IF 2.1 4区医学

Spinal cord Pub Date : 2024-11-19 DOI: 10.1038/s41393-024-01048-8

Yongqi Xie, Weichao Zhao, Run Peng, Liang Zhang, Yunxiao Jia, Mingliang Yang, Lianjun Guo

{"title":"The influencing factors for tracheostomy decannulation after traumatic cervical spinal cord injury: a retrospective study.","authors":"Yongqi Xie, Weichao Zhao, Run Peng, Liang Zhang, Yunxiao Jia, Mingliang Yang, Lianjun Guo","doi":"10.1038/s41393-024-01048-8","DOIUrl":"https://doi.org/10.1038/s41393-024-01048-8","url":null,"abstract":"Study design: Retrospective study.Objective: To investigate the outcomes and influencing factors of tracheostomy decannulation (TD) in persons with traumatic cervical spinal cord injury (SCI).Setting: China Rehabilitation Research Center (CRRC) in Beijing, China.Methods: From January 2017 to December 2021, 365 persons with traumatic cervical SCI were admitted to the China Rehabilitation Research Center. During hospitalization, tracheostomy patients were enrolled and divided into the TD group and non-TD group. Demographic and clinical data, as well as functional assessments, were collected and recorded for all persons. The factors influencing TD were analyzed using both univariate and multivariate logistic regression.Results: A total of 78 persons with traumatic cervical SCI from CRRC were enrolled in this study. Of these, 48 persons (61.5%) underwent successful decannulation, with a median time of 93.5 days (IQR: 62.0-143.8 days). Multivariate logistic regression revealed that AIS A (P = 0.021, OR: 5.378, 95% CI, 1.287-22.474) and Charlson comorbidity index (CCI) (P = 0.003, OR: 1.836, 95% CI, 1.230-2.740) were significant risk factors of reduced success in TD. PEF in the TD group was 145.44 ± 50.56 L/min. Middle-aged and young persons with traumatic cervical SCI at C3 to C5 neurological level did not satisfy the criterion of PEF (over 160 L/min), but they can still attempt tracheostomy decannulation.Conclusion: AIS A and a high CCI will reduce the success rate of tracheostomy decannulation in persons suffering from traumatic cervical SCI.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142676825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

"What should a rehabilitation hospital be like?" Priorities and expectations of people with spinal cord injury in Türkiye. "康复医院应该是什么样的？土耳其脊髓损伤患者的优先事项和期望。

IF 2.1 4区医学

Spinal cord Pub Date : 2024-11-15 DOI: 10.1038/s41393-024-01049-7

Mucahit Atasoy, Eser Kalaoglu, Omer Faruk Bucak, Evrim Coskun

{"title":"\"What should a rehabilitation hospital be like?\" Priorities and expectations of people with spinal cord injury in Türkiye.","authors":"Mucahit Atasoy, Eser Kalaoglu, Omer Faruk Bucak, Evrim Coskun","doi":"10.1038/s41393-024-01049-7","DOIUrl":"https://doi.org/10.1038/s41393-024-01049-7","url":null,"abstract":"Study design: Survey study OBJECTIVES: To understand the priorities and expectations of individuals with disabilities caused by spinal cord injuries(SCI) who require long-term inpatient rehabilitation at a rehabilitation hospital.Setting: Başakşehir Çam and Sakura City Hospital, İstanbul, Türkiye METHODS: This cross-sectional clinical study included individuals over the age of 18 with SCI who had previously been hospitalized in a rehabilitation hospital. The 18-question survey, titled \"What should a rehabilitation hospital be like according to persons with spinal cord injuries?\" was administered to individuals hospitalized in the inpatient service of Çam Sakura City Hospital. It was also disseminated to people with SCI through social media. The participants' demographic data was recorded.Results: The survey was completed by 120 participants, comprising 70 males and 50 females. The mean age was 37.47 ± 11.63 years. The time since the SCI was less than one year for 20 individuals and more than one year for 100 individuals. The results showed that robotic rehabilitation and psychological support were the most requested rehabilitation domains, while interest in sexual rehabilitation was less than that in other rehabilitation domains. Furthermore, in the correlation analysis, elderly participants indicated that there should be more specialized services and outpatient clinics exclusive to the SCI.Conclusions: The study revealed a striking trend - participants expressed a strong desire for SCI-specific rehabilitation units and robotic rehabilitation. Additionally, the significance and necessity of sexual rehabilitation should be conveyed to people with SCI.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142639644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The effect of abdominal functional electrical stimulation on blood pressure in people with high level spinal cord injury. 腹部功能性电刺激对高位脊髓损伤患者血压的影响。

IF 2.1 4区医学

Spinal cord Pub Date : 2024-11-01 DOI: 10.1038/s41393-024-01046-w

Teodora Bojanic, Euan J McCaughey, Harrison T Finn, Peter Humburg, Rachel A McBain, Bonsan B Lee, Simon C Gandevia, Claire L Boswell-Ruys, Jane E Butler

{"title":"The effect of abdominal functional electrical stimulation on blood pressure in people with high level spinal cord injury.","authors":"Teodora Bojanic, Euan J McCaughey, Harrison T Finn, Peter Humburg, Rachel A McBain, Bonsan B Lee, Simon C Gandevia, Claire L Boswell-Ruys, Jane E Butler","doi":"10.1038/s41393-024-01046-w","DOIUrl":"https://doi.org/10.1038/s41393-024-01046-w","url":null,"abstract":"Study design: Single centre training study.Objectives: To investigate, in a group of people with spinal cord injury (SCI), the effect of transcutaneous functional electrical stimulation of the abdominal muscles (abdominal FES) during cough training on blood pressure (BP), and how it is affected by injury characteristics and alters over time.Setting: Laboratory and community.Methods: Sixteen participants with SCI (C4-T5) underwent 25 of abdominal FES cough training (5 sets of 10 stimulated coughs) over 6 weeks as part of a previously published study on the effect of abdominal FES training on cough. Systolic BP (SBP), diastolic BP (DBP) and calculated mean arterial pressure (MAP) were measured at the completion of each set.Results: Abdominal FES coughing resulted in an average ~30% acute increase in BP from initial resting BP across all sessions in almost all participants (p < 0.001). However, the increase in BP during abdominal FES coughs from rest reduced over the 25 sessions of training by ~35% for SBP, MAP and DBP (p = 0.024, p = 0.013 and p = 0.042, respectively). There was no meaningful change in resting BP over time (p = 0.935, p = 0.705 and p = 0.988, respectively). Overall, increases in BP during abdominal FES coughs were greatest for those with chronic injuries and cervical injuries.Conclusions: Transcutaneous abdominal FES during cough training acutely increases BP. However, the magnitude of the increase is reduced after 25 sessions of training. Abdominal FES may offer a solution to combat orthostatic hypotension, but its effectiveness may diminish over time.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142565091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Mortality and causes of death of traumatic spinal cord injury in Finland. 芬兰外伤性脊髓损伤的死亡率和死亡原因。

IF 2.1 4区医学

Spinal cord Pub Date : 2024-10-30 DOI: 10.1038/s41393-024-01047-9

Elina Johansson, Eerika Koskinen, Mika Helminen, Aki Vainionpää, Teemu M Luoto

{"title":"Mortality and causes of death of traumatic spinal cord injury in Finland.","authors":"Elina Johansson, Eerika Koskinen, Mika Helminen, Aki Vainionpää, Teemu M Luoto","doi":"10.1038/s41393-024-01047-9","DOIUrl":"https://doi.org/10.1038/s41393-024-01047-9","url":null,"abstract":"Study design: Prospective cohort study.Objectives: To study the mortality rates of TSCI patients compared to matched controls and to examine possible TSCI-related mortality risk factors and causes of death.Setting: Oulu and Tampere University Hospital, Finland.Methods: All consecutive patients with a new TSCI were included in a prospective study (n = 344, 2012-16). All patients were followed until death or the end of 2019. Patients were compared to a control group formed by randomly choosing gender, age, municipality, and calendar time-matched controls (5 controls/TSCI patient). Standardized mortality ratios (SMR) were calculated using general population mortality rates. Mortality information was extracted from the Statistics of Finland (Helsinki, Finland).Results: TSCI patients had an increased mortality (SMR = 2.9) compared with the Finnish population. During the observation period, 26% of TSCI patients and 12% of the matched controls died. Of the TSCI patient deaths, 51% occurred within the first two years postinjury. Increased age, severity of TSCI (as per International SCI Core Data Set) and fall were related to mortality (p < 0.05). The two most common etiologies of death were: circulatory (30%), and pulmonary diseases (28%). Pneumonia was the single most frequent disease leading to death among TSCI patients.Conclusions: During the first years after injury, the mortality of the patients with TSCI is double compared to the controls. Most deaths occur within two years postinjury. Elderly patients with more severe fall-related injury have the highest mortality risk. Circulatory diseases and pulmonary diseases, especially pneumonia, are the foremost causes of death after TSCI.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142547551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Correspondence to "Walking improvement in chronic incomplete spinal cord injury with exoskeleton robotic training (WISE): a randomized controlled trial". 通讯："通过外骨骼机器人训练（WISE）改善慢性不完全脊髓损伤患者的行走能力：随机对照试验"。

IF 2.1 4区医学

Spinal cord Pub Date : 2024-10-28 DOI: 10.1038/s41393-024-01043-z

Meriç Selim Şipal

引用次数: 0

Response: Use of the WISCI-II score in assessing outcome of intensive robot-assisted gait training in spinal cord injury. 回应：使用 WISCI-II 评分评估脊髓损伤患者强化机器人辅助步态训练的效果。

IF 2.1 4区医学

Spinal cord Pub Date : 2024-10-28 DOI: 10.1038/s41393-024-01044-y

D J Edwards, A Jayaraman

引用次数: 0

Learning to direct one's care: barriers and facilitators reported by people with tetraplegia. 学习指导自己的护理：四肢瘫痪者报告的障碍和促进因素。

IF 2.1 4区医学

Spinal cord Pub Date : 2024-10-26 DOI: 10.1038/s41393-024-01045-x

Jeanne M Zanca, Carol M Gibson-Gill, Joyce Williams, Tomicka McMillion, John T Morris, Marcel P Dijkers

{"title":"Learning to direct one's care: barriers and facilitators reported by people with tetraplegia.","authors":"Jeanne M Zanca, Carol M Gibson-Gill, Joyce Williams, Tomicka McMillion, John T Morris, Marcel P Dijkers","doi":"10.1038/s41393-024-01045-x","DOIUrl":"https://doi.org/10.1038/s41393-024-01045-x","url":null,"abstract":"Study design: Qualitative analysis of focus group data.Objective: Identifying barriers to and facilitators of learning to direct one's own care as a person with tetraplegia due to spinal cord injury (SCI).Setting: Community, in New Jersey and Georgia, USA.Methods: Three focus groups of veterans and civilians with SCI, involving 26 people with chronic (≥1 year) tetraplegia due to SCI who provided direction to caregivers on a daily basis. Content analysis was used to identify barriers and facilitators.Results: Challenges to learning to direct one's care included: (1) lack of acceptance of lasting effects of SCI; (2) not yet understanding one's body post-SCI; (3) embarrassment; (4) being overwhelmed with information; (5) differences between the inpatient rehabilitation setting and the \"real world\"; (6) lack of capable and willing assistants; and (7) hesitance to criticize caregivers. Factors that helped participants become successful directors of care included: (1) experience living with SCI; (2) being observant; (3) communicating effectively; (4) developing confidence to advocate for one's own needs; (5) learning when to \"let go\" and when to speak up; and (6) learning from peers.Conclusions: Direction of care is a complex skill that is developed over time, and requires awareness of one's needs and preferences, self-confidence, and strong communication skills. Rehabilitation clinicians' efforts to prepare people with SCI to direct their own care effectively should cultivate awareness of one's body, identify strategies for communicating successfully with caregivers, and provide opportunities for practice of care direction skills and discussion with experienced peers.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142508287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Is neck pain a marker for something serious? Like myelopathy. 颈部疼痛是严重疾病的标志吗？比如脊髓病变。

IF 2.1 4区医学

Spinal cord Pub Date : 2024-10-14 DOI: 10.1038/s41393-024-01041-1

Alisha W Sial, Stone Sima, Rajpal Narulla, Nashwa Najib, Mark Davies, Ashish D Diwan

引用次数: 0

Does the presence or absence of preoperative lower extremity neurologic symptoms influence postoperative clinical outcome in patients with cervical intradural extramedullary tumors?: a single-center retrospective comparative study. 颈椎硬膜外肿瘤患者术前有无下肢神经症状会影响术后临床预后吗：一项单中心回顾性比较研究。

IF 2.1 4区医学

Spinal cord Pub Date : 2024-10-09 DOI: 10.1038/s41393-024-01042-0

Toshiki Okubo, Narihito Nagoshi, Takahito Iga, Kazuki Takeda, Masahiro Ozaki, Satoshi Suzuki, Morio Matsumoto, Masaya Nakamura, Kota Watanabe

{"title":"Does the presence or absence of preoperative lower extremity neurologic symptoms influence postoperative clinical outcome in patients with cervical intradural extramedullary tumors?: a single-center retrospective comparative study.","authors":"Toshiki Okubo, Narihito Nagoshi, Takahito Iga, Kazuki Takeda, Masahiro Ozaki, Satoshi Suzuki, Morio Matsumoto, Masaya Nakamura, Kota Watanabe","doi":"10.1038/s41393-024-01042-0","DOIUrl":"https://doi.org/10.1038/s41393-024-01042-0","url":null,"abstract":"Study design: Retrospective comparative study OBJECTIVES: To investigate whether the presence or absence of preoperative lower extremities neurological symptoms (LENS) influences clinical outcomes following tumor resection in patients with cervical intradural extramedullary (IDEM) tumors.Setting: The single institution in Japan.Methods: Ninety-two patients with cervical IDEM tumors requiring surgical resection were included. Based on the degree of preoperative LENS assessed using the modified McCormick scale (MMCS), patients were categorized into LENS (-) and (+) groups. Demographic and surgical characteristics were compared between both groups.Results: There were no significant differences observed in sex, tumor location, tumor size, surgical time, estimated blood loss, approach for tumorectomy, or tumor histopathology between the two groups. Additionally, the overall surgical outcomes were favorable for both groups. At the final follow-up, 91.1% of the patients in the LENS (+) group were able to walk without support. Improvement in LENS was observed after surgery in most patients with preoperative MMCS II-IV, but it persisted in approximately 40% of patients with preoperative MMCS V. In the LENS (+) group, there were no significant differences in demographic or surgical data between the patients with MMCS I and II-III at the final follow-up.Conclusions: Regardless of the presence or absence of preoperative LENS, clinical improvement was observed after tumor resection in most patients with cervical IDEM tumors. These findings suggest that neurological status is likely to improve sufficiently if tumor resection is performed before preoperative LENS deteriorates to an extremely severe stage as MMCS V.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142393480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Disability trajectories individuals with spinal cord injury in mainland China: do psychosocial resources and diseases factors predict trajectories? 中国大陆脊髓损伤患者的残疾轨迹：社会心理资源和疾病因素能否预测残疾轨迹？

IF 2.1 4区医学

Spinal cord Pub Date : 2024-10-08 DOI: 10.1038/s41393-024-01040-2

Hui Huang, Mengmeng Chen, Peipei Ding, Xiaoxiao Xia, Qing Dai, Linsheng Feng, Li Xu, Junmei Shu, Lunlan Li

{"title":"Disability trajectories individuals with spinal cord injury in mainland China: do psychosocial resources and diseases factors predict trajectories?","authors":"Hui Huang, Mengmeng Chen, Peipei Ding, Xiaoxiao Xia, Qing Dai, Linsheng Feng, Li Xu, Junmei Shu, Lunlan Li","doi":"10.1038/s41393-024-01040-2","DOIUrl":"https://doi.org/10.1038/s41393-024-01040-2","url":null,"abstract":"Study design: Observational cohort study.Objective: To identify classes of disability trajectories from 1 month post-injury (acute hospital) to 6 months post-injury (individuals with SCI individuals who stay in rehabilitation setting or back in the community), and to investigate whether psychosocial resources and disease factors can predict disability trajectory.Setting: Spinal surgery in three Class III hospitals. Hospitals in China are divided into three classes (Class I, II and III).Methods: All the participants were submitted to WHO Disability Assessment Schedule (WHO-DAS 2.0) at three times; and personal data anamnesis, level of hope, level of PTSD, level of social support were recorded at first time. All the data collected by the master's students who participated in this study.Results: Two disability trajectories were identified using the latent class growth model: the continuous high disability group (N = 196, 93.3%) and the low starting point stabilization group (N = 14, 6.7%). Complete injury(ASIA-A) with SCI and more depression in the stable condition after SCI surgery were more likely to be classified as having higher disability than those with a lower disability trajectory. Occupation, annual family income, hope, social support, and Post-traumatic Stress Disorder (PTSD) cannot predict individuals belonging to trajectory classes.Conclusion: These findings emphasize the importance of ASIA and depression in the early recovery stage after SCI and support the opinion that strengthening psychological nursing and rehabilitation management at an early stage after SCI will benefit individuals with a lower disability trajectory.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142393479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

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