Topics in Spinal Cord Injury Rehabilitation最新文献

{"title":"Development, Construct Validity, and Reliability Testing of a Revised Version of the Leisure Time Physical Activity Questionnaire for People With Spinal Cord Injury.","authors":"Cameron M Gee, Ava Neely, Aleksandra Jevdjevic, Kenedy Olsen, Kathleen A Martin Ginis","doi":"10.46292/sci24-00031","DOIUrl":"https://doi.org/10.46292/sci24-00031","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate the content validity, construct validity, and test-retest reliability of a revised version of the Leisure Time Physical Activity Questionnaire for People with Spinal Cord Injury [LTPAQ-SCI(R)] that measures all four components of the spinal cord injury (SCI) exercise guidelines (i.e., exercise frequency, intensity, duration, and type).</p><p><strong>Methods: </strong>Ten adults with SCI (6M/4F) were interviewed to develop the LTPAQ-SCI(R) and assess its content validity. Twenty-three adults with SCI (50 ± 14 years; 18M/5F) completed the LTPAQ-SCI(R), other self-report measures of aerobic leisure time physical activity (LTPA), moderate-to-vigorous LTPA (MVPA), and strength-training activities as well as cardiorespiratory fitness (i.e., peak oxygen consumption [V̇O_2peak]) and muscular strength tests.</p><p><strong>Results: </strong>User interviews provided information to refine the questionnaire and support content validity. LTPAQ-SCI(R) measures of minutes per week of aerobic and strength-training LTPA shared large correlations with other self-report measures of aerobic LTPA, aerobic MVPA, and strength-training LTPA (<i>r</i> = 0.542 to 0.687, <i>P</i>s < .01). LTPAQ-SCI(R) measures of minutes per week of aerobic LTPA and all LTPA (i.e., combined aerobic and strength-training LTPA) shared significant medium-sized positive correlations with relative V̇O_2peak (<i>r</i> = 0.393 and 0.406, respectively, <i>P</i>s < .05). All variables measured by the LTPAQ-SCI(R) demonstrated good-to-excellent test-retest reliability (intraclass correlations = 0.854 to 1.000, <i>P</i>s < .001).</p><p><strong>Conclusion: </strong>This study provides preliminary evidence of the validity and reliability of the LTPAQ-SCI(R) as a measure of minutes per week of aerobic and strength-training LTPA in individuals with SCI. The LTPAQ-SCI(R) is recommended for use in community- and rehabilitation-based settings to collect epidemiological data on LTPA participation among individuals living with SCI.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"32 1","pages":"83-95"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12926802/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147285464","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":"Upper Extremity Measures in Spinal Cord Injury: Convergent Validity and Prediction of Functional Independence.","authors":"Candace Tefertiller, Mitch Sevigny, Bria Mellick, Kaitlyn Hays, Brandon Busch, R J Tuchscherer, Andrew Smith","doi":"10.46292/sci25-00127","DOIUrl":"https://doi.org/10.46292/sci25-00127","url":null,"abstract":"<p><strong>Objectives: </strong>To examine associations between 3 standardized upper extremity (UE) measures-the Capabilities of Upper Extremity Test (CUE-T), Graded Redefined Assessment of Strength, Sensibility and Prehension (GRASSP), and the International Standards for Neurological Classification of Spinal Cord Injury Upper Extremity Motor Score (ISNCSCI-UEMS)-and functional independence at discharge, measured by the Continuity Assessment Record and Evaluation (CARE) Tool, and their predictive value for discharge outcomes.</p><p><strong>Methods: </strong>This was a secondary analysis of a randomized controlled trial in cervical spinal cord injury (SCI) conducted at an inpatient rehabilitation facility specializing in SCI. Participants were 75 adults with traumatic cervical SCI (C1-C8, AIS B-D) within 5 months post injury undergoing inpatient rehabilitation. Baseline UE measures (CUE-T, GRASSP total and subscales, UEMS) were administered early during rehabilitation. CARE tool total and self-care scores were extracted from records at baseline and discharge. Pearson correlations and linear regression models assessed relationships between UE measures and CARE outcomes.</p><p><strong>Results: </strong>Baseline CARE total and self-care scores showed moderate to strong correlations with CUE-T (<i>r</i> = 0.72, 0.57), GRASSP total (<i>r</i> = 0.75, 0.60), and GRASSP prehension performance (<i>r</i> = 0.76, -0.59), respectively. CUE-T demonstrated the strongest predictive value for self-care outcomes at discharge (<i>r</i> = 0.62). Each 1-unit increase in CUE-T predicted a 0.75-unit increase in CARE total and 0.33-unit increase in CARE self-care.</p><p><strong>Conclusion: </strong>This study supports the convergent validity of the CARE tool with established UE outcome measures in SCI rehabilitation. Baseline CUE-T scores show the strongest predictive value for self-care independence at inpatient rehabilitation discharge.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"32 Suppl 1","pages":"14-23"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13102077/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785468","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 Association Between Psychoactive Substances Usage and Unintentional Injuries After Traumatic Spinal Cord Injury.","authors":"Yue Cao, Nicole D DiPiro, Edelle C Field-Fote, Debbie Coleman, Anne Deutsch, Lynn A Worobey, Amanda L Botticello, Jennifer Coker, James S Krause","doi":"10.46292/sci25-00126","DOIUrl":"https://doi.org/10.46292/sci25-00126","url":null,"abstract":"<p><strong>Background: </strong>In the United States, unintentional injuries (UIs) are a leading cause of healthcare utilization, disability, and mortality. Among adults with traumatic spinal cord injury (TSCI), subsequent UIs are often reported and have been recognized as the sixth leading cause of death after TSCI. There is a need to better understand the potential role of psychoactive substances (PASs) on UIs among people with TSCI.</p><p><strong>Objectives: </strong>To examine the occurrence of fall-related and non-fall-related UIs at the first Form II follow-up assessment after being discharged from inpatient rehabilitation and identify the relationships between PAS usage (excluding alcohol) and different types of UI.</p><p><strong>Methods: </strong>Adults with TSCI were identified from the SCI Model Systems (SCIMS). Data on self-reported UIs were collected and linked with the SCIMS data collected at admission to inpatient rehabilitation and year 1 follow-up, including clinical and demographic characteristics and self-reported PAS usage measured using the World Health Organization (WHO) Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) Phase II. We developed 2 logistic regression models to investigate the association between PAS usage and fall-related UIs and non-fall-related UIs.</p><p><strong>Results: </strong>Among the 316 participants, 15% had at least one UI in the past year. PAS usage was significantly associated with fall-related UIs but not with non-fall-related UIs, after adjusting for injury and demographic covariates.</p><p><strong>Conclusion: </strong>To prevent subsequent fall-related UIs after SCI, healthcare providers should assess and closely monitor people's PAS usage, especially for people who are ambulatory.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"32 Suppl 1","pages":"127-136"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13102071/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785521","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":"Nontraumatic Spinal Cord Injury Etiology and Rehabilitation Outcomes: SCI Model Systems Pilot Study Data.","authors":"Ronald K Reeves, Yuying Chen, Yue Zhang, Thomas N Bryce, Anne Deutsch, Brittany A Snider, Lynn Worobey, Steven Kirshblum","doi":"10.46292/sci25-00119","DOIUrl":"https://doi.org/10.46292/sci25-00119","url":null,"abstract":"<p><strong>Background: </strong>The Spinal Cord Injury Model Systems (SCIMS) began studying traumatic SCI (TSCI) in 1970. The National Institute of Disability, Independent Living and Rehabilitation Research (NIDILRR) provided pilot funding during the 2021-2026 SCIMS funding cycle to perform an initial study of individuals with nontraumatic spinal cord injury (NTSCI).</p><p><strong>Objectives: </strong>To describe the demographic and etiological profiles and inpatient rehabilitation outcomes of the SCIMS NTSCI pilot cohort.</p><p><strong>Methods: </strong>This was a descriptive study of adults with NTSCI admitted to SCIMS centers who consented to medical records abstraction and completed survey questionnaires near the completion of inpatient rehabilitation.</p><p><strong>Results: </strong>One hundred eighty-seven people with NTSCI consented to participate and provided data. The etiology of patients' NTSCI was degenerative vertebral causes (<i>n</i> = 67), tumor-malignant (<i>n</i> = 29), tumor-benign/unknown (<i>n</i> = 16), vascular (<i>n</i> = 28), infection (<i>n</i> = 26), and other NTSCI causes (<i>n</i> = 21). The average age was 59.2 years. Over 40% of the population was age 60-74 years. The population was 35% female, 59.5% non-Hispanic White, 21.6% non-Hispanic Black, and 11.4% Hispanic. Age, sex, race, and ethnicity distributions did not differ significantly across etiology groups. Only symptom onset time (<i>P</i> = .002) and marital status (<i>P</i> = .005) were significantly different between groups. Vascular disorders onset was less than a day in 60% of cases. Greater than 60% of tumor-malignant, vascular, and other NTSCI individuals were married or living with a partner.</p><p><strong>Conclusion: </strong>The US SCIMS program can recruit a population of NTSCI research participants that is consistent with previously published results. Ongoing study of NTSCI through the US SCIMS could provide important data akin to that available regarding TSCI.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"32 Suppl 1","pages":"177-187"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13102074/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785550","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":"Intravesical Therapeutics Among People With Spinal Cord Injury and Disease: Time for a Change.","authors":"Suzanne L Groah, Ana Valeria Aguirre Guemez, Susan Solman","doi":"10.46292/sci24-00088","DOIUrl":"https://doi.org/10.46292/sci24-00088","url":null,"abstract":"<p><p>Lower urinary tract symptoms (LUTS) are a frequent complaint after spinal cord injury and disease (SCI/D). As such, the majority of people with upper motor neuron SCI/D utilize medications for neurogenic detrusor overactivity (NDO), and overtreatment with systemic antimicrobials is common. Many people with SCI/D utilize urinary catheters for bladder management. These devices offer a conduit for delivery of targeted intravesical therapeutics for both NDO and LUTS (including those due to urinary tract infection [UTI]), which have the potential for greater efficacy due to higher concentration of therapeutics and fewer systemic side effects due to limited permeability of the uroepithelium. Specifically, intravesical therapeutics have the potential to prevent and treat UTI by altering uropathogen's access to the uroepithelium, washout of bacteria, uropathogen adherence, bladder ischemia, and other possible mechanisms of infection. This article presents intravesical therapeutic options for people with neurogenic lower urinary tract dysfunction (NLUTD) due to SCI/D, including bladder flushes and instillates of readily accessible medications and experimental agents (such as live biotherapeutics) in normal saline or sterile water. We propose that the intravesical approach to drug delivery is underutilized for people with NLUTD due to SCI/D and offers a valuable alternative to systemic medications.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"32 1","pages":"21-29"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12926791/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147285415","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":"Factors Affecting Self-Care Activities and Mobility in Patients With Incomplete Tetraplegia.","authors":"Jung Eun Lim, Duk Youn Cho, Jun Min Lee, Onyoo Kim","doi":"10.46292/sci24-00040","DOIUrl":"https://doi.org/10.46292/sci24-00040","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the factors affecting activities of daily living and mobility in patients with incomplete spinal cord injury (SCI) and to suggest the direction of training necessary for functional improvement.</p><p><strong>Methods: </strong>Sixty-three adult patients with SCI who were admitted to the National Rehabilitation Center (Seoul, Korea) formed our study population. Scores of 2 categories (self-care and mobility) in the Korean version of the Spinal Cord Independence Measure-III (KSCIM-III) were compared to the upper extremity motor score (UEMS), lower extremity motor score (LEMS), Modified Ashworth Scale (MAS), Visual Analog Scale (VAS), Graded Redefined Assessment of Strength, Sensibility, and Prehension (GRASSP), grip and pinch strength, Functional Ambulation Category (FAC), Berg Balance Scale (BBS), Trunk Impairment Scale (TIS), Korean version of Beck Depression Inventory-II, Korean version of the Pittsburgh Sleep Quality Index, and Lean indices. Correlation analysis was performed to investigate any correlation between each variable, and multiple regression analysis was performed to evaluate a causal relationship.</p><p><strong>Results: </strong>Self-care correlated significantly with American Spinal Injury Association Impairment Scale (AIS) classification D (<i>B</i> = -3.54, <i>P</i> = .035), GRASSP total (<i>B</i> = 0.05, <i>P</i> ≤ .001), and TIS total (<i>B</i> = 0.46, <i>P</i> ≤ .001). Mobility correlated significantly with GRASSP total (<i>B</i> = 0.05, <i>P</i> = .005), FAC (<i>B</i> = 3.21, <i>P</i> ≤ .001), and TIS total (<i>B</i> = 0.64, <i>P</i> = .005).</p><p><strong>Conclusion: </strong>This study demonstrated that upper and lower extremity functions and trunk control ability significantly affect self-care and mobility in patients with incomplete SCI. Thus, trunk control training should be emphasized in patients with incomplete SCI.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"32 1","pages":"38-50"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12926805/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147285493","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":"Gaps in Wheelchair Skills Training: Clinician Confidence, Capacity, and Service Provision in US Rehabilitation Practice.","authors":"Lynn A Worobey, Lauren R Malacarne, Aileen Chou, Olivia G Campbell, Elizabeth M Stanley, R Lee Kirby","doi":"10.46292/sci25-00112","DOIUrl":"https://doi.org/10.46292/sci25-00112","url":null,"abstract":"<p><strong>Background: </strong>Clinician ability to teach wheelchair skills varies widely and has not been characterized in the US. Identifying gaps in clinician capacity is integral to improving service provision and client outcomes.</p><p><strong>Objectives: </strong>To describe clinicians' capacity and confidence in performing and teaching wheelchair skills in the US.</p><p><strong>Methods: </strong>This was a cross-sectional survey conducted as part of a larger trial. A convenience sample of 234 rehabilitation therapists was surveyed. Measures included the Self-Efficacy for Assessing, Training, and Spotting Test for Manual Wheelchairs (SEATS), the Wheelchair Skills Test Questionnaire 5.1 (WST-Q), and data on training quantity (number of trainees, duration) and quality (skills trained, trainee skill mastery).</p><p><strong>Results: </strong>Over a 6-month period, clinicians trained a median of 2 people for 60 minutes on 2 skills per trainee, predominantly in inpatient settings (<i>P</i> < .001). For advanced skills, most clinicians reported being \"not at all\" confident in teaching. The number of trainees and trainee skill mastery were low across all skills and were nearly absent for community/advanced skills. SEATS scores for training (45%) were lower (<i>P</i> < .001) compared to spotting (68%) and assessing (57%). Clinicians' WST-Q capacity (33%) and confidence (30%) scores were low. Years of practice did not influence outcomes. Correlations were strong within WST-Q domains (<i>R</i> = 0.904) and SEATS domains (<i>R</i> = 0.707 to 0.724) and moderate between number of skills trained and SEATS training (<i>R</i> = 0.569).</p><p><strong>Conclusion: </strong>Clinicians lack confidence and infrequently train users, focusing mostly on basic skills. Higher clinician competency correlates with greater confidence and a wider variety of skills taught.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"32 Suppl 1","pages":"68-79"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13102070/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785358","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 Depression and Resilience During Acute Inpatient Rehabilitation on Pain Outcomes One Year After Spinal Cord Injury.","authors":"Elizabeth J Richardson, Casey B Azuero, Ricardo A Battaglino, Thomas N Bryce, Lisa L Haubert, Allen Heinemann, Kimberly R Monden, Leslie R Morse, Angela H Philippus, Heather R Taylor, Elizabeth R Felix","doi":"10.46292/sci25-00131","DOIUrl":"https://doi.org/10.46292/sci25-00131","url":null,"abstract":"<p><strong>Background: </strong>Chronic pain is a common and debilitating consequence of spinal cord injury (SCI) that interferes with many aspects of life. Although resilience can be a protective factor, few studies have examined its role in pain outcomes post SCI.</p><p><strong>Objectives: </strong>To examine whether depression and resilience, measured during inpatient rehabilitation, were predictive of pain severity and interference 1 year post SCI, whether resilience moderated the impact of depression on pain outcomes, and whether these relationships differed by pain type (neuropathic or non-neuropathic).</p><p><strong>Method: </strong>Data were drawn from 2327 individuals enrolled in the National SCI Model Systems Database. Depression and resilience were measured during inpatient rehabilitation and pain outcomes were obtained at 1 year post injury. Regression models tested main and interactive effects of resilience and depression on overall pain outcomes, and mixed models examined these effects across pain types.</p><p><strong>Results: </strong>Early depression consistently predicted future pain outcomes post SCI, demonstrating stronger associations with overall pain intensity and interference than resilience, which showed minimal independent effects. Early resilience was not associated with later pain interference. Although a modest depression by resilience interaction emerged in some models, depression largely overshadowed any protective influence of resilience. Moderating effects did not differ by pain type, though neuropathic pain was associated with higher pain intensity and greater interference with sleep.</p><p><strong>Conclusion: </strong>Level of depressive symptoms during acute rehabilitation is a robust predictor of pain outcomes 1 year post SCI, whereas resilience demonstrates limited predictive value and does not substantially moderate depression's association with pain.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"32 Suppl 1","pages":"149-161"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13102079/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785369","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":"Factors Contributing to Transition of Bladder Management Method Following Traumatic Spinal Cord Injury.","authors":"Rachel E Cowan, Christopher S Elliot, Huacong Wen, Elizabeth Twist, Michael J DeVivo, Yuying Chen","doi":"10.46292/sci25-00121","DOIUrl":"https://doi.org/10.46292/sci25-00121","url":null,"abstract":"<p><strong>Objectives: </strong>To identify demographic and medical factors associated with changing bladder management method and document the reason for changing bladder management method among adults with spinal cord injury (SCI).</p><p><strong>Methods: </strong>This cohort study included 20 Spinal Cord Injury Model Systems (SCIMS) centers. Participants were individuals injured between 1972 and 2019 who completed 2 consecutive assessments of bladder management method within 5 years and identified the reason for changing bladder management method at the second assessment. Main outcome measures were change in bladder management method since first assessment (changed/not changed) and, if change occurred, reason for changing.</p><p><strong>Results: </strong>Of 10,769 persons included in the analysis, 10.6% reported change in bladder management at the second assessment. After adjusting for covariates, higher odds of changing bladder management was observed among people who completed first assessment at discharge from initial rehabilitation and those who (a) used nonvolitional voiding for bladder management, (b) were older than 44 years of age, (c) had less than high school education, and (d) resided in a hospital or nursing home. The most reported reason for changing bladder management was medical-related factors (48.2%), followed by functional improvement (28.5%) and personal factors (19.6%).</p><p><strong>Conclusion: </strong>Understanding the patterns and predictors of bladder management transitions can help clinicians anticipate potential changes, provide proactive education and support, and implement strategies to minimize secondary complications.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"32 Suppl 1","pages":"208-219"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13102058/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785427","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":"Feasibility of a Home-based Transcutaneous Spinal Stimulation Program on Autonomic-Cardiovascular Safety After Incomplete Tetraplegia.","authors":"Muhammad Uzair Rehman, Momal A Wasim, Jakob N Deitrich, Rajbir Chaggar, Timothy Lavis, Ronald T Seel, Ashraf S Gorgey","doi":"10.46292/sci25-00116","DOIUrl":"https://doi.org/10.46292/sci25-00116","url":null,"abstract":"<p><strong>Objectives: </strong>We examined the safety and feasibility of delivering a home-based transcutaneous spinal stimulation (TSS) program in persons with incomplete tetraplegia. We also explored the cardiovascular-autonomic safety during the program.</p><p><strong>Methods: </strong>Males with chronic incomplete tetraplegia were invited to receive 4 weeks of supervised in-person education and training followed by 16 weeks of home-based training with assistance from a caregiver. Home-based training sessions (3 times weekly) were supervised by secured telehealth video-connect system that included monitoring blood pressure (BP) to ensure cardiovascular safety. Participants were randomized to either a TSS and blood flow restriction enhanced neuromuscular electrical stimulation exercise (BES) program (TSS+BES) or a sham TSS+BES group. Measurements were conducted at baseline 1 (BL1), BL2, post intervention (PI), and follow-up (Fw) including 60-degree head tilt with monitoring of blood pressure (BP) and pulmonary function tests.</p><p><strong>Results: </strong>Six participants completed the entire feasibility trial and were randomized into TSS+BES (<i>n</i> = 4) or sham TSS+BES (<i>n</i> = 2). Adherence rates were 80% ± 15% and 95% ± 7% for the TSS+BES and sham TSS+BES groups, respectively. Ten qualified participants were unable to enroll because of failure to identify a dedicated caregiver. No adverse events were reported during the trial. Home-based autonomic-cardiovascular safety of TSS+BES was ensured via reporting systolic BP during the entire session and absence of episodes of autonomic dysreflexia or orthostatic hypotension during the trial.</p><p><strong>Conclusion: </strong>Home-based TSS is a feasible rehabilitation approach after incomplete tetraplegia. The feasibility trial provided evidence for the cardiovascular safety of TSS, with no participants developing autonomic adverse events over the 20-week education and training intervention period. Future clinical trials may deliver home-based TSS with caregiver assistance and telehealth supervision to increase access to neuromodulation treatment that may enhance autonomic nervous system and hemodynamic stability in persons with SCI.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"32 Suppl 1","pages":"80-94"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13102063/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785430","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}