Spinal cord最新文献

{"title":"Motor-cognitive interaction in adults with spina bifida: dual-task effects","authors":"Martina Bendt, Emelie Butler Forslund, Göran Hagman, Urban Ekman, Lucian Bezuidenhout, Hanna Johansson, Anders Rydström, Claes Hultling, Åke Seiger, Erika Franzén","doi":"10.1038/s41393-025-01099-5","DOIUrl":"10.1038/s41393-025-01099-5","url":null,"abstract":"Cross-sectional design. To study motor-cognitive interaction during walking while performing a cognitive task (dual-task [DT]) in ambulatory adults with spina bifida (SB). A specialized spinal cord center, The Spinalis clinic at Aleris Rehab Station Stockholm, Sweden. Assessments of muscle strength and ambulatory function were performed. Gait was assessed with a sensor-based system with/without the auditory Stroop. Timed-up-and-go (TUG) with/without a cognitive task was also assessed. Regarding cognitive function, episodic memory, executive function, and processing speed were assessed. The percentage of difference between single-task (ST) and dual-task (DT) was used to calculate the DT effect (DTE) as cost or benefit. Differences were analyzed with t-test and Wilcoxon’s signed rank test. Forty-one persons were included, mean age 37 years (SD 12) and 20 (49%) were women. Thirty-four completed the DTE analysis. Seven could not perform the cognitive task and/or gait data and could not be registered. There was a DT cost on gait speed (4%), stride length (3%) and double support phase (3%), and cognitive function showed a cost of 3%. DTE for TUG was a 26% cost. We showed a DT cost on gait, possibly indicating fall risk during DT walking. The largest DT cost was seen during TUG with a cognitive task, indicating a valuable clinical test for motor-cognitive performance for adults with SB. This study is pioneering in that it increases our understanding of DT performance in ambulatory adults with SB which could facilitate development of targeted rehabilitation interventions and self-management strategies.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"63 9","pages":"514-521"},"PeriodicalIF":2.2,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12413317/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144969660","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":"Self-managed digital technologies for pressure injury prevention in individuals with spinal cord injury: a systematic scoping review","authors":"Samuel David Williamson, Maria Zofia Geisler, Randi Kjær Steensgaard, Knærke Søgaard, Søren Steen Nielsen, Line Trine Dalsgaard, Sophie Lykkegaard Ravn","doi":"10.1038/s41393-025-01113-w","DOIUrl":"10.1038/s41393-025-01113-w","url":null,"abstract":"Systematic scoping review. Pressure injuries (PI) are a serious but mostly preventable complication associated with living with spinal cord injuries (SCI). This review aims to identify and summarize evidence concerning self-managed digital technologies for preventing PI in the SCI population. A systematic search was performed across seven databases—Embase, Medline, PsycInfo, Web of Science, Scopus, CENTRAL, and CINAHL. To be eligible, studies had to be peer-reviewed and report original findings on self-managed digital technologies for PI prevention in adults (≥18 years) with SCI. Supplementary searches were conducted using Google Scholar, PEDro, and citation tracking to locate relevant studies not identified by the systematic search. Data from the included studies were extracted and synthesized. The systematic search identified 9797 unique studies. After screening and excluding 8939 records at the title-and-abstract level, 858 full-text records were assessed, and 12 met the inclusion criteria. The included studies fell into categories: (i) technology-driven feedback systems that provide real-time pressure distribution data and (ii) digital self-management and educational systems aimed at improving adherence to PI-preventive measures. Feedback systems were associated with improved pressure-relieving behaviours, though adherence to reminder-based interventions remained a challenge. Digital self-management tools were shown to enhance knowledge and confidence related to PI prevention. Self-managed digital technologies increased awareness, confidence, and engagement in pressure relief behaviours among individuals with SCI. However, their direct impact on PI prevention remains inconclusive. Difficulties relating to adherence indicate that such technologies should complement, rather than replace, traditional prevention strategies.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"63 9","pages":"492-498"},"PeriodicalIF":2.2,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12413319/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144875312","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":"The two questions we're not asking: Depression screening in spinal cord injury.","authors":"Ahmad Jasem Abdulsalam, Andrei Krassioukov","doi":"10.1038/s41393-025-01115-8","DOIUrl":"https://doi.org/10.1038/s41393-025-01115-8","url":null,"abstract":"","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":" ","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144837761","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}

{"title":"An Australian and New Zealand clinical practice guideline for the physiotherapy management of people with spinal cord injuries","authors":"Joanne V. Glinsky, Lisa A. Harvey, Keira E. Tranter, Leanne Rees, Mark McDonald, Brooke Wadsworth, Emilie Gollan, Verna Stavric, Jo Nunnerley, Jennifer Dunn, Deanne Wilson, Australian and New Zealand Clinical Practice Guidelines Consortium","doi":"10.1038/s41393-025-01088-8","DOIUrl":"10.1038/s41393-025-01088-8","url":null,"abstract":"Development of a Clinical Practice Guideline (CPG). To develop a CPG for the physiotherapy management of people with Spinal Cord Injuries (SCI). Australia and New Zealand. Systematic reviews of randomised controlled trials (RCTs) of physiotherapy interventions for adults with SCI were conducted to address over 100 clinical questions. Questions were decided a priori and written in PICO format (Participant, Intervention, Comparison and Outcome). Meta-analyses were conducted across trials that made similar comparisons. A Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to assess evidence certainty and formulate recommendations. A Guideline panel made evidence recommendations and consensus-based opinion statements based on a standardised process that included voting. Seventy-six RCTs met the inclusion criteria for the systematic reviews. These RCTs informed 20 meta-analyses that were used in the development of the CPG. More than one hundred evidence recommendations and consensus-based opinion statements across 13 categories of physiotherapy interventions were made by the panel. The Australian and New Zealand CPG for the Physiotherapy Management of people with SCI provide clear and readily accessible guidance to physiotherapists based on evidence and consensus of clinical experts. The Guideline is available at www.sciptguide.com .","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"63 9","pages":"470-476"},"PeriodicalIF":2.2,"publicationDate":"2025-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12413318/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144837760","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":"Increased risk of osteoarthritis in persons with spinal cord injury: a population-based longitudinal follow-up study in Taiwan","authors":"Chien-Po Liu, Shin-Liang Pan","doi":"10.1038/s41393-025-01112-x","DOIUrl":"10.1038/s41393-025-01112-x","url":null,"abstract":"Retrospective cohort study. To assess the relative risk of osteoarthritis (OA) in individuals with newly diagnosed spinal cord injury (SCI) compared to a matched non-SCI group. Taiwan’s Longitudinal Health Insurance Database. We identified 1373 individuals aged 20–69 years with newly diagnosed SCI between 2002 and 2005 as the SCI group. A propensity-score-matched non-SCI group (N = 5492) with similar baseline demographic and clinical characteristics was selected for comparison. Both groups were followed until December 2011. OA-free survival was analyzed via Kaplan-Meier curves, and the association between SCI and OA risk was evaluated via stratified Cox proportional-hazards regression. To assess temporal risk variations, we performed landmark analysis with a 1-year cutoff, dividing follow-up into early (0–1 year) and long-term (≥1 year) periods. The respective incidence rates of OA for the SCI and non-SCI groups were 45.4 per 1000 person-years (95% confidence interval [CI], 40.1–50.1) and 31.6 per 1000 person-years (95% CI, 29.8–33.4). The hazard ratio of OA for the SCI group, as compared to the non-SCI group, was 1.52 (95% CI 1.34–1.72, p < 0.0001). This population-based longitudinal follow-up study indicates that there is an increased long-term risk of OA in persons with SCI, underscoring the need for clinical vigilance and early diagnostic measures in this population. Further research is needed to explore the mechanisms underlying the association between these two conditions.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"63 9","pages":"508-513"},"PeriodicalIF":2.2,"publicationDate":"2025-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812333","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}

{"title":"Sexual function is the most commonly investigated aspect of sexuality in individuals with spinal cord injury or disease – a systematic review","authors":"Jasmin L. Mahler, Judith J. W. van Beek, Jens Wöllner, Jörg Krebs, Jürgen Pannek","doi":"10.1038/s41393-025-01111-y","DOIUrl":"10.1038/s41393-025-01111-y","url":null,"abstract":"Systematic review. To create an overview of standardized assessments to evaluate sexuality after SCI/D in a systematic literature review. Furthermore, we explored the various dimensions of sexuality assessed by these tools and analyzed sex and gender differences. In a systematic review (PROSPERO CRD42023416855), we reviewed published assessments of sexuality in individuals with SCI/D with a focus on differences between women and men. The comprehensive search was conducted in PUBMED, Medline, CINAHL and psychINFO in March 2023. The extracted publications were grouped and analyzed according to their objectives. A total of 264 papers were included in the analysis and divided into three categories: “physiological aspects of sexuality”, “psychological aspects of sexuality”, and “sexual adjustment”. Most assessments of sexuality after SCI/D concern physiological aspects (n = 176, 66.7%). Fewer studies focus on psychological aspects (n = 49, 18.6%), and sexual adjustment (n = 39, 14.8%) is the least investigated topic. More research has been published on men’s compared to women’s sexuality (n = 195, 73.9% versus n = 125, 47.3%). In men, the most frequently used standardized assessment is the International Index for Erectile Function (IIEF). In women, the equivalent to the IIEF, the Female Sexual Function Index (FSFI), is most frequently used. Most assessments focus primarily on sexual function in men. New assessments are needed to address other aspects of sexuality as well. Furthermore, more research on female sexuality is needed.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"63 10","pages":"523-529"},"PeriodicalIF":2.2,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144795533","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}

{"title":"Development of the tele-neurological assessment for the level, severity, and completeness of spinal cord injury (TNASCI): reliability and validity","authors":"Phantira Techaworarak, Aitthanatt C. Eitivipart, Sintip Pattanakuhar, Pooriput Waongenngarm","doi":"10.1038/s41393-025-01109-6","DOIUrl":"10.1038/s41393-025-01109-6","url":null,"abstract":"Psychometric study. To introduce a novel, simple, tele-assessment tool designed to report the level and severity of spinal cord injury (SCI) and to assess its reliability and validity. Two academic-affiliated rehabilitation facilities in Thailand. The Tele-Neurological Assessment for the level, severity, and completeness of Spinal Cord Injury (TNASCI) was designed to assess the SCI level and severity according to the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) using telecommunication. This study comprised three phases: (1) the development process involving three experts using the Delphi method, (2) a face validity examination of each TNASCI item’s comprehension and suitability, and (3) an evaluation of the concurrent validity, intra-rater reliability, and inter-rater reliability using data from 40 participants with chronic SCI (>12 months post-injury). The Thai version of TNASCI, was developed to contain four sections, including sensory, motor, anorectal function, and summary sections to determine the SCI level and severity grade. The assessment tool exhibited good face validity. When compared with the ISNCSCI, the TNASCI showed good to excellent inter-rater and intra-rater reliability, with an intraclass correlation coefficient (ICC) (2,1) of 0.791–0.941 and an ICC (3,1) of 0.785–1.00, and good to excellent validity in almost all sections except for the sensory-related components (r = 0.764–0.986). Our TNASCI tool, which was assessed by trained clinicians, demonstrated acceptable inter-rater and intra-rater reliability, face validity, and concurrent validity. It serves as an alternative tool to evaluate the SCI level and severity predominantly in people with chronic, motor-complete SCI who cannot be evaluated using the hands-on ISNCSCI in person. However, this study is an initial step in validating a novel tele-assessment tool, with future studies needed to confirm its utility in other conditions and settings.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"63 9","pages":"499-507"},"PeriodicalIF":2.2,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144765513","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}

{"title":"Rehabilitation for degenerative cervical myelopathy: systematic review and scoping review of UK patient information","authors":"Toby O. Smith, Christopher Newton, Ayshea Farrell, Jithy Boby, Jonathan Dove, Fiona Dove, Kelly Turner, Benjamin M. Davies","doi":"10.1038/s41393-025-01110-z","DOIUrl":"10.1038/s41393-025-01110-z","url":null,"abstract":"Systematic Literature Review & Patient-Information Scoping Review To assess the evidence on prehabilitation and post-operative rehabilitation interventions for people undergoing surgery for degenerative cervical myelopathy (DCM) and to determine what publicly accessible information is provided to patients from the NHS surrounding DCM surgery. A systematic literature review was searched from inception to 19 May 2025. Studies reporting pain, function, disability or quality of life for prehabilitation or post-operative rehabilitation interventions for people undergoing DCM surgery were eligible. Downs and Black appraisal tool was used to assess study quality. Data were analysed in a narrative analysis. Secondary, a review of UK NHS Patient Information Documents (PID) was searched using a Google platform assessment. PID reporting prehabilitation or post-operative information for people awaiting DCM surgery were included. The type of information being provided were extracted and descriptive statistics were used to report frequency of information provision. From 5218 screened studies, six studies (n = 685) met the eligibility criteria. The evidence was low to moderate in quality. Rehabilitation offered demonstrated improved clinical outcomes but there was limited evidence compared to non-rehabilitation or superiority between different rehabilitation strategies. The PID review identified 38 documents. This indicates education and guidance is commonly offered on returning to work (68%), driving (76%) and normal activities of daily living (63%). There remains uncertainty on what should be and is offered to patients with DCM in respect to prehabilitation or post-operative rehabilitation. Robust clinical trial evidence on rehabilitation approaches for this population is needed. PROSPERO (CRD42024604184).","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"63 9","pages":"482-491"},"PeriodicalIF":2.2,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12413311/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144691554","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":"Stem cell therapy for locomotion recovery and neuropathic pain alleviation in spinal cord injury: an umbrella review and meta-analysis","authors":"Amir Azimi, Amirmohammad Toloui, Mohammadhossein Mozafarybazargany, Mohammad Kiah, Hamed Zarei, Parsa Paridari, Sajjad Jabermoradi, Donya Pourkand, Hamzah Adel Ramawad, Alexander R. Vaccaro, Mostafa Hosseini, Mahmoud Yousefifard, Vafa Rahimi-Movaghar","doi":"10.1038/s41393-025-01104-x","DOIUrl":"10.1038/s41393-025-01104-x","url":null,"abstract":"An Umbrella Review and Meta-analysis. This umbrella review and meta-analysis aims to evaluate the efficacy of stem cell therapy for locomotion recovery and neuropathic pain alleviation in rodent models of spinal cord injury (SCI). A comprehensive literature search was conducted in Medline, Embase, Scopus, and Web of Science until May 2024 to identify systematic reviews/meta-analyses on stem cell therapy for SCI. Original studies from these reviews were screened based on the predefined inclusion criteria. Data on locomotion, thermal hyperalgesia, and mechanical allodynia were extracted. Standardized mean differences (SMD) with 95% confidence intervals (CIs) were calculated and pooled to determine overall effect sizes. Subgroup analyses and meta-regressions were performed to investigate the optimal conditions for efficacy in each stem cell type. 31 systematic reviews/meta-analyses with 323 original studies (516 experiments, 11,290 rodents) were included. Significant locomotion recovery was observed across stem cell types, with umbilical cord-derived mesenchymal stem cells (U-MSCs) (SMD = 2.34, 95% CI 1.76–2.93) and oligodendrocyte progenitor cells (OPCs) (SMD = 2.14, 95% CI 1.24–3.03) demonstrating superior efficacy. Only bone marrow-derived mesenchymal stem cells (BM-MSCs) alleviated mechanical allodynia (SMD = 1.33, 95% CI 0.61–2.05). Subgroup analysis showed that the efficacy of stem cell therapy is dependent on injury models, injury to treatment interval, stem cell dosage, and use of antibiotics/immunosuppressants. The certainty of evidence assessment showed high certainty for U-MSC in locomotion recovery, medium for BM-MSC in pain alleviation, and low for OPCs in locomotion recovery. With moderate-to-high certainty, our study demonstrated superior efficacy of mesenchymal stem cells, particularly U-MSCs, when administered immediately post-injury at lower doses without antibiotics for locomotion recovery and BM-MSCs for pain alleviation. These findings suggest further clinical investigation of these stem cell types under optimal conditions.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"63 8","pages":"393-409"},"PeriodicalIF":2.2,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144668551","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}

{"title":"Time-restricted feeding modulates neuron-glial interactions and circadian rhythm in the spinal cord of male Wistar rats fed a high-fat diet","authors":"Han Jiao, Jarne Jermei, Delaram Poormoghadam, Milan Dorscheidt, Sanne Wiekard, Andries Kalsbeek, Chun-Xia Yi","doi":"10.1038/s41393-025-01106-9","DOIUrl":"10.1038/s41393-025-01106-9","url":null,"abstract":"This study utilized male Wistar rats to investigate the effects of time-restricted feeding (TRF) on high-fat diet (HFD)-induced alterations in neuron-glial interactions and gene expression levels in the spinal cord (T5-T9). To evaluate whether TRF mitigates HFD-induced alterations in microglial morphology, astrocyte numbers, perineuronal net (PNN) integrity, purinergic receptor expression, inflammation and circadian rhythm-related gene expression in the spinal cord. Amsterdam University Medical Centers, location AMC, The Netherlands. Male Wistar rats were initially fed either a standard chow diet or a HFD ad libitum for 4 weeks. After this period, rats in the HFD group were further divided into two subgroups: continued HFD ad libitum or HFD with TRF for an additional 4 weeks. Rats in the chow group continued with ad libitum feeding throughout the experimental period. At the end of the intervention, spinal cords (T5–T9) were collected for analysis. Microglial morphology, astrocyte cell numbers, and PNN integrity were assessed in the spinal cord. Expression levels of purinergic receptors, inflammation and clock genes were analyzed to investigate neuron-glial interactions and circadian rhythm stabilization. TRF reduced microglial activation, preserved PNN integrity, suppressed HFD-induced upregulation of purinergic receptors, and stabilized circadian clock gene expression. These findings suggest that TRF is a promising non-pharmacological strategy to counteract obesogenic diet-induced perineuronal net degradation and neuroinflammation, highlighting its potential as a lifestyle-based intervention for pain management.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"63 8","pages":"437-443"},"PeriodicalIF":2.2,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144638127","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}