tesla MRI performed and resting-state functional MRI (fMRI) was acquired. FC metrics were obtained from the comparisons of resting-state fMRI among our various groups. A seed-to-voxel analysis was pursued, encompassing six gyri of the insula. For multiple comparisons, a correction was applied with a significance level of p < .05. RESULTS There were significant differences in FC of the insula between SCI participants with chronic pain compared with HC. In the SCI participants, there was hyperconnectivity of the AI and PI to the frontal pole. In addition, there was increased FC noted between the PI and the anterior cingulate cortex. Hyperconnectivity was also observed between the AI and the occipital cortex. CONCLUSIONS These findings illustrate that there is a complex hyperconnectivity and modulation of pain pathways after traumatic SCI.
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Affiliation(s)
- Shreya Mandloi
- Department of Neurological Surgery, Vickie and Jack Farber Institute for Neuroscience, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Mashaal Syed
- Department of Neurological Surgery, Vickie and Jack Farber Institute for Neuroscience, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Omid Shoraka
- Department of Neurological Surgery, Vickie and Jack Farber Institute for Neuroscience, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Isaiah Ailes
- Department of Neurological Surgery, Vickie and Jack Farber Institute for Neuroscience, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Ki Chang Kang
- Department of Neurological Surgery, Vickie and Jack Farber Institute for Neuroscience, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Anish Sathe
- Department of Neurological Surgery, Vickie and Jack Farber Institute for Neuroscience, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Joshua Heller
- Department of Neurological Surgery, Vickie and Jack Farber Institute for Neuroscience, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Sara Thalheimer
- Department of Neurological Surgery, Vickie and Jack Farber Institute for Neuroscience, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Feroze B Mohamed
- Thomas Jefferson Integrated Magnetic Resonance Imaging Center, Department of Radiology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Ashwini Sharan
- Department of Neurological Surgery, Vickie and Jack Farber Institute for Neuroscience, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - James Harrop
- Department of Neurological Surgery, Vickie and Jack Farber Institute for Neuroscience, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Laura Krisa
- Department of Physical Therapy, Jefferson College of Rehabilitation Sciences, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Caio Matias
- Department of Neurological Surgery, Vickie and Jack Farber Institute for Neuroscience, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
| | - Mahdi Alizadeh
- Department of Neurological Surgery, Vickie and Jack Farber Institute for Neuroscience, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
- Thomas Jefferson Integrated Magnetic Resonance Imaging Center, Department of Radiology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA
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Van de Winckel A, Carpentier ST, Deng W, Zhang L, Philippus A, Battaglino R, Morse LR. Feasibility of using remotely delivered Spring Forest Qigong to reduce neuropathic pain in adults with spinal cord injury: a pilot study. Front Physiol 2023; 14:1222616. [PMID: 37719467 PMCID: PMC10500194 DOI: 10.3389/fphys.2023.1222616] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 08/10/2023] [Indexed: 09/19/2023] Open
Abstract
Introduction: Approximately 69% of 299,000 Americans with spinal cord injury (SCI) suffer debilitating chronic neuropathic pain, which is intractable to treatment. The aim of this study is to determine feasibility, as the primary objective, and estimates of efficacy of a remotely delivered Qigong intervention in adults with SCI-related neuropathic pain, as the secondary objective. Methods: We recruited adults with SCI-related neuropathic pain, with SCI ≥3 months, with complete or incomplete SCI, and highest neuropathic pain level of >3 on the Numeric Pain Rating Scale (NPRS), using nationwide volunteer sampling. Using a non-randomized controlled trial design, participants practiced Spring Forest Qigong's "Five Element Qigong Healing Movements" (online video) by combining movement to the best of their ability with kinesthetic imagery, at least 3x/week for 12 weeks. Adherence was automatically tracked through the Spring Forest Qigong website. Outcomes of neuropathic pain intensity (NPRS) were assessed weekly, and SCI-related symptoms were assessed at baseline, 6, and 12 weeks of Qigong practice and at 6-week and 1-year follow-ups. Results: We recruited 23 adults with chronic SCI (7/2021-2/2023). In total, 18 participants started the study and completed all study components, including the 6-week follow-up. Twelve participants completed the 1-year follow-up assessment. Feasibility was demonstrated through participants' willingness to participate, adherence, and acceptability of the study. Mean age of the 18 participants was 60 ± 12 years, and they were 15 ± 11 years post-SCI with the highest baseline neuropathic pain of 7.94 ± 2.33, which was reduced to 4.17 ± 3.07 after 12 weeks of Qigong practice (Cohen's d = 1.75). This pain relief remained at 6-week and 1-year follow-ups. Participants reported reduced spasm frequency (change score 1.17 ± 1.20, d = 0.98) and severity (0.72 ± 1.02, d = 0.71), reduced interference of neuropathic pain on mood (3.44 ± 2.53, d = 1.36), sleep (3.39 ± 2.40, d = 1.41), daily activities (3.17 ± 2.77, d = 1.14), greater ability to perform functional activities (6.68 ± 3.07, d = 2.18), and improved mood (2.33 ± 3.31, d = 0.70) after Qigong. Discussion: Remote Spring Forest Qigong's "Five Element Qigong Healing Movements" practice is feasible in adults with SCI-related neuropathic pain, with promising prolonged results of neuropathic pain relief and improvement in SCI-related symptoms after Qigong practice. Clinical trial registration: https://www.clinicaltrials.gov/ct2/show/NCT04917107, identifier NCT04917107.
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Affiliation(s)
- Ann Van de Winckel
- Division of Physical Therapy, Division of Rehabilitation Science, Department of Rehabilitation Medicine, Medical School, University of Minnesota, Minneapolis, MN, United States
| | - Sydney T. Carpentier
- Division of Rehabilitation Science, Department of Rehabilitation Medicine, Medical School, University of Minnesota, Minneapolis, MN, United States
| | - Wei Deng
- Division of Rehabilitation Science, Department of Rehabilitation Medicine, Medical School, University of Minnesota, Minneapolis, MN, United States
| | - Lin Zhang
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN, United States
| | - Angela Philippus
- Department of Rehabilitation Medicine, Medical School, University of Minnesota, Minneapolis, MN, United States
| | - Ricardo Battaglino
- Department of Rehabilitation Medicine, Medical School, University of Minnesota, Minneapolis, MN, United States
| | - Leslie R. Morse
- Department of Rehabilitation Medicine, Medical School, University of Minnesota, Minneapolis, MN, United States
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Abrams SK, Rabinovitch BS, Zafar R, Aziz AS, Cherup NP, McMillan DW, Nielson JL, Lewis EC. Persons With Spinal Cord Injury Report Peripherally Dominant Serotonin-Like Syndrome After Use of Serotonergic Psychedelics. Neurotrauma Rep 2023; 4:543-550. [PMID: 37636336 PMCID: PMC10457609 DOI: 10.1089/neur.2023.0022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/29/2023] Open
Abstract
Psychedelic-assisted therapy (PAT) may treat various mental health conditions. Despite its promising therapeutic signal across mental health outcomes, less attention is paid on its potential to provide therapeutic benefits across complex medical situations within rehabilitation medicine. Persons with spinal cord injury (SCI) have a high prevalence of treatment-resistant mental health comorbidities that compound the extent of their physical disability. Reports from online discussion forums suggest that those living with SCI are using psychedelics, though the motivation for their use is unknown. These anecdotal reports describe a consistent phenomenon of neuromuscular and autonomic hypersensitivity to classical serotonergic psychedelics, such as psilocybin and lysergic acid diethylamide (LSD). Persons describe intense muscle spasms, sweating, and tremors, with an eventual return to baseline and no reports of worsening of their baseline neurological deficits. The discomfort experienced interferes with the subjective beneficial effects self-reported. This phenomenon has not been described previously in the academic literature. We aim to provide a descriptive review and explanatory theoretical framework hypothesizing this phenomenon as a peripherally dominant serotonin syndrome-like clinical picture-that should be considered as such when persons with SCI are exposed to classical psychedelics. Raising awareness of this syndrome may help our mechanistic understanding of serotonergic psychedelics and stimulate development of treatment protocols permitting persons with SCI to safely tolerate their adverse effects. As PAT transitions from research trials into accepted clinical and decriminalized use, efforts must be made from a harm reduction perspective to understand these adverse events, while also serving as an informed consent process aid if such therapeutic approaches are to be considered for use in persons living with SCI.
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Affiliation(s)
| | - Brenden Samuel Rabinovitch
- Numinus Toronto, Toronto, Ontario, Canada
- Division of Fundamental Neurobiology, Krembil Research Institute, Toronto, Ontario, Canada
- Department of Physiology, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Rayyan Zafar
- Centre for Psychedelic Research and Neuropsychopharmacology, Imperial College, London, United Kingdom
| | - Aly Shah Aziz
- Pediatric Neurology Clinic, Oakville, Ontario, Canada
| | - Nicholas Paul Cherup
- The Miami Project to Cure Paralysis, University of Miami Leonard M. Miller School of Medicine, Miami, Florida, USA
- Department of Neurological Surgery, University of Miami Leonard M. Miller School of Medicine, Miami, Florida, USA
| | - David W. McMillan
- The Miami Project to Cure Paralysis, University of Miami Leonard M. Miller School of Medicine, Miami, Florida, USA
- Department of Neurological Surgery, University of Miami Leonard M. Miller School of Medicine, Miami, Florida, USA
| | - Jessica L. Nielson
- Department of Psychiatry and Behavioral Sciences; Institute for Health Informatics, University of Minnesota, Minneapolis, Minnesota, USA
| | - Evan Cole Lewis
- Numinus Toronto, Toronto, Ontario, Canada
- Department of Pediatrics, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
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Ginsenoside Rg1 attenuation of neurogenesis disorder and neuronal apoptosis in the rat hippocampus after spinal cord injury may involve brain-derived neurotrophic factor/extracellular signal-regulated kinase signaling. Neuroreport 2023; 34:290-298. [PMID: 36881751 DOI: 10.1097/wnr.0000000000001891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2023]
Abstract
OBJECTIVE We previously demonstrated that spinal cord injury (SCI) induced hippocampus injury and depression in rodents. Ginsenoside Rg1 effectively prevents neurodegenerative disorders. Here, we investigated the effects of ginsenoside Rg1 on the hippocampus after SCI. METHODS We used a rat compression SCI model. Western blotting and morphologic assays were used to investigate the protective effects of ginsenoside Rg1 in the hippocampus. RESULTS Brain-derived neurotrophic factor/extracellular signal-regulated kinases (BDNF/ERK) signaling was altered in the hippocampus at 5 weeks after SCI. SCI attenuated neurogenesis and enhanced the expression of cleaved caspase-3 in the hippocampus; however, ginsenoside Rg1 attenuated cleaved caspase-3 expression and improved neurogenesis and BDNF/ERK signaling in the rat hippocampus. The results suggest that SCI affects BDNF/ERK signaling, and ginsenoside Rg1 can attenuate hippocampal damage after SCI. CONCLUSION We speculate that the protective effects of ginsenoside Rg1 in hippocampal pathophysiology after SCI may involve BDNF/ERK signaling. Ginsenoside Rg1 shows promise as a therapeutic pharmaceutical product when seeking to counter SCI-induced hippocampal damage.
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Bai XY, Liu XL, Deng ZZ, Wei DM, Zhang D, Xi HL, Wang QY, He MZ, Yang YL. Ferroptosis is a new therapeutic target for spinal cord injury. Front Neurosci 2023; 17:1136143. [PMID: 36998732 PMCID: PMC10047267 DOI: 10.3389/fnins.2023.1136143] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Accepted: 02/27/2023] [Indexed: 03/15/2023] Open
Abstract
Spinal cord injury is a serious traumatic disease. As Ferroptosis has been increasingly studied in recent years, it has been found to be closely related to the pathophysiological processes of spinal cord injury. Iron overload, reactive oxygen species accumulation, lipid peroxidation and glutamate accumulation associated with Ferroptosis are all present in spinal cord injury, and thus Ferroptosis is thought to be involved in the pathological processes secondary to spinal cord injury. This article highlights the relationship between Ferroptosis and spinal cord injury, lists substances that improve spinal cord injury by inhibiting Ferroptosis, and concludes with a discussion of the problems that may be encountered in the clinical translation of Ferroptosis inhibitors as a means of enabling their faster use in clinical treatment.
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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.
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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
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Hunt A, McQuillan KA. Acute Management of Cervical Spinal Cord Injuries. Crit Care Nurs Clin North Am 2023; 35:119-128. [PMID: 37127369 DOI: 10.1016/j.cnc.2023.02.004] [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: 03/29/2023]
Abstract
Traumatic cervical spinal cord injury can cause significant neurologic disability. A cervical spine injury impacts not only the neurologic system but also numerous other organ systems of the body. This complex injury requires a systematic approach to assessment and care aimed at preventing, recognizing, and treating potentially devastating secondary spinal cord injury and multisystem complications. This article focuses on the pathophysiology, initial presentation, and treatment of cervical spinal cord injury by body system.
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Affiliation(s)
- Alexandra Hunt
- R Adams Cowley Shock Trauma Center, University of Maryland Medical Center, 22 South Greene Street, Baltimore, MD 21201, USA.
| | - Karen A McQuillan
- R Adams Cowley Shock Trauma Center, University of Maryland Medical Center, 22 South Greene Street, Baltimore, MD 21201, USA
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Van de Winckel A, Carpentier ST, Deng W, Zhang L, Philippus A, Monden KR, Battaglino R, Morse LR. Using remotely delivered Spring Forest Qigong™ to reduce neuropathic pain in adults with spinal cord injury: A non-randomized controlled trial. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.02.11.23285793. [PMID: 36824929 PMCID: PMC9949188 DOI: 10.1101/2023.02.11.23285793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Importance The manuscript proposes the feasibility and potential of a remote Qigong intervention to reduce neuropathic pain in adults with spinal cord injury (SCI)-related neuropathic pain. Objective We determined the feasibility and estimates of efficacy of a remotely delivered Qigong intervention in adults with SCI-related neuropathic pain. Design This is a non-randomized controlled trial with outcomes assessed at baseline-, 6- and 12-weeks of Qigong practice, and at 6-weeks and 1-year follow-up. Setting Completely remote clinical trial. Participants Adults with SCI-related neuropathic pain, with SCI ≥3 months, with complete or incomplete SCI, and highest neuropathic pain level of >3 on the Numeric Pain Rating Scale (NPRS). We used nationwide volunteer sampling.We recruited 23 adults with chronic SCI (7/2021-2/2022). Eighteen participants started the study and completed all study components, including the 6-week follow-up. Twelve participants completed the 1-year follow-up assessment. Intervention Participants practiced the Spring Forest Qigong™ "Five Element Healing Movements" with an online video by combining movement with kinesthetic imagery, at least 3x/week for 12 weeks. Main Outcomes and Measures To address the feasibility outcome and track adherence, the website automatically monitored the days and duration that the Qigong video was played. Self-report neuropathic pain intensity and SCI-related symptoms such as spasms, functional performance, mood, and body appreciation were also collected. Results Eighteen participants, 60±12 years of age, 15±11 years post-SCI had a highest baseline neuropathic pain of 7.94±2.33 on the NPRS, which was reduced to 4.17±3.07 after 12 weeks of Qigong practice (Cohen's d =1.75). This pain relief remained at 6-week and 1-year follow-ups. Participants reported reduced spasm frequency (change score 1.17±1.20, d =0.98) and severity (0.72±1.02, d =0.71), and reduced interference of neuropathic pain on mood (3.44±2.53, d =1.36), sleep (3.39±2.40, d =1.41), and daily activities (3.17±2.77, d =1.14). They had a greater ability to perform functional activities (Patient Specific Functional Scale, 6.68±3.07, d =2.18) and had improved mood (Patient Health Questionnaire-9, 2.33±3.31, d =0.70). Conclusions and Relevance Our preliminary data demonstrate the feasibility of Qigong practice in adults with SCI-related neuropathic pain and promising results of neuropathic pain relief and improvement in SCI-related symptoms after Qigong practice. Trial Registration this manuscript refers to the quasi-experimental substudy CREATION: A Clinical Trial of Qigong for Neuropathic Pain Relief in Adults with Spinal Cord Injury, NCT04917107 , https://www.clinicaltrials.gov/ct2/show/NCT04917107 .
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Han A, Wilroy JD, Jenkins J, Yuen HK. Effects of a coach-guided videoconferencing acceptance and commitment therapy intervention combined with psychoeducation on distressed individuals living with spinal cord injury: a preliminary mixed-methods study. Disabil Rehabil 2023; 45:644-654. [PMID: 35156500 DOI: 10.1080/09638288.2022.2038283] [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] [Indexed: 01/28/2023]
Abstract
PURPOSE This study examined effects of coach-guided videoconferencing acceptance and commitment therapy (ACT) accompanied by psychoeducation on distressed individuals with spinal cord injury (SCI) and explored participants' experiences in the intervention. MATERIALS AND METHODS Ten people with SCI participated in 8 individual videoconferencing sessions delivered by trained coaches. Data using self-reported questionnaires and individual interviews was collected at pretest and posttest and analyzing using Wilcoxon signed-rank tests and interpretative phenomenological analysis (ClinicalTrials.gov ID: NCT04670406). RESULTS Statistically significant improvements were found in depression, anxiety, stress, grief, engagement in meaningful activities, and self-compassion with medium to large effect sizes. There was no significant change in quality of life, resilience, and ACT processes. Participants gained a new way of thinking by: being aware of thoughts and emotions; exploring perceptions of others; and focusing on the present. Also, the intervention equipped participants to deal with challenges by: improving coping with SCI-related conditions; practicing self-compassion, acceptance, and meditation; and acquiring skills of value-based decision making and committed action. CONCLUSIONS Findings contribute to the limited evidence as the first study that measured effects of videoconferencing ACT on people with SCI. Future randomized controlled trials are needed to measure efficacy of internet-delivered ACT for people with SCI.IMPLICATIONS FOR REHABILITATIONGuided videoconferencing ACT may reduce depressive symptoms, anxiety, stress, and grief and increase engagement in meaningful activities and self-compassion in people with SCI.Professionals may consider ACT as a supportive or adjunct service for people with SCI who experience psychological distress.
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Affiliation(s)
- Areum Han
- Department of Occupational Therapy, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Jereme D Wilroy
- Department of Physical Medicine and Rehabilitation, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Jeremy Jenkins
- Telehealth Private Practice: jeremyjenkins.icouch.me, Edmond, OK, USA
| | - Hon K Yuen
- Department of Occupational Therapy, University of Alabama at Birmingham, Birmingham, AL, USA
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Sharma A, Muresanu DF, Tian ZR, Nozari A, Lafuente JV, Buzoianu AD, Sjöquist PO, Feng L, Wiklund L, Sharma HS. Co-Administration of Nanowired Monoclonal Antibodies to Inducible Nitric Oxide Synthase and Tumor Necrosis Factor Alpha Together with Antioxidant H-290/51 Reduces SiO 2 Nanoparticles-Induced Exacerbation of Pathophysiology of Spinal Cord Trauma. ADVANCES IN NEUROBIOLOGY 2023; 32:195-229. [PMID: 37480462 DOI: 10.1007/978-3-031-32997-5_5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/24/2023]
Abstract
Military personnel are often exposed to silica dust during combat operations across the globe. Exposure to silica dust in US military or service personnel could cause Desert Strom Pneumonitis also referred to as Al Eskan disease causing several organs damage and precipitate autoimmune dysfunction. However, the effects of microfine particles of sand inhalation-induced brain damage on the pathophysiology of traumatic brain or spinal cord injury are not explored. Previously intoxication of silica nanoparticles (50-60 nm size) is shown to exacerbates spinal cord injury induces blood-spinal cord barrier breakdown, edema formation and cellular changes. However, the mechanism of silica nanoparticles-induced cord pathology is still not well known. Spinal cord injury is well known to alter serotonin (5-hydroxytryptamine) metabolism and induce oxidative stress including upregulation of nitric oxide synthase and tumor necrosis factor alpha. This suggests that these agents are involved in the pathophysiology of spinal cord injury. In this review, we examined the effects of combined nanowired delivery of monoclonal antibodies to neuronal nitric oxide synthase (nNOS) together with tumor necrosis factor alpha (TNF-α) antibodies and a potent antioxidant H-290/51 to induce neuroprotection in spinal cord injury associated with silica nanoparticles intoxication. Our results for the first time show that co-administration of nanowired delivery of antibodies to nNOS and TNF-α with H-290/51 significantly attenuated silica nanoparticles-induced exacerbation of spinal cord pathology, not reported earlier.
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Affiliation(s)
- Aruna Sharma
- International Experimental Central Nervous System Injury & Repair (IECNSIR), Department of Surgical Sciences, Anesthesiology & Intensive Care Medicine, Uppsala University Hospital, Uppsala University, Uppsala, Sweden
| | - Dafin F Muresanu
- Department Clinical Neurosciences, University of Medicine & Pharmacy, Cluj-Napoca, Romania
- "RoNeuro" Institute for Neurological Research and Diagnostic, Cluj-Napoca, Romania
| | - Z Ryan Tian
- Department Chemistry & Biochemistry, University of Arkansas, Fayetteville, AR, USA
| | - Ala Nozari
- Anesthesiology & Intensive Care, Chobanian & Avedisian School of Medicine, Boston University, Boston, MA, USA
| | - José Vicente Lafuente
- LaNCE, Department Neuroscience, University of the Basque Country (UPV/EHU), Leioa, Bizkaia, Spain
| | - Anca D Buzoianu
- Department of Clinical Pharmacology and Toxicology, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Per-Ove Sjöquist
- Division of Cardiology, Department of Medicine, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - Lianyuan Feng
- Department of Neurology, Bethune International Peace Hospital, Zhongshan, Hebei Province, China
| | - Lars Wiklund
- International Experimental Central Nervous System Injury & Repair (IECNSIR), Department of Surgical Sciences, Anesthesiology & Intensive Care Medicine, Uppsala University Hospital, Uppsala University, Uppsala, Sweden
| | - Hari Shanker Sharma
- International Experimental Central Nervous System Injury & Repair (IECNSIR), Department of Surgical Sciences, Anesthesiology & Intensive Care Medicine, Uppsala University Hospital, Uppsala University, Uppsala, Sweden.
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Li Y, Wong A, Chung WM, Li M, Molasiotis A, Bressington D, Ma CZH, Kor PPK, Yeung WF. Evaluation of a Physical-Psychological Integrative (PPI) intervention for community-dwelling spinal cord injury survivors: Study protocol of a preliminary randomized controlled trial. PLoS One 2023; 18:e0282846. [PMID: 36940214 PMCID: PMC10027219 DOI: 10.1371/journal.pone.0282846] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 02/16/2023] [Indexed: 03/21/2023] Open
Abstract
INTRODUCTION There is a considerably large group of community-dwelling spinal cord injury (SCI) survivors living with low quality of life. Physical inactivity, depression, and chronic pain are major problems faced by SCI survivors discharged from the acute phase of treatment or inpatient rehabilitation. This study aims to evaluate the feasibility, acceptability, and preliminary effects of a Physical-Psychological Integrative (PPI) online group intervention on community-dwelling SCI survivors' physical activity, depression, and chronic pain. METHODS This is a two-arm pilot randomized controlled trial with repeated measures (pre-, post-intervention, and 3-month follow-up) design. Seventy-two participants will be randomly assigned to two study groups. The PPI intervention group will receive a video program for physical activity training and eight-week online group psychological interventions using skills of group-based motivational interviewing and mindfulness-based stress reduction. The control group will receive an eight-week online didactic education programed. Focus-group interviews will be conducted post-intervention to explore their views about acceptance and suggested improvements to the intervention. The feasibility of study procedures and the acceptability of interventions will be evaluated. The effectiveness of the PPI intervention will be evaluated by leisure-time physical activity, depression, chronic pain, exercise efficacy, mindfulness, and quality of life. We will use the generalized estimating equation to assess intervention effects and content analysis for interview data. This study has received ethical approval from the Hong Kong Polytechnic University (HSEARS20210705004) and was registered in ClinicalTrials.gov (NCT05535400). DISCUSSION This study will be the first to provide empirical data on the evaluation of an online-group intervention integrating both physical activity promotion and psychological approaches, aimed at reducing physical inactivity, depression, and chronic pain for community-dwelling SCI survivors in Hong Kong. The findings could provide evidence supporting the use of PPI intervention as a novel online group support, in addressing both the physical and psychological needs of community-dwelling SCI survivors.
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Affiliation(s)
- Yan Li
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Arnold Wong
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | | | - Mengqi Li
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Alex Molasiotis
- College of Arts, Humanities and Education, University of Derby, Derby, United Kingdom
| | - Daniel Bressington
- College of Nursing and Midwifery, Charles Darwin University, Darwin, Australia
| | - Christina Zong-Hao Ma
- Department of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong, China
| | | | - Wing Fai Yeung
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
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Kuo CC, Tsai ST, Huang XL, Chen YC. Potential benefits of spinal cord stimulation treatment on quality of life for paralyzed patients with spinal cord injury. Tzu Chi Med J 2023. [DOI: 10.4103/tcmj.tcmj_102_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Korupolu R, Malik A, Ratcliff C, Robinson-Whelen S, Taylor HB. Feasibility, Acceptability, and Efficacy of Mindfulness Training in People With Upper Motor Neuron Disorders: A Systematic Review. Arch Phys Med Rehabil 2022; 103:2410-2428. [PMID: 35760105 DOI: 10.1016/j.apmr.2022.05.020] [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: 09/27/2021] [Revised: 05/03/2022] [Accepted: 05/12/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVES This systematic review aims to gain a comprehensive understanding of the feasibility, acceptability, and efficacy of mindfulness-based interventions (MBIs) on depression, anxiety, fatigue, and health-related quality of life among individuals with upper motor neuron disorders (UMNDs). DATA SOURCES PubMed, PsycINFO, Excerpta Medica Database, and Cumulative Index to Nursing and Allied Health Literature were searched for relevant studies published between January 2001 and June 2021. STUDY SELECTION Clinical trials published in English evaluating MBIs in adults with the 4 most common UMNDs (multiple sclerosis, brain injury including stroke, spinal cord injury, amyotrophic lateral sclerosis) were included. DATA EXTRACTION Two reviewers independently performed the risk of bias assessment using standardized tools and extracted desired data electronically. DATA SYNTHESIS A total of 44 studies were included: 26 randomized controlled trials, 10 nonrandomized controlled trials, and 8 pre-post intervention studies. The average ± SD duration of MBIs was 8±2 weeks. On average, 85%±14% of participants completed the MBI, and the retention rate at follow-up was 80%±16%. Only 14% of the studies delivered MBIs virtually, and feasibility metrics were similar to in-person studies. Among studies reporting acceptability data, most participants reported satisfaction with the MBI. Randomized controlled trials that evaluated the effects of MBI on depression, anxiety, fatigue, and quality of life revealed greater relative improvement in these outcomes among MBI participants compared with controls, with differences greater when compared with passive control than active control participants. None of the studies included in this review studied dose response. CONCLUSIONS Based on current data, MBIs are feasible and offer a promising approach to address the biopsychosocial needs of individuals with UMNDs. MBIs are associated with a high acceptance rate among participants, with notable improvements in depression, anxiety, fatigue, and quality of life post intervention. Future studies are needed to evaluate alternate models of delivery of MBIs and the dose-response relationship.
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Affiliation(s)
- Radha Korupolu
- Department of Physical Medicine and Rehabilitation, University of Texas Health Sciences Center at Houston, Houston, Texas; TIRR Memorial Hermann, Houston, Texas.
| | - Aila Malik
- Department of Physical Medicine and Rehabilitation, University of Texas Health Sciences Center at Houston, Houston, Texas
| | - Chelsea Ratcliff
- Department of Psychology, Sam Houston State University, Huntsville, Texas
| | - Susan Robinson-Whelen
- TIRR Memorial Hermann, Houston, Texas; Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, Texas
| | - Heather B Taylor
- Department of Physical Medicine and Rehabilitation, University of Texas Health Sciences Center at Houston, Houston, Texas; TIRR Memorial Hermann, Houston, Texas
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Bhattarai M, Smedema SM, Hoyt WT, Bishop M. The role of mindfulness in quality of life of persons with spinal cord injury: a cross-sectional study. Health Qual Life Outcomes 2022; 20:148. [PMID: 36310168 PMCID: PMC9620601 DOI: 10.1186/s12955-022-02059-w] [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] [Received: 02/25/2022] [Revised: 09/27/2022] [Accepted: 10/07/2022] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Quality of life is considered the most overarching psychosocial adaptation outcome following the rehabilitation of persons with spinal cord injury. Literature suggests that the quality of life of persons with spinal cord injury is determined by many personal and psychological factors, including mindfulness. This study aimed to identify the direct and indirect effect of mindfulness on the quality of life of persons living with spinal cord injury. METHODS Participants consisted of 231 members of three spinal cord injury organizations in the United States: United Spinal Association, North American Spinal Cord Injury Consortium, and Paralyzed Veterans of America-Wisconsin Chapter. The participants completed a set of standardized self-report questionnaires in an online Qualtrics survey. A hierarchical regression analysis was performed to identify the contribution of mindfulness to quality of life, controlling for sociodemographic and injury-related factors. A serial mediation analysis was performed to examine the indirect effect of mindfulness on quality of life. RESULTS In the hierarchical regression analysis, sociodemographic and injury-related factors (i.e., age, gender, race, marital status, education, employment, level and completeness of injury, comorbidities, frequency of hospitalization, pain intensity, and functional limitation) and mindfulness explained 59% variance on quality of life of the participants with spinal cord injury. Mindfulness uniquely contributed to the higher quality of life above and beyond sociodemographic and injury-related variables. In the serial mediation analysis, pain and functional limitation did not significantly mediate the relationship between mindfulness and quality of life. However, the indirect effects of mindfulness on functional limitation and quality of life through pain were significant. CONCLUSION The findings underscore the vital role of mindfulness in improving the quality of life of persons with spinal cord injury. Implications of these findings for future research and clinical practice are discussed.
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Affiliation(s)
- Muna Bhattarai
- grid.264756.40000 0004 4687 2082School of Nursing, Texas A&M University, 8447 Riverside Pkwy, 77807-3260 Bryan, TX USA
| | - Susan Miller Smedema
- grid.14003.360000 0001 2167 3675Department of Rehabilitation Psychology & Special Education, University of Wisconsin–Madison, Madison, WI USA
| | - William T. Hoyt
- grid.14003.360000 0001 2167 3675Department of Counseling Psychology, University of Wisconsin–Madison, Madison, WI USA
| | - Malachy Bishop
- grid.14003.360000 0001 2167 3675Department of Rehabilitation Psychology & Special Education, University of Wisconsin–Madison, Madison, WI USA
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Leemhuis E, Favieri F, Forte G, Pazzaglia M. Integrated Neuroregenerative Techniques for Plasticity of the Injured Spinal Cord. Biomedicines 2022; 10:biomedicines10102563. [PMID: 36289825 PMCID: PMC9599452 DOI: 10.3390/biomedicines10102563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 09/18/2022] [Accepted: 10/10/2022] [Indexed: 11/16/2022] Open
Abstract
On the slow path to improving the life expectancy and quality of life of patients post spinal cord injury (SCI), recovery remains controversial. The potential role of the regenerative capacity of the nervous system has led to numerous attempts to stimulate the SCI to re-establish the interrupted sensorimotor loop and to understand its potential in the recovery process. Numerous resources are now available, from pharmacological to biomolecular approaches and from neuromodulation to sensorimotor rehabilitation interventions based on the use of various neural interfaces, exoskeletons, and virtual reality applications. The integration of existing resources seems to be a promising field of research, especially from the perspective of improving living conditions in the short to medium term. Goals such as reducing chronic forms of neuropathic pain, regaining control over certain physiological activities, and enhancing residual abilities are often more urgent than complete functional recovery. In this perspective article, we provide an overview of the latest interventions for the treatment of SCI through broad phases of injury rehabilitation. The underlying intention of this work is to introduce a spinal cord neuroplasticity-based multimodal approach to promote functional recovery and improve quality of life after SCI. Nonetheless, when used separately, biomolecular therapeutic approaches have been shown to have modest outcomes.
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Affiliation(s)
- Erik Leemhuis
- Dipartimento di Psicologia, Sapienza Università di Roma, 00185 Rome, Italy
- Body and Action Lab, IRCCS Fondazione Santa Lucia, 00179 Rome, Italy
- Correspondence: (E.L.); (M.P.)
| | - Francesca Favieri
- Dipartimento di Psicologia, Sapienza Università di Roma, 00185 Rome, Italy
- Body and Action Lab, IRCCS Fondazione Santa Lucia, 00179 Rome, Italy
| | - Giuseppe Forte
- Body and Action Lab, IRCCS Fondazione Santa Lucia, 00179 Rome, Italy
- Dipartimento di Psicologia Dinamica, Clinica e Salute, Sapienza Università di Roma, 00185 Roma, Italy
| | - Mariella Pazzaglia
- Dipartimento di Psicologia, Sapienza Università di Roma, 00185 Rome, Italy
- Body and Action Lab, IRCCS Fondazione Santa Lucia, 00179 Rome, Italy
- Correspondence: (E.L.); (M.P.)
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Parker MA, Ichikawa JK, Bombardier CH, Hammond FM. Association Between Anxiety Symptoms, Depression Symptoms, and Life Satisfaction Among Individuals 1 Year After Spinal Cord Injury: Findings From the SCIRehab Project. Arch Rehabil Res Clin Transl 2022; 4:100211. [PMID: 36123974 PMCID: PMC9482038 DOI: 10.1016/j.arrct.2022.100211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Objective To examine the association between anxiety symptoms, depression symptoms, and life satisfaction 1 year after SCI. Design Cross-sectional analysis of data from the SCIRehab Project. A linear regression model estimated the association between anxiety symptoms and life satisfaction and tested the moderating effect of depression symptoms on the association between anxiety symptoms and depression symptoms with an interaction term. Setting Six rehabilitation facilities across the United States. Participants A total to 940 persons older than 12 years who received inpatient spinal cord injury (SCI) rehabilitation between 2007 and 2009 were followed up 1 year post injury (n=940). Interventions None Main Outcome Measures Life satisfaction 1 year after SCI measured via the Satisfaction With Life Scale. Results Unadjusted analyses showed anxiety symptoms were associated with decreased life satisfaction for individuals with SCI. In adjusted analyses, anxiety symptoms were not associated with life satisfaction. In adding an interaction term, anxiety symptoms were associated with 2 points lower life satisfaction holding the other variables constant (P=.02). There was a moderating effect of depression symptoms on the association between anxiety symptoms and life satisfaction. Persons with anxiety symptoms had lower life satisfaction scores at lower levels of depression symptoms but higher life satisfaction scores at higher levels of depression symptoms than persons with no anxiety. Conclusions In clinical settings, both anxiety and depression symptoms should be monitored, measured, and treated together to optimally improve life satisfaction for persons with SCI. Prioritizing interventions known to have transdiagnostic effects may achieve the best results.
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Affiliation(s)
- Maria A. Parker
- School of Public Health, Department of Epidemiology and Biostatistics, Indiana University, Bloomington, IN
- Corresponding author Maria A. Parker, PhD, MS, MPH, Indiana University School of Public Health, 809 East 9th St, Bloomington, IN 47405.
| | - Jodi K. Ichikawa
- School of Public Health, Department of Epidemiology and Biostatistics, Indiana University, Bloomington, IN
| | | | - Flora M. Hammond
- Department of Physical Medicine and Rehabilitation, Indiana University School of Medicine, Indianapolis, IN
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CE: Pain and Mental Health Symptoms After Traumatic Orthopedic Injury. Am J Nurs 2022; 122:26-37. [DOI: 10.1097/01.naj.0000873444.48723.48] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Eller OC, Willits AB, Young EE, Baumbauer KM. Pharmacological and non-pharmacological therapeutic interventions for the treatment of spinal cord injury-induced pain. FRONTIERS IN PAIN RESEARCH 2022; 3:991736. [PMID: 36093389 PMCID: PMC9448954 DOI: 10.3389/fpain.2022.991736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 08/05/2022] [Indexed: 11/29/2022] Open
Abstract
Spinal cord injury (SCI) is a complex neurophysiological disorder, which can result in many long-term complications including changes in mobility, bowel and bladder function, cardiovascular function, and metabolism. In addition, most individuals with SCI experience some form of chronic pain, with one-third of these individuals rating their pain as severe and unrelenting. SCI-induced chronic pain is considered to be "high impact" and broadly affects a number of outcome measures, including daily activity, physical and cognitive function, mood, sleep, and overall quality of life. The majority of SCI pain patients suffer from pain that emanates from regions located below the level of injury. This pain is often rated as the most severe and the underlying mechanisms involve injury-induced plasticity along the entire neuraxis and within the peripheral nervous system. Unfortunately, current therapies for SCI-induced chronic pain lack universal efficacy. Pharmacological treatments, such as opioids, anticonvulsants, and antidepressants, have been shown to have limited success in promoting pain relief. In addition, these treatments are accompanied by many adverse events and safety issues that compound existing functional deficits in the spinally injured, such as gastrointestinal motility and respiration. Non-pharmacological treatments are safer alternatives that can be specifically tailored to the individual and used in tandem with pharmacological therapies if needed. This review describes existing non-pharmacological therapies that have been used to treat SCI-induced pain in both preclinical models and clinical populations. These include physical (i.e., exercise, acupuncture, and hyper- or hypothermia treatments), psychological (i.e., meditation and cognitive behavioral therapy), and dietary interventions (i.e., ketogenic and anti-inflammatory diet). Findings on the effectiveness of these interventions in reducing SCI-induced pain and improving quality of life are discussed. Overall, although studies suggest non-pharmacological treatments could be beneficial in reducing SCI-induced chronic pain, further research is needed. Additionally, because chronic pain, including SCI pain, is complex and has both emotional and physiological components, treatment should be multidisciplinary in nature and ideally tailored specifically to the patient.
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Affiliation(s)
- Olivia C. Eller
- Department of Cell Biology and Physiology, University of Kansas Medical Center, Kansas City, KS, United States
| | - Adam B. Willits
- Department of Anesthesiology, University of Kansas Medical Center, Kansas City, KS, United States
| | - Erin E. Young
- Department of Cell Biology and Physiology, University of Kansas Medical Center, Kansas City, KS, United States
- Department of Anesthesiology, University of Kansas Medical Center, Kansas City, KS, United States
| | - Kyle M. Baumbauer
- Department of Cell Biology and Physiology, University of Kansas Medical Center, Kansas City, KS, United States
- Department of Anesthesiology, University of Kansas Medical Center, Kansas City, KS, United States
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Mohammadi F, Oshvandi K, Bijani M, Borzou SR, Khodaveisi M, Masoumi SZ. Perception of facing life's challenges in patients with spinal cord injury in Iran: a qualitative study. BMC Psychol 2022; 10:202. [PMID: 35971169 PMCID: PMC9376906 DOI: 10.1186/s40359-022-00909-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 08/10/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Spinal cord injury (SCI) is one of the most serious types of physical trauma and has become a major life-threatening condition in the recent decade. It is essential that the life perception and experiences of patients with SCI be studied and evaluated in different cultural contexts so that their needs and the challenges they face can be properly determined. The present study aims to explore the how patients with SCI in the south of Iran perceive facing life's challenges. METHODS The present study is a qualitative research with a descriptive phenomenological design. Participants were identified through purposive sampling of patients with spinal cord injury admitted to two state hospitals affiliated with a university of medical sciences in western Iran. The researchers collected data using semi-structured, in-depth interviews with 25 SCI patients conducted between August and October 2021. Data was analyzed according to Colaizzi's method using MAXQDA v. 2007. RESULTS Analysis of the data led to the emergence of three themes and nine sub-themes. The three main themes were emotional shock (crisis making and mental rumination, persistent depressive disorder, pitying behaviors, fear of the future), loss of dignity (poor self- care, sexual dysfunction, loss of job and educational status), and lack of effective support (lack of financial institutions and sponsors, lack of social support). CONCLUSION Patients with spinal cord injuries face various issues in their care and social lives. Attention to their psycho-emotional needs along with comprehensive health support play key roles in generating a sense of self efficacy and promoting the mental well-being and dignity of patients with spinal cord injuries. Accordingly, healthcare administrators and caregivers are recommended to provide more comprehensive health support to SCI patients to meet their needs more effectively.
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Affiliation(s)
- Fateme Mohammadi
- Chronic Diseases (Home Care) Research Center and Autism Spectrum Disorders Research Center, Department of Nursing, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Khodayar Oshvandi
- Mother and Child Care Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mostafa Bijani
- Department of Medical Surgical Nursing, Fasa University of Medical Sciences, Fasa, Iran.
| | - Seyed Reza Borzou
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Chronic Diseases (Home Care) Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Masoud Khodaveisi
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Chronic Diseases (Home Care) Research Center, Hamadan University of Medical Sciences, Hamadan, Iran.,Department of Community Health Nursing, School of Nursing and Midwifery, Chronic Diseases (Home Care) Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Seyedeh Zahra Masoumi
- Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Chronic Diseases (Home Care) Research Center, Hamadan University of Medical Sciences, Hamadan, Iran.,Department of Midwifery, School of Nursing and Midwifery, Mother and Child Care Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
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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.
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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
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The Relationship between Physical Activity Level and Functional Status of Subjects with High Spinal Cord Injury. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031787. [PMID: 35162810 PMCID: PMC8835456 DOI: 10.3390/ijerph19031787] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 02/01/2022] [Accepted: 02/02/2022] [Indexed: 12/20/2022]
Abstract
BACKGROUND Spinal cord injuries are one of disability in Poland and in the world. METHODS 80 subjects with a transverse injury of the cervical spinal cord were enrolled in the study. The study group included men aged 20-50, 33.1 ± 7.5. A total of 40 (50%) of the subjects comprised the physically active group (AG)-subjects doing wheelchair sport twice a week for 90 min a day. The physically inactive group (IG) comprised 40 (50%) subjects who had not participated in any sports activities. Statistical analyses were carried out using Shapiro-Wilk W-test and Mann-Whitney U test. RESULTS Significant differences were found between the physically active and inactive men with regard to their functionality status. The biggest differences were found for turning over (p < 0.001) and in adopting a sitting position (p < 0.001). Persons in the AG group had better results in all assessed activities. The biggest differences were observed in the field of toilet and dressing up: tooth-brushing p < 0.007 and washing the top part of the body p < 0.002. CONCLUSIONS People participating in regular physical activity-wheelchair rugby-after spinal cord injury have a better relationship with better fitness, greater independence and a better functional status.
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Online Mindfulness Experience for Emotional Support to Healthcare staff in times of Covid-19. J Med Syst 2022; 46:14. [PMID: 35079899 PMCID: PMC8789545 DOI: 10.1007/s10916-022-01799-y] [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: 10/27/2021] [Accepted: 01/17/2022] [Indexed: 12/29/2022]
Abstract
During the first confinement in Spain, between the months of March to June 2020, Information and Communication Technologies strategies were implemented in order to support health workers in the Wellbeing of Mental Health. Faced with so much uncertainty about the pandemic, an Online Mindfulness course. The objective of the course was to support healthcare professionals in Castilla y León in managing stress, anxiety and other emotional disturbances generated by coping with a situation as uncertain and unexpected as a pandemic, in order to manage emotions and thoughts that can lead to suicidal ideation. The motivations for the demand, reasons or motivations in which the health professionals of Castilla y León decided to participate in the mindfulness course in the first wave of Covid-19 in Spain are described. The descriptive and inferential statistical analysis of the customer satisfaction survey applied at the end of the mindfulness course, to the health professionals who participated in a satisfaction survey (CSQ-8: Client Satisfaction Questionnaire). Professional were asked to complete a survey based on (CSQ-8: Client Satisfaction Questionnaire) whose Cronbach's alpha = 0.917 is why the instrument used with N = 130 participants has high reliability. The 66% answered with a highly satisfied that they would return to the mindfulness online course. The 93% of the people who answered the satisfaction survey were women, of which they are professionals in the nursing area, with a participation of around 62%. In relation to the online system used in the Mindfulness intervention, 74% expressed that they fully agreed that it has been easy to use the online system for the mindfulness intervention. Health Professionals responded with 58% high satisfaction and 36% satisfaction, making a total of 94% on the help received in the online mindfulness courses to solve their problems. There is no difference between the age groups of the professionals who have preferred the Mindfulness online course (p = 0.672).
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Huang Y, Li S, Chen H, Feng L, Yuan W, Han T. Butorphanol reduces the neuronal inflammatory response and apoptosis via inhibition of p38/JNK/ATF2/p53 signaling. Exp Ther Med 2022; 23:229. [PMID: 35222706 PMCID: PMC8815053 DOI: 10.3892/etm.2022.11151] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 12/16/2021] [Indexed: 11/05/2022] Open
Affiliation(s)
- Yingsi Huang
- Department of Anesthesiology, Hainan Hospital of The Chinese PLA General Hospital, Sanya, Hainan 572013, P.R. China
| | - Suhua Li
- Department of Orthopedic Surgery, Hainan Hospital of The Chinese PLA General Hospital, Sanya, Hainan 572013, P.R. China
| | - Huaxin Chen
- Department of Anesthesiology, Hainan Hospital of The Chinese PLA General Hospital, Sanya, Hainan 572013, P.R. China
| | - Long Feng
- Department of Anesthesiology, Hainan Hospital of The Chinese PLA General Hospital, Sanya, Hainan 572013, P.R. China
| | - Weixiu Yuan
- Department of Anesthesiology, Hainan Hospital of The Chinese PLA General Hospital, Sanya, Hainan 572013, P.R. China
| | - Tao Han
- Department of Orthopedic Surgery, Hainan Hospital of The Chinese PLA General Hospital, Sanya, Hainan 572013, P.R. China
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Finlay KA, Hearn JH, Chater A. Grieving a disrupted biography: an interpretative phenomenological analysis exploring barriers to the use of mindfulness after neurological injury or impairment. BMC Psychol 2021; 9:124. [PMID: 34429164 PMCID: PMC8386048 DOI: 10.1186/s40359-021-00628-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 08/11/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Mindfulness has demonstrated strong utility for enhancing self-management and health outcomes in chronic illness. However, sensation-focused mindfulness techniques may not be appropriate for clinical populations with neurological injury. This study aimed to identify how expert mindfulness teachers with sensory loss/impairment naturalistically adapt and experience mindfulness. We aimed to highlight the rationale for and barriers to mindfulness practice when living with sensory loss. METHODS A qualitative, semi-structured interview design was used, analysed via Interpretative Phenomenological Analysis (IPA). Eight (5 females, 3 males) mindfulness teachers with neurological injury were recruited via a national registry of Mindfulness for Health teachers. Interviews (range: 50-93 min) were completed, transcribed verbatim and analysed idiographically for descriptive, linguistic and conceptual themes, before a cross-case analysis was completed. RESULTS Two superordinate themes were identified: (1) Overcoming a disrupted biography; and (2) Proactive self-management. These themes considered the challenge of reconciling, through grief, a past health status with the present reality of living with sensory loss due to Spinal Cord Injury, Multiple Sclerosis or Functional Neurological Disorder. Mindfulness was experienced as a method by which proactive choices could be made to maintain control and autonomy in health, reducing perceptions of suffering, psychological distress, cognitive reactivity and rumination. CONCLUSIONS Mindfulness was found to support the self-management of health after neurological injury/impairment. Mindfulness meditation presented an initial challenge as trauma and grief processes were (re-)activated during mindfulness sessions. However, mindfulness was found to support the resolution of these grief processes and encourage adaptive approach-based coping and acceptance of health and neurological impairment/injury.
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Affiliation(s)
- K. A. Finlay
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, Berks, RG6 7BE UK
| | - J. H. Hearn
- Department of Psychology, Manchester Metropolitan University, Brooks Building, 53 Bonsall Street, Manchester, M15 6GX UK
| | - A. Chater
- Institute for Sport and Physical Activity Research (ISPAR), Centre for Health, Wellbeing and Behaviour Change, University of Bedfordshire, Polhill Avenue
, Bedford, MK41 9EA UK
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Topical application of CNTF, GDNF and BDNF in combination attenuates blood-spinal cord barrier permeability, edema formation, hemeoxygenase-2 upregulation, and cord pathology. PROGRESS IN BRAIN RESEARCH 2021; 266:357-376. [PMID: 34689864 DOI: 10.1016/bs.pbr.2021.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Spinal cord injury (SCI) is one of the leading causes of disability in Military personnel for which no suitable therapeutic strategies are available till today. Thus, exploration of novel therapeutic measures is highly needed to enhance the quality of life of SCI victims. Previously, topical application of BDNF and GDNF in combination over the injured spinal cord after 90min induced marked neuroprotection. In present investigation, we added CNTF in combination with BDNF and/or GDNF treatment to examine weather the triple combination applied over the traumatic cord after 90 or 120min could thwart cord pathology. Since neurotrophins attenuate nitric oxide (NO) production in SCI, the role of carbon monoxide (CO) production that is similar to NO in inducing cell injury was explored using immunohistochemistry of the constitutive isoform of enzyme hemeoxygenase-2 (HO-2). SCI inflicted over the right dorsal horn of the T10-11 segments by making an incision of 2mm deep and 5mm long upregulated the HO-2 immunostaining in the T9 and T12 segments after 5h injury. These perifocal segments are associated with breakdown of the blood-spinal cord barrier (BSCB), edema development and cell injuries. Topical application of CNTF with BDNF and GDNF in combination (10ng each) after 90 and 120min over the injured spinal cord significantly attenuated the BSCB breakdown, edema formation, cell injury and overexpression of HO-2. These observations are the first to show that CNTF with BDNF and GDNF induced superior neuroprotection in SCI probably by downregulation of CO production, not reported earlier.
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Finlay KA, Hearn JH, Chater A. The impact of neurological disability and sensory loss on mindfulness practice. Disabil Rehabil 2021; 44:3825-3833. [PMID: 33621135 DOI: 10.1080/09638288.2021.1887946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVES Mindfulness-based approaches are increasingly recommended in the management of medical conditions associated with sensory loss and absence, such as Spinal Cord Injury (SCI), Multiple Sclerosis (MS) and Functional Neurological Disorder (FND). Yet the implications of undertaking practices such as body scanning when living with sensory loss have not been considered. This study aimed to explore the impact of sensory loss on the practice and experience of mindfulness in qualified mindfulness teachers with SCI/FND/MS. METHODS Eight mindfulness teachers (5 females, 3 males) with SCI/FND/MS, sensory loss and wheelchair use were recruited from mindfulness teacher databases. In-depth, semi-structured interviews were undertaken, lasting between 50 and 93 min. Interviews were transcribed verbatim and analysed using Interpretative Phenomenological Analysis. Idiographic analyses for descriptive, linguistic and conceptual themes were completed before cross-case analyses. RESULTS Analyses resulted in two superordinate themes: (1) Adopting your Body; and (2) Sensation without Loss. These themes reflected the challenge of overcoming initial resistance to areas of the body with sensory disruption, building a relationship with the whole body, such that sensory awareness could be visualised and experienced without proprioception. CONCLUSIONS Mindfulness offers a unique approach to accepting and working with the body after paralysis or sensory loss. Fundamental to the use of mindfulness with such populations, is the prioritisation of inclusive sensory language and exploring sensory absence as well as sensory presence. The cognitive and emotional outcomes of body scanning may be uniquely elevated in populations with neurophysiological disorders, highlighting the benefits of mindfulness for adaptive and protective self-management.IMPLICATIONS FOR REHABILITATIONMindfulness-based practices which focus on the body and sensation are accessible to people with neurological limitations.Mindfulness techniques can be extended through the use of visualisation strategies to encourage (non-proprioceptive) awareness of paralysed limbs or areas of the body with sensory loss.The language used in mindfulness-based interventions may need adapted by practitioners so that it remains inclusive for people with sensory loss as well as sensory presence.Additional care needs to be taken when using body scans during mindfulness as they have the potential to exacerbate psychological distress in people with reduced sensory awareness.
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Affiliation(s)
- K A Finlay
- School of Psychology Clinical Language Sciences, University of Reading, Reading, UK
| | - J H Hearn
- Department of Psychology, Manchester Metropolitan University, Manchester, UK
| | - A Chater
- School of Sport Science and Physical Activity, University of Bedfordshire, Luton, UK
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Kuiper H, van Leeuwen CCM, Kopsky DJ, Stolwijk-Swüste JM, Post MWM. Post-traumatic stress disorder symptoms and pain intensity in persons with spinal cord injury. Spinal Cord 2021; 59:328-335. [PMID: 33495577 DOI: 10.1038/s41393-020-00599-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 11/19/2020] [Accepted: 11/23/2020] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN Cross-sectional. OBJECTIVES To examine the association between post-traumatic stress disorder (PTSD) symptoms and pain intensity, taking symptoms of anxiety and depression into account within persons with spinal cord injury (SCI). SETTING Persons with SCI, who visited a Dutch rehabilitation centre between 2005 and 2010, were invited to complete a survey. METHODS PTSD symptoms were measured with the Trauma Screening Questionnaire (TSQ), pain intensity with an 11-point Numerical Rating Scale (NRS), and symptoms of anxiety and depression with the Hospital Anxiety and Depression Scale (HADS). To determine associations between PTSD symptoms and pain intensity, linear regression analyses were performed. Confounding variables representing anxiety and depression were added to the final model. RESULTS In total, 175 participants (55.8% traumatic, 29.1% complete) were included (response rate of 31.7%). Of them, 11.4% had clinically relevant symptoms of probable PTSD (TSQ score ≥ 6) 69.8% experienced moderate to severe pain levels (NRS ≥ 4), 14.9% had symptoms of anxiety and 20.8% symptoms of depression (HADS scores ≥ 11). Levels of PTSD symptoms were strongly associated with symptoms of anxiety (0.54) and depression (0.49). Bivariate analyses showed a moderate significant association (0.30) between PTSD symptoms and pain intensity. This association became small (0.10) when anxiety and depression comorbidity were factored into the final regression model. CONCLUSIONS No independent association between PTSD symptoms and pain intensity was shown when adjusted for anxiety and depression. Results of this study suggest the usefulness of screening for PTSD in persons with SCI (regardless of injury cause or type/level) who score high on symptoms of anxiety/depression.
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Affiliation(s)
- Heleen Kuiper
- Centre of Excellence for Rehabilitation Medicine, Brain Centre Rudolf Magnus, University Medical Centre Utrecht, Utrecht University and De Hoogstraat Rehabilitation, Utrecht, The Netherlands.,University of Groningen, University Medical Centre Groningen, Centre for Rehabilitation, Groningen, The Netherlands
| | - Christel C M van Leeuwen
- Centre of Excellence for Rehabilitation Medicine, Brain Centre Rudolf Magnus, University Medical Centre Utrecht, Utrecht University and De Hoogstraat Rehabilitation, Utrecht, The Netherlands.,Department of Spinal Cord Injury and Orthopedics, De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - David J Kopsky
- Institute for Neuropathic Pain, Amsterdam, The Netherlands
| | - Janneke M Stolwijk-Swüste
- Centre of Excellence for Rehabilitation Medicine, Brain Centre Rudolf Magnus, University Medical Centre Utrecht, Utrecht University and De Hoogstraat Rehabilitation, Utrecht, The Netherlands.,Department of Spinal Cord Injury and Orthopedics, De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Marcel W M Post
- Centre of Excellence for Rehabilitation Medicine, Brain Centre Rudolf Magnus, University Medical Centre Utrecht, Utrecht University and De Hoogstraat Rehabilitation, Utrecht, The Netherlands. .,University of Groningen, University Medical Centre Groningen, Centre for Rehabilitation, Groningen, The Netherlands.
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Fiani B, Runnels J, Taylor A, Sekhon M, Chacon D, McLarnon M, Houston R, Vereecken S. Prevalence of sports-related spinal injury stratified by competition level and return to play guidelines. Rev Neurosci 2020; 32:169-179. [PMID: 33098634 DOI: 10.1515/revneuro-2020-0080] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 09/06/2020] [Indexed: 11/15/2022]
Abstract
Spinal injury is among the most severe and feared injuries an athlete may face. We present an up-to-date review of the recent literature, stratifying recommendations based on injury location (cervical, thoracic, and lumbar spine) and type, as well as, the level of competitive play (high school, collegiate, professional). A literature search was completed to identify all publications reporting return to play guidelines for athletic injuries or injury-related surgery irrespective of the study design. Publication dates were not restricted by year. Search terms used included "return to play" and "spinal injury" on National Library of Medicine (PubMed) and Google Scholar. Selection criteria for literature included axial spine injury guidelines for athletic participation post-injury or post-surgery. Literature found from the search criteria was sorted based on level of competition and location of axial spine injury involved. It was found that professional athletes are more likely to suffer severe spinal injuries, require surgery, and necessitate a longer return to play (RTP), with high school and college athletes usually returning to play within days or weeks. Injuries occur mainly within contact sports and concordance exists between initial and subsequent spinal injuries. Adequate rest, rehabilitation, and protective equipment alongside the education of athletes and coaches are recommended. In conclusion, a multidisciplinary approach to patient management is required with consideration for the emotional, social, and perhaps financial impact that spinal injury may have upon the athlete. Consensus from the literature states that in order for an athlete to safely return to play, that athlete should not be actively suffering from pain, should have a full range of motion, and complete return of their strength in the absence of neurological deficit.
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Affiliation(s)
- Brian Fiani
- Department of Neurosurgery, Desert Regional Medical Center, 1150 N. Indian Canyon Drive, Palm Springs, CA 92262, USA
| | - Juliana Runnels
- University of New Mexico School of Medicine, 2425 Camino de Salud, Albuquerque, NM 87106, USA
| | - Ashley Taylor
- Department of Psychological, Health, and Learning Sciences, The University of Houston, 4800 Calhoun Rd, Houston, TX 77004, USA
| | - Manraj Sekhon
- Oakland University William Beaumont School of Medicine, 586 Pioneer Drive, Rochester, MI 48309, USA
| | - Daniel Chacon
- Ross University School of Medicine, High St., Bridgetown BB11015, Miramar, FL, Barbados
| | - Michael McLarnon
- Queen's University Belfast, University Rd, Belfast BT7 1NN, Northern Ireland, UK
| | - Rebecca Houston
- Department of Neurosurgery, Desert Regional Medical Center, 1150 N. Indian Canyon Drive, Palm Springs, CA 92262, USA
| | - Sasha Vereecken
- Saint James School of Medicine, 1480 Renaissance Drive, Suite 300, Park Ridge, The Quarter, IL 60068, USA
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Hearn JH, Finlay KA, Sheffield D. ‘Trying to bring attention to your body when you’re not sure where it is’: An interpretative phenomenological analysis of drivers and barriers to mindfulness for people with spinal cord injury. Br J Health Psychol 2020; 26:161-178. [DOI: 10.1111/bjhp.12462] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 07/01/2020] [Indexed: 01/12/2023]
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