Spinal cordPub Date : 2024-04-03DOI: 10.1038/s41393-024-00979-6
Keira E. Tranter, Joanne V. Glinsky, Marsha Ben, Helen Patterson, Lynn Blecher, Jackie Chu, Lisa A. Harvey
{"title":"Using the benefit-harm trade-off method to determine the smallest worthwhile effect of intensive motor training on strength for people with spinal cord injury","authors":"Keira E. Tranter, Joanne V. Glinsky, Marsha Ben, Helen Patterson, Lynn Blecher, Jackie Chu, Lisa A. Harvey","doi":"10.1038/s41393-024-00979-6","DOIUrl":"10.1038/s41393-024-00979-6","url":null,"abstract":"Interviews using the benefit-harm trade-off method and an online survey. To determine the smallest worthwhile effect (SWE) of motor training on strength for people with spinal cord injury (SCI). SCI units, Australia. Forty people with recent SCI who had participated in motor training as part of their rehabilitation program (patient participants) and 37 physiotherapists (physiotherapist participants) working in SCI were recruited. The patient participants underwent an iterative process using the benefit-harm trade-off method to determine the SWE of motor training on strength. The physiotherapist participants were given an online survey to determine the SWE for five different scenarios. Both groups considered the SWE of a physiotherapy intervention involving an additional 12 h of motor training for 10 weeks on top of usual care. They were required to estimate the smallest improvement in strength (points on the Total Motor Score of the International Standards for Neurological Classification of SCI) to justify the effort and associated costs, risks or inconveniences of the motor training. The median (interquartile range) smallest improvement in strength that patient and physiotherapist participants deemed worth the effort and associated costs, risks or inconveniences of the motor training was 3 (1–5) points, and 9 (7–13) points, respectively. People with recent SCI are willing to devote 12 h a week for 10 weeks to motor training in addition to their usual care to gain small changes in strength. Physiotherapists wanted to see greater improvements to justify the intervention.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"62 6","pages":"314-319"},"PeriodicalIF":2.1,"publicationDate":"2024-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41393-024-00979-6.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140561733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Spinal cordPub Date : 2024-04-03DOI: 10.1038/s41393-024-00989-4
Auwal Bello Hassan, Auwal Abdullahi, Musa Sani Danazumi
{"title":"A response to “Toward a better understanding and terminology of transcutaneous spinal cord stimulation”","authors":"Auwal Bello Hassan, Auwal Abdullahi, Musa Sani Danazumi","doi":"10.1038/s41393-024-00989-4","DOIUrl":"10.1038/s41393-024-00989-4","url":null,"abstract":"","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"62 6","pages":"273-274"},"PeriodicalIF":2.1,"publicationDate":"2024-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140561734","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}
Spinal cordPub Date : 2024-04-02DOI: 10.1038/s41393-024-00985-8
Marsha Ben, Federica Tamburella, Matteo Lorusso, Joanne V. Glinsky, Keira E. Tranter, Giorgio Scivoletto, Lynn Blecher, Anneliese Harris, Giovanni Galeoto, Joshua Wan, Lisa A. Harvey
{"title":"A therapist-administered self-report version of the Walking Index for Spinal Cord Injury II (WISCI): a psychometric study","authors":"Marsha Ben, Federica Tamburella, Matteo Lorusso, Joanne V. Glinsky, Keira E. Tranter, Giorgio Scivoletto, Lynn Blecher, Anneliese Harris, Giovanni Galeoto, Joshua Wan, Lisa A. Harvey","doi":"10.1038/s41393-024-00985-8","DOIUrl":"10.1038/s41393-024-00985-8","url":null,"abstract":"To develop a self-report version of the Walking Index for Spinal Cord Injury II (WISCI II) and to test its reliability and validity. Psychometric study. Spinal cord injury (SCI) rehabilitation centres in Australia and Italy. Eighty people with SCI were recruited from a sample of convenience. Two self-report versions of the WISCI II were developed. Both versions were administered in English at the Australian site, and in Italian at the Italian site through an online platform. The format of the first self-report version (SR-V1) was similar to the original face-to-face WISCI II. The second self-report version (SR-V2) had more questions, but each question required participants to focus on one aspect of walking at a time. Participants completed SR-V1 and SR-V2 with assistance from research physiotherapists on two separate occasions, three to seven days apart. The original WISCI II was then administered through a face-to-face assessment by an independent physiotherapist. The intra-rater reliability and validity of SR-V1 and SR-V2 were determined with intraclass correlation coefficients (ICC) and percent close agreements. The data from the Australian and Italian sites were pooled. The validity and reliability of the two self-report versions were very similar, with SR-V2 performing slightly better than SR-V1. The ICC (95% confidence interval) of SR-V2 was 0.87 (0.81–0.92). The ICC reflecting the agreement between the self-report and the face-to-face WISCI was 0.89 (0.84–0.93). Both versions of the self-report WISCI II provide a reasonable substitute for a face-to-face assessment although therapists preferred SR-V2.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"62 6","pages":"307-313"},"PeriodicalIF":2.1,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41393-024-00985-8.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140561706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Long-term trends and risk factors of tracheostomy and decannulation in patients with cervical spinal cord Injury","authors":"Lianjun Gao, Wei Gao, Hongwei Liu, Changbin Liu, Feng Yang, Qimin Wang, Weichao Zhao, Zhaohui Tong","doi":"10.1038/s41393-024-00968-9","DOIUrl":"10.1038/s41393-024-00968-9","url":null,"abstract":"Retrospective study. To investigate the risk factors of tracheostomy and decannulation after cervical spinal cord injury (CSCI) and their epidemiological changes over the past 8 years in Beijing Bo’ai Hospital, China Rehabilitation Research Center (CRRC), China. Beijing Bo’ai Hospital, CRRC. We reviewed 8 years of patient data (2013.1.1 to 2020.12.31) at CRRC, focusing on those hospitalized and diagnosed with CSCI. We analyzed changes in demographic and clinical data’s trends. Logistic regression analysis was used to determine factors impacting tracheostomy and decannulation. Finally, 1641 CSCI patients met the inclusion criteria. Over the past 8 years, the proportion of tracheostomized patients with CSCI was 16.3%, and the proportion of successfully decannulated of tracheostomized patients with TCSCI was 77.9%. We found that Traumatic (OR = 1.8, 95% CI = 1.06, 3.22; p = 0.046), Motor level of injury (C5–C8) (OR = 0.32, 95% CI = −1.91,−0.34; p = 0.005), AIS = A/B/C (OR = 22.7/11.1/4.2, 95% CI = 12.16,42.26/5.74,21.56/2.23,7.89; p < 0.001/p < 0.001/p < 0.001), age > 56 (OR = 1.6, 95% CI = 1.04, 2.32; p = 0.031) were the risk factors for tracheostomy. By analyzing the risk factors of decannulation failure in tracheostomized patients with TCSCI through multivariable logistic regression, statistically significant differences were found in age > 45 (OR = 4.1, 95% CI = 1.44, 11.81; p = 0.008), complete injury (OR = 2.7, 95% CI = 1.26, 5.95; p = 0.011), facet dislocation (OR = 2.8, 95% CI = 1.13,7.07; p = 0.027). Recent years have witnessed shifts in the epidemiological characteristics of CSCI. Identifying the factors influencing tracheostomy and decannulation in CSCI can aid in improving patient prognosis.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"62 6","pages":"300-306"},"PeriodicalIF":2.1,"publicationDate":"2024-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140330133","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}
Spinal cordPub Date : 2024-03-28DOI: 10.1038/s41393-024-00973-y
Thomas Anand Augustine, Henry Prakash M, Suceena Alexander, Mahasampath Gowri S
{"title":"Assessment of renal function in persons with motor complete spinal cord injury—cystatin C as an accurate single marker","authors":"Thomas Anand Augustine, Henry Prakash M, Suceena Alexander, Mahasampath Gowri S","doi":"10.1038/s41393-024-00973-y","DOIUrl":"10.1038/s41393-024-00973-y","url":null,"abstract":"Observational cohort. To show that Cystatin C is an accurate single marker to estimate GFR in motor complete persons with SCI. To assess if Cystatin C is an accurate for estimating GFR in persons with SCI with no preserved motor power. To study if use of Serum creatinine for estimation of GFR in this population significantly overestimates GFR, thereby inaccurate. Tertiary care hospital and Medical College, Vellore, South India. 30 persons with SCI (ASIA A and B) fulfilling the inclusion criteria were recruited. Serum Creatinine and Serum Cystatin C values were obtained, and eGFR was calculated based on available formulae. 24-h urine for urine creatinine clearance-based eGFR was used as a reference value. Analysis with a Bland-Atman plot showed that eGFR estimated with Serum Cystatin C was more accurate than Serum Creatinine, using 24-h urine creatinine as a reference value. eGFR using Serum Creatinine significantly overestimated GFR by over 50.6%. Estimated GFR using Serum Cystatin C showed a meager mean difference of 0.5% from the reference 24-h urine creatinine clearance (mean difference of –2.56%). Serum Cystatin C is a much more accurate marker for estimating GFR in SCI, compared to serum Creatinine which overestimates GFR.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"62 6","pages":"295-299"},"PeriodicalIF":2.1,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140313476","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}
Spinal cordPub Date : 2024-03-22DOI: 10.1038/s41393-024-00977-8
Reed Handlery, Kaci Handlery, Dana Kahl, Lyndsie Koon, Elizabeth W. Regan
{"title":"High intensity functional training for people with spinal cord injury & their care partners","authors":"Reed Handlery, Kaci Handlery, Dana Kahl, Lyndsie Koon, Elizabeth W. Regan","doi":"10.1038/s41393-024-00977-8","DOIUrl":"10.1038/s41393-024-00977-8","url":null,"abstract":"Non-randomized clinical trial. Examine the feasibility, physical and psychosocial effects of a high intensity functional training (HIFT) exercise program for people with spinal cord injury (pSCI) and their care partners (CPs). Community fitness center in a Medically Underserved Area (Fort Smith, USA.) A single-group design with three assessment points (before the program, at midpoint (13 weeks), and post-program (25 weeks) was used to examine the effects of up to 49 HIFT sessions over 25-weeks. Sessions were 60 to 75 min in duration and adapted to the abilities of participants. Feasibility measures included recruitment, retention, attendance, safety and fidelity (exercise intensity rated via session-Rating of Perceived Exertion (RPE). Physical measures included cardiovascular endurance, anaerobic power, and muscular strength. Psychosocial measures included perceived social support for exercise, exercise self-efficacy and health-related quality of life. Fourteen pSCI (7 with paraplegia and 7 with tetraplegia, 2 females) and 6 CPs (4 females) were included (median age = 60) (IQR = 15.8). Recruitment rates were 40% for pSCI and 32% for CPs. On average, participants attended 73% (22%) of exercise sessions with a median session-RPE of 5 (IQR = 1). Retention rates were 83% and 67% for pSCI and CPs, respectively. For pSCI and their CPs, large effect sizes were observed for cardiovascular endurance, anaerobic power, muscular strength, and social support for exercise. For pSCI and their CPs, HIFT appears feasible and potentially leads to improvements in physical and psychosocial health for both groups.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"62 7","pages":"357-366"},"PeriodicalIF":2.1,"publicationDate":"2024-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41393-024-00977-8.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140194546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Spinal cordPub Date : 2024-03-22DOI: 10.1038/s41393-024-00983-w
Samford Wong, Shashivadan P. Hirani, Alastair Forbes, Naveen Kumar, Ramaswamy Hariharan, Jean O’Driscoll, Ravi Sekhar, Ali Jamous
{"title":"Lactobacillus casei Shirota probiotic drinks reduce antibiotic associated diarrhoea in patients with spinal cord injuries who regularly consume proton pump inhibitors: a subgroup analysis of the ECLISP multicentre RCT","authors":"Samford Wong, Shashivadan P. Hirani, Alastair Forbes, Naveen Kumar, Ramaswamy Hariharan, Jean O’Driscoll, Ravi Sekhar, Ali Jamous","doi":"10.1038/s41393-024-00983-w","DOIUrl":"10.1038/s41393-024-00983-w","url":null,"abstract":"This was a sub-group analysis of a multicentre, randomised, placebo-controlled, double-blind trial (ECLISP trial) To assess the efficacy of a probiotic containing at least 6.5 × 109 live Lactobacillus casei Shirota (LcS) in preventing antibiotic associated diarrhoea (AAD) in patients with spinal cord injury (SCI) who consumed proton pump inhibitor (PPI) regularly. LcS or placebo was given once daily for the duration of an antibiotic course and continued for 7 days thereafter. The trial was registered with ISRCTN:13119162. Three SCI centres (National Spinal Injuries Centre, Midland Centre for Spinal Injuries and Princess Royal Spinal Cord Injuries Centre) in the United Kingdom Between November 2014, and November 2019, 95 eligible consenting SCI patients (median age: 57; IQ range: 43-69) were randomly allocated to receive LcS (n = 50) or placebo (n = 45). The primary outcome is the occurrence of AAD up to 30 days after finishing LcS/placebo. The LcS group had a significantly lower incidence of AAD at 30 days after finishing the antibiotic course (28.0 v 53.3%, RR: 95% CI: 0.53, 0.31–0.89; z = 2.5, p = 0.01). Multivariate logistic regression analysis identified that LcS can reduce the risk of AAD at 30 days (OR: 0.36, 95% CI 0.13, 0.99, p < 0.05). No intervention-related adverse events were reported during the study. LcS has the potential to prevent AAD in what could be considered a defined vulnerable group of SCI patients on regular PPI. A confirmatory, randomised, placebo-controlled study is needed to confirm this apparent therapeutic success to translate it into appropriate clinical outcomes. Yakult Honsha Co., Ltd.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"62 5","pages":"255-263"},"PeriodicalIF":2.2,"publicationDate":"2024-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41393-024-00983-w.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140194547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Spinal cordPub Date : 2024-03-22DOI: 10.1038/s41393-024-00984-9
Libak Abou, Oriol Martinez-Navarro, Anna Kratz
{"title":"Satisfaction with social roles and activities across mobility status among persons with spinal cord injury","authors":"Libak Abou, Oriol Martinez-Navarro, Anna Kratz","doi":"10.1038/s41393-024-00984-9","DOIUrl":"10.1038/s41393-024-00984-9","url":null,"abstract":"Cross-sectional study. To examine the differences in satisfaction with social roles and activities among ambulatory individuals, manual wheelchair users, and power wheelchair users with spinal cord injuries (SCIs). Community setting. Participants completed surveys of their demographics and clinical data as well as the Spinal Cord Injury – Quality of Life Satisfaction with Social Roles and Activities- Short Form. Participants’ mobility status was categorized into (1) ambulatory individuals, (2) independent manual wheelchair users, and (3) power wheelchair/scooter users. One-way ANOVA and ANCOVA were used, respectively, to examine unadjusted and adjusted differences in satisfaction with social roles and activities across mobility status. Adjustment covariates included age, sex, time since SCI, and SCI injury level. A total of 129 participants (mean age = 47.4 ± 13.6 years, 73% male) were included in the analyses. Unadjusted (F = 3.8, p = 0.03) and adjusted models (F = 3.4, p = 0.04) evidenced significant differences in satisfaction with social roles and activities according to mobility status. Pairwise Bonferroni Post-Hoc analysis indicated that manual wheelchair users were more satisfied with their social roles and activities when compared to ambulatory individuals (mean difference = 2.8, p < 0.05). Due to the current challenges associated with walking recovery after SCIs, clinicians may want to discuss the use of wheelchairs with individuals with limited walking ability when the goal is to improve participation and quality of life. Emphasizing alternative means of mobility may enhance satisfaction with social roles and activities.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"62 5","pages":"264-269"},"PeriodicalIF":2.2,"publicationDate":"2024-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140194548","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}
Spinal cordPub Date : 2024-03-20DOI: 10.1038/s41393-024-00978-7
Jing Chen
{"title":"Correspondence to “Relationship between employment and quality of life and self-perceived health in people with spinal cord injury: an international comparative study based on the InSCI community survey”","authors":"Jing Chen","doi":"10.1038/s41393-024-00978-7","DOIUrl":"10.1038/s41393-024-00978-7","url":null,"abstract":"","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"62 5","pages":"270-271"},"PeriodicalIF":2.2,"publicationDate":"2024-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140176545","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}
Spinal cordPub Date : 2024-03-20DOI: 10.1038/s41393-024-00982-x
Karin Postma, Tijn van Diemen, Marcel W. M. Post, Janneke M. Stolwijk-Swüste, Rita J. G. van den Berg-Emons, Rutger Osterthun
{"title":"Correlates of physical activity in ambulatory people with spinal cord injury during the first year after inpatient rehabilitation","authors":"Karin Postma, Tijn van Diemen, Marcel W. M. Post, Janneke M. Stolwijk-Swüste, Rita J. G. van den Berg-Emons, Rutger Osterthun","doi":"10.1038/s41393-024-00982-x","DOIUrl":"10.1038/s41393-024-00982-x","url":null,"abstract":"Longitudinal cohort study. Examine the longitudinal association between mobility and level of physical activity (PA) and explore which other factors are also associated with level of PA in ambulatory people with Spinal Cord Injury (SCI) during the first-year post-inpatient rehabilitation. Three SCI-specialized rehabilitation centers and the Dutch community. Forty-seven adults with recent SCI and ambulatory function were included. All had motor incomplete lesions, 49% had tetraplegia, and the mean age was 55 ± 13 years. Duration of accelerometry-based all-day PA and self-reported level of mobility, exertion of walking, pain, fatigue, depressive mood symptoms, fear of falling, exercise self-efficacy, and attitude toward PA were measured just before discharge from inpatient rehabilitation and 6 and 12 months after discharge. All data were longitudinally analyzed using generalized estimating equations analyses. Models were corrected for age, lesion level, and time since injury. Mobility was longitudinally associated with level of PA (beta: 4.5, P < 0.001, R2: 41%). In addition, lower levels of exertion of walking (beta: −5.6, P < 0.001), fear of falling (beta: −34.1, P < 0.001), and higher levels of exercise self-efficacy (beta: 2.3, P = 0.038) were associated with higher levels of PA. Exertion of walking and fear of falling were associated with level of PA independent of mobility. Mobility, exertion of walking, fear of falling, and exercise self-efficacy seem to be correlates of level of PA in ambulatory people with SCI during the first year after inpatient rehabilitation. Targeting these factors using an interdisciplinary approach may enhance levels of PA in this population.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"62 5","pages":"249-254"},"PeriodicalIF":2.2,"publicationDate":"2024-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140176544","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}