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Tsou HK, Chen HY, Shih KC, Lin YC. Para table tennis improves psychological/mental and cardiovascular health in individuals with spinal cord injury. NeuroRehabilitation 2024:NRE240083. [PMID: 39058455 DOI: 10.3233/nre-240083] [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: 07/28/2024]
Abstract
BACKGROUND Although rehabilitation exercise is known to be beneficial for cardiovascular and mental health, it remains a daunting challenge for patients with spinal cord injury (SCI) who rely on wheelchairs for mobility. OBJECTIVE This study aimed to examine the effectiveness of a 4-week para table tennis program in enhancing self-efficacy and health outcomes in adults with SCI. METHODS A total of 39 SCI patients were included and divided into the experimental group (n = 18, a 4-week para table tennis training program) and the control group (n = 21). Frequency domain indices of heart rate variability (HRV) were used to evaluate the function of the autonomic nervous system. RESULTS Following para table tennis training, there was a significant reduction in the physical stress index (PSI, P < 0.001), accompanied by shifts in autonomic regulation of vagal dominance. Additionally, the para table tennis training led to significant improvements in vessel state, differential pulse wave index, atrial elasticity, eccentric constriction power, remaining blood volume, and self-efficacy (all P < 0.05). CONCLUSION Para table tennis training results in favorable changes in sympathetic tone, enhanced self-efficacy, improved cardiovascular well-being, and an overall positive transformation in HRV.
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Affiliation(s)
- Hsi-Kai Tsou
- Functional Neurosurgery Division, Neurological Institute, Taichung Veterans General Hospital, Taichung, Taiwan
- Department of Rehabilitation, Jen-Teh Junior College of Medicine, Nursing and Management, Miaoli County, Taiwan
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, Taiwan
- College of Health, National Taichung University of Science and Technology, Taichung, Taiwan
| | - Hsiao-Yu Chen
- Department of Nursing, National Taichung University of Science and Technology, Taiwan
| | | | - Yueh-Chiang Lin
- Neurological Institute, Taichung Veterans General Hospital, Taichung, Taiwan
- National Taichung University of Science and Technology, Taichung, Taiwan
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Saia T, Vogel E, Salazar S. "We need a world we can operate in": Exploring the relationship between societal stigma and depression among wheelchair users. Disabil Health J 2024; 17:101624. [PMID: 38631970 DOI: 10.1016/j.dhjo.2024.101624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 03/21/2024] [Accepted: 04/07/2024] [Indexed: 04/19/2024]
Abstract
BACKGROUND Stigma looms over the disability community. OBJECTIVE OR HYPOTHESIS The aim of this paper is to gain a deeper understanding of how societal stigma impacts depression among wheelchair users. METHODS Mixed research methods were used on a sample of sixty full-time wheelchair users (M age = 43.78, SD = 15.50) whose disability was either acquired (n = 32) or congenital (n = 28). Data was collected via an anonymous Qualtrics survey. Qualitative and quantitative content analyses were performed. RESULTS Three major themes were identified from the qualitative analysis, including pity, discomfort, and invisibility which demonstrated that our participants felt frequently stigmatized in public. Several participants noted how assumptions were made about their competence, intellect, ability, and the entire disability experience based on the physical representation of their wheelchair. The quantitative results demonstrated a positive correlation between The Major Depression Index and the Able Privilege Scale-Revised, a scale constructed to examine personal power and privilege in relation to society depending on disability type. CONCLUSIONS Wheelchair users feel stigmatized by members of society, which is associated with increased levels of depression and perceived pity, discomfort, and invisibility.
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Affiliation(s)
- Toni Saia
- Department of Administration, Rehabilitation, & Postsecondary Education, San Diego State, USA.
| | - Emily Vogel
- Department of Psychological Sciences, Northern Arizona University, USA.
| | - Sadie Salazar
- Department of Administration, Rehabilitation, & Postsecondary Education, San Diego State, USA.
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Sharma S, Kalyani N, Dutta T, Velázquez-González JS, Llamas-Garro I, Ung B, Bas J, Dubey R, Mishra SK. Optical Devices for the Diagnosis and Management of Spinal Cord Injuries: A Review. BIOSENSORS 2024; 14:296. [PMID: 38920599 PMCID: PMC11201428 DOI: 10.3390/bios14060296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 05/21/2024] [Accepted: 06/02/2024] [Indexed: 06/27/2024]
Abstract
Throughout the central nervous system, the spinal cord plays a very important role, namely, transmitting sensory and motor information inwardly so that it can be processed by the brain. There are many different ways this structure can be damaged, such as through traumatic injury or surgery, such as scoliosis correction, for instance. Consequently, damage may be caused to the nervous system as a result of this. There is no doubt that optical devices such as microscopes and cameras can have a significant impact on research, diagnosis, and treatment planning for patients with spinal cord injuries (SCIs). Additionally, these technologies contribute a great deal to our understanding of these injuries, and they are also essential in enhancing the quality of life of individuals with spinal cord injuries. Through increasingly powerful, accurate, and minimally invasive technologies that have been developed over the last decade or so, several new optical devices have been introduced that are capable of improving the accuracy of SCI diagnosis and treatment and promoting a better quality of life after surgery. We aim in this paper to present a timely overview of the various research fields that have been conducted on optical devices that can be used to diagnose spinal cord injuries as well as to manage the associated health complications that affected individuals may experience.
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Affiliation(s)
- Sonika Sharma
- Department of Physics, Graphic Era Hill University, Dehradun 248002, Uttarakhand, India;
| | - Neeti Kalyani
- Department of Biotechnology and Biomedicine, Denmark Technical University, 2800 Kongens Lyngby, Denmark;
| | - Taposhree Dutta
- Department of Chemistry, Indian Institute of Engineering Science and Technology, Shibpur, Howarh 711103, West Bengal, India;
| | - Jesús Salvador Velázquez-González
- Navigation and Positioning, Center Technologic de Telecomunicacions de Catalunya (CTTC), Avinguda Carl Friedrich Gauss, 11, 08860 Castelldefels, Spain; (J.S.V.-G.); (I.L.-G.)
| | - Ignacio Llamas-Garro
- Navigation and Positioning, Center Technologic de Telecomunicacions de Catalunya (CTTC), Avinguda Carl Friedrich Gauss, 11, 08860 Castelldefels, Spain; (J.S.V.-G.); (I.L.-G.)
| | - Bora Ung
- Electrical Engineering Department, Ecole de Technologie Superieure, Montreal, QC H3C 1K3, Canada;
| | - Joan Bas
- Space and Resilient Communications and Systems (SRCOM), Center Technologic de Telecomunicacions de Catalunya (CTTC), Avinguda Carl Friedrich Gauss, 11, 08860 Castelldefels, Spain;
| | - Rakesh Dubey
- Institute of Physics, University of Szczecin, 70-453 Szczecin, Poland;
| | - Satyendra K. Mishra
- Space and Resilient Communications and Systems (SRCOM), Center Technologic de Telecomunicacions de Catalunya (CTTC), Avinguda Carl Friedrich Gauss, 11, 08860 Castelldefels, Spain;
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Jaffe RH, Coyte PC, Chan BCF, Hancock-Howard RL, Malhotra AK, Ladha K, Wilson JR, Witiw CD. Traumatic Cervical Spinal Cord Injury and Income and Employment Status. JAMA Netw Open 2024; 7:e2418468. [PMID: 38916890 PMCID: PMC11200142 DOI: 10.1001/jamanetworkopen.2024.18468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 04/20/2024] [Indexed: 06/26/2024] Open
Abstract
Importance Spinal cord injury (SCI) causes drastic changes to an individual's physical health that may be associated with the ability to work. Objective To estimate the association of SCI with individual earnings and employment status using national administrative health databases linked to income tax data. Design, Setting, and Participants This was a retrospective, national, population-based cohort study of adults who were hospitalized with cervical SCI in Canada between January 2005 and December 2017. All acute care hospitalizations for SCI of adults ages 18 to 64 years were included. A comparison group was constructed by sampling from individuals in the injured cohort. Fiscal information from their preinjury years was used for comparison. The injured cohort was matched with the comparison group based on age, sex, marital status, province of residence, self-employment status, earnings, and employment status in the year prior to injury. Data were analyzed from August 2022 to January 2023. Main outcomes and Measures The first outcome was the change in individual annual earnings up to 5 years after injury. The change in mean yearly earnings was assessed using a linear mixed-effects differences-in-differences regression. Income values are reported in 2022 Canadian dollars (CAD $1.00 = US $0.73). The second outcome was the change in employment status up to 5 years after injury. A multivariable probit regression model was used to compare proportions of individuals employed among those who had experienced SCI and the paired comparison group of participants. Results A total of 1630 patients with SCI (mean [SD] age, 47 [13] years; 1304 male [80.0%]) were matched to patients in a preinjury comparison group (resampled from the same 1630 patients in the SCI group). The mean (SD) of preinjury wage earnings was CAD $46 000 ($48 252). The annual decline in individual earnings was CAD $20 275 (95% CI, -$24 455 to -$16 095) in the first year after injury and CAD $20 348 (95% CI, -$24 710 to -$15 985) in the fifth year after injury. At 5 years after injury, 52% of individuals who had an injury were working compared with 79% individuals in the preinjury comparison group. SCI survivors had a decrease in employment of 17.1 percentage points (95% CI, 14.5 to 19.7 percentage points) in the first year after injury and 17.8 percentage points (14.5 to 21.1 percentage points) in the fifth year after injury. Conclusions and Relevance In this study, SCI was associated with a decline in earnings and employment up to 5 years after injury for adults aged 18 to 64 years in Canada.
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Affiliation(s)
- Rachael H. Jaffe
- Institute for Health Policy, Management and Evaluation, University of Toronto, Ontario, Canada
- Division of Neurosurgery, St Michael’s Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Peter C. Coyte
- Institute for Health Policy, Management and Evaluation, University of Toronto, Ontario, Canada
| | - Brian C.-F. Chan
- Institute for Health Policy, Management and Evaluation, University of Toronto, Ontario, Canada
- KITE-Toronto Rehabilitation Institute, University Health Network, University of Toronto, Toronto, Ontario, Canada
| | | | - Armaan K. Malhotra
- Institute for Health Policy, Management and Evaluation, University of Toronto, Ontario, Canada
- Division of Neurosurgery, St Michael’s Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Karim Ladha
- Institute for Health Policy, Management and Evaluation, University of Toronto, Ontario, Canada
- Department of Anesthesiology and Pain Medicine, St Michael’s Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Jefferson R. Wilson
- Institute for Health Policy, Management and Evaluation, University of Toronto, Ontario, Canada
- Division of Neurosurgery, St Michael’s Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Christopher D. Witiw
- Institute for Health Policy, Management and Evaluation, University of Toronto, Ontario, Canada
- Division of Neurosurgery, St Michael’s Hospital, University of Toronto, Toronto, Ontario, Canada
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Berryman K, Wirth M, Bombardier CH, Motl RW, Bartle B, Jacob RL, Aguina K, LaVela SL. Variables Associated With Moderate to High Loneliness Among Individuals Living With Spinal Cord Injuries and Disorders. Arch Phys Med Rehabil 2024; 105:1076-1082. [PMID: 38281576 DOI: 10.1016/j.apmr.2024.01.010] [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: 08/03/2023] [Revised: 01/04/2024] [Accepted: 01/10/2024] [Indexed: 01/30/2024]
Abstract
OBJECTIVE To identify variables independently associated with moderate to high loneliness in individuals living with Spinal Cord Injuries or Disorders (SCI/D). DESIGN A cross-sectional, national survey of a random sample of community-dwelling Veterans with SCI/D in the United States. Survey methodology was used to collect data on demographic and injury characteristics, general health, chronic and SCI-secondary conditions, and loneliness. SETTING The VHA SCI/D System of Care including 25 regional SCI/D Centers (or Hubs). PARTICIPANTS Among 2466 Veterans with SCI/D, 592 completed surveys (24%). Most participants were men (91%), white (81%), not currently married (42%), had tetraplegia (33%), and on average injured for 18 years at the time of data collection (N=562). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURE The dependent variable, loneliness, was collected using the UCLA-3 instrument. Loneliness was dichotomized into never/low loneliness and moderate/high loneliness (UCLA score ≥ 4). RESULTS Bivariate analyses assessed unadjusted associations in demographics, injury characteristics, chronic disease, and SCI-secondary conditions. Multivariable logistic regression was used to identify factors independently associated with moderate/high loneliness. Participants had a mean loneliness score of 5.04, SD=1.99. The point prevalence of moderate to high loneliness was 66%. Lower duration of injury, paraplegia, being unmarried, being in fair/poor general health, having dysfunctional sleep, and having a diagnosis of bowel dysfunction were each independently associated with greater odds of moderate/high loneliness. CONCLUSIONS Findings suggest that interventions to reduce/manage loneliness in the Veteran SCI/D population should focus on those who are more newly injured, have paraplegia, currently unmarried, have bowel problems, and experience dysfunctional sleep.
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Affiliation(s)
- Kelsey Berryman
- Center of Innovation for Complex Chronic Healthcare (CINCCH), Department of Veterans Affairs, Edward Hines Jr VA Hospital, Hines, IL.
| | - Marissa Wirth
- Center of Innovation for Complex Chronic Healthcare (CINCCH), Department of Veterans Affairs, Edward Hines Jr VA Hospital, Hines, IL
| | | | - Robert W Motl
- Department of Kinesiology and Nutrition, University of Illinois at Chicago, Chicago, IL
| | - Brian Bartle
- Center of Innovation for Complex Chronic Healthcare (CINCCH), Department of Veterans Affairs, Edward Hines Jr VA Hospital, Hines, IL
| | - R Lorie Jacob
- Center of Innovation for Complex Chronic Healthcare (CINCCH), Department of Veterans Affairs, Edward Hines Jr VA Hospital, Hines, IL
| | - Keith Aguina
- Center of Innovation for Complex Chronic Healthcare (CINCCH), Department of Veterans Affairs, Edward Hines Jr VA Hospital, Hines, IL
| | - Sherri L LaVela
- Center of Innovation for Complex Chronic Healthcare (CINCCH), Department of Veterans Affairs, Edward Hines Jr VA Hospital, Hines, IL; Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, IL
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Lai R, McKerchar R, Western MJ, Flannigan R, Krassioukov AV, Elliott S, Nightingale TE. Lived Experiences of Sexuality and Sexual Functioning in Males with SCI: A Mixed-Methods Study. Top Spinal Cord Inj Rehabil 2024; 30:37-53. [PMID: 38799605 PMCID: PMC11123612 DOI: 10.46292/sci23-00082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2024]
Abstract
Background Sexual dysfunction is highly prevalent in males with spinal cord injury (SCI) and has been recognized to be a key recovery priority. Objectives This cross-sectional, mixed-methods study aimed to investigate the major themes linked to sexual functioning in males with chronic (>1 year) SCI. Methods Twenty male participants with SCI, aged 25 to 59 years, completed validated questionnaires exploring sexual function/satisfaction and health-related quality of life and a semi-structured interview with an experienced sexual medicine physician. Sex hormone concentrations and metabolic biomarkers, along with body composition and habitual physical activity levels, were assessed. Interview recordings were transcribed and thematic analysis performed using combined COM-B (Capability, Opportunity, Motivation, and Behavior) and biopsychosocial models to identify and organize major contributors and barriers to sexual functioning. Results Metabolic and hormonal biomarkers largely fell within normal physiological ranges despite reduced sexual functioning reported in our cohort (19/20 participants reported some degree of erectile dysfunction). Qualitative analysis of interview transcripts revealed 24 themes. Adaptability was important for improving sexual satisfaction. Attraction and attentiveness to sex and partners remained stable over time, while the desire for intimacy increased post injury. Sexual social norms, and comparisons to the able-bodied population, provided challenges for sexual activity and partnership. Environmental concerns regarding access to sexual health resources and accessible physical spaces during intimacy were relevant. Mood disorders and general life stressors negatively impacted sexual desire, while physical activity encouraged sexual activity. Conclusion By considering a holistic view of sexuality in males with SCI, we identified key contributors and barriers to sexual functioning for the cohort studied.
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Affiliation(s)
- Rachel Lai
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, British Columbia, Canada
| | - Rory McKerchar
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, British Columbia, Canada
| | - Max J. Western
- Centre for Motivation and Health Behaviour Change, Department for Health, University of Bath, Bath, United Kingdon
| | - Ryan Flannigan
- Department of Urologic Sciences, University of British Columbia, Vancouver, British Columbia, Canada
- Vancouver Prostate Centre, Vancouver General Hospital, Vancouver, British Columbia, Canada
- Department of Urology, Weill Cornell Medicine, New York, New York, USA
| | - Andrei V. Krassioukov
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, British Columbia, Canada
- Department of Medicine, Division of Physical Medicine and Rehabilitation, University of British Columbia, Vancouver, British Columbia, Canada
- GF Strong Rehabilitation Centre, Vancouver Coastal Health, Vancouver, British Columbia, Canada
| | - Stacy Elliott
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, British Columbia, Canada
- Vancouver Coastal Health, B.C. Centre for Sexual Medicine, Vancouver, British Columbia, Canada
- Departments of Psychiatry and Urologic Sciences, University of British Columbia, Vancouver, British Columbia, Canada
| | - Tom E. Nightingale
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Vancouver, British Columbia, Canada
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, United Kingdom
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Emrich Accioly JP, Bena J, Xiao H, Jeong S, Khouri RK, Angermeier KW, Dewitt-Foy M, Nemunaitis G, Wood HM. Decisional regret and impacts on quality of life following genitourinary reconstruction for neurogenic bladder: A comparison between acquired and congenital spinal cord injury. PM R 2024. [PMID: 38676469 DOI: 10.1002/pmrj.13157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 11/06/2023] [Accepted: 11/14/2023] [Indexed: 04/29/2024]
Abstract
INTRODUCTION Patient expectations and baseline health are important drivers of outcomes following major genitourinary reconstructive surgery for neurogenic bladder (NGB). Differences in expectations and quality of life (QoL) improvements among different populations with NGB remain insufficiently explored in the literature. OBJECTIVE To compare decisional regret (DR) and urinary-related QoL (UrQoL) in patients undergoing urinary diversion for NGB arising from spinal cord injury of acquired (A-SCI) and congenital (C-SCI) etiologies. We hypothesize that patients with A-SCI have higher expectations of improvement in QoL following surgery when compared with C-SCI, which may lead to higher DR and decreased UrQoL, postoperatively. DESIGN In this cross-sectional survey study, we compared A-SCI to C-SCI in terms of DR, UrQoL, and postoperative changes in self-reported physical health, mental health, and pain using validated patient-reported outcome measures. SETTING Participants were enrolled from a quaternary care institution via mail and MyChart. PARTICIPANTS The A-SCI group consistied of 17 patients with traumatic spinal cord injury the C-SCI group was composed of 20 patients with spina bifida. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES The Decisional Regret Scale, Short form- Qualiveen (SF-Qualiveen), and Patient-reported outcomes measurement Information system-10 (PROMIS-10) Global Health surveys. RESULTS The A-SCI group displayed poorer preoperative physical health than the C-SCI cohort, but absolute postoperative changes in this score, along with mental health score and pain level, were not significant after adjusting for baseline scores and follow-up time. SF-Qualiveen scores revealed significantly worse impact of NGB in UrQoL for A-SCI than for C-SCI when adjusted for other factors. No differences in DR were seen between the groups. CONCLUSIONS Patients with A-SCI demonstrate lower self-reported baseline physical health compared with patients with C-SCI, which may have implications in setting patient expectations when undergoing urinary diversion. In this small cohort, we found a milder self-reported postoperative impact of NGB in UrQoL in patients with C-SCI.
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Affiliation(s)
- João Pedro Emrich Accioly
- Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - James Bena
- Department of Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - Huijun Xiao
- Department of Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - Stacy Jeong
- Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - Roger K Khouri
- Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - Kenneth W Angermeier
- Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - Molly Dewitt-Foy
- Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - Gregory Nemunaitis
- Department of Physical Medicine and Rehabilitation, Neurological Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - Hadley M Wood
- Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA
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Middleton JW, Arora M, Jerram KAS, Bourke J, McCormick M, O’Leary D, Weber G, Lembke T, Craig A. Co-design of the Spinal Cord Injury Health Maintenance Tool to Support Self-Management: A Mixed-Methods Approach. Top Spinal Cord Inj Rehabil 2024; 30:59-73. [PMID: 38433736 PMCID: PMC10906369 DOI: 10.46292/sci23-00042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2024]
Abstract
Background There is a lack of consumer-friendly tools to empower and support people living with spinal cord injury (SCI) to self-manage complex health needs in community. This article describes the co-design process of the new SCI Health Maintenance Tool (SCI-HMT). Methods Co-design of the SCI-HMT using a mixed-methods approach included a rapid review, e-Delphi surveys with range of multidisciplinary health care professionals (n = 62), interviews of participants with SCI (n = 18) and general practitioners (n = 4), focus groups (n = 3 with 7, 4, and 4 participants with SCI, respectively), design workshops with stakeholders (n = 11, 8), and end-user testing (n = 41). Results The SCI-HMT (healthmaintenancetool.com) was developed based on participatory research with data synthesis from multiple sources. Five priority health maintenance issues for bladder, bowel, skin, pain, and autonomic dysreflexia were originally covered. Best practice recommendations, red flag conditions, referrals, and clinical pathways were agreed on through an e-Delphi technique. Qualitative analysis identified six broad key concepts for self-management, including early symptom recognition, role of SCI peers, knowledge sharing with primary care, general practitioners as gatekeepers, and shared decision-making and highlighted a need to place much stronger emphasis on mental health and well-being. Design workshops and end-user testing provided key insights about user experience, functionality, and content for the SCI-HMT. Conclusion The co-design process engaging end users, including people with SCI and general practitioners, enabled a shared understanding of the problem and identification of important needs and how to meet them. Informed by this process, the SCI-HMT is a freely accessible resource supporting SCI self-management, shared decision-making, and early problem identification.
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Affiliation(s)
- James W. Middleton
- John Walsh Centre for Rehabilitation Research, Northern Sydney Local Health District, St Leonards, NSW Australia
- The Kolling Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW Australia
- Royal Rehab, Ryde NSW Australia
- State Spinal Cord Injury Service, NSW Agency for Clinical Innovation, St Leonards, NSW Australia
| | - Mohit Arora
- John Walsh Centre for Rehabilitation Research, Northern Sydney Local Health District, St Leonards, NSW Australia
- The Kolling Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW Australia
| | - K. Anne Sinnott Jerram
- John Walsh Centre for Rehabilitation Research, Northern Sydney Local Health District, St Leonards, NSW Australia
- The Kolling Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW Australia
| | - John Bourke
- John Walsh Centre for Rehabilitation Research, Northern Sydney Local Health District, St Leonards, NSW Australia
- The Kolling Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW Australia
- Burwood Academy Trust, Burwood Hospital, Christchurch, New Zealand
| | | | | | | | - Tony Lembke
- The Alstonville Clinic, Alstonville, NSW Australia
| | - Ashley Craig
- John Walsh Centre for Rehabilitation Research, Northern Sydney Local Health District, St Leonards, NSW Australia
- The Kolling Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW Australia
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Maresca G, Latella D, Formica C, Veneziani I, Ielo A, Quartarone A, Calabrò RS, De Cola MC. The Effects of Home Automation on Personal and Social Autonomies in Spinal Cord Injury Patients: A Pilot Study. J Clin Med 2024; 13:1275. [PMID: 38592129 PMCID: PMC10932432 DOI: 10.3390/jcm13051275] [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: 01/24/2024] [Revised: 02/19/2024] [Accepted: 02/22/2024] [Indexed: 04/10/2024] Open
Abstract
Background: Spinal cord injury (SCI) is a severe and progressive neurological condition caused by trauma to the nervous system, resulting in lifelong disability and severe comorbidities. This condition imposes serious limitations on everyday life, interfering with patients' social lives and compromising their quality of life, psychological well-being, and daily living activities. Rehabilitation is essential to helping SCI patients gain more independence in their daily routines. Home automation (HA) systems provide personalized support to users, allowing them to manage various aspects of their living environment, promoting independence and well-being. This study aims to demonstrate the efficacy of an HA system in enhancing personal and social autonomies in SCI patients, resulting in improved cognitive function and reduced anxiety-depressive symptoms compared to traditional training. Methods: We enrolled 50 SCI patients undergoing neurorehabilitation at IRCCS Centro Neurolesi (Messina, Italy). These patients were randomly assigned to one of two groups: a control group (CG) and an experimental group (EG). The CG received traditional training, while the EG underwent HA training. We evaluated the patients before (T0) and after (T1) rehabilitation using various scales, including the Montreal Cognitive Assessment (MoCA), the Beck Depression Inventory (BDI), the Hamilton Rating Scale for Anxiety (HRS-A), the 12-Item Short-Form Survey (SF-12), the Functional Independence Measure (FIM), Activities of Daily Living (ADL), Instrumental Activities of Daily Living Scale (IADL), and the EQ-5D-5L. Results: The effect of the experimental treatment showed an improvement in all patients test scores in the EG, especially regarding cognitive functions, mood disorders, activities of daily living, and quality of life. Conclusion: Our findings suggest that HA may be effective in improving daily autonomy and, in turn, alleviating mood disorders and enhancing psychological well-being.
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Affiliation(s)
- Giuseppa Maresca
- IRCCS Centro Neurolesi “Bonino-Pulejo”, S.S. 113 Via Palermo C. da Casazza, 98124 Messina, Italy; (G.M.); (D.L.); (A.I.); (A.Q.); (R.S.C.); (M.C.D.C.)
| | - Desirèe Latella
- IRCCS Centro Neurolesi “Bonino-Pulejo”, S.S. 113 Via Palermo C. da Casazza, 98124 Messina, Italy; (G.M.); (D.L.); (A.I.); (A.Q.); (R.S.C.); (M.C.D.C.)
| | - Caterina Formica
- IRCCS Centro Neurolesi “Bonino-Pulejo”, S.S. 113 Via Palermo C. da Casazza, 98124 Messina, Italy; (G.M.); (D.L.); (A.I.); (A.Q.); (R.S.C.); (M.C.D.C.)
| | - Isabella Veneziani
- Department of Nervous System and Behavioural Sciences, Psychology Section, University of Pavia, Piazza Botta 11, 27100 Pavia, Italy
| | - Augusto Ielo
- IRCCS Centro Neurolesi “Bonino-Pulejo”, S.S. 113 Via Palermo C. da Casazza, 98124 Messina, Italy; (G.M.); (D.L.); (A.I.); (A.Q.); (R.S.C.); (M.C.D.C.)
| | - Angelo Quartarone
- IRCCS Centro Neurolesi “Bonino-Pulejo”, S.S. 113 Via Palermo C. da Casazza, 98124 Messina, Italy; (G.M.); (D.L.); (A.I.); (A.Q.); (R.S.C.); (M.C.D.C.)
| | - Rocco Salvatore Calabrò
- IRCCS Centro Neurolesi “Bonino-Pulejo”, S.S. 113 Via Palermo C. da Casazza, 98124 Messina, Italy; (G.M.); (D.L.); (A.I.); (A.Q.); (R.S.C.); (M.C.D.C.)
| | - Maria Cristina De Cola
- IRCCS Centro Neurolesi “Bonino-Pulejo”, S.S. 113 Via Palermo C. da Casazza, 98124 Messina, Italy; (G.M.); (D.L.); (A.I.); (A.Q.); (R.S.C.); (M.C.D.C.)
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10
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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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11
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Clifton S, Bray E, Dong S, McCabe R, Siddall P. Co-design of an intervention exploring meaning and purpose after spinal cord injury. Disabil Rehabil 2024:1-10. [PMID: 38258447 DOI: 10.1080/09638288.2023.2300655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 12/27/2023] [Indexed: 01/24/2024]
Abstract
PURPOSE Rebuilding a strong sense of meaning and purpose following trauma is a vital contributor to post-traumatic growth and adapting well to a spinal cord injury. This project aimed to develop an intervention that used the concept of post-traumatic growth to foster a stronger sense of meaning and purpose in people with a spinal cord injury. METHODS Using participatory action research methodology, the intervention was designed in an iterative process with health professionals and people with lived experience of spinal cord injury. We developed a ten-week online group program and delivered two pilot programs to 13 participants. We used their feedback to further refine the program before finalisation. RESULTS A participatory action research approach resulted in a positive intervention well received by participants and consumer organisations. Feedback suggests the intervention shows promise for improvements in functional and psychosocial outcomes and has long-term viability. CONCLUSIONS The project successfully developed and delivered a novel program that uses the concept of post-traumatic growth to foster a stronger sense of meaning and purpose. Further implementation of the program with larger numbers will allow for evaluation of the program's effectiveness.
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Affiliation(s)
- Shane Clifton
- Centre for Disability Research and Policy, Faculty of Health Sciences, The University of Sydney, Camperdown, Australia
| | - Emily Bray
- Spinal Cord Injuries Australia, Sydney, Australia
| | - Skye Dong
- Melanoma Institute Australia, Wollstonecraft, Australia
| | | | - Philip Siddall
- Hammondcare, Sydney, Australia
- Sydney Medical School-Northern, The University of Sydney, Camperdown, Australia
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12
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Armstrong A, Oetinger K, Weimer K, Hönig K. Digital psychosocial interventions for individuals with spinal cord injury: a scoping review. Front Psychiatry 2024; 15:1289138. [PMID: 38317764 PMCID: PMC10838963 DOI: 10.3389/fpsyt.2024.1289138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 01/05/2024] [Indexed: 02/07/2024] Open
Abstract
Objective To provide an overview of the digital mental health care landscape for individuals with spinal cord injury (SCI). Methods PubMed, PsycInfo, and PSYNDEX were searched for articles meeting the following criteria: (1) article written in English or German; (2) digital psychosocial intervention; (3) SCI only; (4) treatment of individuals with SCI and not their relatives or caregivers. Records were screened by title and abstract and records meeting the inclusion criteria were obtained for full text screening. The references of identified articles were screened to find further relevant articles. The literature search was updated before submission. Risk of Bias was assessed by using the Cochrane risk-of-bias tool for randomized trials (RoB 2) and a narrative synthesis was conducted. Results Ten randomized-controlled trials (RCT) and ten non-randomized-controlled trials were identified and compared in this review, evaluating twelve internet- and mobile-based interventions, five smartphone apps, and three virtual reality applications. The interventions were primarily used as stand-alone aftercare programs. While some were not based on any theory, cognitive behavioral therapy mostly served as the theoretical basis for the online interventions. The extent of human support also varied greatly between the studies. The number of intervention modules ranged between 2 and 72. There were also major differences in outcome variables and effects. A meta-analytical evaluation of the data was not conducted due to heterogeneity of studies. Conclusion Digital applications to promote the psychosocial health of individuals with SCI are an emerging field of research with many treatment approaches still to come. First high quality RCT studies report promising results. Unfortunately, not all studies are of high quality or the interventions have been insufficiently adapted to the needs of people with SCI. Therefore, more research is needed to further develop applications, and to generalize and test the effects found in the long term.
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Affiliation(s)
| | - Katja Oetinger
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Centre, Ulm, Germany
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13
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Mokhtari T, Uludag K. Role of NLRP3 Inflammasome in Post-Spinal-Cord-Injury Anxiety and Depression: Molecular Mechanisms and Therapeutic Implications. ACS Chem Neurosci 2024; 15:56-70. [PMID: 38109051 DOI: 10.1021/acschemneuro.3c00596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2023] Open
Abstract
The majority of research on the long-term effects of spinal cord injury (SCI) has primarily focused on neuropathic pain (NP), psychological issues, and sensorimotor impairments. Among SCI patients, mood disorders, such as anxiety and depression, have been extensively studied. It has been found that chronic stress and NP have negative consequences and reduce the quality of life for individuals living with SCI. Our review examined both human and experimental evidence to explore the connection between mood changes following SCI and inflammatory pathways, with a specific focus on NLRP3 inflammasome signaling. We observed increased proinflammatory factors in the blood, as well as in the brain and spinal cord tissues of SCI models. The NLRP3 inflammasome plays a crucial role in various diseases by controlling the release of proinflammatory molecules like interleukin 1β (IL-1β) and IL-18. Dysregulation of the NLRP3 inflammasome in key brain regions associated with pain processing, such as the prefrontal cortex and hippocampus, contributes to the development of mood disorders following SCI. In this review, we summarized recent research on the expression and regulation of components related to NLRP3 inflammasome signaling in mood disorders following SCI. Finally, we discussed potential therapeutic approaches that target the NLRP3 inflammasome and regulate proinflammatory cytokines as a way to treat mood disorders following SCI.
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Affiliation(s)
- Tahmineh Mokhtari
- Hubei Key Laboratory of Embryonic Stem Cell Research, Faculty of Basic Medical Sciences, Hubei University of Medicine, Shiyan 442000, Hubei, People's Republic of China
- Department of Histology and Embryology, Faculty of Basic Medical Sciences, Hubei University of Medicine, Shiyan 442000, Hubei, People's Republic of China
| | - Kadir Uludag
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, People's Republic of China
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14
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Lee W, Jeong S, Lee BS, Lim JC, Kim O. Association between functional outcomes and psychological variables in persons with spinal cord injury. Sci Rep 2023; 13:23092. [PMID: 38155215 PMCID: PMC10754915 DOI: 10.1038/s41598-023-50252-8] [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: 07/21/2023] [Accepted: 12/18/2023] [Indexed: 12/30/2023] Open
Abstract
We aimed to explore the association of functional outcomes with psychological variables, including depression, anxiety, sleep quality, and suicide risk, in persons with spinal cord injuries (SCIs). The secondary aim was to determine specific functions related to the psychological variables. This retrospective study included 259 persons with SCIs who were admitted to the Korean National Rehabilitation Center between 2019 and 2021. The participants were interviewed by a psychiatrist and completed questionnaires, including the Korean Beck Depression Inventory II (K-BDI-II), Korean Beck Anxiety Index, Insomnia Severity Index, and Mini International Neuropsychiatric Interview. To assess functional outcomes, the Spinal Cord Independence Measure III (SCIM III) and Walking Index for Spinal Cord Injury were determined by a physical therapist. The findings revealed a negative correlation of SCIM III subdivisions 1 and 3 with K-BDI-II. Specifically, feeding and mobility in bed and actions to prevent pressure injuries were functional factors associated with all four psychological variables. Our findings can guide clinicians to focus on improving functional independence and activities of daily living during the management of persons with SCI to prevent psychological consequences. Developing devices that aid in improving functional independence is crucial and may improve psychological problems in such individuals.
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Affiliation(s)
- Wonha Lee
- Department of Physical Medicine and Rehabilitation, National Rehabilitation Center, 58, Samgaksan-ro, Gangbuk-gu, Seoul, 01022, Republic of Korea
| | - SangHyup Jeong
- Department of Neuropsychiatry, National Rehabilitation Center, Seoul, Republic of Korea
| | - Bum-Suk Lee
- Department of Rehabilitation Medicine, Catholic Kwandong University, International St. Mary's Hospital, Incheon, Korea
| | - Jin-Cheol Lim
- Department of Education Measurement and Evaluation, Sungkyunkwan University, Seoul, Korea
| | - Onyoo Kim
- Department of Physical Medicine and Rehabilitation, National Rehabilitation Center, 58, Samgaksan-ro, Gangbuk-gu, Seoul, 01022, Republic of Korea.
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15
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Acosta-Santillán PL, Toro-Sashida MF, Rosas-Mendoza AV, Fuentes-Orozco C, Jasso-García K, García de León-Flores P, Mellado-Téllez MP, Ibarra-Camargo SA, Chejfec-Ciociano JM, Barbosa-Camacho FJ, Flores-Prado JA, Cervantes-Guevara G, Cervantes-Pérez E, Cevantes-Cardona GA, Alvarez-Villaseñor AS, González-Ojeda A. Quality of sexual life in Mexican men after spinal cord injury. J Rehabil Med 2023; 55:jrm11641. [PMID: 38124428 PMCID: PMC10802783 DOI: 10.2340/jrm.v55.11641] [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: 03/16/2023] [Accepted: 10/24/2023] [Indexed: 12/23/2023] Open
Abstract
OBJECTIVE To evaluate the quality of sexual life in men with spinal cord injury. DESIGN Cross-sectional analytical study. PATIENTS Males with a history of spinal cord injury who attended an outpatient rehabilitation service. METHODS An analytical study examined adult male patients with complete spinal cord injury in rehabilitation. A modified Sexual Life Quality Questionnaire (SLQQ) examined quality of sexual life, with scores below 50 suggesting significant sexual dysfunction and dissatisfaction. The assessment evaluated age, occupation, marital status, comorbidities, and treatment methods. RESULTS A total of 80 patients were included; 33 (41%) had a thoracic spinal cord injury, and 47 (59%) had a lumbar spinal cord injury. Thirty-seven patients (46%) were dissatisfied with the quality of their sexual life; 29 patients (88%) with thoracic spinal cord injury and 8 patients (17%) with lumbar spinal cord injury were dissatisfied with the quality of their sexual life (p = 0.001). Patients with higher education level experienced less sexual dissatisfaction (p = 0.03). CONCLUSION Human sexuality involves numerous interconnected elements that impact on general health. Sexual pleasure, self-esteem, and personal relationships are crucial for patients with spinal cord injury to identify rehabilitation needs. These results indicate the importance of supporting sexual well-being in recovery. Further studies of sexual enjoyment and quality of life for patients with spinal cord injury are needed, using larger and more diverse populations.
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Affiliation(s)
- Paulina Lucia Acosta-Santillán
- Department of Physical Rehabilitation, Specialties Hospital of the National Medical Center of the West, Mexican Institute of Social Security, Guadalajara, Jalisco, México
| | - Maria Fernanda Toro-Sashida
- Department of Physical Rehabilitation, Specialties Hospital of the National Medical Center of the West, Mexican Institute of Social Security, Guadalajara, Jalisco, México
| | - Alejandra Viridiana Rosas-Mendoza
- Department of Physical Rehabilitation, Specialties Hospital of the National Medical Center of the West, Mexican Institute of Social Security, Guadalajara, Jalisco, México
| | - Clotilde Fuentes-Orozco
- Biomedical Research Unit 02, Specialties Hospital of the National Medical Center of the West, Mexican Institute of Social Security, Guadalajara, Jalisco, México
| | - Kelvin Jasso-García
- Biomedical Research Unit 02, Specialties Hospital of the National Medical Center of the West, Mexican Institute of Social Security, Guadalajara, Jalisco, México
| | - Paulina García de León-Flores
- Biomedical Research Unit 02, Specialties Hospital of the National Medical Center of the West, Mexican Institute of Social Security, Guadalajara, Jalisco, México
| | - Mel Paul Mellado-Téllez
- Biomedical Research Unit 02, Specialties Hospital of the National Medical Center of the West, Mexican Institute of Social Security, Guadalajara, Jalisco, México
| | - Silvia Alejandra Ibarra-Camargo
- Biomedical Research Unit 02, Specialties Hospital of the National Medical Center of the West, Mexican Institute of Social Security, Guadalajara, Jalisco, México
| | - Jonathan Matías Chejfec-Ciociano
- Biomedical Research Unit 02, Specialties Hospital of the National Medical Center of the West, Mexican Institute of Social Security, Guadalajara, Jalisco, México
| | - Francisco José Barbosa-Camacho
- Department of Psychiatry, Civil Hospital of Guadalajara Fray Antonio Alcalde, University Center of Health Sciences, University of Guadalajara, Guadalajara, Jalisco, México
| | - Juan Armando Flores-Prado
- Biomedical Research Unit 02, Specialties Hospital of the National Medical Center of the West, Mexican Institute of Social Security, Guadalajara, Jalisco, México
| | - Gabino Cervantes-Guevara
- Department of Wellbeing and Sustainable Development, Centro Universitario del Norte, University of Guadalajara, Guadalajara, Jalisco, México
| | - Enrique Cervantes-Pérez
- Department of Internal Medicine, Civil Hospital of Guadalajara Fray Antonio Alcalde, University Center of Health Sciences, University of Guadalajara, Guadalajara, Jalisco. México
| | - Guillermo Alonso Cevantes-Cardona
- Department of Philosophical, Methodological and Instrumental Disciplines, University Center of Health Sciences, University of Guadalajara, Guadalajara, Jalisco, México
| | | | - Alejandro González-Ojeda
- Biomedical Research Unit 02, Specialties Hospital of the National Medical Center of the West, Mexican Institute of Social Security, Guadalajara, Jalisco, México.
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16
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Kassahun Bekele B, Boluwatife Samuel F, Soufan F, Kravarioti D, Nazir A, Ahmad Nakhleh H, Wojtara M, Uwishema O. Acute spinal cord injury in Africa: exploring the long-term outcomes and future directions of acute spinal cord injury - short communication. Ann Med Surg (Lond) 2023; 85:5847-5851. [PMID: 38098542 PMCID: PMC10718392 DOI: 10.1097/ms9.0000000000001405] [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: 06/13/2023] [Accepted: 10/08/2023] [Indexed: 12/17/2023] Open
Abstract
Acute spinal cord injury (ASCI), a key factor behind serious sensory, motor, and autonomic dysfunctions, holds on as a fundamental cause of morbidity, psychological disturbances, and high socioeconomic burden. This study sheds light, particularly on the African countries where it is found that traumatic ASCI, mainly due to road traffic accidents, remains the leading cause, with 130 cases per million in this part of the world. Moreover, limited resources, with the lack of funds and equipment, as well as widespread poverty, restrict the availability of suitable diagnostic, management, and treatment options. The weight of the evidence suggests that there is an ultimate need for well-developed infrastructure embracing a multidisciplinary approach to rehabilitation in Africa. Furthermore, international collaborations, posing a significantly wide background for evidence-based information and resources, are indispensable for ASCI prospects and future studies among the African population. The purpose of this study is to fill a part of the persistent gap in the research era regarding the ASCI in Africa and direct future research toward investigating its different aspects as well as exploring its interventional needs.
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Affiliation(s)
- Bezawit Kassahun Bekele
- Oli Health Magazine Organization, Research and Education, Kigali, Rwanda
- Addis Ababa University, School of Medicine, Addis Ababa, Ethiopia
- George Washington University, Milken Institute of Public Health, Washington, DC, USA
| | - Fatokun Boluwatife Samuel
- Oli Health Magazine Organization, Research and Education, Kigali, Rwanda
- Department of Medical Laboratory Science, Federal Teaching Hospital, Ido, Ekiti
- Kwara State University, School of Basic Medical Sciences, Malete, Nigeria
| | - Fatima Soufan
- Oli Health Magazine Organization, Research and Education, Kigali, Rwanda
- Faculty of Medicine, Beirut Arab University, Beirut, Lebanon
| | - Dionysia Kravarioti
- Oli Health Magazine Organization, Research and Education, Kigali, Rwanda
- Department of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
| | - Abubakar Nazir
- Oli Health Magazine Organization, Research and Education, Kigali, Rwanda
- Department of Medicine, King Edward Medical University, Pakistan
| | - Hamza Ahmad Nakhleh
- Oli Health Magazine Organization, Research and Education, Kigali, Rwanda
- University of Jordan, School of Medicine, Amman, Jordan
| | - Magda Wojtara
- Oli Health Magazine Organization, Research and Education, Kigali, Rwanda
- University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Olivier Uwishema
- Oli Health Magazine Organization, Research and Education, Kigali, Rwanda
- Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey
- Clinton Global Initiative University, New York, USA
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17
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Wiest MJ, Gargaro J, Bayley MT. What Is the Pathway to the Best Model of Care for Traumatic Spinal Cord Injury? Evidence-Based Guidance. Top Spinal Cord Inj Rehabil 2023; 29:103-111. [PMID: 38174142 PMCID: PMC10759857 DOI: 10.46292/sci23-00059s] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2024]
Abstract
Introduction People with traumatic spinal cord injury (tSCI) experience lifelong physical and emotional health impacts, needing specialized care that is complex to navigate. The non-standardized care pathways used by different jurisdictions to address these needs lead to care inequities and poor health outcomes. Purpose To develop an evidence-based integrated tSCI Care Pathway, from time of injury to life in the community. Methods and Analysis Eighty key partners engaged in planning, providing, and receiving tSCI care (1) identified existing guidelines, pathways, and care models; (2) created the tSCI Care Pathway with key elements or building blocks ("the what"), not specific recommendations ("the how") for each care stage (Acute, Rehabilitation, and Community), with elements highlighting the role of primary care and equity considerations on the pathway; (3) identified regional gaps in the tSCI Pathway and prioritized them for implementation; and (4) developed quality indicators. Outcomes The tSCI Pathway was drafted in overarching and detailed formats. For Acute Care, building blocks focused on appropriate assessment, initial management, and transition planning; for Rehabilitation, building blocks focused on access to specialized rehabilitation and assessment and planning of community needs; for Community, building blocks focused on follow-up, mechanisms for re-access, and holistic support for persons and families; and for equity considerations, building blocks focused on those at-risk or requiring complex supports. Team-based primary care and navigation supports were seen as crucial to reduce inequities. Conclusion This is the first comprehensive care pathway for tSCI. The Pathway is grounded in person-centred care, integrated care and services, and up-to-date clinical practice guidelines. The tSCI Care Pathway is flexible to regional realities and individual needs to ensure equitable care for all.
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Affiliation(s)
- Matheus Joner Wiest
- KITE Research Institute, Toronto Rehabilitation Institute – University Health Network, Toronto, ON, Canada
| | - Judith Gargaro
- KITE Research Institute, Toronto Rehabilitation Institute – University Health Network, Toronto, ON, Canada
| | - Mark T. Bayley
- KITE Research Institute, Toronto Rehabilitation Institute – University Health Network, Toronto, ON, Canada
- Division of Physical Medicine and Rehabilitation, University of Toronto, Toronto, ON, Canada
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18
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Han S, Kim W, Kim O. Risk Factors for Suicidality in Individuals With Spinal Cord Injury: A Focus on Physical and Functional Characteristics. Ann Rehabil Med 2023; 47:377-384. [PMID: 37907229 PMCID: PMC10620485 DOI: 10.5535/arm.23110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 08/08/2023] [Accepted: 08/11/2023] [Indexed: 11/02/2023] Open
Abstract
OBJECTIVE : To demonstrate the association between the physical and functional characteristics of individuals with spinal cord injury (SCI) and suicidality, an area of research that is less understood than the association with demographic, social, and psychological characteristics. METHODS : A retrospective cross-sectional study was conducted with 259 patients with SCI admitted for rehabilitation at the National Rehabilitation Center, Seoul, between January 2019 and December 2021. Demographic, SCI-related, physical, and functional data were collected from their medical records. Suicide risk was assessed using the Mini International Neuropsychiatric Interview. RESULTS : The 259 participants had an average age of 49.1 years, and 75.7% were male. The analysis revealed a statistically significant negative correlation between age and suicidality. No significant differences were found for sex, education, occupation, or SCI-related factors. Lower upper extremity motor score (UEMS) was significantly associated with higher suicide risk. Regarding functional factors, the inability to perform independent rolling, come to sit, wheelchair propelling, and self-driving were associated with increased suicidality. In the multiple linear regression analysis, lower UEMS, limited shoulder joint motion, upper extremity spasticity, and dependent wheelchair propulsion were predictors of higher suicide risk. CONCLUSION : This study highlights the associations among physical status, functional dependency, and suicide risk in individuals with SCI. These findings emphasize the need to address psychological aspects and physical and functional factors in the management of individuals with SCI who are at a high risk of suicide.
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Affiliation(s)
- Sora Han
- Department of Rehabilitation Medicine, National Rehabilitation Center, Seoul, Korea
| | - Wooyeung Kim
- Department of Rehabilitation Medicine, National Rehabilitation Center, Seoul, Korea
| | - Onyoo Kim
- Department of Rehabilitation Medicine, National Rehabilitation Center, Seoul, Korea
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19
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Guízar-Sahagún G, Grijalva I, Franco-Bourland RE, Madrazo I. Aging with spinal cord injury: A narrative review of consequences and challenges. Ageing Res Rev 2023; 90:102020. [PMID: 37487887 DOI: 10.1016/j.arr.2023.102020] [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: 03/29/2023] [Revised: 07/12/2023] [Accepted: 07/19/2023] [Indexed: 07/26/2023]
Abstract
Given the increase in life expectancy, aging with a pre-existing spinal cord injury (SCI) is becoming more common. This condition is challenging as compromised health status and functional independence can worsen. We aimed to provide an updated overview of the consequences of aging with SCI, highlighting the main challenges facing this population in a narrative review of the current literature we retrieved from the PubMed database from 2000 to 2022 on any aspect related to aging in persons with SCI. Here we address adverse circumstances that increase disability and hinder an active lifestyle, such as progressive physical deterioration, secondary health conditions, limitations in personal activity, changes in family and social support structures, aging of caregivers, and depletion of economic resources. Favorable changes are also observed, including psychosocial adjustments that improve quality of life. Additionally, various interventions are discussed to promote well-being, health, and social participation. Due to the relevance of this issue, people with SCI and all those who take care of them must have up-to-date information to carry out the necessary measures to promote healthy aging in a more inclusive social environment.
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Affiliation(s)
- Gabriel Guízar-Sahagún
- Research Unit for Neurological Diseases, Instituto Mexicano del Seguro Social, 4430 Calzada de Tlalpan, Mexico City, Mexico.
| | - Israel Grijalva
- Research Unit for Neurological Diseases, Instituto Mexicano del Seguro Social, 4430 Calzada de Tlalpan, Mexico City, Mexico
| | - Rebecca E Franco-Bourland
- Department of Biochemistry, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, 289 Calzada México-Xochimilco, Mexico City, Mexico
| | - Ignacio Madrazo
- Research Unit for Neurological Diseases, Instituto Mexicano del Seguro Social, 4430 Calzada de Tlalpan, Mexico City, Mexico
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20
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Varni JW, Zebracki K, Hwang M, Mulcahey MJ, Vogel LC. Bladder and bowel function effects on emotional functioning in youth with spinal cord injury: a serial multiple mediator analysis. Spinal Cord 2023; 61:415-421. [PMID: 37414836 DOI: 10.1038/s41393-023-00912-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 06/25/2023] [Accepted: 06/27/2023] [Indexed: 07/08/2023]
Abstract
STUDY DESIGN Preliminary explanatory or mechanistic cross-sectional study. OBJECTIVES This preliminary cross-sectional study investigates the hypothesized serial mediating effects of bladder/bowel worry, social worry, and social participation in the relationship between bladder function or bowel function and emotional functioning in youth with spinal cord injury (SCI) from their perspective. METHODS The Bladder Function, Bowel Function, Worry Bladder Bowel, Worry Social, and Social Participation Scales from the PedsQL™ Spinal Cord Injury Module and the Emotional Functioning Scale from the PedsQL™ 4.0 Generic Core Scales Short Form SF15 were completed by 127 youth with SCI ages 8-24. Serial multiple mediator model analyses were conducted to test the hypothesized sequential mediating effects of bladder/bowel worry, social worry, and social participation as intervening variables separately for the cross-sectional association between bladder function or bowel function and emotional functioning. RESULTS The separate cross-sectional negative association of bladder function and bowel function with emotional functioning were serially mediated by bladder/bowel worry, social worry and social participation, accounting for 28% and 31%, respectively, of the variance in youth-reported emotional functioning (p < 0.001), representing large effect sizes. CONCLUSIONS In this preliminary study, bladder/bowel worry, social worry, and social participation explain in part the cross-sectional negative association of bladder function and bowel function with emotional functioning in youth with SCI from the youth perspective. Identifying the hypothesized associations of bladder function and bowel function, bladder/bowel worry, social worry, and social participation with emotional functioning may help inform future clinical research and practice for youth with SCI.
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Affiliation(s)
- James W Varni
- Department of Pediatrics, College of Medicine, Department of Landscape Architecture and Urban Planning, College of Architecture, Texas A&M University, College Station, TX, USA.
| | - Kathy Zebracki
- Shriners Children's Chicago, Chicago, IL, USA
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | | | - Mary Jane Mulcahey
- Center for Outcomes and Measurement, Jefferson College of Rehabilitation Sciences, Department of Physical Medicine, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
| | - Lawrence C Vogel
- Shriners Children's Chicago, Chicago, IL, USA
- Department of Pediatrics, Rush Medical College, Chicago, IL, USA
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Damci A, Hoeijmakers JGJ, den Hollander M, Köke A, de Mooij M, Faber CG, Verbunt JAMCF. Acceptability, usability and feasibility of experienced sampling method in chronic secondary pain syndromes. Front Neurol 2023; 14:1219236. [PMID: 37503509 PMCID: PMC10368891 DOI: 10.3389/fneur.2023.1219236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 06/28/2023] [Indexed: 07/29/2023] Open
Abstract
Background In chronic pain syndromes, symptoms can fluctuate and change over time. Standard questionnaires cannot register these fluctuations. Nonetheless, the experience sampling method (ESM) is developed to collect momentary measurements of everyday complaints, tracing fluctuations in symptoms and disabling factors over time. Although valuable information can be collected in this way, assessment may also be a burden. This study aimed to investigate the acceptability, usability, and feasibility of ESM in chronic secondary pain syndromes, in a single-center study in the Netherlands. Methods A prospective observational study with repeated measurements was conducted in patients with chronic secondary neuropathic and musculoskeletal pain syndromes, including small fiber neuropathy, spinal cord injury, and rheumatoid disorder. Results Thirty-four participants were included and filled in the ESM, of whom 19 were diagnosed with small fiber neuropathy, 11 with spinal cord injury, and 4 with a rheumatoid disorder. The mean age was 54.7 ± 13.9 years (range: 23-77) of whom 52.9% were female. In total, 19 participants filled in the general and user-friendliness evaluation about the acceptability and usability of the ESM. The general evaluation showed no influence of ESM on participants' social contacts (mean 1.47, SD 1.12), activities (mean 1.74, SD 1.44), and mood (mean 1.89, SD 1.59). The answers options of ESM were a good representation of the experiences of participants (mean 4.58, SD 1.77). Regarding feasibility, the overall response rate for answering the beep signals of ESM was 44.5% in total. The missing rate per person varied from 13% to 97% with a median of 54.1%. Conclusion The general evaluation and the user-friendliness revealed sufficient outcomes in favor of the ESM application. ESM seems a promising measurement tool to use in secondary chronic pain syndromes.
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Affiliation(s)
- Aysun Damci
- MHeNS, School for Mental Health and Neuroscience, Maastricht University, Maastricht, Netherlands
- Department of Neurology, Maastricht University Medical Center+, Maastricht, Netherlands
| | - Janneke G. J. Hoeijmakers
- MHeNS, School for Mental Health and Neuroscience, Maastricht University, Maastricht, Netherlands
- Department of Neurology, Maastricht University Medical Center+, Maastricht, Netherlands
| | - Marlies den Hollander
- Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
- Department of Rehabilitation Medicine, Maastricht University Medical Center+, Maastricht, Netherlands
- Adelante Zorggroep, Center of Rehabilitation Medicine, Hoensbroek, Netherlands
| | - Albère Köke
- Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
- Department of Rehabilitation Medicine, Maastricht University Medical Center+, Maastricht, Netherlands
- Adelante Zorggroep, Center of Rehabilitation Medicine, Hoensbroek, Netherlands
- Dutch Network Pain Rehabilitation, Hoensbroek, Netherlands
| | - Marion de Mooij
- Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
| | - Catharina G. Faber
- MHeNS, School for Mental Health and Neuroscience, Maastricht University, Maastricht, Netherlands
- Department of Neurology, Maastricht University Medical Center+, Maastricht, Netherlands
| | - Jeanine A. M. C. F. Verbunt
- Care and Public Health Research Institute, Maastricht University, Maastricht, Netherlands
- Department of Rehabilitation Medicine, Maastricht University Medical Center+, Maastricht, Netherlands
- Adelante Zorggroep, Center of Rehabilitation Medicine, Hoensbroek, Netherlands
- Dutch Network Pain Rehabilitation, Hoensbroek, Netherlands
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22
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Awuah WA, Ghosh S, Adebusoye FT, Wellington J, Tenkorang PO, Abdul-Rahman T, Mykolaivna NI. Letter: Appraising the Recent Management Gaps for Spinal Cord Injuries in Low-Resource Settings: The Case of Sub-Saharan African Countries. Neurosurgery 2023; 93:e17-e18. [PMID: 37070827 DOI: 10.1227/neu.0000000000002505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Accepted: 03/14/2023] [Indexed: 04/19/2023] Open
Affiliation(s)
| | - Shankhaneel Ghosh
- Institute of Medical Sciences and SUM Hospital, Siksha 'O' Anusandhan, Bhubaneswar , India
| | | | - Jack Wellington
- Cardiff University School of Medicine, Cardiff University, Wales , UK
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23
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de Araújo Morais L, Cipriano G, Martins WR, Chiappa GR, Formiga MF, Cipriano GFB. Inspiratory muscle training on quality of life in individuals with spinal cord injury: A systematic review and meta-analysis. Spinal Cord 2023; 61:359-367. [PMID: 37393409 DOI: 10.1038/s41393-023-00906-1] [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: 07/20/2022] [Revised: 06/19/2023] [Accepted: 06/20/2023] [Indexed: 07/03/2023]
Abstract
STUDY DESIGN Systematic review and meta-analysis. OBJECTIVES The objective was to summarize the effectiveness of Inspiratory Muscle Training (IMT) on the quality of life in individuals with Spinal Cord Injury (SCI). METHODS An online systematic literature search was conducted in the following databases: PubMed/MEDLINE, PubMed CENTRAL, EMBASE, ISI Web of Science, SciELO, CINAHL/SPORTDiscus, and PsycINFO. Randomized and non-randomized clinical studies investigating the effectiveness of IMT in quality of life were included in the present study. The results used the mean difference and 95% confidence interval for maximal inspiratory pressure (MIP), forced expiratory volume in 1 s (FEV1), maximal expiratory pressure (MEP), and the standardized mean differences for the quality of life and maximum ventilation volume. RESULTS The search found 232 papers, and after the screening, four studies met the inclusion criteria and were included in the meta-analytical procedures (n = 150 participants). No changes were demonstrated in the quality of life domains (general health, physical function, mental health, vitality, social function, emotional problem, and pain) after IMT. The IMT provided a considerable effect over the MIP but not on FEV1 and MEP. Conversely, it was not able to provide changes in any of the quality of life domains. None of the included studies evaluated the IMT effects on the expiratory muscle maximal expiratory pressure. CONCLUSION Evidence from studies shows that inspiratory muscle training improves the MIP; however, this effect does not seem to translate to any change in the quality of life or respiratory function outcomes in individuals with SCI.
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Affiliation(s)
| | - Gerson Cipriano
- Science and Technology in Health Program (PPGCTS), University of Brasília, Brasília, Brazil
- Rehabilitation Sciences Graduate Program (PPGCR), University of Brasília, Brasília, Brasil
- Graduate Program in Human Movement and Rehabilitation of Evangelical (PPGMHR), UniEVANGÉLICA, Anápolis, Brazil
| | | | - Gaspar R Chiappa
- Graduate Program in Human Movement and Rehabilitation of Evangelical (PPGMHR), UniEVANGÉLICA, Anápolis, Brazil
| | - Magno F Formiga
- Master's Program in Physical Therapy and Functioning, Department of Physical Therapy, School of Medicine, Federal University of Ceará, Fortaleza, Brazil
| | - Graziella França Bernardelli Cipriano
- Science and Technology in Health Program (PPGCTS), University of Brasília, Brasília, Brazil
- Rehabilitation Sciences Graduate Program (PPGCR), University of Brasília, Brasília, Brasil
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24
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Lo Buono V, Corallo F, Bonanno L, Quartarone A, De Cola MC. Body Image and Emotional Status in Patients with Acquired Brain Injury. J Clin Med 2023; 12:4070. [PMID: 37373763 DOI: 10.3390/jcm12124070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 06/13/2023] [Accepted: 06/14/2023] [Indexed: 06/29/2023] Open
Abstract
Emotional experiences can lead to a real or distorted self-representation. After brain damage, altered self-perception of one's own body image is frequent. This study evaluates the relationship of mood disorders and lesion sites on body image in a cohort of ABI patients. A total of 46 patients (26 men, 20 women) without severe physical impairments were found eligible for this study. Patients underwent Beck's Depression Inventory and the Hamilton Rating Scale for Anxiety to assess mood disorders, whereas the Body Image Scale and Human Figure Drawing were used to evaluate body dissatisfaction and implicit body image. The Montreal Cognitive Assessment was used to assess patients' cognitive condition. We found a moderate correlation between depression and body image (r = 0.48), as well as between anxiety and body image (r = 0.52), and the regression model also reported the right lesion site as a predictive variable for body image score. In addition, the regression model built by Human Figure Drawing scores showed anxiety, cognitive functioning, and a marital status of single to be significant predictors. The study confirmed that participants with acquired brain injury have deficits in body representation associated with mood disorders, regardless of the side of the lesions. A neuropsychological intervention could be useful for these patients to improve their cognitive performance and learn to manage emotional dysfunction in order to increase their self-perception of body image and improve their quality of life.
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Affiliation(s)
| | | | - Lilla Bonanno
- IRCCS Centro Neurolesi Bonino-Pulejo, 98124 Messina, Italy
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25
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Ortega MA, Fraile-Martinez O, García-Montero C, Haro S, Álvarez-Mon MÁ, De Leon-Oliva D, Gomez-Lahoz AM, Monserrat J, Atienza-Pérez M, Díaz D, Lopez-Dolado E, Álvarez-Mon M. A comprehensive look at the psychoneuroimmunoendocrinology of spinal cord injury and its progression: mechanisms and clinical opportunities. Mil Med Res 2023; 10:26. [PMID: 37291666 PMCID: PMC10251601 DOI: 10.1186/s40779-023-00461-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Accepted: 06/01/2023] [Indexed: 06/10/2023] Open
Abstract
Spinal cord injury (SCI) is a devastating and disabling medical condition generally caused by a traumatic event (primary injury). This initial trauma is accompanied by a set of biological mechanisms directed to ameliorate neural damage but also exacerbate initial damage (secondary injury). The alterations that occur in the spinal cord have not only local but also systemic consequences and virtually all organs and tissues of the body incur important changes after SCI, explaining the progression and detrimental consequences related to this condition. Psychoneuroimmunoendocrinology (PNIE) is a growing area of research aiming to integrate and explore the interactions among the different systems that compose the human organism, considering the mind and the body as a whole. The initial traumatic event and the consequent neurological disruption trigger immune, endocrine, and multisystem dysfunction, which in turn affect the patient's psyche and well-being. In the present review, we will explore the most important local and systemic consequences of SCI from a PNIE perspective, defining the changes occurring in each system and how all these mechanisms are interconnected. Finally, potential clinical approaches derived from this knowledge will also be collectively presented with the aim to develop integrative therapies to maximize the clinical management of these patients.
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Affiliation(s)
- Miguel A. Ortega
- Department of Medicine and Medical Specialities, University of Alcala, 28801 Alcala de Henares, Spain
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain
| | - Oscar Fraile-Martinez
- Department of Medicine and Medical Specialities, University of Alcala, 28801 Alcala de Henares, Spain
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain
| | - Cielo García-Montero
- Department of Medicine and Medical Specialities, University of Alcala, 28801 Alcala de Henares, Spain
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain
| | - Sergio Haro
- Department of Medicine and Medical Specialities, University of Alcala, 28801 Alcala de Henares, Spain
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain
| | - Miguel Ángel Álvarez-Mon
- Department of Medicine and Medical Specialities, University of Alcala, 28801 Alcala de Henares, Spain
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain
- Department of Psychiatry and Mental Health, Hospital Universitario Infanta Leonor, 28031 Madrid, Spain
| | - Diego De Leon-Oliva
- Department of Medicine and Medical Specialities, University of Alcala, 28801 Alcala de Henares, Spain
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain
| | - Ana M. Gomez-Lahoz
- Department of Medicine and Medical Specialities, University of Alcala, 28801 Alcala de Henares, Spain
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain
| | - Jorge Monserrat
- Department of Medicine and Medical Specialities, University of Alcala, 28801 Alcala de Henares, Spain
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain
| | - Mar Atienza-Pérez
- Service of Rehabilitation, National Hospital for Paraplegic Patients, Carr. de la Peraleda, S/N, 45004 Toledo, Spain
| | - David Díaz
- Department of Medicine and Medical Specialities, University of Alcala, 28801 Alcala de Henares, Spain
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain
| | - Elisa Lopez-Dolado
- Department of Medicine and Medical Specialities, University of Alcala, 28801 Alcala de Henares, Spain
- Department of Psychiatry and Mental Health, Hospital Universitario Infanta Leonor, 28031 Madrid, Spain
| | - Melchor Álvarez-Mon
- Department of Medicine and Medical Specialities, University of Alcala, 28801 Alcala de Henares, Spain
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain
- Immune System Diseases-Rheumatology Service and Internal Medicine, University Hospital Príncipe de Asturias (CIBEREHD), 28806 Alcala de Henares, Spain
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26
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Liu Y, Hasimu M, Jia M, Tang J, Wang Y, He X, Yan T, Xie S, Li K. The Effects of APP-Based Intervention for Depression Among Community-Dwelling Individuals With Spinal Cord Injury: A Randomized Controlled Trial. Arch Phys Med Rehabil 2023; 104:195-202. [PMID: 36332676 DOI: 10.1016/j.apmr.2022.10.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 09/28/2022] [Accepted: 10/03/2022] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To assess the effect of a self-management intervention delivered by mobile application (APP) for depression among community-dwelling individuals with spinal cord injury (SCI). DESIGN Randomized controlled trial. SETTINGS General communities in China. PARTICIPANTS Community-dwelling individuals with SCI who were diagnosed within 2 years were recruited in this study (N=98). It was a convenience sample with an average age of 41.71, 82.7% participants were men. INTERVENTIONS Participants in the intervention group (n=49) received 5 sessions on self-management training provided by nurse-led multidisciplinary team via APP at the second, fourth, sixth, eighth, and 12th weeks, respectively, after they discharge from hospitals. Participants in the control group (n=49) received routine telephone counselling provided by follow-up nurses at the 12th week after they discharge. OUTCOME MEASURE The outcome of this study is depression, which is not the primary outcomes in the registration of this program. Depression was measured by version 2 of Beck Depression Inventory at discharge (T0), the 12th week after discharge from hospitals (T1), and the 24th week after discharge from hospitals (T2). RESULTS There were 98 participants (49 in the intervention group and 49 in the control group) completing the intervention and data collection. Compared with the control group, the intervention group had lower level of depression at T2 (B=-5.76; 95% CI=-9.97, -1.54; P=.007). Small to moderate effect sizes on depression favoring the intervention were demonstrated at T1 (Cohen's d=-.178) and T2 (Cohen's d=-.535). CONCLUSIONS APP-based self-management support can be a potential intervention to reduce depression among community-dwelling individuals with SCI.
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Affiliation(s)
- Yinnan Liu
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| | | | - Mengmeng Jia
- School of Nursing, Sun Yat-sen University, Guangzhou, China
| | - Jie Tang
- Department of Spinal Cord Injury Rehabilitation, Affiliated Sichuan Provincial Rehabilitation Hospital of Chengdu University of TCM, Chengdu, China
| | - Yingmin Wang
- Department of Rehabilitation Medicine, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Xiaokuo He
- Department of Rehabilitation Medicine, The Fifth Hospital of Xiamen, Xiamen, China
| | - Tiebin Yan
- Department of Rehabilitation Medicine, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Sumei Xie
- Department of Nursing, Guangdong Provincial Work Injury Rehabilitation Hospital, Guangzhou, China
| | - Kun Li
- School of Nursing, Sun Yat-sen University, Guangzhou, China.
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27
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Sneij A, Farkas GJ, Carino Mason MR, Gater DR. Nutrition Education to Reduce Metabolic Dysfunction for Spinal Cord Injury: A Module-Based Nutrition Education Guide for Healthcare Providers and Consumers. J Pers Med 2022; 12:2029. [PMID: 36556250 PMCID: PMC9786330 DOI: 10.3390/jpm12122029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 10/31/2022] [Accepted: 11/29/2022] [Indexed: 12/14/2022] Open
Abstract
Spinal cord injury (SCI) results in a high prevalence of neurogenic obesity and metabolic dysfunction. The increased risk for neurogenic obesity and metabolic dysfunction is mainly due to the loss of energy balance because of significantly reduced energy expenditure following SCI. Consequently, excessive energy intake (positive energy balance) leads to adipose tissue accumulation at a rapid rate, resulting in neurogenic obesity, systemic inflammation, and metabolic dysfunction. The purpose of this article is to review the existing literature on nutrition, dietary intake, and nutrition education in persons with SCI as it relates to metabolic dysfunction. The review will highlight the poor dietary intakes of persons with SCI according to authoritative guidelines and the need for nutrition education for health care professionals and consumers. Nutrition education topics are presented in a module-based format with supporting literature. The authors emphasize the role of a diet consisting of low-energy, nutrient-dense, anti-inflammatory foods consistent with the Dietary Guidelines for Americans' MyPlate to effectively achieve energy balance and reduce the risk for neurogenic obesity and metabolic dysfunction in individuals with SCI.
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Affiliation(s)
- Alicia Sneij
- Department of Physical Medicine and Rehabilitation, University of Miami Miller School of Medicine, P.O. Box 016960 (C-206), Miami, FL 33101, USA
- Christine E. Lynn Rehabilitation Center for the Miami Project to Cure Paralysis, Miami, FL 33101, USA
| | - Gary J. Farkas
- Department of Physical Medicine and Rehabilitation, University of Miami Miller School of Medicine, P.O. Box 016960 (C-206), Miami, FL 33101, USA
- Christine E. Lynn Rehabilitation Center for the Miami Project to Cure Paralysis, Miami, FL 33101, USA
| | - Marisa Renee Carino Mason
- Department of Physical Medicine and Rehabilitation, University of Miami Miller School of Medicine, P.O. Box 016960 (C-206), Miami, FL 33101, USA
| | - David R. Gater
- Department of Physical Medicine and Rehabilitation, University of Miami Miller School of Medicine, P.O. Box 016960 (C-206), Miami, FL 33101, USA
- Christine E. Lynn Rehabilitation Center for the Miami Project to Cure Paralysis, Miami, FL 33101, USA
- The Miami Project to Cure Paralysis, University of Miami Miller School of Medicine, Miami, FL 33136, USA
- South Florida Spinal Cord Injury Model System, University of Miami Miller School of Medicine, Miami, FL 33101, USA
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