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":"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":"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":"International Standards for Neurological Classification of Spinal Cord Injury: Case Examples Reinforcing Concepts From the 2019 Revision.","authors":"Brittany Snider, Steven Kirshblum, Ruediger Rupp, Christian Schuld, Fin Biering-Sorensen, Stephen Burns, James Guest, Linda Jones, Andrei Krassioukov, Gianna Rodriguez, Mary Schmidt Read, Keith Tansey, Kristen Walden","doi":"10.46292/sci24-00049","DOIUrl":"https://doi.org/10.46292/sci24-00049","url":null,"abstract":"<p><strong>Background: </strong>The International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) is the most widely accepted system for characterizing sensorimotor impairments after spinal cord injury (SCI). There have been a number of ISNCSCI revisions, with the most recent edition published in 2019. Newer concepts, including the revised definitions of the zones of partial preservation (ZPPs) and documentation of non-SCI conditions, require training and practice for successful utilization. The International Standards Committee developed an ISNCSCI workbook of 26 practice cases, each with detailed explanations of the correct classification components. In this article, we present seven cases, which were selected from the workbook to reinforce the changes implemented in 2019.</p><p><strong>Methods: </strong>Hypothetical ISNCSCI cases were created to illustrate important classification rules, definitions, and nuances. All cases were reviewed by members of the American Spinal Injury Association (ASIA) International Standards Committee, and if any discrepancies were identified, they were discussed until a consensus was reached. To confirm agreement, cases were also entered into online algorithms, which are compliant with the 2019 ISNCSCI revision. The seven cases in this article highlight newer classification concepts and include a discussion of key elements.</p><p><strong>Cases: </strong>Each case reinforces the revised definitions of the ZPPs, such as the applicability of sensory ZPPs in all injuries without sensory sacral sparing and applicability of motor ZPPs in all injuries without voluntary anal contraction (VAC). Non-SCI-related impairments and their impact on the classification are reviewed in Cases 4-7.</p><p><strong>Conclusion: </strong>The seven cases presented in this article feature key concepts from the 2019 ISNCSCI revision. These cases, as well as the full ISNCSCI workbook, can serve as valuable training tools to improve classification accuracy.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"31 3","pages":"1-14"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12376161/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973829","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":"Development and Validation of an Algorithm for Item Reduction of the International Standards for Neurological Classification of Spinal Cord Injury Examination to Determine Level and Severity of SCI.","authors":"Stephen P Burns, Kristen Walden, Steven Kirshblum, Mary Schmidt-Read, Keith Tansey, Christian Schuld, Ruediger Rupp","doi":"10.46292/sci25-00008","DOIUrl":"https://doi.org/10.46292/sci25-00008","url":null,"abstract":"<p><strong>Background: </strong>In 2020, a first, expedited version of the International Standards for Neurological Classification of Spinal Cord Injury (E-ISNCSCI-V1) was proposed for determination of neurological level of injury (NLI) and American Spinal Injury Association Impairment Scale (AIS) classifications.</p><p><strong>Objectives: </strong>This work describes assessment of E-ISNCSCI-V1 classification accuracy and the development and data-based validation of an ISNCSCI Item Reduction Algorithm (IIRA).</p><p><strong>Methods: </strong>Classification accuracy for E-ISNCSCI-V1 examination shortcut options was assessed with automated analysis of 7026 full ISNCSCI examinations. Rules for the IIRA were iteratively adjusted to optimize the balance between omitting exam items and minimizing misclassification errors, and then it was validated through classification of 100 full ISNCSCI exams.</p><p><strong>Results: </strong>If S1 findings are substituted for anorectal exam findings as proposed for E-ISNCSCI-V1, the error rate for AIS is 10%, with a high error rate (45%) for classifying true AIS B. The IIRA, which begins with full motor testing, followed by limited sensory testing required an average of 31% (42/134) of the full ISNCSCI exam items, with a 2% error rate for NLI and no AIS errors.</p><p><strong>Conclusion: </strong>The previously proposed E-ISNCSCI-V1, which included an option to substitute S1 findings for anorectal exam findings, is not recommended due to AIS error rate. The IIRA provides a standardized option for a shortened examination classifying NLI and AIS with high accuracy. It will serve as a basis for version 2 of the E-ISNCSCI.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"31 3","pages":"61-67"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12376155/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973833","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":"International Spinal Cord Injury Fracture History Extended Data Set.","authors":"Leslie R Morse, William A Bauman, B Catharine Craven, William D Leslie, Thomas J Schnitzer, Karen Troy, Fin Biering-Sorensen","doi":"10.46292/sci25-00025","DOIUrl":"10.46292/sci25-00025","url":null,"abstract":"<p><strong>Objectives: </strong>The objective of the study is to develop the International Spinal Cord Injury (SCI) Fracture History Extended Data Set within the framework of the International SCI Data Sets to permit consistent collection and reporting of fracture history in the SCI population.</p><p><strong>Methods: </strong>The International SCI Fracture History Extended Data Set has been developed by a working group. The initial data set was open for 2 months for discussion and was revised based on suggestions from members of the International SCI Data Sets Committee, the International Spinal Cord Society (ISCoS) Executive and Scientific Committees, American Spinal Injury Association (ASIA) Board, other interested organizations, societies, and individual reviewers. The data set was also posted for 2 months for comments on ISCoS's and ASIA's websites.</p><p><strong>Results: </strong>The final data set contains questions on fractures after SCI. Because the information may be collected at any time, the date of data collection is important to capture relative to the time lapsed after SCI. The data set includes information on fracture history (location, etiology, treatment, complications for each fracture event), osteoporosis treatment (current and past use), bone measures by quantitative computed tomography (6 variables), and body composition (7 variables). The complete instructions for data collection and the data sheet itself are freely available on the ISCoS website (https://cdn.ymaws.com/www.iscos.org.uk/resource/resmgr/fracture/iscieds_fracture_1.pdf).</p><p><strong>Conclusion: </strong>The data set proposes to collect information on bone loss, other factors potentially predictive of fracture risk, and fracture in persons with SCI to guide clinical management and future research activities.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"31 3","pages":"121-128"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12376145/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973798","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":"ISNCSCI Exam Changes Following Spinal Cord Stimulation.","authors":"Ryan J Solinsky, Daniel D Veith, Megan L Gill, Lisa A Beck, Candee J Mills, Anders J Asp, K A Fernandez, Omid Jahanian, Kristin D Zhao, Peter J Grahn","doi":"10.46292/sci25-00017","DOIUrl":"https://doi.org/10.46292/sci25-00017","url":null,"abstract":"<p><strong>Objectives: </strong>To describe changes in the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) exam in sublesional motor and sensory domains following short-term epidural electrical stimulation of lumbosacral spinal segments in individuals with spinal cord injury (SCI).</p><p><strong>Methods: </strong>Twenty individuals with SCI underwent implantation of percutaneous epidural spinal cord stimulation followed by stimulation parameter optimization and 10-12 sessions of stimulation-enabled motor training. Pre-/postintervention ISNCSCI exams were compared to determine changes in motor/sensory scores for regions within 3 levels of the neurological level of injury (NLI) and caudal to this, with subanalyses per motor/sensory complete versus incomplete baseline status.</p><p><strong>Results: </strong>Individuals with motor complete SCI gained 6% ± 3% of available motor points within 3 levels of NLI and 1% ± 0% of motor points caudal to this (<i>P</i> = .08). Motor incomplete individuals gained 9% ± 22% of available motor points within 3 levels of NLI and lost 4% ± 7% of motor points caudal to this (<i>P</i> = .63). Following stimulation, changes in motor scores with potential high functional impact occurred in 3 individuals (5 total muscle groups with conversion from baseline <3/5 strength to ≥3/5 at completion). Individuals with sensory complete SCI had fewer sensory gains within 3 levels of NLI (6%) compared to those with sensory incomplete SCI (30%, <i>P</i> = .02).</p><p><strong>Discussion: </strong>Spinal cord stimulation after SCI rapidly induces changes in both motor and sensory domains that are retained after stimulation is removed. These changes primarily occur within 3 levels of the NLI and occur to a greater degree in those with incomplete SCI.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"31 3","pages":"68-76"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12376142/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973838","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}