1
|
Gomes Costa RR, Ribeiro Neto F, Ramos BL, Tanhoffer R, O'Shea B, Winckler C. Age-Related Trajectory and Age at Peak Competitive Performance in Wheelchair Rugby Players at the Paralympic Games. Am J Phys Med Rehabil 2024; 103:747-752. [PMID: 38206584 DOI: 10.1097/phm.0000000000002434] [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: 01/12/2024]
Abstract
OBJECTIVE The first objective is to examine the age-related trajectory of competitive performance and the age at peak competitive performance in wheelchair rugby players at the Paralympic Games. Another objective is to verify age correlations with performance over the years for each class. DESIGN This is a retrospective cohort study. RESULTS Data were collected from the official results books of the Paralympic games. The mean age (SD) of the 267 players and 448 analyzed data from all Paralympic games (from Sidney 2004 to Tokyo 2020) across all classes was 32.8 (6.4) yrs, and the age at peak competitive performance was 30.6 (7.4) yrs. Each class had no statistical difference in age at peak competitive performance. In addition, there was no significant correlation between age and performance within classes or across all Paralympic games. CONCLUSIONS The findings indicate that wheelchair rugby players' age at peak competitive performance is 30.6 yrs, which remains consistent across all classes. There is no statistical correlation between age and performance in wheelchair rugby. These findings significantly affect effective talent identification and athlete development programs. This impact ensures that athletes receive the necessary support to reach their maximum potential while avoiding the pitfalls of underestimating or overestimating their stages of development.
Collapse
Affiliation(s)
- Rodrigo Rodrigues Gomes Costa
- From the SARAH Network of Rehabilitation Hospitals, Brasilia, Brazil (RRGC, FRN); Brasilia University, Brasilia, Brazil (BLR); Paraná Federal University, Curitiba, Brazil (RT); Stoke Mandeville Maulers, Aylesbury, United Kingdom (BO); and São Paulo Federal University, Santos, Brazil (RRGC, CW)
| | | | | | | | | | | |
Collapse
|
2
|
Nevzati E, Kemp OAG, Rhoads C, Witt JP, Finn M, Moser M, Spiessberger A. Biomechanical analysis of stabilization for thoracolumbar anterior spinal failure caused by osteolytic lesions, a finite element comparison of direct lateral corpectomy and posterior long segment instrumentation. Spine J 2024:S1529-9430(24)00892-1. [PMID: 39074736 DOI: 10.1016/j.spinee.2024.06.570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 06/22/2024] [Accepted: 06/23/2024] [Indexed: 07/31/2024]
Abstract
BACKGROUND CONTEXT Osteolytic lesions caused by infection or metastatic disease of the spine can induce instability. Different surgical strategies are available to restore stability in this scenario, however little is known how various reconstruction techniques affect spinal biomechanics. PURPOSE To analyze and quantify the biomechanical effects of three different surgical reconstruction techniques in the treatment of a T12 osteolytic model. STUDY DESIGN/SETTING Finite element analysis of the thoracic spine with a T12 osteolytic lesion. METHODS Using CT scans from a 20-year-old man without structural deformity, simulation of an osteolytic lesion with a 50% defect at the posterior aspect of T12 vertebral body (anterior? Posterior? Be specific) was created. (was the defect created by the force? Or was the force then delivered after the defect was created?) by a 490 N vertical force to T9. Next, three common instrumentation techniques treating the osteolytic lesion were modeled and biomechanically tested. These included: Model A, corpectomy with short segment fixation (T11-L1) and two long-segment instrumentations; Model B long segment fixation with triple rod construct; Model C long segment fixation with dual rod construct. A load of 480N was then applied on the spine models in vertically downward direction on T9. Von Mises stresses were measured (MPa) in the discs, vertebrae, and implants. RESULTS Model A demonstrated the lowest stress on construct material, adjacent vertebral bodies, and discs but increased stress on the instrumented vertebrae. Model B was more rigid and demonstrated lower construct stress compared to Model C. However, Model C had the lowest vertebral body stress in flexion, extension, and lateral bending in the most upper instrumented vertebral body, but the highest screw pull-out stress when compared to Model A and Model B. CONCLUSIONS This osteolytic T12 model provides unique biomechanical data that can help to tailor surgical strategies in select scenarios. While optimal outcomes are best achieved with a construct tailored to a specific patient's need for stabilization, our findings can be generalized for instances of cancerous lesions, low bone density, and infectious causes. CLINICAL RELEVANCE The results of this study can help with the choice of appropriate surgical reconstruction technique based on patient-specific characteristics.
Collapse
Affiliation(s)
- Edin Nevzati
- Department of Neurosurgery, Cantonal Hospital of Lucerne, Spitalstrasse, 6000 Lucerne, Switzerland; University of Basel, Faculty of Medicine, Basel, Switzerland, Klingelbergstrasse 61, 4056 Basel; Department of Neurosurgery, University of Colorado Anschutz Medical Campus School of Medicine, 1635 Aurora, Aurora, CO 80045, USA
| | - Oliver A G Kemp
- Department of Neurosurgery, Cantonal Hospital of Lucerne, Spitalstrasse, 6000 Lucerne, Switzerland
| | - Colin Rhoads
- Department of Orthopedic Surgery, Cleveland Clinic South Pointe Hospital 20000 Harvard Rd, Warrensville Heights, OH 44122.
| | - Jens-Peter Witt
- Department of Neurosurgery, University of Colorado Anschutz Medical Campus School of Medicine, 1635 Aurora, Aurora, CO 80045, USA
| | - Michael Finn
- Department of Neurosurgery, University of Colorado Anschutz Medical Campus School of Medicine, 1635 Aurora, Aurora, CO 80045, USA
| | - Manuel Moser
- Department of Neurosurgery, Cantonal Hospital of Lucerne, Spitalstrasse, 6000 Lucerne, Switzerland; Department of Neurosurgery, Cantonal Hospital Graubuenden, Loëstrasse 170, Chur 7000, Switzerland
| | | |
Collapse
|
3
|
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.
Collapse
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
| |
Collapse
|
4
|
Zakeri Z, Heiderzadeh M, Kocaarslan A, Metin E, Hosseini Karimi SN, Saghati S, Vural A, Akyoldaş G, Baysal K, Yağcı Y, Gürsoy-Özdemir Y, Taşoğlu S, Rahbarghazi R, Sokullu E. Exosomes encapsulated in hydrogels for effective central nervous system drug delivery. Biomater Sci 2024; 12:2561-2578. [PMID: 38602364 DOI: 10.1039/d3bm01055d] [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: 04/12/2024]
Abstract
The targeted delivery of pharmacologically active molecules, metabolites, and growth factors to the brain parenchyma has become one of the major challenges following the onset of neurodegeneration and pathological conditions. The therapeutic effect of active biomolecules is significantly impaired after systemic administration in the central nervous system (CNS) because of the blood-brain barrier (BBB). Therefore, the development of novel therapeutic approaches capable of overcoming these limitations is under discussion. Exosomes (Exo) are nano-sized vesicles of endosomal origin that have a high distribution rate in biofluids. Recent advances have introduced Exo as naturally suitable bio-shuttles for the delivery of neurotrophic factors to the brain parenchyma. In recent years, many researchers have attempted to regulate the delivery of Exo to target sites while reducing their removal from circulation. The encapsulation of Exo in natural and synthetic hydrogels offers a valuable strategy to address the limitations of Exo, maintaining their integrity and controlling their release at a desired site. Herein, we highlight the current and novel approaches related to the application of hydrogels for the encapsulation of Exo in the field of CNS tissue engineering.
Collapse
Affiliation(s)
- Ziba Zakeri
- Research Center for Translational Medicine (KUTTAM), Koç University, Rumeli Feneri, 34450, Istanbul, Sariyer, Turkey.
| | - Morteza Heiderzadeh
- Research Center for Translational Medicine (KUTTAM), Koç University, Rumeli Feneri, 34450, Istanbul, Sariyer, Turkey.
| | - Azra Kocaarslan
- Chemistry Department, Faculty of Science, İstanbul Technical University, İstanbul, Turkey
| | - Ecem Metin
- Research Center for Translational Medicine (KUTTAM), Koç University, Rumeli Feneri, 34450, Istanbul, Sariyer, Turkey.
| | | | - Sepideh Saghati
- Department of Tissue Engineering, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Atay Vural
- Research Center for Translational Medicine (KUTTAM), Koç University, Rumeli Feneri, 34450, Istanbul, Sariyer, Turkey.
- Department of Neurology, School of Medicine, KoÒ« University, Istanbul 34450, Turkey
| | - Göktuğ Akyoldaş
- Department of Neurosurgery, Koç University Hospital, Istanbul 34450, Turkey
| | - Kemal Baysal
- Research Center for Translational Medicine (KUTTAM), Koç University, Rumeli Feneri, 34450, Istanbul, Sariyer, Turkey.
- Department of Biochemistry, School of Medicine, Koç University, Istanbul 34450, Turkey
| | - Yusuf Yağcı
- Chemistry Department, Faculty of Science, İstanbul Technical University, İstanbul, Turkey
| | - Yasemin Gürsoy-Özdemir
- Research Center for Translational Medicine (KUTTAM), Koç University, Rumeli Feneri, 34450, Istanbul, Sariyer, Turkey.
- Department of Neurology, School of Medicine, KoÒ« University, Istanbul 34450, Turkey
| | - Savaş Taşoğlu
- Research Center for Translational Medicine (KUTTAM), Koç University, Rumeli Feneri, 34450, Istanbul, Sariyer, Turkey.
- Mechanical Engineering Department, School of Engineering, Koç University, Rumeli Feneri, 34450, Istanbul, Sariyer, Turkey
| | - Reza Rahbarghazi
- Stem Cell Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Applied Cell Sciences, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Emel Sokullu
- Research Center for Translational Medicine (KUTTAM), Koç University, Rumeli Feneri, 34450, Istanbul, Sariyer, Turkey.
- Biophysics Department, Koç University School of Medicine, Rumeli Feneri, 34450, Istanbul, Sariyer, Turkey
| |
Collapse
|
5
|
Deutsch A, Burns J, Potelle J, Kessler A. Trends in the characteristics and outcomes of older patients with non-traumatic spinal cord injury treated in inpatient rehabilitation facilities: 2013-2018. J Spinal Cord Med 2024:1-11. [PMID: 38588027 DOI: 10.1080/10790268.2024.2335414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/10/2024] Open
Abstract
OBJECTIVE To describe the characteristics and outcomes of older (≥ 65 years of age) patients with a non-traumatic spinal cord injury (NTSCI) treated in inpatient rehabilitation facilities (IRFs) between 2013 and 2018. DESIGN Observational study. SETTING IRFs in the United States. PARTICIPANTS 93,631 IRF Medicare stays for patients with NTSCI. INTERVENTIONS Not Applicable. MAIN OUTCOME MEASURES Length of stay, self-care and mobility function, discharge destination. RESULTS Between 2013 and 2018, the number of older (≥ 65 years of age) Medicare patients with a NTSCI treated in IRFs increased about 22.1 percent, from 14,149 to 17,275. In addition to the increase, patients' sociodemographic characteristics shifted to have a slightly higher percentage of patients aged 65-74 years, a slightly higher percentage of males, and slightly fewer patients who identified as Hispanic. There was also a trend of more patients in the higher acuity case-mix groups and comorbidities tiers, but the median length of stay remained 12 days across all years. The percent of patients discharged home or to a community-based setting varied from 73.7 to 75.2 without a trend, although discharge self-care and mobility function increased slightly across the years. CONCLUSIONS Between 2013 and 2018, the number of Medicare patients with NTSCI treated in IRFs increased by more than 22 percent. While patient complexity increased, the median length of stay remained 12 days across the years. Discharge self-care and mobility function increased slightly, and the percent of patients discharged home ranged from 73.7 to 75.2 across the years.
Collapse
Affiliation(s)
- Anne Deutsch
- Center for Rehabilitation Outcomes Research, Shirley Ryan AbilityLab, Chicago, Illinois, USA
- Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
- Health Practice, RTI International, Waltham, Massachusetts, USA
| | - Jennifer Burns
- Center for Rehabilitation Outcomes Research, Shirley Ryan AbilityLab, Chicago, Illinois, USA
| | - John Potelle
- Health Practice, RTI International, Waltham, Massachusetts, USA
| | - Allison Kessler
- Health Practice, RTI International, Waltham, Massachusetts, USA
- Renee Crown Center for Spinal Cord Innovation, Shirley Ryan AbilityLab, Chicago, Illinois, USA
| |
Collapse
|
6
|
Liu R, Fan Q, He J, Wu X, Tan W, Yan Z, Wang W, Li Z, Deng YW. Clinical characteristics analysis of pediatric spinal cord injury without radiological abnormality in China: a retrospective study. BMC Pediatr 2024; 24:236. [PMID: 38570804 PMCID: PMC10988788 DOI: 10.1186/s12887-024-04716-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 03/21/2024] [Indexed: 04/05/2024] Open
Abstract
PURPOSE This study aims to analyze the clinical characteristics of Chinese children with spinal cord injury (SCI) without radiographic abnormality (SCIWORA) and explore their contributing factors and mechanisms of occurrence. METHODS A retrospective analysis was conducted on the clinical data of pediatric patients diagnosed with SCIWORA from January 2005 to May 2020. Epidemiological, etiological, mechanistic, therapeutic, and outcome aspects were analyzed. RESULTS A total of 47 patients with SCIWORA were included in this study, comprising 16 males and 31 females. The age range was 4 to 12 years, with an average age of 7.49 ± 2.04 years, and 70% of the patients were below eight. Sports-related injuries constituted 66%, with 70% attributed to dance backbend practice. Thoracic segment injuries accounted for 77%. In the American Spinal Injury Association (ASIA) classification, the combined proportion of A and B grades accounted for 88%. Conservative treatment was chosen by 98% of the patients, with muscle atrophy, spinal scoliosis, hip joint abnormalities, and urinary system infections being the most common complications. CONCLUSION SCIWORA in Chinese children is more prevalent in those under eight years old, with a higher incidence in females than males. Thoracic spinal cord injuries are predominant, dance backbend as a primary contributing factor, and the social environment of "neijuan" is a critical potential inducing factor. Furthermore, the initial severity of the injury plays a decisive role in determining the prognosis of SCIWORA.
Collapse
Affiliation(s)
- Renfeng Liu
- Department of Spinal Surgery, The Third Xiangya Hospital of Central South University, Changsha, Hunan Province, China
| | - Qizhi Fan
- Department of Spinal Surgery, The Third Xiangya Hospital of Central South University, Changsha, Hunan Province, China
| | - Jingpeng He
- Department of Spinal Surgery, The Third Xiangya Hospital of Central South University, Changsha, Hunan Province, China
| | - Xin Wu
- Department of Spinal Surgery, The Third Xiangya Hospital of Central South University, Changsha, Hunan Province, China
| | - Wei Tan
- Department of Spinal Surgery, The Third Xiangya Hospital of Central South University, Changsha, Hunan Province, China
| | - Zuyun Yan
- Department of Spinal Surgery, The Third Xiangya Hospital of Central South University, Changsha, Hunan Province, China
| | - Weiguo Wang
- Department of Spinal Surgery, The Third Xiangya Hospital of Central South University, Changsha, Hunan Province, China
| | - Zhiyue Li
- Department of Spinal Surgery, The Third Xiangya Hospital of Central South University, Changsha, Hunan Province, China
| | - You-Wen Deng
- Department of Spinal Surgery, The Third Xiangya Hospital of Central South University, Changsha, Hunan Province, China.
| |
Collapse
|
7
|
van der Gaag SME, Frankema SPG, van der Ploeg ES, Baart SJ, Huygen FJMP. Evaluating Community-Based Intrathecal Baclofen Therapy: Effectiveness, Safety, and Feasibility. J Clin Med 2024; 13:1840. [PMID: 38610605 PMCID: PMC11012490 DOI: 10.3390/jcm13071840] [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: 02/07/2024] [Revised: 03/14/2024] [Accepted: 03/18/2024] [Indexed: 04/14/2024] Open
Abstract
Background: Intrathecal baclofen (ITB) is used for the treatment of intractable spasticity. The burden of traveling for ITB screening and aftercare is problematic for nursing home residents with severe spasticity and seems to result in undertreatment of spasticity. The aim of this study is to evaluate the effectiveness, safety, and feasibility of ITB for nursing home residents treated in their home, describing the selection phase, the initial trial of ITB, and aftercare up to 3 months after implantation of an ITB pump. Methods: This retrospective database study included immobile, adult nursing home residents with severe spasticity, referred to an Ambulatory Care Clinic between 2016 and 2021. When eligible, an ITB trial was performed by ITB experts in the nursing home. If a permanent pump was implanted, dose titration and aftercare were performed on location. Results: A total of 102 patients were referred; 80 underwent an ITB trial on location, and 94% improved significantly on the Modified Ashworth Scale and clonus scale pre-ITB trial versus post-ITB trial, as well as at 3 months post-implantation. There was a low incidence of adverse events, mostly procedure- and drug-related. Conclusions: This study indicates that selection, testing, and aftercare for ITB on location is effective and safe.
Collapse
Affiliation(s)
- Simone M. E. van der Gaag
- Ambulatory Care Clinic, Care4homecare, Rond Deel 12, 5531 AH Bladel, The Netherlands;
- Center for Pain Medicine, Erasmus University Medical Center, Doctor Molewaterplein 40, 3015 GD Rotterdam, The Netherlands; (S.P.G.F.); (S.J.B.); (F.J.M.P.H.)
| | - Sander P. G. Frankema
- Center for Pain Medicine, Erasmus University Medical Center, Doctor Molewaterplein 40, 3015 GD Rotterdam, The Netherlands; (S.P.G.F.); (S.J.B.); (F.J.M.P.H.)
| | - Eva S. van der Ploeg
- Ambulatory Care Clinic, Care4homecare, Rond Deel 12, 5531 AH Bladel, The Netherlands;
| | - Sara J. Baart
- Center for Pain Medicine, Erasmus University Medical Center, Doctor Molewaterplein 40, 3015 GD Rotterdam, The Netherlands; (S.P.G.F.); (S.J.B.); (F.J.M.P.H.)
| | - Frank J. M. P. Huygen
- Center for Pain Medicine, Erasmus University Medical Center, Doctor Molewaterplein 40, 3015 GD Rotterdam, The Netherlands; (S.P.G.F.); (S.J.B.); (F.J.M.P.H.)
| |
Collapse
|
8
|
Cesca N, Lin C, Abu-Jurji Z, Wexler A, Mark J, McCullum S, Kamran R, Chan B, Musselman KE. Exploring knowledge and implementation gaps of activity-based therapy in centers lacking specialized spinal cord injury services: understanding therapists' perspectives. Spinal Cord Ser Cases 2024; 10:14. [PMID: 38514640 PMCID: PMC10957876 DOI: 10.1038/s41394-024-00619-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 02/14/2024] [Accepted: 02/16/2024] [Indexed: 03/23/2024] Open
Abstract
STUDY DESIGN Qualitative exploratory OBJECTIVES: Rehabilitation following spinal cord injury (SCI) is a life-long process involving healthcare in a variety of settings, including facilities lacking SCI-specific services (i.e., non-SCI-specialized centers). Activity-based therapy (ABT) is a neurorestorative approach involving intensive, task-specific movement practice below the injury level. This study explored the existing knowledge, perceptions, and implementation of ABT among physical and occupational therapists working in non-SCI-specialized centers. SETTING Canadian hospitals and community clinics DESIGN/METHODS: Semi-structured interviews were conducted with Canadian therapists who worked at non-SCI-specialized centers and treated at least one patient with SCI within the last 18 months. The Theoretical Domains Framework was used to develop interview questions that queried therapists' experiences in delivering SCI rehabilitation, their understanding of ABT and experience with its implementation. Interviews were audio-recorded, transcribed verbatim and analyzed using interpretive description. RESULTS Four physical therapists and three occupational therapists, from diverse settings (i.e., acute care, inpatient rehabilitation, long-term care, outpatient rehabilitation, rural outpatient clinic) participated. Three themes were identified: (1) Available knowledge, resources and therapy time in non-SCI-specialized centers challenge ABT implementation, (2) How current therapy practices in non-SCI-specialized centers align with ABT and (3) Desire for ABT knowledge. Although participants were not familiar with the term ABT, it was identified that they were unknowingly incorporating some components of ABT into their practice. Participants expressed a keenness to learn more about ABT. CONCLUSION Current knowledge and implementation of ABT in non-SCI-specialized centers is limited. Tailoring ABT education to therapists at non-SCI-specialized centers may increase ABT implementation.
Collapse
Affiliation(s)
- Nicole Cesca
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- KITE Research Institute, Toronto Rehabilitation Institute - University Health Network, Toronto, ON, Canada
| | - Chantal Lin
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Zeina Abu-Jurji
- Faculty of Health Sciences, Masters of Physiotherapy, McMaster University, Hamilton, ON, Canada
| | - Aaron Wexler
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Jonas Mark
- First Steps Wellness Centre, Winnipeg, MB, Canada
| | - Shane McCullum
- Stan Cassidy Centre for Rehabilitation, Horizon Health Network, Fredericton, NB, Canada
| | - Rija Kamran
- Rehabilitation Science, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
| | - Brian Chan
- KITE Research Institute, Toronto Rehabilitation Institute - University Health Network, Toronto, ON, Canada
- Institute for Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
| | - Kristin E Musselman
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
- KITE Research Institute, Toronto Rehabilitation Institute - University Health Network, Toronto, ON, Canada.
- Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
| |
Collapse
|
9
|
Biben V, Defi IR, Surjadi E, Fajarulhuda M, Nurarifah SAH. Influence of Personality on Geriatric Rehabilitation Outcomes in Cauda Equina Syndrome Case. Gerontol Geriatr Med 2024; 10:23337214231220831. [PMID: 38162690 PMCID: PMC10757440 DOI: 10.1177/23337214231220831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 11/20/2023] [Accepted: 11/29/2023] [Indexed: 01/03/2024] Open
Abstract
Cauda Equina Syndrome (CES) becomes more common as the population ages, making diagnosis challenging and leading to underdiagnosis and poor management. Person-centered care is crucial for successful rehabilitation outcomes, and patient's personality influences it. Female, 77 years old, diagnosed with CES caused by nucleus pulposus herniation at fourth to fifth lumbar vertebrae, with a complication of pressure injury grade IV due to immobilization. Her family's lack of caregiving skills, poverty, and histrionic personality disorder were her barriers to comply to rehabilitation program. Adding a psychotherapy based on personality on rehabilitation program increased her functional outcome. This case highlight the significance of assessing each patient's personality to optimize outcomes, emphasizing the importance of tailoring rehabilitation programs to individual needs, including psychosocial and environmental factors.
Collapse
Affiliation(s)
- Vitriana Biben
- Physical Medicine and Rehabilitation Department, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
| | - Irma Ruslina Defi
- Physical Medicine and Rehabilitation Department, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
| | - Elisa Surjadi
- Physical Medicine and Rehabilitation Department, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
| | - Muhammad Fajarulhuda
- Physical Medicine and Rehabilitation Department, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
| | - Sitti Ayu Hemas Nurarifah
- Physical Medicine and Rehabilitation Department, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
| |
Collapse
|
10
|
Oh HHY, Pontis S. Understanding individuals with spinal cord injury's self-care practices: a technology probe study to promote pressure relief adherence. Disabil Rehabil Assist Technol 2023:1-15. [PMID: 38131605 DOI: 10.1080/17483107.2023.2293876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 12/06/2023] [Indexed: 12/23/2023]
Abstract
Pressure reliefs (PRs) are self-care practices essential for individuals with spinal cord injury (SCI) to prevent life-threatening pressure injuries (PIs). Despite the benefits, individuals often do not do these exercises at home, leading to increased patient morbidity and mortality. To examine how digital technology could improve this population's adherence to PR exercises, we conducted a technology probe study with five individuals with SCI over ten consecutive business days. A chat-based intervention was created to send user-scheduled PR reminders, which were personalized with visual elements and progress trackers. Participants were interviewed before and after interacting with the probe to better understand their experiences with PIs and PR practices. Results shed light on specific factors that may impact individuals with SCI's behaviours towards PRs and four considerations to design a customisable reminder intervention: (1) easy to use and friendly technology, (2) design-your-own- schedule feature, (3) communication style feature, and (4) dialogue support features. Personalisation supported with gamified visual progress tracking and motivational messages emerged as a strong strategy to increase PR adherence. Both sets of findings expand upon the human-computer interaction (HCI) literature for mobile health tools that encourage self-care practices; in particular, to the specific needs of individuals with SCI and the use of visual elements to increase engagement.
Collapse
Affiliation(s)
- Hannah Hye Yeon Oh
- Integrated Design and Management, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Sheila Pontis
- Integrated Design and Management, Massachusetts Institute of Technology, Cambridge, MA, USA
| |
Collapse
|
11
|
Amiri M, Kangatharan S, Brisbois L, Farahani F, Khasiyeva N, Burley M, Craven BC. Developing and Evaluating Data Infrastructure and Implementation Tools to Support Cardiometabolic Disease Indicator Data Collection. Top Spinal Cord Inj Rehabil 2023; 29:124-141. [PMID: 38174138 PMCID: PMC10759866 DOI: 10.46292/sci23-00018s] [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
Background Assessment of aerobic exercise (AE) and lipid profiles among individuals with spinal cord injury or disease (SCI/D) is critical for cardiometabolic disease (CMD) risk estimation. Objectives To utilize an artificial intelligence (AI) tool for extracting indicator data and education tools to enable routine CMD indicator data collection in inpatient/outpatient settings, and to describe and evaluate the recall of AE levels and lipid profile assessment completion rates across care settings among adults with subacute and chronic SCI/D. Methods A cross-sectional convenience sample of patients affiliated with University Health Network's SCI/D rehabilitation program and outpatients affiliated with SCI Ontario participated. The SCI-HIGH CMD intermediary outcome (IO) and final outcome (FO) indicator surveys were administered, using an AI tool to extract responses. Practice gaps were prospectively identified, and implementation tools were created to address gaps. Univariate and bivariate descriptive analyses were used. Results The AI tool had <2% error rate for data extraction. Adults with SCI/D (n = 251; 124 IO, mean age 61; 127 FO, mean age 55; p = .004) completed the surveys. Fourteen percent of inpatients versus 48% of outpatients reported being taught AE. Fifteen percent of inpatients and 51% of outpatients recalled a lipid assessment (p < .01). Algorithms and education tools were developed to address identified knowledge gaps in patient AE and lipid assessments. Conclusion Compelling CMD health service gaps warrant immediate attention to achieve AE and lipid assessment guideline adherence. AI indicator extraction paired with implementation tools may facilitate indicator deployment and modify CMD risk.
Collapse
Affiliation(s)
- Mohammadreza Amiri
- KITE Research Institute, University Health Network, Toronto, ON, Canada
- ICON plc, Burlington, ON, Canada
| | - Suban Kangatharan
- KITE Research Institute, University Health Network, Toronto, ON, Canada
| | - Louise Brisbois
- KITE Research Institute, University Health Network, Toronto, ON, Canada
| | - Farnoosh Farahani
- KITE Research Institute, University Health Network, Toronto, ON, Canada
| | | | | | - B. Catharine Craven
- KITE Research Institute, University Health Network, Toronto, ON, Canada
- Department of Medicine, Temerty Faculty of Medicine, Toronto, ON, Canada
| |
Collapse
|
12
|
Rahim Khan S, Ahmad A, Saqib M, Iftikhar M. Cervical Pott's Disease Presenting As Quadriplegia in a Young Patient: A Case Report. Cureus 2023; 15:e46949. [PMID: 38022183 PMCID: PMC10640701 DOI: 10.7759/cureus.46949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/13/2023] [Indexed: 12/01/2023] Open
Abstract
Cervical Pott's disease, a form of spinal tuberculosis (TB), is a significant concern in low- and middle-income countries (LMICs). Early detection and treatment are critical to preventing complications like vertebral collapse. Clinical and radiological features of cervical Pott's disease can resemble other spinal conditions, posing diagnostic challenges. We present a case of a 28-year-old female who initially presented with quadriplegia, cervical instability, and high-grade fever. Through multidisciplinary collaboration and prompt intervention, the patient was diagnosed with cord compression syndrome secondary to a cervical abscess and probable cervical Pott's disease. Anti-tuberculosis treatment (ATT) and steroids were initiated, leading to significant improvement in symptoms and disease resolution. In summary, this case underscores the diagnostic challenge of cervical Pott's disease and the importance of imaging in TB diagnosis in resource-limited settings. The positive treatment response emphasizes early intervention's significance.
Collapse
Affiliation(s)
- Sana Rahim Khan
- Department of Medicine, Khyber Teaching Hospital, Peshawar, PAK
| | - Afaq Ahmad
- Department of Medicine, Khyber Teaching Hospital, Peshawar, PAK
| | - Muhammad Saqib
- Department of Medicine, Khyber Teaching Hospital, Peshawar, PAK
- Department of Clinical Research, Kahuta Research Laboratory (KRL) Hospital, Islamabad, PAK
| | - Muhammad Iftikhar
- Department of Medicine, Khyber Teaching Hospital, Peshawar, PAK
- Department of Clinical Research, Kahuta Research Laboratory (KRL) Hospital, Islamabad, PAK
| |
Collapse
|
13
|
Uddin T, Islam MT, Hossain M, Hossain MS, Salek A, Islam MJ, Haque S, Rahim HR, Hossain MS, Hassanuzzaman M, Islam M, Khan MUH, Ahmed S, Mahmud K, Hasan MR, Tasnim A, Haque MA. Demographic and Clinical Characteristics of Persons With Spinal Cord Injury in Bangladesh: Database for the International Spinal Cord Injury Community Survey 2023. Neurotrauma Rep 2023; 4:598-604. [PMID: 37731648 PMCID: PMC10507932 DOI: 10.1089/neur.2023.0040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/22/2023] Open
Abstract
The study aims to explore the demographic and clinical characteristics of persons with spinal cord injury (SCI) in Bangladesh. A total of 3035 persons with SCI spanning from 2018 to 2022 were included in this cross-sectional study. Information about demographic and clinical variables was obtained from the medical records and verified through telephone calls to ensure accuracy and consistency. Approximately half (48.30%) of the study participants were located in Dhaka Division. The average age of persons with SCI was 38.3 years, with a standard deviation of 15.9 years, and the largest proportion (33.4%) fell within the age range of 18-30 years. Males outnumbered females by nearly 2.5 times. In the study, 59.6% had suffered traumatic injuries, whereas 40.4% had SCI attributable to disease-related causes; 58.1% were diagnosed with tetraplegia and 40.1% with paraplegia. Fall from height (42.1%) and road traffic trauma (27%) were the most common causes of traumatic injuries. Degenerative myelopathy (41.1%) was the most frequent cause of non-traumatic SCI, followed by tumors (27.7%) and tuberculosis (TB; 14.8%). Both traumatic (58.3%) and degenerative (56.7%) causes of SCI commonly affected the cervical spine, whereas TB (24.4%) and tumors (47.5%) had a higher incidence of affecting the dorsal spine. In the absence of a registry or national database for patients with SCI in Bangladesh, this study would serve as representative data for future studies.
Collapse
Affiliation(s)
- Taslim Uddin
- Department of Physical Medicine and Rehabilitation, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Mohammad Tariqul Islam
- Department of Physical Medicine and Rehabilitation, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Mohammad Hossain
- Department of Neurosurgery, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | | | - A.K.M. Salek
- Department of Physical Medicine and Rehabilitation, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - M. Jahidul Islam
- Department of Physical Medicine and Rehabilitation, Dhaka Medical College, Dhaka, Bangladesh
| | - Shahidul Haque
- Department of Physical Medicine and Rehabilitation, Combined Military Hospital, Dhaka, Bangladesh
| | - Hasna Raihan Rahim
- Department of Physical Medicine and Rehabilitation, Combined Military Hospital, Dhaka, Bangladesh
| | - Md. Shahadat Hossain
- Department of Physical Medicine and Rehabilitation, Shaheed Suhrawardy Medical College, Dhaka, Bangladesh
| | - Md. Hassanuzzaman
- Department of Neurology, Chittagong Medical College Hospital, Chattogram, Bangladesh
| | - Monirul Islam
- Department of Physical Medicine and Rehabilitation, National Institute of Traumatology and Orthopedic Rehabilitation, Dhaka, Bangladesh
| | - Moin Uddin Hossain Khan
- Department of Physical Medicine and Rehabilitation, National Institute of Traumatology and Orthopedic Rehabilitation, Dhaka, Bangladesh
| | - Sharif Ahmed
- Department of Physical Medicine and Rehabilitation, National Institute of Traumatology and Orthopedic Rehabilitation, Dhaka, Bangladesh
| | - Khurshid Mahmud
- Department of Physical Medicine and Rehabilitation, National Institute of Neurosciences and Hospital, Dhaka, Bangladesh
| | - Md. Rakibul Hasan
- Department of Physical Medicine and Rehabilitation, Dhaka Medical College, Dhaka, Bangladesh
| | - Anika Tasnim
- Department of Public Health and Informatics, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - M. Atiqul Haque
- Department of Public Health and Informatics, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| |
Collapse
|
14
|
Hong HA, Fallah N, Wang D, Cheng CL, Humphreys S, Parsons J, Noonan VK. Multimorbidity in persons with non-traumatic spinal cord injury and its impact on healthcare utilization and health outcomes. Spinal Cord 2023; 61:483-491. [PMID: 37604933 DOI: 10.1038/s41393-023-00915-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 05/24/2023] [Accepted: 07/12/2023] [Indexed: 08/23/2023]
Abstract
STUDY DESIGN Cross-sectional survey in Canada. OBJECTIVES To explore multimorbidity (the coexistence of two/more health conditions) in persons with non-traumatic spinal cord injury (NTSCI) and evaluate its impact on healthcare utilization (HCU) and health outcomes. SETTING Community-dwelling persons. METHODS Data from the Spinal Cord Injury Community Survey (SCICS) was used. A multimorbidity index (MMI) consisting of 30 secondary health conditions (SHCs), the 7-item HCU questionnaire, the Short Form-12 (SF-12), Life Satisfaction-11 first question, and single-item Quality of Life (QoL) measure were administered. Additionally, participants were grouped as "felt needed healthcare was received" (Group 1, n = 322) or "felt needed healthcare was not received" (Group 2, n = 89) using the HCU question. Associations among these variables were assessed using multivariable analysis. RESULTS 408 of 412 (99%) participants with NTSCI reported multimorbidity. Constipation, spasticity, and fatigue were the most prevalent self-reported SHCs. Group 1 had a higher MMI score compared to Group 2 (p < 0.001). A higher MMI score correlated with the feeling of not receiving needed care (OR 1.4, 95% CI 1.08-1.21), lower SF-12 (physical/mental component summary scores), being unsatisfied with life, and lower QoL (all p < 0.001). Additionally, Group 1 had more females (p < 0.001), non-Caucasians (p = 0.034), and lower personal annual income (p = 0.025). CONCLUSIONS Persons with NTSCI have multimorbidity, and the MMI score was associated with increased HCU and worse health outcomes. This work emphasizes the critical need for improved healthcare and monitoring. Future work determining specific thresholds for the MMI could be helpful for triage screening to identify persons at higher risk of poor outcomes.
Collapse
Affiliation(s)
- Heather A Hong
- Praxis Spinal Cord Institute, Vancouver, British Columbia, Canada
| | - Nader Fallah
- Praxis Spinal Cord Institute, Vancouver, British Columbia, Canada
- Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Di Wang
- Praxis Spinal Cord Institute, Vancouver, British Columbia, Canada
| | | | | | - Jessica Parsons
- Praxis Spinal Cord Institute, Vancouver, British Columbia, Canada
| | - Vanessa K Noonan
- Praxis Spinal Cord Institute, Vancouver, British Columbia, Canada.
- International Collaboration on Repair Discoveries, University of British Columbia, Vancouver, British Columbia, Canada.
| |
Collapse
|
15
|
Jia Z, Zeng H, Ye X, Dai M, Tang C, Liu L. Hydrogel-based treatments for spinal cord injuries. Heliyon 2023; 9:e19933. [PMID: 37809859 PMCID: PMC10559361 DOI: 10.1016/j.heliyon.2023.e19933] [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: 06/22/2023] [Revised: 09/05/2023] [Accepted: 09/06/2023] [Indexed: 10/10/2023] Open
Abstract
Spinal cord injury (SCI) is characterized by damage resulting in dysfunction of the spinal cord. Hydrogels are common biomaterials that play an important role in the treatment of SCI. Hydrogels are biocompatible, and some have electrical conductivity that are compatible with spinal cord tissues. Hydrogels have a high drug-carrying capacity, allowing them to be used for SCI treatment through the loading of various types of active substances, drugs, or cells. We first discuss the basic anatomy and physiology of the human spinal cord and briefly discuss SCI and its treatment. Then, we describe different treatment strategies for SCI. We further discuss the crosslinking methods and classification of hydrogels and detail hydrogel biomaterials prepared using different processing methods for the treatment of SCI. Finally, we analyze the future applications and limitations of hydrogels for SCI. The development of biomaterials opens up new possibilities and options for the treatment of SCI. Thus, our findings will inspire scholars in related fields and promote the development of hydrogel therapy for SCI.
Collapse
Affiliation(s)
- Zhiqiang Jia
- The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325200, China
| | - Huanxuan Zeng
- The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325200, China
| | - Xiuzhi Ye
- The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325200, China
| | - Minghai Dai
- The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325200, China
| | - Chengxuan Tang
- The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325200, China
| | - Liangle Liu
- The Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325200, China
| |
Collapse
|
16
|
Ghai S. Does Music Therapy Improve Gait after Traumatic Brain Injury and Spinal Cord Injury? A Mini Systematic Review and Meta-Analysis. Brain Sci 2023; 13:brainsci13030522. [PMID: 36979332 PMCID: PMC10046548 DOI: 10.3390/brainsci13030522] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 03/12/2023] [Accepted: 03/15/2023] [Indexed: 03/30/2023] Open
Abstract
There is a growing body of research examining the potential benefits of music therapy-based auditory stimulation (MT) for individuals with movement disorders in improving gait performance. However, there is limited knowledge about the effects of MT on gait outcomes in individuals with traumatic brain injury (TBI) or spinal cord injury (SCI). A previous review of MT's impact on gait in TBI had limitations, and there are no studies on its effects on gait in SCI. In this study, we conducted a meta-analysis to more thoroughly evaluate the impact of MT on gait outcomes in individuals with TBI and SCI. We systematically searched through eight databases and found six studies on MT in TBI and four on SCI. Our meta-analysis showed that MT has positive medium effect improvements on spatiotemporal aspects of gait in individuals with TBI (Hedge's g: 0.52) and SCI (0.53). These findings suggest that MT could be a practical intervention for enhancing different aspects of gait in these populations, although the limited number and "fair" quality of the studies included in the meta-analysis may affect the generalizability of the outcomes. Further research is needed to fully understand the mechanisms by which MT may influence gait and determine the optimal parameters for its use.
Collapse
Affiliation(s)
- Shashank Ghai
- Psychology of Learning and Instruction, Department of Psychology, School of Science, Technische Universität Dresden, 01069 Dresden, Germany
- Centre for Tactile Internet with Human-in-the-Loop (CeTI), Technische Universität Dresden, 01069 Dresden, Germany
| |
Collapse
|
17
|
Myokines may target accelerated cognitive aging in people with spinal cord injury: A systematic and topical review. Neurosci Biobehav Rev 2023; 146:105065. [PMID: 36716905 DOI: 10.1016/j.neubiorev.2023.105065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 01/23/2023] [Accepted: 01/25/2023] [Indexed: 01/29/2023]
Abstract
Persons with spinal cord injury (SCI) can suffer accelerated cognitive aging, even when correcting for mood and concomitant traumatic brain injury. Studies in healthy older adults have shown that myokines (i.e. factors released from muscle tissue during exercise) may improve brain health and cognitive function. Myokines may target chronic neuroinflammation, which is considered part of the mechanism of cognitive decline both in healthy older adults and SCI. An empty systematic review, registered in PROSPERO (CRD42022335873), was conducted as proof of the lack of current research on this topic in people with SCI. Pubmed, Embase, Cochrane and Web of Science were searched, resulting in 387 articles. None were considered eligible for full text screening. Hence, the effect of myokines on cognitive function following SCI warrants further investigation. An in-depth narrative review on the mechanism of SCI-related cognitive aging and the myokine-cognition link was added to substantiate our hypothetical framework. Readers are fully updated on the potential role of exercise as a treatment strategy against cognitive aging in persons with SCI.
Collapse
|