Topics in Spinal Cord Injury Rehabilitation最新文献

{"title":"Perspectives on Barriers to Use and Benefits of Functional Electrical Stimulation From Australians and New Zealanders With SCI and Clinicians and Researchers in the Field.","authors":"Anne E Palermo, Edward Gorgon, Antonio Vecchio, Lisa Tedesco Triccas, Euan McCaughey, Maggie Donovan-Hall","doi":"10.46292/sci24-00013","DOIUrl":"10.46292/sci24-00013","url":null,"abstract":"<p><strong>Objectives: </strong>To document, through a survey, perceptions of functional electrical stimulation (FES) from people with spinal cord injury (SCI) and carers, clinicians, and researchers (CCR).</p><p><strong>Methods: </strong>Online questionnaires were completed in Australia and New Zealand from December 1, 2021 to August 31, 2022. Subgroups included people with SCI who have used FES, people with SCI who have not used FES, CCRs who have used FES, and CCRs who have not used FES. Frequencies and percentages of subgroup data were calculated for all questions. Open-ended responses were analyzed with inductive content analysis.</p><p><strong>Results: </strong>Ninety-nine responses (70 people with SCI, 29 CCR) were analyzed. Out of the 99 responses, 47 people with SCI and 27 CCRs had used or currently use FES. Muscle strength was the most frequently reported benefit by people with SCI and CCRs who use(d) FES. Lack of training was the most frequently reported barrier to FES by people with SCI (85% of question responders) and CCRs (94%) who had used FES. People with SCI (95%) who had not used FES reported access as a barrier. The leading priorities for future research include improved ease of use for people with SCI (60% people with SCI) and clinical guidelines (48% CCR). Qualitative findings supported the quantitative findings.</p><p><strong>Conclusion: </strong>This survey identified access as a barrier to FES and echoed benefits (strength) and barriers (training) reported in previous research. Ameliorating the barriers and investigating the areas of future research identified in this study will ultimately improve FES uptake in SCI rehabilitation.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"31 1","pages":"100-112"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11848137/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143504721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effect of a Low-Glycemic Index Diet on Postprandial Hypotension in Individuals With Chronic Spinal Cord Injury: Results From a Pilot Study.","authors":"Matthew Farrow, Jia Li, Sana Chahande, Raquel Minarsch, Tonya Orchard, Jan Schwab, Ceren Yarar-Fisher","doi":"10.46292/sci24-00044","DOIUrl":"10.46292/sci24-00044","url":null,"abstract":"<p><strong>Background: </strong>One in two individuals with spinal cord injury (SCI) experiences postprandial hypotension (PPH), a decline (>20 mm Hg) in systolic blood pressure (SBP) within 2 hours after eating. Consuming meals with a low glycemic index (GI) could prevent or lessen PPH.</p><p><strong>Objectives: </strong>To determine the effect of a low-GI diet on PPH and postprandial glucose and insulin in individuals with chronic SCI (>1 year postinjury).</p><p><strong>Methods: </strong>Eleven participants (6 males, 5 females; age 43 ± 11 years) with chronic SCI (C4-C7, 7; T4-T12, 4) took part in a randomized crossover study (low GI vs. high GI). On each occasion, BP, glucose, and insulin were measured in the fasted state and for 2 hours after consuming a breakfast meal (60% carbohydrate, 28% fat, 12% protein) in laboratory-controlled conditions. Participants wore an ambulatory BP monitor and continuous glucose monitor for 3 days at home, and consumed study meals that were macronutrient-matched across conditions.</p><p><strong>Results: </strong>The maximum decrease in systolic blood pressure (SBP) following the laboratory-controlled breakfast meals tended to be lower in the low-GI (14 ± 12 mm Hg) compared to the high-GI (24 ± 25 mm Hg) diet (<i>d</i> = 0.52, <i>P</i> = .056). Serum glucose (<i>P</i> < .01) and insulin (<i>P</i> = .026) concentrations were lower at 30 minutes in the low-GI diet. In the home setting, peak glucose concentrations were lower after lunch (<i>P</i> = .011) and dinner (<i>P</i> < .01) in the low-GI diet.</p><p><strong>Conclusion: </strong>A low-GI meal may be an effective solution to reduce the magnitude of PPH and peak glucose concentrations in individuals with chronic SCI.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"31 1","pages":"30-41"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11848139/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143504722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Breastfeeding After Spinal Cord Injury: A Systematic Review of Prevalence and Associated Complications.","authors":"Andrei Krassioukov, Amanda H X Lee, Stacy Elliott, Teri Thorson, Nathan Agon-Chen, Gavin Naicker, Matthew Querée, Janice Eng","doi":"10.46292/sci24-00035","DOIUrl":"10.46292/sci24-00035","url":null,"abstract":"<p><strong>Background: </strong>Breastfeeding can be a vital component for maternal and infant health, but successful breastfeeding may be especially difficult for mothers with spinal cord injury (SCI). No reliable research on prevalence or complications associated with breastfeeding for mothers with SCI currently exists.</p><p><strong>Methods: </strong>Our systematic review aimed to answer the following: (1) What are the breastfeeding rates in women after SCI? (2) What are the rates and nature of postpartum complications reported by women with SCI in conjunction with breastfeeding?</p><p><strong>Results: </strong>Ten studies were included; the reported rates at which women with SCI were able to breastfeed varied widely, ranging from 11% to 100%. Generally speaking, women with higher-level SCI (above T6) were less likely to breastfeed and would breastfeed less frequently than women with lower-level SCI and less frequently than women without SCI. Complications reported included problems with the let-down reflex, autonomic dysreflexia, and a higher incidence of postpartum depression in women with SCI.</p><p><strong>Conclusion: </strong>More research on mothers with SCI is needed, especially matched-control research comparing mothers with and without SCI on successful breastfeeding and associated complications.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"31 1","pages":"52-65"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11848132/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143504503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of Dietary Quality on Neurogenic Bowel Dysfunction in Individuals With Spinal Cord Injury.","authors":"Willemijn X M Faber, Janneke Nachtegaal, Janneke Stolwijk, Ben J M Witteman, Renate Winkels","doi":"10.46292/sci24-00055","DOIUrl":"10.46292/sci24-00055","url":null,"abstract":"<p><strong>Background: </strong>Neurogenic bowel dysfunction (NBD) occurs in up to 95% of individuals with spinal cord injury (SCI) and negatively impacts the quality of life. Although diet is an important component in the management of NBD, the relationship between diet quality and NBD is understudied in the SCI population.</p><p><strong>Objectives: </strong>To assess the diet quality of individuals with chronic SCI and explore possible relationships between diet quality, especially fiber, and symptoms of NBD, and to evaluate whether individuals with SCI themselves recognize relationships between dietary intake and NBD symptoms.</p><p><strong>Methods: </strong>Individuals with chronic SCI, recruited via their rehabilitation center, completed web-based questionnaires and 24-hour dietary recalls regarding the quality and intake of their diet and the severity of NBD. Ten individuals participated in interviews to explore their views on potential relationships between their diet and NBD.</p><p><strong>Results: </strong>Twenty-eight participants were recruited, of which ten were interviewed. All participants had symptoms of NBD of varying degrees and a low diet quality, but there was no difference between the NBD groups. The more severe NBD group had a lower intake of vegetables and a higher intake of salt. Almost half of the participants interviewed did not report experiencing an association between dietary intake and their NBD.</p><p><strong>Conclusions: </strong>A low diet quality was observed among individuals with chronic SCI, irrespective of their NBD symptoms. Many participants were unaware of a potential relationship between their diet and NBD. The sample size is insufficient to draw definitive conclusions; however, a potential hypothesis is that those with more severe NBD may consume not enough vegetables and too much salt. Further longitudinal prospective research is required to enhance nutritional guidelines for individuals with SCI and NBD.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"31 1","pages":"42-51"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11848138/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143504703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"No Beneficial Effects of the Alfasigma VSL#3 Probiotic Treatment After Cervical Spinal Cord Injury in Rats.","authors":"Pamela J F Raposo, Antoinette T Nguyen, Emma K A Schmidt, Abel Torres Espin, Keith K Fenrich, David J Bennett, Karim Fouad","doi":"10.46292/sci24-00004","DOIUrl":"10.46292/sci24-00004","url":null,"abstract":"<p><strong>Background: </strong>The bidirectional communication between the gastrointestinal tract and the central nervous system appears to be linked to the intestinal microbiome. Research has shown that spinal cord injury (SCI) can disrupt the gut microbiome, leading to gut dysbiosis. These changes can have several negative impacts, such as exacerbated systemic inflammation and susceptibility to infection. Probiotics administered to mice with SCI have been shown to ameliorate gut dysbiosis, confer neuroprotection, and improve locomotor recovery. However, probiotics have also produced conflicting results, making potential claims regarding the application of probiotics as a therapeutic supplement ambiguous.</p><p><strong>Objectives: </strong>This study aimed to investigate the effects of a commercially available probiotic on recovery in a rat model of cervical SCI.</p><p><strong>Methods: </strong>Rats with cervical contusion SCI received probiotics over 7 days immediately after injury, and their recovery in motor, sensory, and cognitive tasks was compared to that of untreated animals.</p><p><strong>Results: </strong>Compared with a control group, the oral administration of probiotics influenced neither motor nor cognitive outcomes. We did observe a significantly different lesion size between the two groups, where the probiotic group had less spared tissue, despite a lack of differences in functional outcomes. In addition, probiotic treatment delayed gut microbiome composition recovery to baseline levels for up to 35 days postinjury (DPI). We found significantly higher proportions of <i>Lactobacillus</i> in the fecal matter of SCI-vehicle rats at 35 DPI, whereas <i>Streptococcus</i> was higher in SCI-probiotics fecal matter at 14 and 35 DPI, and <i>Bacillales</i> was higher in the latter group at 35 DPI.</p><p><strong>Conclusion: </strong>Taken together, our results do not support the application of the utilized probiotic cocktail as a dietary supplement for the treatment of cervical SCI-induced gut dysbiosis and secondary complications.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"31 1","pages":"1-16"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11848136/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143504708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nutritional Intakes of People With Spinal Cord Injury Who Have Pressure Injuries in Hospital: A Secondary Analysis of a Randomized Controlled Trial.","authors":"Amy N Nevin, Kathleen Dwyer, Sridhar S Atresh, Angela Vivanti, Ingrid J Hickman, Merrilyn Banks","doi":"10.46292/sci24-00003","DOIUrl":"10.46292/sci24-00003","url":null,"abstract":"<p><strong>Background: </strong>People living with spinal cord injury (SCI) have one of the highest rates of pressure injury prevalence globally, yet the nutrition-related characteristics of this group are inadequately described.</p><p><strong>Objectives: </strong>This secondary analysis aimed to explore the nutritional status, dietary intakes, and healing outcomes of people with SCI who have pressure injuries in hospital.</p><p><strong>Methods: </strong>Participant demographics, pressure injury-related information, anthropometry, nutritional status (subjective global assessment), and nutrition interventions were recorded. Assessments of energy and protein intake (24-hour dietary recalls), comparison with evidence-based guideline recommendations, and pressure injury healing (surface area measurements) were collected weekly until one of these occurred: complete healing, hospital discharge, surgical repair, or day 28. Factors associated with overall healing were explored using Mann-Whitney <i>U</i> tests.</p><p><strong>Results: </strong>Twenty-six people (mean age, 51 ± 14 years; 81% male) were included. Most were well nourished (77%), receiving dietetic input (85%), and on high-protein, high-energy diets (92%). Between 50% and 90% were exceeding energy and protein recommendations at all time points, and there was a weak negative correlation between energy intake and healing (<i>r</i> = -0.430, <i>P</i> = .036). Reduced healing was observed among participants with severe pressure injuries (stage 4 or unstageable, size >5 cm², >1 pressure injury present) and in those exceeding energy and protein recommendations (<i>P</i> < .05).</p><p><strong>Conclusion: </strong>People with SCI who have coexisting pressure injuries are at risk of excess intake that may be detrimental for pressure injury healing. Future studies examining the nutritional requirements of this population and the impact of both under- and overnutrition are critically needed to guide clinical care.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"31 1","pages":"17-29"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11848134/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143504719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Grocery Shopping and Eating Behaviors Differ Between Persons With and Without a Spinal Cord Injury.","authors":"Zachary J Donato, Adam S Levy, Alicia Sneij, Sherri L LaVela, Arthur S Berg, Lauren T Shapiro, Gary J Farkas","doi":"10.46292/sci24-00028","DOIUrl":"10.46292/sci24-00028","url":null,"abstract":"<p><strong>Background: </strong>Spinal cord injury (SCI) heightens the susceptibility to neurogenic obesity, which is driven by alterations in energy metabolism and suboptimal dietary habits after injury. Those with SCI may adjust their grocery shopping and eating behaviors, notably influencing overall health outcomes.</p><p><strong>Objectives: </strong>To assess differences in grocery shopping and eating behaviors between persons with and without (controls) SCI.</p><p><strong>Methods: </strong>In an online, cross-sectional study, adults with (<i>n</i> = 207) and without (<i>n</i> = 52) SCI completed a one-time survey that assessed grocery shopping behavior (shopping frequency and who completed the shopping) and eating behaviors, including the frequency of consuming alcoholic beverages, fast food, and preferences for fried food. Regression analyses were employed for group comparisons, controlling for relevant measures.</p><p><strong>Results: </strong>Compared to the controls, a smaller proportion of persons with SCI grocery shopped independently in person (<i>P</i> = .002), and a greater proportion relied on others to fulfill grocery needs (<i>P</i> = .008). Individuals with SCI demonstrated a reduced monthly frequency of overall (<i>P</i> = .019) and independent in-person grocery shopping than controls (<i>P</i> = .014). In contrast, the monthly frequency of grocery shopping through delivery and from their caregivers was similar (<i>P</i> > .05). Fried food and fast-food intake were comparable (<i>P</i> > .05), whereas alcoholic beverage consumption was lower in individuals with SCI than controls (<i>P</i> = .006).</p><p><strong>Conclusion: </strong>People with SCI reported obtaining groceries less often than controls, and a greater proportion relied on others, rather than themselves, to fulfill grocery needs. These findings highlight the influence of SCI on biobehavioral activities affecting neurogenic obesity, suggesting potential targets for interventions to enhance health outcomes post-SCI.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"31 1","pages":"66-76"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11848133/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143504692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effects of Functional Electrical Stimulation Cycling on Muscle Spasticity in Individuals With Spinal Cord Injury: A Systematic Review.","authors":"Stephanie K Couper, Moira Smith","doi":"10.46292/sci23-00048","DOIUrl":"10.46292/sci23-00048","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the effects of functional electrical stimulation (FES) cycling on muscle spasticity in individuals with spinal cord injury (SCI) and provide recommendations for optimal FES cycling parameters to treat muscle spasticity.</p><p><strong>Method: </strong>In this systematic review, database searches of CINAHL, MEDLINE (Ovid), PEDro, PubMed, and Scopus were conducted to identify relevant studies published up to June 2023. Studies were screened for eligibility. Those that included an FES cycling intervention, an outcome measure of spasticity, and were available in full-text English were included. Two independent reviewers extracted the data and appraised the literature via the Crowe Critical Appraisal Tool (CCAT).</p><p><strong>Results: </strong>Of the 1782 studies identified, 16 satisfied the criteria for this review. Two-hundred and three participants were included, aged 7 to 80 years old. Ten studies identified a reduction in spasticity following FES cycling via objective or subjective outcome measures. Methodological quality was variable, with CCAT scores ranging from 19/40 (48%) to 35/40 (88%). National Health and Medical Research Council hierarchy levels ranged from II to IV.</p><p><strong>Conclusion: </strong>Evidence for the effectiveness of FES cycling to reduce muscle spasticity remains inconclusive. Long-term effects on spasticity were evident in moderate- to high-quality studies where FES cycling was conducted for 60 minutes, three times per week for 16 weeks. Additional research with larger sample sizes is warranted to confirm these findings. Further clarification of the optimal parameters of FES frequency, amplitude, and pulse width to reduce spasticity is required.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"31 1","pages":"77-99"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11848135/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143504648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparing the Accuracy of Standard Equations to Predict Glomerular Filtration Rate for Persons with Spinal Cord Injury: Which Is the \"Best Fit?\"","authors":"Nicholas Brown, Kathryn Struck, Terry Romo, Wouter Koek, Ashley Everett Garcia, Mark Fredrickson, Michelle Trbovich","doi":"10.46292/sci24-00001","DOIUrl":"https://doi.org/10.46292/sci24-00001","url":null,"abstract":"<p><strong>Background: </strong>Patients with spinal cord injury (SCI) are at increased risk of renal insufficiency, so their renal function must regularly be monitored. Glomerular filtration rate (GFR) assessment is challenging as it requires measuring clearance of exogenous markers, which is impractical in most clinical settings. Thus, equations have been formulated to estimate GFR that utilize serum creatinine (Cr) or cystatin C (CysC).</p><p><strong>Objectives: </strong>Given loss of muscle mass after SCI, we hypothesized equations using CysC would be more accurate than those using Cr after SCI.</p><p><strong>Methods: </strong>Fifty-eight persons (51 male/7 female; age 22-87 years) with SCI level C2-L1/AIS A-D were enrolled. Serum CysC and Cr, 24-hour urine creatinine (24hrUCr) and 24-hour urine urea (24hrUurea) were collected. Average of the 24hrUCr clearance and 24hrUurea clearance was calculated (AvgCl_CrUr). Six GFR estimating equations were compared to AvgCl_CrUr. For each equation, mean bias (AvgCl_CrUr - eGFR) was calculated followed by the Pearson correlation calculation between AvgCl_CrUr and eGFR. In addition, the percentage of estimated values within 15%, 30%, and 50% of AvgCl_CrUr values are reported for each estimating equation.</p><p><strong>Results: </strong>2012 CKD-EPI CysC equation (bias 9.32 mg/dL, 95% CI, -1.23 to -17.41) was the most accurate predictor of GFR. This model accurately predicted GFR of 81%, 57%, and 33% within ±50%, ±30%, and ±15% of the AvgCl_CrUr, respectively. <b>Conclusion</b>: In persons with SCI, the CKD-EPI 2012 CysC equation, which uses cystatin C rather than creatinine, is the most accurate of the six equations tested in estimating GFR in persons with SCI.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"30 4","pages":"57-65"},"PeriodicalIF":2.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11603108/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting Complete versus Incomplete Long-Term Functional Independence after Acute AIS Grade D Spinal Cord Injury: A Prospective Cohort Study.","authors":"Antoine Dionne, Andréane Richard-Denis, Jean-Marc Mac-Thiong","doi":"10.46292/sci23-00090","DOIUrl":"10.46292/sci23-00090","url":null,"abstract":"<p><strong>Background: </strong>The proportion of patients with American Spinal Injury Association Impairment Scale (AIS) grade D traumatic spinal cord injuries (tSCI) is increasing. Although initial motor deficits can be relatively mild, some individuals fail to recover functional independence.</p><p><strong>Objectives: </strong>This study aims to identify factors associated with failure to reach complete functional independence after AIS grade D tSCI.</p><p><strong>Methods: </strong>An observational prospective cohort study was conducted at a level 1 trauma center specialized in SCI care. A prospective cohort of 121 individuals with an AIS-D tSCI was considered. The baseline characteristics, length of acute stay, need for inpatient rehabilitation, and 12-month functional status were assessed. Univariate and classification and regression tree (CART) analyses were performed to identify factors associated with reaching complete versus incomplete functional independence (defined as perfect total SCIM III score at 12-month follow-up).</p><p><strong>Results: </strong>There were 69.3%, 83.3%, and 61.4% individuals reaching complete independence in self-care, respiration/sphincter management, and mobility, respectively. A total of 64 individuals (52%) reached complete functional independence in all three domains. In the CART analysis, we found that patients are more likely to achieve complete functional independence when they have a baseline motor score ≥83 (65% individuals) and if they present fewer medical comorbidities (70% individuals if Charlson Comorbidity Index [CCI] ≤4).</p><p><strong>Conclusion: </strong>About half of individuals with AIS grade D tSCI can expect complete long-term functional independence. It is important to recognize early during acute care individuals with baseline motor score <83 or a high burden of comorbidities (CCI ≥5) to optimize their rehabilitation plan.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"30 3","pages":"50-58"},"PeriodicalIF":2.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11317641/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141976854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}