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Serafini ERS, Guerrero-Mendez CD, Bastos-Filho TF, Cotrina-Atencio A, de Azevedo Dantas AFO, Delisle-Rodriguez D, do Espirito-Santo CC. Gait Training-Based Motor Imagery and EEG Neurofeedback in Lokomat: A Clinical Intervention With Complete Spinal Cord Injury Individuals. IEEE Trans Neural Syst Rehabil Eng 2024; 32:1896-1905. [PMID: 38739520 DOI: 10.1109/tnsre.2024.3400040] [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: 05/16/2024]
Abstract
Robotic systems, such as Lokomat® have shown promising results in people with severe motor impairments, who suffered a stroke or other neurological damage. Robotic devices have also been used by people with more challenging damages, such as Spinal Cord Injury (SCI), using feedback strategies that provide information about the brain activity in real-time. This study proposes a novel Motor Imagery (MI)-based Electroencephalogram (EEG) Visual Neurofeedback (VNFB) system for Lokomat® to teach individuals how to modulate their own μ (8-12 Hz) and β (15-20 Hz) rhythms during passive walking. Two individuals with complete SCI tested our VNFB system completing a total of 12 sessions, each on different days. For evaluation, clinical outcomes before and after the intervention and brain connectivity were analyzed. As findings, the sensitivity related to light touch and painful discrimination increased for both individuals. Furthermore, an improvement in neurogenic bladder and bowel functions was observed according to the American Spinal Injury Association Impairment Scale, Neurogenic Bladder Symptom Score, and Gastrointestinal Symptom Rating Scale. Moreover, brain connectivity between different EEG locations significantly ( [Formula: see text]) increased, mainly in the motor cortex. As other highlight, both SCI individuals enhanced their μ rhythm, suggesting motor learning. These results indicate that our gait training approach may have substantial clinical benefits in complete SCI individuals.
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Romanini F, Zambetta RM, Padula N, Gaspar RC, Russo TL, Ilha J. Reliability and validity of the T-shirt test for the assessment of unsupported sitting in manual wheelchair users with spinal cord injury. Int J Rehabil Res 2023; 46:331-337. [PMID: 37581288 DOI: 10.1097/mrr.0000000000000600] [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: 08/16/2023]
Abstract
This study aimed to evaluate the validity and reliability of the T-shirt test (TST) in assessing sitting stability under three thigh support conditions and with timed outcomes derived in six ways among individuals with a spinal cord injury (SCI). The TST was performed five times under three thigh support conditions (85%, 55% and 25% of total thigh length) in two evaluations spaced between 7-14 days. For each thigh condition, six different outcomes were derived (average or best time from 2, 3, and 5 trial). All outcomes derivation showed excellent reliability on test day (intraclass correlation coefficient; ICC ≥ 0.997) and excellent test-retest reliability (ICC ≥ 0.874) for each thigh support condition. The TST showed high inverse correlations with the Spinal Cord Independence Measure III (SCIM)-mobility score for all outcomes and support conditions (ρ≥-0.706), except for Best-5; moderate inverse correlations with total SCIM-total scores for most outcome derivations and support conditions (ρ≥-0.636); and a moderate inverse correlation with confidence and capacity domains of Wheelchair Skills Test-Questionnaire for most outcome derivation and support conditions (ρ≥-0.504). The TST could discriminate cervical from high and low thoracic levels of injuries under minimal thigh support condition. Overall, all the TST-derived outcomes and support conditions showed adequate validity and test-retest reliability, but Best-5 had inconsistency. Under the minimal thigh support condition, all outcome derivations except Best-3 could discriminate cervical from other injury-level groups. Although all outcome derivations and thigh support conditions provided reliable results, we recommend using the average of 3 trials under the maximal thigh support condition.
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Affiliation(s)
- Francielle Romanini
- Spinal Cord Injury Rehabilitation Research Group (SCIR-group), Department of Physiotherapy, College of Health and Sport Science, Universidade do Estado de Santa Catarina (UDESC)
- Neuroscience Graduate Program, Universidade Federal de Santa Catarina (UFSC), Florianópolis, Santa Catarina
| | - Rafaella M Zambetta
- Department of Physiotherapy, Universidade Federal de São Carlos (UFSCar), São Carlos
| | - Natália Padula
- Acreditando Centro de Recuperação Neuromotora Saúde e Bem-estar, São Paulo, SP, Brazil
| | - Roberta C Gaspar
- Acreditando Centro de Recuperação Neuromotora Saúde e Bem-estar, São Paulo, SP, Brazil
| | - Thiago L Russo
- Department of Physiotherapy, Universidade Federal de São Carlos (UFSCar), São Carlos
| | - Jocemar Ilha
- Spinal Cord Injury Rehabilitation Research Group (SCIR-group), Department of Physiotherapy, College of Health and Sport Science, Universidade do Estado de Santa Catarina (UDESC)
- Neuroscience Graduate Program, Universidade Federal de Santa Catarina (UFSC), Florianópolis, Santa Catarina
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Galante-Maia GA, Magalhães LC, Teixeira-Salmela LF, Scianni AA. Cross-cultural adaptation and measurement properties of the Brazilian Portuguese version of the spinal cord injury - Falls Concern Scale. Spinal Cord 2022; 60:193-198. [PMID: 34168266 DOI: 10.1038/s41393-021-00660-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 06/11/2021] [Accepted: 06/14/2021] [Indexed: 02/06/2023]
Abstract
STUDY DESIGN Psychometric study. OBJECTIVES To cross-culturally adapt the spinal cord injury-falls concern scale (SCI-FCS) to the Brazilian Portuguese language and to evaluate its measurement properties. SETTING SARAH Network of Rehabilitation Hospitals, Belo Horizonte, Brazil. METHODS The SCI-FCS was translated and culturally adapted to the Brazilian- Portuguese language, following recommended guidelines. The following measurement properties were verified: internal consistency (Cronbach's α), test-retest reliability (ICC and quadratic-weighted kappa coefficients), and construct validity (Rasch analysis). RESULTS One-hundred and thirty individuals participated. The median SCI-FCS-Brazil score was 27 (22-34). The Cronbach's α was 0.95; ICC was 0.92 (95% CI, 0.86-0.95) for the total test-retest scores, and the Kappa coefficients ranged from 0.04 to 0.87 (95% CI, 0.01-1) for the item-level reliability. Rasch analysis reliability index was 0.81 and 0.98 and the separation index was 2.10 and 6.25 for the persons and items, respectively. Both items and persons fitted the statistics model's expectations, ensuring its unidimensionality. CONCLUSIONS The SCI-FCS-Brazil showed adequate measurement properties. Its use in manual wheelchair users with SCI is recommended to help defining rehabilitation strategies.
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Affiliation(s)
- Gabriela A Galante-Maia
- Graduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.,SARAH Network of Rehabilitation Hospitals, Belo Horizonte, Brazil
| | - Lívia C Magalhães
- Graduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Luci F Teixeira-Salmela
- Graduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Aline A Scianni
- Graduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.
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Simis M, Imamura M, Sampaio de Melo P, Marduy A, Battistella L, Fregni F. Deficit of Inhibition as a Marker of Neuroplasticity (DEFINE Study) in Rehabilitation: A Longitudinal Cohort Study Protocol. Front Neurol 2021; 12:695406. [PMID: 34434160 PMCID: PMC8380986 DOI: 10.3389/fneur.2021.695406] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 06/21/2021] [Indexed: 12/15/2022] Open
Abstract
Background: Brain plasticity is an intrinsic property of the nervous system, which is modified during its lifetime. This is one mechanism of recuperation after injuries with an important role in rehabilitation. Evidence suggests that injuries in the nervous system disturb the stability between inhibition and excitability essential for the recuperation process of neuroplasticity. However, the mechanisms involved in this balance are not completely understood and, besides the advancement in the field, the knowledge has had a low impact on the rehabilitation practice. Therefore, the understanding of the relationship between biomarkers and functional disability may help to optimize and individualize treatments and build consistent studies in the future. Methods: This cohort study, the deficit of inhibition as a marker of neuroplasticity study, will follow four groups (stroke, spinal cord injury, limb amputation, and osteoarthritis) to understand the neuroplasticity mechanisms involved in motor rehabilitation. We will recruit 500 subjects (including 100 age- and sex-matched controls). A battery of neurophysiological assessments, transcranial magnetic stimulation, electroencephalography, functional near-infrared spectroscopy, and magnetic resonance imaging, is going to be used to assess plasticity on the motor cortex before and after rehabilitation. One of the main hypotheses in this cohort is that the level of intracortical inhibition is related to functional deficits. We expect to develop a better understanding of the neuroplasticity mechanisms involved in the rehabilitation, and we expect to build neurophysiological “transdiagnostic” biomarkers, especially the markers of inhibition, which will have great relevance in the scientific and therapeutic improvement in rehabilitation. The relationship between neurophysiological and clinical outcomes will be analyzed using linear and logistic regression models. Discussion: By evaluating the reliability of electroencephalography, functional near-infrared spectroscopy, transcranial magnetic stimulation, and magnetic resonance imaging measures as possible biomarkers for neurologic rehabilitation in different neurologic disorders, this study will aid in the understanding of brain plasticity mechanisms in rehabilitation, allowing more effective approaches and screening methods to take place.
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Affiliation(s)
- Marcel Simis
- Núcleo de Estudos Avançados em Reabilitação, Universidade de São Paulo, São Paulo, Brazil
| | - Marta Imamura
- Núcleo de Estudos Avançados em Reabilitação, Universidade de São Paulo, São Paulo, Brazil
| | - Paulo Sampaio de Melo
- Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital, Boston, MA, United States
| | - Anna Marduy
- Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital, Boston, MA, United States
| | - Linamara Battistella
- Núcleo de Estudos Avançados em Reabilitação, Universidade de São Paulo, São Paulo, Brazil
| | - Felipe Fregni
- Neuromodulation Center and Center for Clinical Research Learning, Spaulding Rehabilitation Hospital, Boston, MA, United States
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Translation and validation of the Chinese version of the Spinal Cord Independence Measure (SCIM III) Self-Report. Spinal Cord 2021; 59:1045-1052. [PMID: 33446937 DOI: 10.1038/s41393-020-00601-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 11/25/2020] [Accepted: 11/27/2020] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN A cross-sectional psychometric study. OBJECTIVE To translate, culturally adapt and validate the Chinese version of the Spinal Cord Independence Measure III-Self Report (SCIM-SR). SETTING Four rehabilitation centers in Guangzhou, Chengdu, and Shiyan, China. METHODS Translation and cultural adaptation of the Chinese version of the SCIM-SR was conducted according to Brislin guidelines. A total of 147 spinal cord injury patients self-rated their functional independence using translated instrument. The psychometric properties of content validity, criterion-related validity, internal consistency reliability, and test-retest reliability were examined. RESULTS The content validity index of the new scale was 0.99. The intraclass correlation coefficient between the total SCIM-SR and SCIM III scores was 0.935, and the coefficients for its three subscales were 0.899, 0.760, and 0.942. Bland-Altman analysis showed that the mean difference between the total SCIM-SR and SCIM III scores was 2.35 (95% confidence interval -0.58 to 5.28), and differences for the three subscales were 0.75 (-0.51-2.01), 1.30 (-0.63-3.23), and 0.30 (-0.80-1.40). The Cronbach's α coefficients for the total scale, the self-care subscale, and the mobility subscale were 0.908, 0.913, and 0.895, respectively. The α for the respiration and sphincter management subscale was 0.581. Test-retest reliability after 2 weeks yielded a Spearman coefficient for the total scale of and subscale values all above 0.73. CONCLUSIONS Our results indicate acceptable validity and reliability of the Chinese version of SCIM-SR. It may facilitate long-term evaluations of independence in Chinese spinal cord injury patients in the community and at home.
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Xing H, Liu N, Biering-Sørensen F. An investigation into the validity and reliability of the Chinese version of Spinal Cord Independence Measure III (SCIM III). Clin Rehabil 2020; 35:436-445. [PMID: 33103924 DOI: 10.1177/0269215520966703] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To investigate the validity and reliability of a Chinese version of Spinal Cord Independence Measure III (SCIM III) in individuals with spinal cord injury. DESIGN Study on psychometric properties. SETTING An inpatient rehabilitation facility in China. SUBJECTS 102 participants with spinal cord injury. Mean (SD) age was 48.8 (15.6) years; tetraplegia/paraplegia ratio was 50/52; median time post injury was 2 months. INTERVENTION SCIM III was translated into Chinese. Chinese versions of Barthel Index and SCIM III were filled out for each participant by Rater 1. SCIM III was then administered by Rater 2 after 24 hours (n = 67) and 7 days (n = 65). MAIN MEASURES Validity, inter-rater/test-retest reliability, and internal consistency of the Chinese version of SCIM III. RESULTS The total scores between the two raters were similar (mean ± SD: 33.8 ± 25.8 vs 33.8 ± 25.5, P = 0.95). Total agreement between the raters in each item was >80%, with both Pearson and intraclass correlation coefficients >0.97 (P < 0.01) for each subscale and total score. The Pearson correlation coefficients of the two independent assessments performed by Rater 2 were also >0.97 (P < 0.01) for each subscale and the total score. Cronbach α was >0.7 for each subscale and the total score for both raters. High consistency was found between Barthel Index and SCIM III total scores (Pearson correlation coefficient = 0.88, P < 0.01). CONCLUSION The Chinese version of SCIM III is valid and reliable for the functional assessment of patients with SCI.
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Affiliation(s)
- Huayi Xing
- Department of Rehabilitation Medicine, Peking University Third Hospital, Beijing, China
| | - Nan Liu
- Department of Rehabilitation Medicine, Peking University Third Hospital, Beijing, China
| | - Fin Biering-Sørensen
- Clinic for Spinal Cord Injuries, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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Cross-cultural adaptation and psychometric testing of the Thai version of the Spinal Cord Independence Measure III-Self Report. Spinal Cord 2020; 59:291-297. [PMID: 32963364 DOI: 10.1038/s41393-020-00556-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Revised: 09/03/2020] [Accepted: 09/11/2020] [Indexed: 11/08/2022]
Abstract
STUDY DESIGN Cross-sectional reliability and validation study. OBJECTIVE To translate and assess the psychometric properties of the Thai version of the Spinal Cord Independence Measure III-Self Report (TH-SCIM-SR) in Thai spinal cord injury (SCI) patients. SETTING Faculty of Medicine Siriraj Hospital, Mahidol University. METHODS A cross-cultural forward and backward translation of the original Spinal Cord Independence Measure III-Self Report (SCIM-SR) was performed at the Faculty of Medicine Siriraj Hospital, Mahidol University, Thailand, to create the TH-SCIM-SR. The inclusion criteria were Thai patients with SCI duration of ≥3 months. Patients were evaluated by a team of healthcare professionals using the Thai version of the Spinal Cord Independence Measure Version III (TH-SCIM III). Study patients subsequently completed the TH-SCIM-SR two times with a 3-day interval between evaluations. Cronbach's Alpha, Pearson's correlation coefficient, and intraclass correlation coefficient (ICC) were used to examine internal consistency, concurrent validity, and reliability, respectively. Bland-Altman plot was used to compare scoring results between the TH-SCIM III and the TH-SCIM-SR. RESULTS Thirty-two patients were included. Cronbach's alpha of total score, self-care subscale, respiration/sphincter management, and mobility subscale were 0.91, 0.94, 0.75, and 0.90, respectively. The reliability analysis showed good reliability. The test-retest ICC of total score, self-care subscale, respiration/sphincter management, and mobility subscale were 0.95, 0.95, 0.78, and 0.96, respectively. Regarding construct validity, the subscales of TH-SCIM-SR demonstrated a strong correlation with those of the TH-SCIM III (0.85-0.96). CONCLUSIONS TH-SCIM-SR showed good reliability and validity for assessing functional independence in Thai patients with SCI.
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Dorneles JR, Neto FR, Gonçalves CW, Costa RRG, Carregaro RL. Does prolonged walking cause greater muscle fatigability in individuals with incomplete spinal cord injury compared with matched-controls? Gait Posture 2020; 78:65-71. [PMID: 32268249 DOI: 10.1016/j.gaitpost.2020.03.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 03/17/2020] [Accepted: 03/22/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Individuals with incomplete spinal cord injury (iSCI) might show muscle fatigability during walking, primarily over long distances. The cause can be related to the motor impairment and walking compensations identified in this population. However, evidence on the occurrence of muscle fatigability after prolonged walking in individuals with iSCI is conflicting. RESEARCH QUESTION Does prolonged walking cause higher muscle fatigability in individuals with iSCI compared with matched-controls? METHODS We adopted a repeated measures design, in which maximal voluntary isometric contractions were performed before and after a walking test to induce the fatigability, in 24 individuals with iSCI and 24 matched-controls. Body weight-normalized peak torque (PT/BW), rate of force development (RFD), root mean square (RMS) and neuromuscular efficiency were used to assess the muscle fatigability. A mixed model ANOVA (2 × 2) was used for between-group and within-group comparisons. The significance was set in 5%. RESULTS Individuals with iSCI showed a greater decline in the PT/BW and RMS after the walking test. However, the RFD presented a greater decrease in the control group. SIGNIFICANCE Our results showed that prolonged walking caused higher muscle fatigability in individuals with iSCI compared to healthy individuals. Therefore, muscle fatigability should be considered during the rehabilitation planning and in activities of daily living of individuals with iSCI. Moreover, the identification of muscle fatigability in individuals with iSCI might be useful to prevent high levels of physical exertion and, possibly, the risk of fall.
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Affiliation(s)
- Jefferson Rodrigues Dorneles
- Master Program in Rehabilitation Sciences, Universidade De Brasília (UnB), Campus UnB Ceilândia, Brasília, Brazil; Spinal Cord Injury Department, Sarah Hospital Rehabilitation Network, Brasilia, Brazil
| | | | | | | | - Rodrigo Luiz Carregaro
- Master Program in Rehabilitation Sciences, Universidade De Brasília (UnB), Campus UnB Ceilândia, Brasília, Brazil.
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Batista KG, Reis KB, Campelo RDCL, Lana MRV, Polese JC. Comparação da incapacidade percebida e independência funcional em indivíduos com lesão medular atletas e não atletas. FISIOTERAPIA E PESQUISA 2019. [DOI: 10.1590/1809-2950/18046626042019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO Os comprometimentos da funcionalidade em indivíduos com lesão medular (LM) geram complicações secundárias, sendo o descondicionamento físico preponderante e um exacerbador das complicações da lesão. O objetivo foi avaliar em atletas e não atletas com LM a incapacidade percebida e a independência funcional. Os questionários WHODAS 2.0 e SCIM III foram aplicados em 37 voluntários com LM e seus dados sociodemográficos foram coletados. Os escores totais do WHODAS 2.0 e SCIM III de indivíduos com LM torácica e LM cervical foram comparados por meio do teste de Mann-Whitney. Quanto à incapacidade percebida observou-se diferença significativa no WHODAS 2.0 entre atletas e não atletas com LM torácica. Em relação à independência funcional não houve diferenças significativas entre os grupos no SCIM III. Apesar de a prática esportiva promover benefícios para a saúde, no grupo de indivíduos com LM cervical não foram encontradas diferenças significativas, o que pode ser explicado pelo maior grau de comprometimento motor desses indivíduos.
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Reliability and Validity of the Korean Version of the Spinal Cord Independence Measure III. Am J Phys Med Rehabil 2019; 99:305-309. [DOI: 10.1097/phm.0000000000001327] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Liu N, Xing H, Zhou M, Biering-Sørensen F. Lack of knowledge and training are the major obstacles in application of the Spinal Cord Independence Measure (SCIM) in China. J Spinal Cord Med 2019; 42:437-443. [PMID: 29595400 PMCID: PMC6718138 DOI: 10.1080/10790268.2018.1454021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Abstract
OBJECTIVE To investigate the use of functional outcome measurements after spinal cord injury (SCI) in current clinical practice and to explore the knowledge about the Spinal Cord Independence Measure (SCIM) among SCI physicians in China, and to find facilitators for a broader utilization of SCIM. DESIGN A survey-based study. SETTING SCI workshops at Peking University. PARTICIPANTS 125 Chinese SCI physicians attending annual workshops in two consecutive years. INTERVENTIONS Not applicable. OUTCOME MEASURES A questionnaire was administered. The following items were included: whether functional outcome measurement for SCI individuals was performed and with which assessment tool(s); what items should be included in the assessment; whether they knew about the SCIM, its latest version, the Chinese translation, and if so from what source; the possible reasons why SCIM was not implemented in clinical practice; and whether training before using the SCIM was needed, and the training method preferred. RESULTS Among these physicians, 84.8% performed functional outcome measurement for individuals with SCI, but only 29.6% of attendees were aware of the SCIM and 20.8% had used it. Lack of training was the major reason why SCIM was not used in clinical practice. Furthermore, 74.4% of the physicians felt they needed formal training before using the SCIM. CONCLUSION The use of SCIM is limited in clinical practice in China, which is mainly attributed to lack of knowledge and training. Formal training on the use of the SCIM is essential for its dissemination and will improve functional SCI outcome measurement in China.
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Affiliation(s)
- Nan Liu
- Department of Rehabilitation Medicine, Peking University Third Hospital, Beijing, China
| | - Huayi Xing
- Department of Rehabilitation Medicine, Peking University Third Hospital, Beijing, China
| | - Mouwang Zhou
- Department of Rehabilitation Medicine, Peking University Third Hospital, Beijing, China,Correspondence to: Professor Mouwang Zhou, Department of Rehabilitation Medicine, Peking UniversityThird Hospital, No. 49 North Garden Road, Beijing, China, 100191; Ph: +86 (10) 8226-6688, Fax: +86 (10) 8226-5861.
| | - Fin Biering-Sørensen
- Clinic for Spinal Cord Injuries, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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Saberi H, Vosoughi F, Derakhshanrad N, Yekaninejad M, Khan ZH, Kohan AH, Parvaneh S, Ghahari S, Agheli F, Vosoughi F. Development of Persian version of the Spinal Cord Independence Measure III assessed by interview: a psychometric study. Spinal Cord 2018; 56:980-986. [DOI: 10.1038/s41393-018-0160-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 04/27/2018] [Accepted: 04/28/2018] [Indexed: 11/09/2022]
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Ribeiro Neto F, Costa RRG, Lopes ACG, Carregaro RL. Cross-cultural validation of a Brazilian version of the adapted manual wheelchair circuit (AMWC-Brazil). Physiother Theory Pract 2018; 35:860-872. [PMID: 29659301 DOI: 10.1080/09593985.2018.1458356] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Purpose: To translate, culturally adapt and validate the Adapted Manual Wheelchair Circuit (AMWC) into Brazilian-Portuguese. Design: Cross-sectional study. Methods: Sixty-six men (median age of 30.5 years [percentiles 25 and 75: 24.0; 38.3 years]) with traumatic spinal cord injury were consecutively enrolled and divided into two groups: tetraplegia (TP) and paraplegia (PP). The participants performed the AMWC-Brazil and were evaluated by the Spinal Cord Injury Measure version III (SCIM-III). Translation, translation synthesis, back-translation, committee review and construct validity were adopted for the cross-cultural adaptation. Construct validity was performed by testing whether the test scores were significantly correlated (Spearman's correlation coefficient) to the subjects' injury level, age, time since injury, body mass index (BMI) and SCIM-III scale. Results: All the AMWC-Brazil's outcomes were significantly correlated with SCIM-III total score and subscales (P ≤ 0.01). However, when the analyses were stratified over injury level, only the TP showed a high correlation between the AMWC-Brazil's outcomes and the SCIM-III. For construct validity, 4 of 5 hypotheses were confirmed. Only BMI was not a significant predictor of the AMWC-Brazil outcomes. Conclusion: The AMWC was successfully translated to the Brazilian-Portuguese (AMWC-Brazil) and presented high and satisfactory construct validity.
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Affiliation(s)
- Frederico Ribeiro Neto
- a College of Physical Education , Universidade de Brasilia (UnB) , Brasília , DF , Brazil.,b Spinal Cord Injury Department, SARAH Rehabilitation Hospital Network/SARAH , Brasilia , DF , Brazil
| | | | - Ana Cláudia Garcia Lopes
- b Spinal Cord Injury Department, SARAH Rehabilitation Hospital Network/SARAH , Brasilia , DF , Brazil
| | - Rodrigo Luiz Carregaro
- a College of Physical Education , Universidade de Brasilia (UnB) , Brasília , DF , Brazil.,c School of Physical Therapy , Universidade de Brasilia (UnB), Campus UnB Ceilândia, Centro Metropolitano, Ceilândia Sul , Brasília , DF , Brazil
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Ribeiro Neto F, Guanais P, Lopes GH, Dornelas E, de Campos Barbetta D, Coutinho AC, Gonçalves CW, Gomes Costa RR. Influence of Relative Strength on Functional Independence of Patients With Spinal Cord Injury. Arch Phys Med Rehabil 2016; 98:1104-1112. [PMID: 27717738 DOI: 10.1016/j.apmr.2016.08.483] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Revised: 07/29/2016] [Accepted: 08/25/2016] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To investigate the influence of strength values and fat mass on functional independence of men with different spinal cord injury (SCI) levels. DESIGN Cross-sectional study. SETTING Hospital network. PARTICIPANTS Men with SCI (N=45). INTERVENTIONS Subjects were assessed in functional independence scales, a 1 repetition maximum (1RM) test, and body composition to detect absolute and relative strength: 1RM divided by body mass (BM) and lean body mass (LBM), respectively. MAIN OUTCOME MEASURES Stepwise multiple regression analysis was used to verify the influence of predictors on functional independence (FIM and Spinal Cord Independence Measure [SCIM] scale and subscales). Receiver operating characteristic curves were created to identify cutoff points of strength for functional independence. RESULTS The best models for FIM total, FIM mobility, and SCIM total used 1RM as the best predictor (adjusted R2=.75, .67, and .65, respectively; P<.05). Relative strength (1RM/LBM) was the best predictor for SCIM mobility (adjusted R2=.62, P<.05). A FIM score of 69 has a 1RM cutoff point of 50.1kg, and a FIM score of 76 has cutoff points of .73 for 1RM/BM and .91 for 1RM/LBM. A SCIM score of 68 has cutoff points for 1RM, 1RM/BM, and 1RM/LBM of 50.1kg, .77, and .92, respectively. CONCLUSIONS Cutoff points of relative strength should be used as determinant variables for independence, health, or sports performance. This study may contribute to more adequate guidance of physical activity during a rehabilitation program and after discharge.
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Affiliation(s)
| | | | - Guilherme H Lopes
- College of Physical Education, University of Brasília, Brasília/DF, Brazil
| | - Elisa Dornelas
- SARAH Rehabilitation Hospital Network, Brasília/DF, Brazil
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Almeida CD, Coelho JN, Riberto M. Applicability, validation and reproducibility of the Spinal Cord Independence Measure version III (SCIM III) in patients with non-traumatic spinal cord lesions. Disabil Rehabil 2016; 38:2229-34. [PMID: 26800790 DOI: 10.3109/09638288.2015.1129454] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To verify the applicability, reproducibility and validity of the SCIM III patients with non-traumatic spinal cord injury. METHOD The cross-sectional study included 30 patients (66% females; 41.5 ± 14.7 yo) with non-traumatic spinal cord injury of any etiology. Subjects were subjected by computerized gait analysis and answered the Brazilian versions of SCIM III (0-100 points) and FIM™ (18-126 points) by two raters (A and B) at the same day and 1 week later (A). RESULTS The intraclass correlation coefficient for the use of SCIM III indicated appropriated intra- and inter-evaluator reproducibility (ICC = 0.9). Correlation between the SCIM III and the motor FIM™ was appropriate (r = 0.6; p = 0.0). SCIM III subscales and FIM™ domains correlated strongly for self-care (r = 0.8; p ≤ 0.001), moderately for transfers (r = 0.6; p = 0.0005) and locomotion (r = 0.6; p = 0.0006). SCIM III mobility subscale positively correlated with the cadence (r = 0.8; p ≤ 0.01), gait speed (r = 0.7; p ≤ 0.01) and step length (r = 0.6; p ≤ 0.01). CONCLUSIONS SCIM III is a reproducible functional assessment instrument and capable of evaluating the level of independence of the individual with non-traumatic spinal cord injury. The SCIM III is more sensitive than the MIF™ for non-traumatic spastic paraplegic patients with higher levels of independence, particularly if they can walk independently. Linear gait parameters correlated with its mobility subscale. Implications for Rehabilitation Applicability, validation and reproducibility of the Spinal Cord Independence Measure version III (SCIM III) in patients with non-traumatic spinal cord lesions. There are not many studies focused on patients with non-traumatic spinal cord lesion. Disability varies in severity, but frequently contributes to limitations in the activities of daily living (ADL) and participation. We do not find in the literature studies that assess the functionality of these individuals as comprehensive as ours.
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Affiliation(s)
- Camila de Almeida
- a Rehabilitation Center of the University Hospital of Ribeirão Preto, Medical School, University of São Paulo , São Paulo , Brazil
| | - Juliana Nogueira Coelho
- a Rehabilitation Center of the University Hospital of Ribeirão Preto, Medical School, University of São Paulo , São Paulo , Brazil
| | - Marcelo Riberto
- a Rehabilitation Center of the University Hospital of Ribeirão Preto, Medical School, University of São Paulo , São Paulo , Brazil
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Padula N, Costa M, Batista A, Gaspar R, Motta C, Palma G, Torriani-Pasin C. Long-term effects of an intensive interventional training program based on activities for individuals with spinal cord injury: a pilot study. Physiother Theory Pract 2015; 31:568-74. [PMID: 26467667 DOI: 10.3109/09593985.2015.1070938] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES To investigate the long-term effects of a rehabilitation program using activity-based therapies in daily activities and the participation of individuals with spinal cord injury (SCI). METHOD A descriptive study of case reports assessing the performance of daily activities and quality of life as a dependent variable, using the Functional Independence Measure (FIM) and the Short-Form Health Survey (SF-36), respectively. Seven individuals were included in the intervention composed of a multimodal intensive therapies program based on activities (activity-based therapy, ABT) conducted for 18 months. RESULTS It was possible to descriptively observe that the individual with the shortest time of injury and previous training obtained the largest variation in the FIM score. But no statistically significant difference was found in the assessments. CONCLUSION For trained individuals with chronic SCIs, classified "A" according to the American Spinal Injury Association (ASIA), an ABT program did not significantly affect the scores of the scales used to assess quality of life (SF-36) and functional independence (FIM).
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Affiliation(s)
- Natalia Padula
- a Acreditando Recovery Centre - Neuromotor Recovery, Health and Well-Being , São Paulo , Brazil and.,b School of Physical Education and Sport (EEFE), University of São Paulo (USP) , São Paulo , Brazil
| | - Mariana Costa
- b School of Physical Education and Sport (EEFE), University of São Paulo (USP) , São Paulo , Brazil
| | - Alexsandro Batista
- b School of Physical Education and Sport (EEFE), University of São Paulo (USP) , São Paulo , Brazil
| | - Roberta Gaspar
- a Acreditando Recovery Centre - Neuromotor Recovery, Health and Well-Being , São Paulo , Brazil and.,b School of Physical Education and Sport (EEFE), University of São Paulo (USP) , São Paulo , Brazil
| | - Camilo Motta
- a Acreditando Recovery Centre - Neuromotor Recovery, Health and Well-Being , São Paulo , Brazil and
| | - Gisele Palma
- b School of Physical Education and Sport (EEFE), University of São Paulo (USP) , São Paulo , Brazil
| | - Camila Torriani-Pasin
- b School of Physical Education and Sport (EEFE), University of São Paulo (USP) , São Paulo , Brazil
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Reliability and discriminative ability of the spinal cord independence measure III (Thai version). Spinal Cord 2015; 54:213-20. [DOI: 10.1038/sc.2015.114] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Revised: 06/01/2015] [Accepted: 06/01/2015] [Indexed: 11/08/2022]
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