Topics in Spinal Cord Injury Rehabilitation最新文献

{"title":"Poster (Knowledge Generation) ID 1985362","authors":"B. C. Craven, Lindsie M. Blencowe, Lora M. Giangregorio, Laura Carbone, Frances M. Weaver, Susan B. Jaglal, Barry Munro, Lynn Boag, Vanessa K. Noonan, S. Humphreys, Mohammad Alavinia","doi":"10.46292/sci23-1985362s","DOIUrl":"https://doi.org/10.46292/sci23-1985362s","url":null,"abstract":"To develop a lower extremity (LE) fragility fracture risk score estimation method among adults with chronic spinal cord injury (SCI). Adults (≥18) with chronic traumatic SCI (n=90, C2-T12, AIS:A-D) participated in a 2-year prospective cohort study. We used a literature search and practice expertise to identify LE fracture predictors. Reference categories (i.e., risk score = 0) were: no prior fracture, 0-9 years post-injury, AIS-CD, no parental history of osteoporosis, and no opioid use. Using logistic regression coefficients, we calculated how far each category is from the base category and computed βi (Wij-WiREF) for each risk factor. In this model, B was the increase in risk associated with each year post injury. The point value for each fracture risk category was calculated by Pointsij=βi (Wij-WiREF)/B. The total points range from 0-21, and the probability of LE fracture is calculated for each point to determine the probability of developing a LE fracture using the formula: Most participants had an AIS-A impairment (60.0%), the mean time post-injury=15.23 years (SD=9.58). For the points system (0-17), prior fracture, years post-injury, AIS, Benzodiazepine use, Opioid use, and parental osteoporosis were defined risk factors. An individual’s risk profile can estimate LE fracture risk. A score of 11 equates to 20% or high fracture risk over a 5-year time period. We describe our preliminary model to estimate LE fracture risk among those with chronic SCI. We plan to apply statistical and machine learning algorithms using Canadian RHSCIR data and US VHA data to validate the model, and increase the model’s predictability.","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"59 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139345563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Poster (Health Services, Economics and Policy Change) ID 2001712","authors":"Chris Marks","doi":"10.46292/sci23-2001712s","DOIUrl":"https://doi.org/10.46292/sci23-2001712s","url":null,"abstract":"Collaborative research with community members has been identified as “one of the best ways to support rapid application of research evidence” by focusing research to the needs of users. As funders and researchers rush to bridge the gap in healthcare delivery, there arises a need to build on integrated knowledge translation (IKT) best practices to support equitable PLEX compensation. This research will help determine the monetary value of PLEX when participating in research. An environmental scan of healthcare funders, institutions and organizations patient partners /lived experience compensation rates in Canada, United States, and select countries from 2010-2023 provided a baseline data set. A systematic scan of published literature and grey literature of this nascent field, PLEX compensation rates was synthesized from this analysis and aligned with the SPOR guidelines. A third party conducted a check of the data abstraction to ensure high data quality. Early results indicate a wide range of patient compensation rates from $40-200 a session with limited information on SCI-specific compensation. This research provides a rationale for fair and equitable compensation of PLEX, with a compensation matrix based on the level of engagement.","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"48 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139345575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Poster (Knowledge Generation) ID 1987820","authors":"David S. Ditor, Alexandria Roa Agudelo, E. Loh, Sussan Askari, Chetan P. Phadke","doi":"10.46292/sci23-1987820s","DOIUrl":"https://doi.org/10.46292/sci23-1987820s","url":null,"abstract":"Anti-inflammatory diets have shown effective in reducing pro-inflammatory cytokines, and neuropathic pain and depression in individuals with spinal cord injury or disease (SCI/D). However, work to date has focused on community-dwelling individuals with SCI/D, and the diet’s efficacy in an inpatient population, and the feasibility of offering it in a hospital, are unknown. The inpatient setting may be ideal for introducing an anti-inflammatory diet, as immune-related health complications peak acutely after SCI, and forming new dietary habits may be easier in an inpatient setting. Thus, it is necessary to investigate the feasibility of an anti-inflammatory diet in the inpatient SCI/D setting. Phase 1: Understand the nutritional value of the current meal plans in selected inpatient SCI/D hospitals and their compliance with our anti-inflammatory diet. Phase 2: Understand the opinions that inpatients with SCI/D have regarding their currently offered meal choices and their readiness to learn about, and adopt, an anti-inflammatory diet. Phase 3: Understand the barriers and facilitators for implementing an anti-inflammatory diet in an inpatient setting from the perspective of hospital administrators. This study will take place in the SCI inpatient settings in two Ontario hospitals. Four to five inpatients from each site will be interviewed in Phase 1 and 2, and four to five Food Services administrators from each site will be interviewed in Phase 3. Menu plans, as well as individual food logs will be analyzed for nutritional value and compliance to an anti-inflammatory diet. Interviews will be subject to thematic analysis.","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"26 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139346454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Workshop (Clinical/Best Practice Implementation) ID 1985360","authors":"B. C. Craven, Anita Kaiser, Hope Jervis-Rademeyer, Wendy Murphy, Lynn Boag, M. Miyatani, Lindsie M. Blencowe","doi":"10.46292/sci23-1985360s","DOIUrl":"https://doi.org/10.46292/sci23-1985360s","url":null,"abstract":"The Paralyzed Veterans of America inaugural Clinical Practice Guideline (CPG) for Bone Health and Osteoporosis Management for individuals with spinal cord injury or disease (SCI/D) was published for clinicians in 2022. To disseminate knowledge, we developed a series of nine podcasts and handouts, “The Bare Bones Series” (TBBS), linked with each CPG chapter. The intent was to share the CPG content with people with lived experience of SCI/D (PLEX). This workshop will: 1) introduce TBBS and intended use of the CPG framework; and 2) provide participants the opportunity to apply their learning from the podcast episodes “Get Moving and Loading” and “Snap and Crack” through discussion of two case based scenarios. The aim, content, intended use and targeted audience for TBBS will be highlighted. TBBS was developed and hosted by two PLEX, project team members, and 11 guests who were the CPG chapter authors. Podcast handouts contain infographics, key concepts and recommendations for action. Attendees including clinicians, PLEX, family and friends, will review 3 of 9 episodes. The panelists (Chair, PLEX and project team) will discuss the CPG content and actions to take to improve bone health and reduce fracture risk in PLEX with SCI/D. TBBS will be shared through social media, stakeholder and community events, and conference presentations across North America. Workshop attendance will aid participants in advocating for bone health assessments, understanding fracture risk, and promoting a dialogue with their care team about how to prevent fracture, and reduce fracture related morbidity and mortality.","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"1 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139346845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Poster (Clinical/Best Practice Implementation) ID 1985182","authors":"Andrea Chase, Sharol E. Cordner, Jennifer M. Duley, Marty Doupe, Charlie Giurleo, Julianne W. Y. Hong, A. Kras-Dupuis, A. Ventre, Julie Watson, D. Wolfe, Nancy Xia","doi":"10.46292/sci23-1985182s","DOIUrl":"https://doi.org/10.46292/sci23-1985182s","url":null,"abstract":"Persons with spinal cord injury (SCI) are at increased risk of developing pressure injuries throughout their lifetime. This significant yet preventable secondary complication can have a negative impact on one’s health and well-being. A key aspect of prevention is performing regular daily skin checks; however, a gap in knowledge is apparent among clinicians and patients on how exactly to perform them. To develop a universal and widely available skin check video resource that supports clinicians and patients. Clinicians across the SCI-IEQCC Network from Parkwood Institute, Hamilton Regional Reha-bilitation Centre, Ottawa Hospital Rehabilitation Center, Lyndhurst, Providence Care, and in partnership with SCIO, Cortree and persons with lived experiences, all contributed in an iterative manner to the development of a skin check video resource. Feedback from all relevant stakeholders was gathered after each round of edits to ensure the content would meet the educational needs of persons with lived experience and rehabilitation staff. This collaboration allowed for the development of an open-source skin check video resource for both clinicians and persons with lived experience. This video is in process of being integrated within patient skin check education of the various rehabilitation sites across Ontario. The video identifies key factors to consider when completing skin checks and demonstrates the technique on how to complete skin checks independently and with assistance. While a successful skin check video resource was created, next steps will look to its sustainable implementation and dissemination at a local and provincial level.","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"51 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139346941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Connecting Researchers and Clinicians Before Connecting the Injured Spinal Cord","authors":"Laura Krisa, Erica Witoslawski, Linda Jones, MJ Mulcahey, Karim Fouad","doi":"10.46292/sci22-00044","DOIUrl":"https://doi.org/10.46292/sci22-00044","url":null,"abstract":"Background Translating research findings from animal models of spinal cord injury (SCI) to humans is a challenging enterprise. It is likely that differences in the use of common terms contribute to this. Objectives The purpose of this study was to identify how scientists and clinicians define terms used across the research and clinical care continuum. Methods We utilized the Delphi technique to develop consensus on the opinions of experts (defined as researchers and/or clinicians working in the field of SCI) through a series of structured, iterative surveys. A focus group of stakeholders developed the terms on the initial survey. Results were used to create definitions and formulate questions for a second and third survey. Results Survey 1 yielded one definition for eight terms and multiple definitions for six terms in addition to three new terms that respondents believed should be defined. In Survey 2, definitions for eight terms reached at least 80% agreement: anatomically complete spinal cord injury, functionally complete spinal cord injury, neuromodulation, physical exercise, physical rehabilitation, plasticity, task specificity, and training intensity. Consensus was not reached for six terms. In Survey 3, definitions for seven additional terms reached at least 80% agreement: recovery, repair, compensation, regeneration, physical function, physiological function, and chronic. There were three terms that did not reach agreement after the three rounds: acute, translational research, and sprouting. Conclusion We found that different terminology contributes to the gap between preclinical and clinical research and clinical application. This suggests that increased communication among different disciplines could be a way to advance the field.","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"128 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135195498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Randomized Trial of Two Exercise Programs to Increase Physical Activity and Health-Related Quality of Life for Persons With Spinal Cord Injury","authors":"J. Butzer, A. Kozlowski, Rachel Hern, Cally Gooch","doi":"10.46292/sci21-00042","DOIUrl":"https://doi.org/10.46292/sci21-00042","url":null,"abstract":"Objectives: To compare the effectiveness of two different interventions that promote physical activity in individuals with traumatic spinal cord injury (SCI) and determine the effect of relapse prevention. Methods: A sequential, multiple assignment, randomized trial was conducted at a universally designed community-based exercise facility. Participants were individuals with traumatic SCI, >3 months post injury, levels C5 to T12, age ≥18 years (N = 79). After randomization, Bridge Program participants completed an 8-week personalized, less intense, exercise program informed by American College of Sports Medicine (ACSM) guidelines and supported with hands-on peer mentoring, exercise of choice, and caregiver training. Structured Exercise participants completed an 8-week program in a group format based on ACSM guidelines. After intervention, participants were randomized to receive or not receive relapse prevention for 6 months. The time and intensity of physical activity and psychological change in depression, anxiety, self-efficacy, and function were assessed with self-reported measures. Results: Compared to baseline, physical activity increased post intervention for both the Bridge and Structured Exercise programs. Compared to baseline, participants in the Bridge Program recorded fewer anxiety symptoms. No significant changes were noted for either program in depressive symptoms, self-efficacy, or function. There was no difference in relapse prevention between the two groups at 6 months. Conclusions: The Bridge Program, a novel personalized exercise program with peer support, exercise of choice, and caregiver training, and a structured exercise program both improved self-reported physical activity, but the Bridge Program also reduced anxiety symptoms. This study provides important insight into the limitations of commonly used measures of physical activity and psychosocial domains in people with SCI.","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2023-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45183828","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiorespiratory Responses to an Acute Bout of High Intensity Interval Training and Moderate Intensity Continuous Training on a Recumbent Handcycle in People With Spinal Cord Injury: A Within-Subject Design.","authors":"Joseph Peters, Kellie Halloran, Michael Focht, Kathryn Huang, Mariana Kersh, Ian Rice","doi":"10.46292/sci23-00026","DOIUrl":"10.46292/sci23-00026","url":null,"abstract":"<p><strong>Objectives: </strong>To compare acute cardiorespiratory responses during high intensity interval training (HIIT) and moderate intensity continuous training (MICT) on a recumbent handcycle in persons with spinal cord injury (PwSCI).</p><p><strong>Methods: </strong>Eleven males and nine females with chronic SCI (T3 - L5), aged 23 (9) years, participated in this within-subject design. Based off peak power outputs from an incremental test to exhaustion, participants engaged in a HIIT and MICT session at matched workloads on a recumbent handcycle. Workloads (Joules), time, oxygen uptake (VO₂), metabolic equivalent of task (MET), heart rate (HR), and energy expenditure (kcal) were recorded during HIIT and MICT.</p><p><strong>Results: </strong>Total workload was similar across HIIT (87820 ± 24021 Joules) and MICT sessions (89044 ± 23696 Joules; <i>p</i> > .05). HIIT (20.00 [.03] minutes) was shorter in duration than MICT (23.20 [2.56]; <i>p</i> < .01). Average VO₂ (20.96 ± 4.84 vs. 129.38 ± 19.13 mL/kg/min O₂), MET (7.54 ± 2.00 vs. 6.21 ± 1.25), and HR (146.26 ± 13.80 vs. 129.38 ± 19.13 beats per minute) responses were significantly greater during HIIT than MICT (<i>p</i> < .01). Participants burned significantly more kilocalories during HIIT (128.08 ± 35.65) than MICT (118.93 ± 29.58; <i>p</i> < .01) and at a faster rate (6.40 ± 1.78 [HIIT] vs. 5.09 ± 1.14 [MICT] kcal/min; <i>p</i> < .01).</p><p><strong>Conclusion: </strong>HIIT elicits greater increases in oxygen uptake and HR than MICT in PwSCI. In significantly less time, HIIT also burned more calories than MICT.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"29 4","pages":"16-26"},"PeriodicalIF":2.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10704215/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138812422","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":"Challenges in Translating Regenerative Therapies for Spinal Cord Injury.","authors":"Andrew N Stewart, John C Gensel, Linda Jones, Karim Fouad","doi":"10.46292/sci23-00044S","DOIUrl":"10.46292/sci23-00044S","url":null,"abstract":"<p><p>Regenerating the injured spinal cord is a substantial challenge with many obstacles that need to be overcome to achieve robust functional benefits. This abundance of hurdles can partly explain the limited success when applying regenerative intervention treatments in animal models and/or people. In this article, we elaborate on a few of these obstacles, starting with the applicability of animal models and how they compare to the clinical setting. We then discuss the requirement for combinatorial interventions and the associated problems in experimental design, including the addition of rehabilitative training. The article expands on differences in lesion sizes and locations between humans and common animal models, and how this difference can determine the success or failure of an intervention. An additional and frequently overlooked problem in the translation of interventions that applies beyond the field of neuroregeneration is the reporting bias and the lack of transparency in reporting findings. New data mandates are tackling this problem and will eventually result in a more balanced view of the field. Finally, we will discuss strategies to negotiate the challenging course of successful translation to facilitate successful translation of regeneration promoting interventions.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"29 Suppl","pages":"23-43"},"PeriodicalIF":2.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10759906/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139089024","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":"Racial and Ethnical Discrepancies and Similarities in the Epidemiology, Survival, and Neurological Outcomes After Acute Traumatic Spinal Cord Injury: A Retrospective Cohort Study Using Data from the NASCIS-1 Trial.","authors":"Julio C Furlan","doi":"10.46292/sci23-00055S","DOIUrl":"10.46292/sci23-00055S","url":null,"abstract":"<p><strong>Background: </strong>Little is known about the impact of race/ethnicity on the clinical and neurological outcomes after acute traumatic spinal cord injury (tSCI).</p><p><strong>Objectives: </strong>This study examined the influence of race/ethnicity on the individuals' survival and neurological recovery within the first year after tSCI.</p><p><strong>Methods: </strong>The 306 cases enrolled in the First National Acute Spinal Cord Injury Study (NASCIS-1) were grouped as African American individuals (<i>n</i> = 84), non-Hispanic White individuals (<i>n</i> = 159), and other races/ethnicities that included Hispanic individuals (<i>n</i> = 60) and Asian individuals (<i>n</i> = 3). Outcome measures included survival and neurological recovery within the first year after tSCI. Data analyses were adjusted for major potential confounders.</p><p><strong>Results: </strong>There were 39 females and 267 males with mean age of 31 years who mostly sustained cervical severe tSCI after motor vehicle accidents or falls. The three groups were comparable regarding sex distribution, level and severity of tSCI, level of consciousness at admission, and total received dose of methylprednisolone. African American individuals were significantly older than non-Hispanic White individuals (<i>p</i> = .0238). African American individuals and individuals of other races/ethnicities more often had a tSCI with open wound caused by missile and water-related accidents than non-Hispanic White individuals (<i>p</i> < .0001). Survival rates within the first year after tSCI were comparable among the three groups (<i>p</i> = .3191). Among the survivors, there were no significant differences among the three groups regarding motor and pinprick and light-touch sensory recovery (<i>p</i> > .0500).</p><p><strong>Conclusions: </strong>The results of this study suggest that, while there were few differences among the racial/ethnical groups regarding the epidemiology of tSCI, race/ethnicity did not influence survival rate or neurological recovery within the first year post-tSCI.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"29 Suppl","pages":"88-102"},"PeriodicalIF":2.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10759859/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139089037","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}