Post Doc Competition (Knowledge Generation) ID 1987817

IF 2.4 Q1 REHABILITATION
Thomas P. Walden, Shajaky Parameswaran, Louise Brisbois, B. C. Craven
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引用次数: 0

Abstract

Individuals with a neurologic level of injury (NLI) C1-T10 have an UMN bowel and propensity for external anal sphincter spasm and need chemical/mechanical stimuli to evacuate their bowels versus those with an NLI T11-S5 and LMN bowel whom have a patulous sphincter and complete manual bowel disimpaction. We describe the associations between independence in sphincter control for 5 years following discharge among individuals with traumatic SCI (tSCI). Adults with tSCI (n=113, 80 men) whom completed baseline, 1, 2, and 5-year community follow-up interviews (2014-2021) were included. Responses to the Spinal Cord Independence Measure (SCIM-III) Sphincter Control and Respiration subscores were extracted. Participants were separated into UMN and LMN groups. A linear mixed model determined longitudinal differences in SCIM subscores. NLI and follow-up time points were assigned as fixed effects, age a random effect, and sex as a covariate. Observed differences were compared to the minimal clinically importance difference (MCID) in SCIM-III subscores. The mean difference in SCIM-III subscores was 4.85 between the UMN and LMN bowel groups, with UMN group scoring lower at all-time points (p≤0.017). The mean group difference was equal to the MCID, constituting a substantial meaningful difference. No differences in SCIM subscores were noted across time (p≥0.9), regardless of NLI or bowel impairment. Self-reported sphincter control remains stable for 5 years post-injury, emphasizing the need to maximizing bowel independence before discharge. Individuals with UMN bowel have lower sphincter control scores than individuals with a LMN bowel.
博士后竞赛(知识生成) ID 1987817
神经损伤程度(NLI)为 C1-T10 的患者的肠道为 UMN 肠道,容易发生肛门外括约肌痉挛,需要通过化学/机械刺激排便,而神经损伤程度为 T11-S5 和 LMN 肠道的患者的括约肌松弛,可以完全手动排便。我们描述了创伤性 SCI(tSCI)患者出院后 5 年内括约肌控制独立性之间的关联。 我们纳入了完成基线、1年、2年和5年社区随访(2014-2021年)的成年创伤性脊髓损伤患者(人数=113,男性80人)。提取了脊髓独立性测量(SCIM-III)括约肌控制和呼吸子评分。参与者被分为 UMN 组和 LMN 组。线性混合模型确定了 SCIM 子分数的纵向差异。NLI 和随访时间点作为固定效应,年龄作为随机效应,性别作为协变量。将观察到的差异与 SCIM-III 子分数的最小临床重要性差异 (MCID) 进行比较。 UMN 和 LMN 肠道组 SCIM-III 子分数的平均差异为 4.85,UMN 组在所有时间点的得分都较低(P≤0.017)。平均组间差异等于 MCID,构成了有意义的实质性差异。无论 NLI 或肠道功能受损情况如何,SCIM 子分数在不同时期均无差异(p≥0.9)。 自我报告的括约肌控制能力在伤后五年内保持稳定,这强调了在出院前最大限度地提高肠道独立性的必要性。UMN肠患者的括约肌控制评分低于LMN肠患者。
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来源期刊
CiteScore
3.20
自引率
3.40%
发文量
33
期刊介绍: Now in our 22nd year as the leading interdisciplinary journal of SCI rehabilitation techniques and care. TSCIR is peer-reviewed, practical, and features one key topic per issue. Published topics include: mobility, sexuality, genitourinary, functional assessment, skin care, psychosocial, high tetraplegia, physical activity, pediatric, FES, sci/tbi, electronic medicine, orthotics, secondary conditions, research, aging, legal issues, women & sci, pain, environmental effects, life care planning
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