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Wolffbrandt MM, Soendergaard PL, Biering-Sørensen F, Sundekilde L, Kjeldgaard A, Schow T, Arango-Lasprilla JC, Norup A. A manual-based family intervention for families living with acquired brain or spinal cord injury: a qualitative study of families' experiences. Disabil Rehabil 2024; 46:4503-4513. [PMID: 37985438 DOI: 10.1080/09638288.2023.2280063] [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: 01/26/2023] [Revised: 10/31/2023] [Accepted: 11/01/2023] [Indexed: 11/22/2023]
Abstract
PURPOSE To explore families' experiences of participating in a family intervention, targeting families living with the consequences of acquired brain injury (ABI) or spinal cord injury (SCI). MATERIALS AND METHODS Individuals with ABI or SCI and their family members were recruited from a randomised controlled trial investigating the effectiveness of the manual-based family intervention, which consisted of eight weekly sessions. Semi-structured interviews were conducted with 16 families (n = 33). The data were analyzed through reflexive thematic analysis. RESULTS One central theme was developed "A sense of belonging together again", describing the value of the reciprocal format of the family intervention, where individuals with ABI or SCI and their family members gained new insights into each other while building up their relationship. The central theme was supported by three additional themes: "Strengthened communication and emotional control", "Acknowledging the changed life situation" and "Being seen as a whole person". CONCLUSIONS The family intervention supported the families to strengthen family cohesion and to be capable to manage the changed life situation. The findings emphasize the importance of a family-centered approach in neurorehabilitation, and how healthcare professionals play a significant role in facilitating families to achieve a balanced level of family cohesion.
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Affiliation(s)
- Mia Moth Wolffbrandt
- Neurorehabilitation Research and Knowledge Centre, Rigshospitalet, Denmark
- Department of Psychology, University of Southern Denmark, Odense, Denmark
| | - Pernille Langer Soendergaard
- Neurorehabilitation Research and Knowledge Centre, Rigshospitalet, Denmark
- Department of Psychology, University of Southern Denmark, Odense, Denmark
- Neurorehabilitaion-CPH, City of Copenhagen, Hellerup, Denmark
| | - Fin Biering-Sørensen
- Department of Brain and Spinal Cord Injuries, Rigshospitalet, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Linda Sundekilde
- Neurorehabilitation Research and Knowledge Centre, Rigshospitalet, Denmark
| | - Amanda Kjeldgaard
- Neurorehabilitation Research and Knowledge Centre, Rigshospitalet, Denmark
- Neurorehabilitaion-CPH, City of Copenhagen, Hellerup, Denmark
| | - Trine Schow
- Neurorehabilitation Research and Knowledge Centre, Rigshospitalet, Denmark
| | | | - Anne Norup
- Neurorehabilitation Research and Knowledge Centre, Rigshospitalet, Denmark
- Department of Psychology, University of Southern Denmark, Odense, Denmark
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Zeh RM, Glisic M, Capossela S, Bertolo A, Valido E, Jordan X, Hund-Georgiadis M, Pannek J, Eriks-Hoogland I, Stucki G, Stoyanov J. The Swiss Spinal Cord Injury Cohort Study (SwiSCI) biobank: from concept to reality. Spinal Cord 2024; 62:117-124. [PMID: 38287141 PMCID: PMC10920187 DOI: 10.1038/s41393-024-00958-x] [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: 07/12/2022] [Revised: 01/12/2024] [Accepted: 01/19/2024] [Indexed: 01/31/2024]
Abstract
OBJECTIVES To describe the concept, establishment and the operationalization of the biobank of the Swiss Spinal Cord Injury Cohort Study (SwiSCI), the available biosamples, and demographic and clinical characteristics of study participants. SETTING The SwiSCI biobank is a platform for research within SwiSCI. It collects and processes serum, plasma, PBMCs, RNA, DNA, and urine from three rehabilitation centers. Samples are collected at admission to first rehabilitation and at discharge. Additionly, the biobank provides services to projects nested in SwiSCI or otherclinical trials among Spinal Cord Injury population. METHODS Descriptive statistics were used for an overview of available biosamples, study participant characteristics, and comparison of the participating centers. RESULTS Between the SwiSCI biobank establishment on June 27th, 2016, and October 19th, 2023, the SwiSCI Study has obtained informed consent from 524 individuals. Of these, 315 (60.1%) have agreed to donate biospecimens to the biobank. The average age of the contributors was 54 years (range: 38-65), with the majority being male (80%). Most participants suffered from traumatic injuries (66%) and were classified as paraplegic (64%). Approximately 80% presented with motor and sensory-incomplete SCI. The median Spinal Cord Independence Measure (SCIM) score was 31 (Interquartile Range: 19-58). The proportion of individuals providing paired biosamples at two distinct time points ranged from 63% (for RNA) to 65% (for urine and urine sediment). CONCLUSIONS The SwiSCI biobank is a unique platform designed to serve as a basis for collaborative SCI research, including multi-omics approaches. The longitudinal collection of biospecimens and cryopreservation of multiple aliquots for each participant are fundamental for scrutinizing the temporal associations, ensuring research reproducibility, and achieving an adequate sample size for future investigations.
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Affiliation(s)
- Ramona M Zeh
- Swiss Paraplegic Research, Guido A. Zäch Str. 4, 6207, Nottwil, Switzerland
| | - Marija Glisic
- Swiss Paraplegic Research, Guido A. Zäch Str. 4, 6207, Nottwil, Switzerland
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland
| | - Simona Capossela
- Swiss Paraplegic Research, Guido A. Zäch Str. 4, 6207, Nottwil, Switzerland
| | - Alessandro Bertolo
- Swiss Paraplegic Research, Guido A. Zäch Str. 4, 6207, Nottwil, Switzerland
- Department of Orthopedic Surgery, University of Bern, Bern Inselspital, Bern, Switzerland
| | - Ezra Valido
- Swiss Paraplegic Research, Guido A. Zäch Str. 4, 6207, Nottwil, Switzerland
| | - Xavier Jordan
- Clinique romande de réadaptation, Avenue du Grand-Champsec 90, 1950, Sion, Switzerland
| | | | - Jürgen Pannek
- Swiss Paraplegic Center, Guido A. Zäch Str. 1, 6207, Nottwil, Switzerland
- Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | | | - Gerold Stucki
- Swiss Paraplegic Research, Guido A. Zäch Str. 4, 6207, Nottwil, Switzerland
| | - Jivko Stoyanov
- Swiss Paraplegic Research, Guido A. Zäch Str. 4, 6207, Nottwil, Switzerland.
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Bern, Switzerland.
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Choi Y, Leigh JH. Epidemiology of Traumatic and Non-Traumatic Spinal Cord Injury in Korea: A Narrative Review. Korean J Neurotrauma 2023; 19:434-445. [PMID: 38222829 PMCID: PMC10782106 DOI: 10.13004/kjnt.2023.19.e54] [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: 09/19/2023] [Revised: 09/27/2023] [Accepted: 10/07/2023] [Indexed: 01/16/2024] Open
Abstract
This review describes the incidence rates and trends of traumatic spinal cord injuries (TSCI) and non-traumatic spinal cord injuries (NTSCI) in South Korea. The incidence of NTSCI has increased more rapidly than that of TSCI in recent years. In 2007, TSCI was more common, but by 2020, NTSCI had surpassed TSCI, particularly in older individuals. While men have a higher incidence of both TSCI and NTSCI, the incidence difference by sex is greater in TSCI. The incidence rates of both TSCI and NTSCI are higher in older individuals, particularly those in their 70s and 80s. For TSCI, falls and traffic accidents are the most common causes, with falls being more prevalent in older adults. Cervical SCIs are the most common TSCI, especially in high-income countries like South Korea. Patients with NTSCI predominantly display paraplegia, which is usually associated with non-traumatic causes such as degenerative disorders and tumors. Higher rates of tetraplegia and paraplegia are observed with TSCI and NTSCI, respectively. The neurological levels of injury also differ between TSCI and NTSCI. Overall, SCIs are a growing concern in South Korea and there is a need for targeted interventions for their management and prevention, especially in older age groups.
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Affiliation(s)
- Yoonjeong Choi
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul, Korea
- National Traffic Injury Rehabilitation Research Institute, National Traffic Injury Rehabilitation Hospital, Yangpyeong, Korea
| | - Ja-Ho Leigh
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul, Korea
- National Traffic Injury Rehabilitation Research Institute, National Traffic Injury Rehabilitation Hospital, Yangpyeong, Korea
- Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul, Korea
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Hong HA, Fallah N, Wang D, Cheng CL, Humphreys S, Parsons J, Noonan VK. Multimorbidity in persons with non-traumatic spinal cord injury and its impact on healthcare utilization and health outcomes. Spinal Cord 2023; 61:483-491. [PMID: 37604933 DOI: 10.1038/s41393-023-00915-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 05/24/2023] [Accepted: 07/12/2023] [Indexed: 08/23/2023]
Abstract
STUDY DESIGN Cross-sectional survey in Canada. OBJECTIVES To explore multimorbidity (the coexistence of two/more health conditions) in persons with non-traumatic spinal cord injury (NTSCI) and evaluate its impact on healthcare utilization (HCU) and health outcomes. SETTING Community-dwelling persons. METHODS Data from the Spinal Cord Injury Community Survey (SCICS) was used. A multimorbidity index (MMI) consisting of 30 secondary health conditions (SHCs), the 7-item HCU questionnaire, the Short Form-12 (SF-12), Life Satisfaction-11 first question, and single-item Quality of Life (QoL) measure were administered. Additionally, participants were grouped as "felt needed healthcare was received" (Group 1, n = 322) or "felt needed healthcare was not received" (Group 2, n = 89) using the HCU question. Associations among these variables were assessed using multivariable analysis. RESULTS 408 of 412 (99%) participants with NTSCI reported multimorbidity. Constipation, spasticity, and fatigue were the most prevalent self-reported SHCs. Group 1 had a higher MMI score compared to Group 2 (p < 0.001). A higher MMI score correlated with the feeling of not receiving needed care (OR 1.4, 95% CI 1.08-1.21), lower SF-12 (physical/mental component summary scores), being unsatisfied with life, and lower QoL (all p < 0.001). Additionally, Group 1 had more females (p < 0.001), non-Caucasians (p = 0.034), and lower personal annual income (p = 0.025). CONCLUSIONS Persons with NTSCI have multimorbidity, and the MMI score was associated with increased HCU and worse health outcomes. This work emphasizes the critical need for improved healthcare and monitoring. Future work determining specific thresholds for the MMI could be helpful for triage screening to identify persons at higher risk of poor outcomes.
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Affiliation(s)
- Heather A Hong
- Praxis Spinal Cord Institute, Vancouver, British Columbia, Canada
| | - Nader Fallah
- Praxis Spinal Cord Institute, Vancouver, British Columbia, Canada
- Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Di Wang
- Praxis Spinal Cord Institute, Vancouver, British Columbia, Canada
| | | | | | - Jessica Parsons
- Praxis Spinal Cord Institute, Vancouver, British Columbia, Canada
| | - Vanessa K Noonan
- Praxis Spinal Cord Institute, Vancouver, British Columbia, Canada.
- International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, British Columbia, Canada.
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Choi Y, Leigh JH, Jeon J, Lee GJ, Shin HI, Bang MS. Trends in the Incidence and Etiology of Non-Traumatic Spinal Cord Injury in Korea: A Nationwide Population-Based Study From 2007 to 2020. J Korean Med Sci 2023; 38:e158. [PMID: 37158777 PMCID: PMC10166702 DOI: 10.3346/jkms.2023.38.e158] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 01/25/2023] [Indexed: 05/10/2023] Open
Abstract
BACKGROUND Although patients with non-traumatic spinal cord injury (NTSCI) have distinct epidemiological characteristics compared to those with traumatic spinal cord injury, no previous study has reported the incidence of NTSCI on a national scale in Korea. In this study, we examined the trend in incidence of NTSCI in Korea and described the epidemiological characteristics of patients with NTSCI using nationwide insurance data. METHODS National Health Insurance Service data were reviewed for the period from 2007 to 2020. The International Classification of Diseases, 10th revision, was used to identify patients with NTSCI. Inpatients with newly diagnosed NTSCI on their first admission during the study period were included. Crude incidence was calculated using the annual number of NTSCI cases divided by the mid-year population estimates. Age-specific incidence was calculated by dividing the number of cases in 10-year age groups by the total number of individuals in that age group. Age-adjusted incidence was calculated using direct standardization. Annual percentage changes were calculated using Joinpoint regression analysis. The Cochrane-Armitage trend test was conducted to examine the trends of NTSCI incidence according to the types or etiologies of NTSCI. RESULTS The age-adjusted incidence of NTSCI increased continuously from 24.11 per million in 2007 to 39.83 per million in 2020, with a significant annual percentage change (4.93%, P < 0.05). The age-specific incidence for those in their 70s and 80s or older was the highest and rapidly increased from 2007 to 2020. According to the types of paralysis in NTSCI, the proportion of tetraplegia decreased, whereas those of paraplegia and cauda equina increased significantly from 2007 to 2020. The proportion of degenerative diseases was the largest among all etiologies and increased significantly during the study period. CONCLUSION The annual incidence of NTSCI in Korea is increasing significantly, particularly among older adults. As Korea is one of the countries with most rapidly aging population in the world, these results have significant implications, indicating that preventive strategies and sufficient rehabilitation medical services are warranted for the population of older adults.
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Affiliation(s)
- Yoonjeong Choi
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul, Korea
- National Traffic Injury Rehabilitation Research Institute, National Traffic Injury Rehabilitation Hospital, Yangpyeong, Korea
| | - Ja-Ho Leigh
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul, Korea
- National Traffic Injury Rehabilitation Research Institute, National Traffic Injury Rehabilitation Hospital, Yangpyeong, Korea
- Department of Rehabilitation Medicine, National Traffic Injury Rehabilitation Hospital, Yangpyeong, Korea
- Institute of Health Policy and Management, Medical Research Center, Seoul National University, Seoul, Korea.
| | - Jooeun Jeon
- Department of Public Health, Graduate School, Yonsei University, Seoul, Korea
- Department of Epidemiology and Health Promotion, Institute for Health Promotion, Graduate School of Public Health, Yonsei University, Seoul, Korea
| | - Goo Joo Lee
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul, Korea
- Department of Rehabilitation Medicine, National Traffic Injury Rehabilitation Hospital, Yangpyeong, Korea
| | - Hyung-Ik Shin
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul, Korea
- Department of Rehabilitation Medicine, National Traffic Injury Rehabilitation Hospital, Yangpyeong, Korea
| | - Moon Suk Bang
- Department of Rehabilitation Medicine, Seoul National University Hospital, Seoul, Korea
- Department of Rehabilitation Medicine, National Traffic Injury Rehabilitation Hospital, Yangpyeong, Korea
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Senthinathan A, Cronin SM, Ho C, New PW, Guilcher SJ, Noonan VK, Craven BC, Christie S, Wai EK, Tsai EC, Sreenivasan V, Wilson J, Fehlings MG, Welk B, Jaglal SB. Using Clinical Vignettes and a Modified Expert Delphi Panel to Determine Parameters for Identifying Non-Traumatic Spinal Cord Injury in Health Administrative and Electronic Medical Record Databases. Arch Phys Med Rehabil 2023; 104:63-73. [PMID: 36002056 DOI: 10.1016/j.apmr.2022.08.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 08/04/2022] [Accepted: 08/05/2022] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To obtain expert consensus on the parameters and etiologic conditions required to retrospectively identify cases of non-traumatic spinal cord injury (NTSCI) in health administrative and electronic medical record (EMR) databases based on the rating of clinical vignettes. DESIGN A modified Delphi process included 2 survey rounds and 1 remote consensus panel. The surveys required the rating of clinical vignettes, developed after chart reviews and expert consultation. Experts who participated in survey rounds were invited to participate in the Delphi Consensus Panel. SETTING An international collaboration using an online meeting platform. PARTICIPANTS Thirty-one expert physicians and/or clinical researchers in the field of spinal cord injury (SCI). MAIN OUTCOME MEASURE(S) Agreement on clinical vignettes as NTSCI. Parameters to classify cases of NTSCI in health administrative and EMR databases. RESULTS In health administrative and EMR databases, cauda equina syndromes should be considered SCI and classified as a NTSCI or TSCI based on the mechanism of injury. A traumatic event needs to be listed for injury to be considered TSCI. To be classified as NTSCI, neurologic sufficient impairments (motor, sensory, bowel, and bladder) are required, in addition to an etiology. It is possible to have both a NTSCI and a TSCI, as well as a recovered NTSCI. If information is unavailable or missing in health administrative and EMR databases, the case may be listed as "unclassifiable" depending on the purpose of the research study. CONCLUSION The Delphi panel provided guidelines to appropriately classify cases of NTSCI in health administrative and EMR databases.
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Affiliation(s)
- Arrani Senthinathan
- From the Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Canada; KITE (Knowledge Innovation Talent Everywhere), Toronto Rehabilitation Institute - University Health Network, Toronto, Canada.
| | - Shawna M Cronin
- From the Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Canada; KITE (Knowledge Innovation Talent Everywhere), Toronto Rehabilitation Institute - University Health Network, Toronto, Canada
| | - Chester Ho
- Division of Physical Medicine & Rehabilitation, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Canada
| | - Peter W New
- Spinal Rehabilitation Service, Caulfield Hospital, Alfred Health, Caulfield, Australia; Department of Medicine & Rehabilitation and Aged Services Program, Kingston Centre, Monash Health, Cheltenham, Australia; Epworth-Monash Rehabilitation Medicine Unit, Monash University, Richmond, Australia; Department of Epidemiology and Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, Prahran, Australia
| | - Sara Jt Guilcher
- From the Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Canada; Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada; Rehabilitation Science Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Vanessa K Noonan
- Praxis Spinal Cord Institute, Vancouver, Canada; International Collaboration on Repair Discoveries, Vancouver, Canada
| | - B Catherine Craven
- KITE (Knowledge Innovation Talent Everywhere), Toronto Rehabilitation Institute - University Health Network, Toronto, Canada; Department of Medicine, University of Toronto, Toronto, Canada; Spinal Cord Rehabilitation Program, Toronto Rehabilitation Institute - University Health Network, Toronto, Canada
| | - Sean Christie
- Division of Neurosurgery, Dalhousie University, Halifax, Canada
| | - Eugene K Wai
- Division of Orthopaedic Surgery and School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Eve C Tsai
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada; Division of Neurosurgery, University of Ottawa, The Ottawa Hospital Research Institute, Ottawa, Canada
| | - Vidya Sreenivasan
- Physical Medicine and Rehabilitation, The Ottawa Hospital, Ottawa, Canada
| | - Jefferson Wilson
- Division of Neurosurgery, University of Toronto, Toronto, Canada; St. Michael's Hospital, Toronto, Canada
| | - Michael G Fehlings
- Division of Neurosurgery, University of Toronto, Toronto, Canada; Department of Surgery and Epidemiology & Biostatistics, Western University, London, Canada
| | - Blayne Welk
- Division of Neurosurgery and Division of Genetics and Development, Krembil Neuroscience Centre, University Health Network, Toronto, Canada
| | - Susan B Jaglal
- From the Institute of Health Policy Management and Evaluation, University of Toronto, Toronto, Canada; KITE (Knowledge Innovation Talent Everywhere), Toronto Rehabilitation Institute - University Health Network, Toronto, Canada; Rehabilitation Science Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada; Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
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Molinares DM, Gater DR, Daniel S, Pontee NL. Nontraumatic Spinal Cord Injury: Epidemiology, Etiology and Management. J Pers Med 2022; 12:1872. [PMID: 36579590 PMCID: PMC9694799 DOI: 10.3390/jpm12111872] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 08/02/2022] [Accepted: 08/08/2022] [Indexed: 11/10/2022] Open
Abstract
The spinal cord is a conduit within the central nervous system (CNS) that provides ongoing communication between the brain and the rest of the body, conveying complex sensory and motor information necessary for safety, movement, reflexes, and optimization of autonomic function. After a traumatic spinal cord injury (SCI), supraspinal influences on the peripheral nervous system and autonomic nervous system (ANS) are disrupted, leading to spastic paralysis, sympathetic blunting, and parasympathetic dominance, resulting in cardiac dysrhythmias, systemic hypotension, bronchoconstriction, copious respiratory secretions, and uncontrolled bowel, bladder, and sexual dysfunction. This article outlines the pathophysiology of the less reported nontraumatic SCI (NTSCI), its classification, its influence on sensory/motor function, and introduces the probable comorbidities associated with SCI that will be discussed in more detail in the accompanying manuscripts of this special issue. Finally, management strategies for NTSCI will be provided.
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Affiliation(s)
- Diana M. Molinares
- Department of Physical Medicine and Rehabilitation, University of Miami Miller School of Medicine, 1611 1095 NW 14th Terrace, Miami, FL 33136, USA
- Christine E. Lynn Rehabilitation Center for the Miami Project to Cure Paralysis, Miami, FL 33136, USA
| | - David R. Gater
- Department of Physical Medicine and Rehabilitation, University of Miami Miller School of Medicine, 1611 1095 NW 14th Terrace, Miami, FL 33136, USA
- Christine E. Lynn Rehabilitation Center for the Miami Project to Cure Paralysis, Miami, FL 33136, USA
- The Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Scott Daniel
- Department of Physical Medicine and Rehabilitation, University of Miami Miller School of Medicine, 1611 1095 NW 14th Terrace, Miami, FL 33136, USA
- Christine E. Lynn Rehabilitation Center for the Miami Project to Cure Paralysis, Miami, FL 33136, USA
| | - Nicole L. Pontee
- Department of Physical Medicine and Rehabilitation, University of Miami Miller School of Medicine, 1611 1095 NW 14th Terrace, Miami, FL 33136, USA
- Christine E. Lynn Rehabilitation Center for the Miami Project to Cure Paralysis, Miami, FL 33136, USA
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Niemi-Nikkola V, Koskinen E, Väärälä E, Kauppila AM, Kallinen M, Vainionpää A. Incidence of Acquired Nontraumatic Spinal Cord Injury in Finland: A 4-Year Prospective Multicenter Study. Arch Phys Med Rehabil 2020; 102:44-49. [PMID: 33007307 DOI: 10.1016/j.apmr.2020.08.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 08/05/2020] [Accepted: 08/25/2020] [Indexed: 12/01/2022]
Abstract
OBJECTIVES To evaluate the incidence and epidemiologic characteristics of acquired nontraumatic spinal cord injury (NTSCI) in Finland. DESIGN Prospective 4-year epidemiologic multicenter study. SETTING Two of the 3 spinal cord injury (SCI) centers in Finland responsible for acute care, immediate rehabilitation, and lifelong follow-up for all SCI patients in a population of 3,073,052 (as of 2013). PARTICIPANTS All newly diagnosed NTSCI patients (N=430) admitted to Tampere University Hospital between 2012 and 2015 and Oulu University Hospital between 2013 and 2016 based on the evaluation of the designated rehabilitation teams. Patients with NTSCI resulting from congenital etiologies or progressive neurologic diseases were excluded. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Incidence and variables, according to the International SCI Core Data Set and the International Standards for Neurological Classification of SCI, including etiology and the severity of injury. RESULTS The incidence of NTSCI was 54.1 per million per year. NTSCI was more common in men (n=260, 60.5%) than women (n=170, 39.5%). The mean age was 62.0±14.6 years old. Degenerative causes were the most common etiology (n=219, 50.9%), followed by malignant (n=88, 20.5%) and benign (n=41, 9.5%) neoplasms. The injury resulted in tetraplegia in 177 patients (41.1%) and paraplegia in 249 patients (57.9%). American Spinal Injury Association Impairment Scale grade D injuries were common, with an incidence of 71% (n=304). Specialized inpatient rehabilitation was needed in 44% (n=189) of the cases. CONCLUSIONS There are no previous studies on the epidemiology of NTSCI in Finland, and international reporting has been limited. The incidence of NTSCI in our study was substantially higher than in most previous studies, which was likely owing to our study including individuals with less severe lesions who did not require inpatient rehabilitation.
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Affiliation(s)
- Ville Niemi-Nikkola
- Oulu University Hospital, Department of Medical Rehabilitation, Oulu, Finland.
| | - Eerika Koskinen
- Tampere University Hospital, Department of Neurosciences and Rehabilitation, Tampere, Finland
| | - Eija Väärälä
- Tampere University Hospital, Department of Neurosciences and Rehabilitation, Tampere, Finland
| | - Anna-Maija Kauppila
- Oulu University Hospital, Department of Medical Rehabilitation, Oulu, Finland
| | - Mauri Kallinen
- Central Finland Central Hospital, Rehabilitation Department, Jyväskylä, Finland; The Center for Life Course Health Research, University of Oulu, Oulu, Finland
| | - Aki Vainionpää
- Seinäjoki Central Hospital, Department of Rehabilitation, Seinäjoki, Finland
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Etiology-specific variation in survival following non-traumatic spinal cord injury: a causal inference approach using data from a population-based cohort. Spinal Cord 2020; 59:257-265. [PMID: 32948845 PMCID: PMC7943420 DOI: 10.1038/s41393-020-00554-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 09/07/2020] [Accepted: 09/09/2020] [Indexed: 11/29/2022]
Abstract
Study design Observational, population-based cohort study. Objectives To evaluate the origin and contribution to excess of survival differences following non-traumatic spinal cord injury (NTSCI) using etiology as proxy for variation in underlying health condition. Setting Specialized rehabilitation centers in Switzerland. Methods Medical record data collected by the Swiss Spinal Cord Injury cohort (SwiSCI) study were linked with mortality information from the Swiss National Cohort. Considering contemporary theory and empirical evidence, a directed acyclic graph (DAG) was developed to formally evaluate causal differences among NTSCI etiologies, relative to traumatic SCI (TSCI). Statistical inference was contingent on hazard ratios (HRs) and marginal survival differences, derived using flexible parametric modeling. Results 3643 individuals (NTSCI = 1357; TSCI = 2286) diagnosed with SCI between 1990 and 2011 were included, contributing a cumulative 41,344 person-years and 1323 deaths. Test statistics confirmed DAG-dataset consistency. As compared to TSCI, mortality was elevated in all NTSCI etiological groups; malignant etiologies had the highest HRs (10; 95% CI, 8.0 to 14) followed by infection (2.6; 1.8 to 3.6) and vascular (2.5; 2.0 to 3.2) etiology groups. At the attained age of 55, the estimated reduction in survival among non-malignant etiologies was 9.4% (5.8 to 13) at 5 years and 17% (11 to 23) at 20 years. Conclusions Causal differences in survival among NTSCI etiological groups are likely a result of chronic variation in health conditions. This study supports the development of long-term interdisciplinary management and policy for individuals with NTSCI, specific to etiology.
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Earle S, O’Dell L, Davies A, Rixon A. Views and Experiences of Sex, Sexuality and Relationships Following Spinal Cord Injury: A Systematic Review and Narrative Synthesis of the Qualitative Literature. SEXUALITY AND DISABILITY 2020. [DOI: 10.1007/s11195-020-09653-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
AbstractResearch examining the effects of spinal cord injury on sexuality has largely focused on physiological functioning and quantification of dysfunction following injury. This paper reports a systematic review of qualitative research that focused on the views and experiences of people with spinal cord injury on sex and relationships. The review addressed the following research question: What are the views and experiences of people with spinal cord injury of sex, sexuality and relationships following injury? Five databases were relevant and employed in the review: CINAHL (1989–2016 only), PsychInfo, PubMed, Scopus and Web of Science, for research published between 1 January 1980 and 30 November 2019. After removing duplicates, 257 records remained and were screened using a two-stage approach to inclusion and quality appraisal. Following screening, 27 met the criteria for inclusion and are reported in the paper. The review includes studies from fifteen countries across five continents. Two main approaches to data analysis summary and thematic synthesis were undertaken to analyze the qualitative data reported in the papers. The analysis revealed four main themes: sexual identity; significant and generalized others, sexual embodiment; and; sexual rehabilitation and education.
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New PW. A Narrative Review of Pediatric Nontraumatic Spinal Cord Dysfunction. Top Spinal Cord Inj Rehabil 2019; 25:112-120. [PMID: 31068743 DOI: 10.1310/sci2502-112] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
This article provides a narrative review of seven key issues relevant to pediatric onset of spinal cord damage not due to trauma, or spinal cord dysfunction (SCDys). The first topic discussed is terminology issues. There is no internationally accepted term for spinal cord damage not due to trauma. The implications of this terminology issue and an approach to addressing this are discussed. Second, a brief history of SCDys is presented, focusing on conditions relevant to pediatrics. Third, the classification of SCDys is outlined, based on the International Spinal Cord Injury Data Sets for Non-Traumatic Spinal Cord Injury. Following this, a summary is given of the epidemiology of pediatric SCDys, primarily focused on the incidence, prevalence, and etiology, with a comparison to traumatic spinal cord injury. Next, important clinical rehabilitation principles unique to children with SCDys are highlighted. Then important prevention opportunities for SCDys in children are discussed. Finally, trends, challenges, and opportunities regarding research in SCDys are mentioned.
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Affiliation(s)
- Peter Wayne New
- Spinal Rehabilitation Service, Department of Rehabilitation, Caulfield Hospital, Alfred Health, Victoria, Australia.,Epworth-Monash Rehabilitation Medicine Unit, Monash University, Melbourne, Victoria, Australia.,Department of Epidemiology and Preventive Medicine, School of Public Health & Preventive Medicine, Monash University, Victoria, Australia
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Buzzell A, Chamberlain JD, Eriks-Hoogland I, Hug K, Jordan X, Schubert M, Zwahlen M, Brinkhof MWG. All-cause and cause-specific mortality following non-traumatic spinal cord injury: evidence from a population-based cohort study in Switzerland. Spinal Cord 2019; 58:157-164. [PMID: 31591462 PMCID: PMC7007408 DOI: 10.1038/s41393-019-0361-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 09/16/2019] [Indexed: 12/20/2022]
Abstract
Study design Observational cohort study. Objective To benchmark all-cause and cause-specific mortality following NTSCI to the general population (GP). Setting Specialized rehabilitation centers in Switzerland. Methods Longitudinal data from the Swiss Spinal Cord Injury (SwiSCI) Medical Record study were probabilistically linked with cause of death (CoD) information from the Swiss National Cohort. Standardized mortality ratios (SMRs) were estimated for all-cause and cause-specific mortality. Competing risk frameworks were used to estimate the probability of death due to specific CoD. Results One thousand five hundred and one individuals were admitted for first rehabilitation with NTSCI between 1990–2011; CoD information was available for 454 individuals of the 525 individuals that died. Overall, the mortality rate for persons with NTSCI was 1.6 times greater than that of the GP. Deaths due to cardiovascular disease (39.8%), neoplasms (22%), and infection (9.9%) were most often reported. Individuals with an SCI due to a vascular etiology indicated the greatest burden of mortality from infection compared with the GP (SMR 5.4; 95% CI, 3.1 to 9.2). Conclusions Cause-specific SMRs varied according to etiology. This supports the need for targeted clinical care and follow-up. Cardiovascular disease, neoplasms, and infection, emerged as main causes of death following NTSCI and should thus be targets for future research and differential clinical management approaches.
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Affiliation(s)
- A Buzzell
- Swiss Paraplegic Research, Nottwil, Switzerland.,Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - J D Chamberlain
- Swiss Paraplegic Research, Nottwil, Switzerland.,Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland.,Institute of Social and Preventative Medicine, University of Bern, Bern, Switzerland
| | | | - K Hug
- REHAB Basel, Basel, Switzerland
| | - X Jordan
- Clinique Romand de Réadaption, Sion, Switzerland
| | - M Schubert
- Spinal Cord Injury Center, Balgrist University Hospital, Zurich, Switzerland
| | - M Zwahlen
- Institute of Social and Preventative Medicine, University of Bern, Bern, Switzerland
| | - M W G Brinkhof
- Swiss Paraplegic Research, Nottwil, Switzerland. .,Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland.
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Rowan CP, Chan BCF, Jaglal SB, Catharine Craven B. Describing the current state of post-rehabilitation health system surveillance in Ontario - an invited review. J Spinal Cord Med 2019; 42:21-33. [PMID: 31573448 PMCID: PMC6781471 DOI: 10.1080/10790268.2019.1605724] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Context: Spinal cord injury (SCI) presents numerous physiological, psychosocial, and environmental complexities resulting in significant healthcare system resource demands. Objective: To describe the current health system surveillance mechanisms in Ontario, Canada and highlight gaps in health surveillance among adults with SCI across their lifespan. Methods: A review of administrative data sources capturing SCI-specific information took place via internet searching and networking among SCI rehabilitation and health services experts with emphasis on functionality, health service utilization, and quality of life data. Results: The review identified a distinct paucity of data elements specific to the health surveillance needs of individuals with SCI living in the community. The gaps identified are: (1) a lack of data usability; (2) inadequate linkage between available datasets; (3) inadequate/infrequent reporting of outcomes; (4) a lack of relevant content/patient-reported outcomes; and, (5) failure to incorporate additional data sources (e.g. Insurance datasets). Conclusion: Currently, SCI-specific health data is disproportionately weighted towards the first 3-6 months post injury with detailed data regarding pre-hospital care, acute management and rehabilitation, but little existing infrastructure supporting community-based health surveillance. Given this reality, the bolstering of meaningful community health surveillance of this population across the lifespan is needed. Addressing the identified gaps in health surveillance must inform the creation of a comprehensive community health dataset incorporating patient-reported outcome measures and enabling linkage with existing administrative and/or clinical databases. A future harmonized data surveillance strategy would, in turn, positively impact function, health services, resource utilization and health-related quality of life surveillance.
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Affiliation(s)
- Chip P. Rowan
- KITE, Toronto Rehab — University Health Network, Toronto, Ontario, Canada,Correspondence to: Chip P. Rowan, Research Department, KITE, Toronto Rehab — University Health Network, Lyndhurst Centre, 520 Sutherland Dr, Toronto, Ontario, Canada M4G 3V9; Ph: 416-597-3422 x6217.
| | - Brian C. F. Chan
- KITE, Toronto Rehab — University Health Network, Toronto, Ontario, Canada,Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
| | - Susan B. Jaglal
- KITE, Toronto Rehab — University Health Network, Toronto, Ontario, Canada,Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada,Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada
| | - B. Catharine Craven
- KITE, Toronto Rehab — University Health Network, Toronto, Ontario, Canada,Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada,Division of Physical Medicine and Rehabilitation, Department of Medicine, University of Toronto, Toronto, Ontario, Canada
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Survival after non-traumatic spinal cord injury: evidence from a population-based rehabilitation cohort in Switzerland. Spinal Cord 2018; 57:267-275. [DOI: 10.1038/s41393-018-0212-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Revised: 10/05/2018] [Accepted: 10/10/2018] [Indexed: 02/07/2023]
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