Topics in Spinal Cord Injury Rehabilitation最新文献

{"title":"Peripheral Vascular Dysfunction Following Spinal Cord Injury: A Systematic Review and Meta-Analysis.","authors":"Thomas Thordarson, Tiev Miller, Martín Calderón-Juárez, Ali Hosseinzadeh, Raza Malik, Rahul Sachdeva, Andrei V Krassioukov","doi":"10.46292/sci24-00036","DOIUrl":"10.46292/sci24-00036","url":null,"abstract":"<p><strong>Background: </strong>Spinal cord injury (SCI) has been shown to impact vascular function and increase the risk of cardiovascular disease (CVD). However, data are limited regarding prognostic factors for identifying subclinical CVD risk in individuals with SCI.</p><p><strong>Objectives: </strong>To identify maladaptive structural and functional changes to central and peripheral vasculature resulting from SCI and to assess the effect of SCI on these parameters relative to able-bodied comparators.</p><p><strong>Methods: </strong>This review was prospectively registered. A systematic search was performed using PRISMA guidelines. Bias was assessed using the ROBINS-I and AHRQ tools. Studies reporting structural or functional changes to vasculature following SCI were included. Data on participant and injury characteristics, outcomes, and assessments used were extracted. Meta-analyses were conducted for adequately powered subgroups based on outcome type, measurement site, and level of injury.</p><p><strong>Results: </strong>A total of 49 studies involving 1026 individuals with SCI and 941 able-bodied comparators were included. Most studies described injury level and severity using standardized impairment classifications. Subgroup analyses showed significantly reduced arterial diameter, compliance, endothelial function, blood flow volume, and high-density lipoprotein (HDL) cholesterol concentration among people with SCI compared to controls. Intima-media thickness, arterial stiffness, shear rate, and blood glucose and triglyceride concentrations were significantly greater for people with SCI compared to controls. Additional subgroup analyses were underpowered.</p><p><strong>Conclusion: </strong>This review synthesizes the current literature reporting central and peripheral vasculature outcomes in people with SCI and able-bodied controls. Between-group differences were observed for several structural and functional vascular outcomes, which suggests that SCI has a significant impact on multiple subclinical CVD risk factors.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"31 2","pages":"88-103"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12202987/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530248","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":"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":"Exploring the Landscape of Biomarkers in Spinal Cord Injury.","authors":"Paulina S Scheuren, Bethany R Kondiles, Angela R Filous, Ona E Bloom, Diana S-L Chow, Edelle C Field-Fote, Patrick Freund, James D Guest, Brian K Kwon, Nikos Kyritsis, Chris Leptak, Monica A Perez, Matthew Szapacs, Christopher R West, Keith Tansey, Jane T C Hsieh, Linda Jones","doi":"10.46292/sci24-00076","DOIUrl":"10.46292/sci24-00076","url":null,"abstract":"<p><p>Despite considerable progress in spinal cord injury (SCI) research, there remains a pressing need for interventions that effectively restore neurological function after injury beyond that which occurs spontaneously. A major steppingstone towards the development of effective therapies for SCI is the ability to accurately predict recovery and identify individuals who are most likely to respond to intervention. Currently, the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) remains the primary tool for assessing neurological impairment after injury. However, based on the inherent limitations of the ISNCSCI exam, accurate and sensitive biomarkers are required. Understanding the role of biomarkers in SCI is crucial for improving diagnosis, prognosis, and treatment strategies. In 2024, the Spinal Cord Outcome Partnership Endeavour (SCOPE) sponsored a precourse at the American Spinal Injuries Association (ASIA) meeting. The international panel discussed the scope, utility, and application of biomarkers in SCI clinical trials and clinical practice. This article summarizes key insights from this discussion, highlighting the value of various types of biomarkers, ranging from molecular and cellular markers to those reflecting neural circuits, systems, and movement. We also summarize the context of using different types of biomarkers and their application in research versus clinical practice. While there are currently no FDAqualified SCI biomarkers, the development of reliable biomarkers holds the potential to accelerate the pace of discovery and enable more precise approaches to treatment.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"31 2","pages":"1-12"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12199613/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530246","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":"Leisure-time Physical Activity in People with Spinal Cord Injury: A Population-based Community Sample.","authors":"Paul K Watson, James W Middleton, Mohit Arora, Camila Quel De Oliveira, Robert Heard, Andrew Nunn, Tim Geraghty, Ruth Marshall, Glen M Davis","doi":"10.46292/sci24-00007","DOIUrl":"10.46292/sci24-00007","url":null,"abstract":"<p><strong>Objectives: </strong>To examine leisure-time physical activity (LTPA) volume in the Australian spinal cord injury (SCI) population while exploring its associations with sociodemographic and injury-related characteristics.</p><p><strong>Methods: </strong>This study was a cross-sectional analysis of the Australian cohort of the International Spinal Cord Injury Survey. The study included 1579 participants aged 18 years or older with an SCI. Analyses included summary statistics, analysis of variance, and regression modelling.</p><p><strong>Results: </strong>Approximately 58% (<i>n</i> = 863) of participants reported some participation in LTPA. The average (<i>SD</i>) total LTPA per week was 333 (318) minutes. Males, younger people, traumatically injured individuals, participants with less time since their injury, and those who required less assistance to ambulate reported between 50% and 200% more engagement in LTPA than their counterparts. Only 204 (13%) participants were compliant with the current SCI-specific physical activity guidelines for fitness improvement. Sociodemographic and injury-related characteristics explained a 2.9% variance for total LTPA, but the model was statistically insignificant.</p><p><strong>Conclusion: </strong>Participation in LTPA in the Australian SCI population was low, and not enough activity was performed at intensities that elicit healthful change. These data add to the growing body of LTPA and physical activity data for the global SCI population. The trends of physical inactivity are globally consistent. Some sociodemographic variables and injury-related characteristics influence the volume and type of LTPA performed, but their effect is mild. Urgent attention is warranted to improve LTPA volume globally.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"31 2","pages":"76-87"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12199567/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530247","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":"Effects of Exercise Interventions on Cardiac Structure, Function, and Mechanics in Individuals with Chronic Motor-Complete Spinal Cord Injury: An Exploratory Randomized Clinical Trial.","authors":"Shane J T Balthazaar, Tom E Nightingale, Abdullah A Alrashidi, Katharine D Currie, Andrei V Krassioukov","doi":"10.46292/sci24-00002","DOIUrl":"10.46292/sci24-00002","url":null,"abstract":"<p><strong>Background: </strong>Individuals with spinal cord injury (SCI) at or above T6 face increased cardiovascular disease (CVD) risks due to altered autonomic control and physical inactivity. Arm cycle ergometry training (ACET) or body weight-supported treadmill training (BWSTT) may improve cardiovascular health, but the impact on cardiac structure and function remains unclear.</p><p><strong>Objectives: </strong>The study aimed to compare the impact of two exercise interventions on cardiac measures in individuals with chronic SCI.</p><p><strong>Methods: </strong>Participants with motor-complete SCI (C4-T6, American Spinal Injury Association Impairment Scale [AIS] grade A or B) were randomly assigned to perform 72 ACET or BWSTT sessions. Left ventricular (LV) echocardiography assessments were performed pre and post training. Data were analyzed using a two-way repeated measures analysis of variance and effect sizes (Cohen's <i>d</i>).</p><p><strong>Results: </strong>Twelve participants underwent analysis (6 per group), revealing significant Group (ACET, BWSTT) x Time (pre, post) interactions for global circumferential systolic and diastolic strain rate (SR) and early diastolic filling velocity (<i>P</i> ≤ .018; Cohen's <i>d</i> > .8/ -.8). Within-group post hoc testing demonstrated a significant decrease in global circumferential systolic SR (<i>P</i> < .001, <i>d</i> = -4.00) and a significant increase in global circumferential diastolic SR (<i>P</i> = .025, <i>d</i> = 2.48) following ACET, with no significant differences following BWSTT. Although there were no statistically significant within-group post hoc changes (<i>P</i> > .58) for diastolic filling, there was a large effect size favoring ACET (<i>d</i> = 1.11).</p><p><strong>Conclusion: </strong>This exploratory study suggests that ACET alters LV mechanics and potentially diastolic function in a cohort of individuals with chronic, cervical or upper thoracic, motor-complete SCI. Conversely, no significant changes were observed following BWSTT. These findings indicate that ACET can improve cardiac function relative to BWSTT in individuals with SCI, though further studies are warranted.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"31 2","pages":"62-75"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12199622/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530244","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":"Systematic Search and Modified e-Delphi Consensus for Serum Bone Biomarkers in Humans and Animal Models with SCI: Methodology.","authors":"Philemon Tsang, Matthew Cleland, Matheus Wiest, Kristine C Cowley, Emily Newton, Eleni Patsakos, Matteo Ponzano, Lora Giangregorio, Saina Aliabadi, Katrina Armstrong, Karim Fouad, David Magnuson, B Catharine Craven","doi":"10.46292/sci24-00042","DOIUrl":"10.46292/sci24-00042","url":null,"abstract":"<p><strong>Introduction: </strong>Alterations to bone metabolism deteriorations in bone density and architecture after spinal cord injury (SCI) are complex and multifactorial: mechanical unloading, impaired osteoblast activity, altered hormone levels, and regional blood flow combine to increase lower extremity fracture incidence and mortality. Bone biomarkers are vital to detect disease, identify candidate therapies, monitor therapy effectiveness, and quantify fracture risk.</p><p><strong>Objectives: </strong>This study aimed to synthesize available literature on serum and plasma bone biomarkers in both animal and human SCI models and to generate consensus regarding their appropriateness for use across the translational continuum.</p><p><strong>Methods: </strong>A systematic search was conducted; 4731 studies were excluded, yielding 125 studies for data extraction. Data were reviewed by an interdisciplinary panel of experts. Through a modified e-Delphi process, consensus statements were iteratively developed regarding the appropriateness of 14 serum bone biomarkers in human and animal models and across the translational continuum.</p><p><strong>Results: </strong>The consensus process highlighted challenges in interpreting animal and human models, emphasizing the need for methodological rigor and standardized biomarker reporting. Consideration of diurnal variations in biomarkers and model selection (transection vs. clip) underscored the complexity of SCI research. Limitations included defining \"adult\" rodents and lack of data on sex-related differences in biomarkers and their interpretation, given most human data were obtained from males and animal data from females.</p><p><strong>Conclusion: </strong>The consensus statements provide guidance, address gaps in reporting and interpretation of biomarkers, promote use of standardized protocols and assay kits, and emphasize interdisciplinary approaches to advancing scientific discovery and facilitating knowledge translation.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"31 2","pages":"13-28"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12199597/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530250","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":"Different Circulating Endothelial Microvesicle Subtype Signature in Subacute and Chronic Spinal Cord Injury.","authors":"Andrew J Park, Hannah K Fandl, Vinicius P Garcia, Auburn R Berry, Kendra N Wegerson, Emily I Ostrander, Hannah L Cardenas, Noah M DeSouza, Jared J Greiner, Brian Stauffer, Christopher A DeSouza","doi":"10.46292/sci24-00068","DOIUrl":"10.46292/sci24-00068","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this study was to determine whether circulating concentrations of activation- and apoptosis-derived endothelial cell-derived microvesicles (EMVs) differ between adults after subacute (time since injury ≤6 months) and chronic (time since injury >12 months) spinal cord injury (SCI).</p><p><strong>Methods: </strong>Peripheral blood was collected from 43 adults (age range 18-71 years): 12 non-injured adults (9 male/3 female), 16 adults with subacute cervical and high thoracic (C2-T3) motor complete injuries (13 male/3 female; time since injury 1-3 months), and 15 adults with chronic cervical and high thoracic (C1-T2) motor complete injuries (14 male/1 female; time since injury 12-52 months). EMVs were defined by markers of endothelial origin either by activation (CD62e⁺) or apoptosis (CD31⁺/CD42b^-) by flow cytometry. Activation-derived but not apoptosis-derived EMVs were significantly higher (<i>P</i> < .05) in adults with chronic SCI (median [IQR], 139 [83-181] EMVs/μL) compared with adults with subacute SCI (median [IQR], 99 [83-104] EMVs/μL) and non-injured adults (median [IQR], 74 [51-104] EMVs/μL). In contrast, apoptosis-derived but not activation-derived EMVs were significantly higher (<i>P</i> < .05) in adults with subacute SCI (mean ± <i>SD</i>, 77 ± 17 EMVs/μL) compared with adults with chronic SCI (mean ± <i>SD</i>, 55 ± 19 EMVs/μL) and non-injured adults (mean ± <i>SD</i>, 52 ± 25 EMVs/μL). Differential expression of circulating EMVs in adults with SCI during the subacute and chronic phase of injury may represent a biomarker of the vascular environment associated with each condition. Our findings suggest that the vascular phenotype is markedly different in subacute compared with the chronic SCI and provide insight into endothelial function after SCI.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"31 2","pages":"29-38"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12199602/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530243","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":"Reliability of SCIseg Automated Measurement of Midsagittal Tissue Bridges in Spinal Cord Injuries Using an External Dataset.","authors":"J R Connor, W A Thornton, K A Weber, D Pfyffer, P Freund, C Tefertiller, A C Smith","doi":"10.46292/sci25-00015","DOIUrl":"10.46292/sci25-00015","url":null,"abstract":"<p><strong>Objectives: </strong>To determine the interrater reliability between an automated and manual measure of lesion damage following spinal cord injury (SCI) using T2-weighted magnetic resonance images (MRI).</p><p><strong>Methods: </strong>Twenty-one MRIs were collected from patients who had completed rehabilitation at Craig Hospital. Manual measurements of midsagittal tissue bridges were conducted by an experienced rater using OsiriX (Pixmeo Sarl, Geneva, Switzerland), and automated measures were taken using the SCIsegV2 automated function through the Spinal Cord Toolbox (SCT). Manual and automated measurements were compared using intraclass correlation coefficients (ICC). Percentage agreement and Cohen's kappa statistic were calculated to compare detection of midsagittal tissue bridges.</p><p><strong>Results: </strong>ICCs between the manual and automated measures were excellent (ICC 0.94, 95% CI 0.84-0.97, <i>P</i> < .001, for ventral tissue bridges; ICC 0.99, 95% CI 0.97-0.99, <i>P</i> < .001, for dorsal tissue bridges). Percentage agreement between raters was 90.8% for ventral, dorsal, and any midsagittal tissue bridge. Cohen's kappa for the detection of tissue bridges showed substantial agreement between the two raters for ventral, dorsal, and any tissue bridges (0.81, <i>P</i> < .001; 0.79, <i>P</i> < .001; and 0.81, <i>P</i> < .001, respectively).</p><p><strong>Conclusion: </strong>Measurements of midsagittal tissue bridges between manual and automated raters are reliable. Automated measurements may help to expedite research related to midsagittal tissue bridges and functional outcomes for individuals with SCI.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"31 2","pages":"39-49"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12199566/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530249","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}