Topics in Spinal Cord Injury Rehabilitation最新文献

{"title":"Predictors of Acute and Late Spasticity After Traumatic Spinal Cord Injury: Implications for Recovery.","authors":"Andréane Richard-Denis, Albert Kabeya Meji, Antoine Dionne, Pascal Mputu Mputu, Jean-Marc Mac-Thiong","doi":"10.46292/sci25-00032","DOIUrl":"10.46292/sci25-00032","url":null,"abstract":"<p><strong>Background: </strong>Spasticity is a common complication following traumatic spinal cord injury (TSCI) that impacts neurofunctional recovery.</p><p><strong>Objectives: </strong>This study aimed to determine the prevalence of acute and late spasticity and identify clinical predictors associated with spasticity onset within the first year after TSCI.</p><p><strong>Methods: </strong>We conducted a retrospective longitudinal cohort study involving 156 adults hospitalized for acute supraconal (C1-T12) TSCI at a level 1 trauma center from April 1, 2010, to December 31, 2021. Independent factors included demographic variables (age, sex, body mass index), trauma-related characteristics, and acute medical complications. Spasticity onset was categorized as acute (during acute hospitalization), late (after acute hospitalization within 1 year), or none. Multinomial logistic regression model was used to identify factors associated with the period of spasticity onset.</p><p><strong>Results: </strong>Among the patients, 57 (36.5%) developed acute spasticity (mean onset at 24.7 ± 13.7 days after admission), 55 (35.3%) experienced late spasticity, and 44 (28.2%) showed no spasticity within the first year. Higher AIS motor score at admission was associated with greater likelihood of either late or no spasticity (OR 1.05, <i>P</i> < .001; OR 1.02, <i>P</i> = .04). High-energy trauma increased the risk of developing acute spasticity (OR 0.37, <i>P</i> = .04). An AIS motor score below 50 (most severely impaired) at admission identified individuals at higher risk of acute spasticity, with 85.7% sensitivity and 71% overall accuracy.</p><p><strong>Conclusion: </strong>Greater injury severity and high-energy trauma are associated with early spasticity onset, highlighting the need for early risk stratification and personalized management strategies to optimize patient outcomes.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"32 3","pages":"149-160"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13460152/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148714010","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":"Scrambler Therapy for Neuropathic Pain After Spinal Cord Injury: Two Case Reports.","authors":"Zhu Wang, Philippines Cabahug, Thomas J Smith","doi":"10.46292/sci25-00143","DOIUrl":"10.46292/sci25-00143","url":null,"abstract":"<p><p>Neuropathic pain after spinal cord injury (SCI) is common and often refractory to treatment. Scrambler Therapy (ST) is a noninvasive neuromodulation approach that delivers synthetic \"nonpain\" signals via cutaneous electrodes. We report 2 cases of SCI-related neuropathic pain treated with ST. One patient experienced transient and inconsistent relief, while the other achieved substantial, durable improvement with functional recovery and complete response after retreatment. ST was well tolerated with minimal adverse effects. These cases highlight variable response and support further study of ST as a potential treatment for refractory SCI-related neuropathic pain.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"32 4","pages":"137-140"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13621287/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149082479","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: 9th edition 2026.","authors":"Ruediger Rupp, Fin Biering-Sørensen, Stephen Burns, Steffen Franz, Julio C Furlan, James Guest, Linda Jones, Steven Kirshblum, Andrei Krassioukov, Isa McClure, Gianna Rodriguez, Mary Schmidt Read, Brittany Snider, Christian Schuld, Keith Tansey, Kristen Walden","doi":"10.46292/sci26-00067","DOIUrl":"10.46292/sci26-00067","url":null,"abstract":"","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"32 4","pages":"141-168"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13621290/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149082423","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":"Proceedings for a Webinar on Aging with Spinal Cord Injury: Opening a Conversation.","authors":"Michael Stillman, Kim Anderson-Erisman, Leslie R Morse, Kristofer Feeko, Ryan Solinsky, Suzanne Groah, Marie Protesto, Ruth Black","doi":"10.46292/sci25-00076","DOIUrl":"10.46292/sci25-00076","url":null,"abstract":"<p><p>Between 1940 and 2010, life expectancy doubled for people with spinal cord injury (SCI). In response to this survival trend, literature emerged examining how people grow older with SCI. While some authors posited that people with SCI age prematurely, others focused on the incidence of coexisting conditions over the course of an injury. These latter data are important in that they can help individuals with SCI, their care partners, and clinicians anticipate medical needs, but they fail to capture the subjective experience of aging with SCI. To date, no work has examined the complex health-related challenges that may attend longer standing injuries or whether and how the presentation and management of coexisting conditions change over time. Given this dearth of knowledge around the real-world experiences of aging with SCI, the authors hosted a community-focused, peer-led, Zoom-based conference addressing medical challenges specific to growing older with SCI. Focusing on bone health, chronic pain, blood pressure management, and neurogenic bladder, invited speakers presented cases and a moderator facilitated discussions between attendees. In this report, we summarize the concerns and questions that arose during the conference and propose topics for future investigation.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"32 3","pages":"161-168"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13460113/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148713997","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":"Improving and Monitoring Adherence to Exercise Interventions Involving Persons with a Spinal Cord Injury: Actionable Strategies.","authors":"Matteo Ponzano, Jennifer R Tomasone, Kenneth S Noguchi, Haley A Berrisford, Kathleen A Martin Ginis","doi":"10.46292/sci25-00078","DOIUrl":"10.46292/sci25-00078","url":null,"abstract":"<p><p>The Physical Activity Special Interest Group of the International Spinal Cord Society (ISCoS) formed an international panel that established consensus-based recommendations to improve the methodological quality of exercise intervention research involving persons with a spinal cord injury (PwSCI). This article presents guidance on using the group's 12 recommendations for supporting and monitoring adherence to exercise interventions. Topics covered include the use of behavior change theories and techniques, physical activity counseling, and strategies to facilitate quality exercise participation experiences. Recommendations for monitoring exercise adherence are also discussed along with advantages, disadvantages, and practical examples of different monitoring techniques. The adoption and reporting of strategies to maximize and monitor adherence is an important step toward improving the overall quality of SCI exercise research.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"32 2","pages":"56-65"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13215345/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148057558","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":"Yoga as Therapy: Reasonable Movements That Rejuvenate the Mind and Body After Spinal Cord Injury.","authors":"Himani Prajapati, W Ben Mortenson, Krista L Best, William C Miller","doi":"10.46292/sci25-00083","DOIUrl":"10.46292/sci25-00083","url":null,"abstract":"<p><strong>Background: </strong>People with spinal cord injury (SCI) experience long-term physical, emotional, and social challenges. Although adaptive yoga may support physical function and psychosocial well-being, its integration into rehabilitation and community care remains limited.</p><p><strong>Objectives: </strong>To explore the experiences and perceptions of yoga for people with SCI, drawing perspectives from people with SCI, healthcare providers (HCPs), and certified yoga therapists.</p><p><strong>Methods: </strong>Using a qualitative descriptive approach, we conducted semi-structured interviews with 20 participants: people with SCI (<i>n</i> = 10), HCPs (<i>n</i> = 4), and certified yoga therapists (<i>n</i> = 6). Interviews were audio-recorded, transcribed verbatim, and thematically analyzed.</p><p><strong>Results: </strong>Four interconnected themes were identified. Breaking Barriers to Participation highlighted financial, transportation, and access-related challenges that limited engagement in adapted yoga. Meeting People Where They Are: Yoga Therapists' Adaptability in Action emphasized the importance of instructor adaptability and inclusive teaching practices, while also describing situations where limited instructor knowledge of SCI shifted the burden of adaptation onto participants. Perceiving Benefits of Doing Yoga captured participants' experiences of physical engagement, mind-body reconnection, emotional regulation, and social inclusion. Finally, Yoga as a Pathway to Long-Term Wellness and Community Integration reflected healthcare professionals' views of yoga as a potential bridge between rehabilitation and community living, alongside perceived barriers to confident recommendation and integration.</p><p><strong>Conclusion: </strong>Adaptive yoga was perceived as a promising person-centered and holistic approach for individuals with SCI. Addressing barriers related to training, access, and clinical pathways could support safer, more inclusive delivery. Cross-sector collaboration is key to embedding yoga into long-term wellness and rehabilitation systems.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"32 3","pages":"169-184"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13460157/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148714058","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":"Understanding Adherence to Mandibular Advancement Device Therapy for Obstructive Sleep Apnea in Chronic Spinal Cord Injury: A Mixed-Methods Study.","authors":"Lenka Honzatkova, Marnie Graco, Jiri Kriz","doi":"10.46292/sci25-00093","DOIUrl":"10.46292/sci25-00093","url":null,"abstract":"<p><strong>Background: </strong>Obstructive sleep apnea (OSA) is common among individuals with spinal cord injury (SCI). Whilst continuous positive airway pressure (CPAP) remains the primary treatment, adherence is low in SCI. Mandibular advancement devices (MADs) offer a viable alternative. Our prior research has demonstrated that MADs effectively treat moderate-to-severe OSA in chronic SCI.</p><p><strong>Objectives: </strong>To estimate adherence to MADs, report common side effects, and explore the barriers and enablers to using MADs from the perspectives of individuals with SCI.</p><p><strong>Methods: </strong>Individuals with chronic SCI with an apnea-hypopnea index (AHI) ≥15/hour received a custom-made MAD. They attended appointments at 1 week and 1, 3, and 6 months after treatment initiation. Questionnaires and semistructured interviews were completed to assess adherence and side effects and to explore the participants' experience of using MAD.</p><p><strong>Results: </strong>Forty participants were included, and 35 completed the study. After 1 month, 65% (26/40) met adherence criteria (≥4 hours/ night). At 6 months, adherence had increased to 70% (28/40). Adherent participants experienced significantly greater improvements in the AHI than nonadherent participants (19.4 ± 15.7 vs. 10.7 ± 5.2; <i>P</i> = .02). Motivating factors for accepting treatment included alleviating daytime fatigue and snoring and receiving care in the familiar rehabilitation facility. Temporary side effects, such as tooth discomfort or excessive salivation, were not reasons for discontinuation.</p><p><strong>Conclusion: </strong>MADs are an acceptable, well-tolerated treatment for OSA in SCI, with adherence rates approximately 3 times higher than reported for CPAP. Improving access to MADs could significantly increase the number of people with SCI being effectively treated for OSA.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"32 3","pages":"109-121"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13460168/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148714041","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":"Can Pupil Changes Detect Autonomic Dysregulation After Spinal Cord Injury? A Systematic Review.","authors":"Raza N Malik, Ali Hosseinzadeh, Gulcenur Ozturan, Janan Niknam, Liliana K Wolak, Tiev Miller, Keith Tansey, Andrei Krassioukov","doi":"10.46292/sci25-00140","DOIUrl":"10.46292/sci25-00140","url":null,"abstract":"<p><strong>Objectives: </strong>The autonomic neural circuitry of the pupil makes it a unique target for identifying impaired autonomic regulation following spinal cord injury (SCI). This systematic review characterizes the evidence on pupillary changes after SCI.</p><p><strong>Methods: </strong>A systematic search was conducted in MEDLINE, Embase, and CINAHL. Articles were independently assessed by 2 reviewers and included studies reporting on pupillary changes (e.g., miosis, mydriasis, anisocoria) following traumatic or nontraumatic SCI at any level. Data on study design, patient demographics, injury characteristics, and pupillary changes were extracted. We used the Joanna Briggs Institute Critical Appraisal checklists for quality assessments and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.</p><p><strong>Results: </strong>We identified 486 studies, of which 37 articles (36 case reports and 1 cross-sectional study) were included and primarily of medium quality. All studies reported anisocoria, with 81% involving unilateral miosis, 16% involving unilateral mydriasis, and 3% unspecified. Pupillary dysfunction predominantly occurred in people with cervical or high thoracic SCI acutely (<20 days after injury) or in the intermediate-to-chronic phase of SCI (>4 months post injury).</p><p><strong>Conclusion: </strong>Most studies identified in this review were case reports describing pupil abnormalities likely related to trauma of autonomic pathways-either central or peripheral-resulting from SCI or associated injuries (e.g., brain injury) during the acute phase. In the intermediate-to-chronic phase, autonomic dysreflexia was often reported alongside pupil changes. Larger cohorts and quantitative pupil detection technologies are needed to validate the utility of pupil data in SCI research and clinical care.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"32 4","pages":"123-136"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13621279/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149082245","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":"Evaluating Psychometric Characteristics of the SCI-QOL Ability to Participate and Satisfaction With Social Roles and Activities.","authors":"Emily J Dinelli, Anne Deutsch, Heerak Choi, Allen W Heinemann","doi":"10.46292/sci25-00105","DOIUrl":"10.46292/sci25-00105","url":null,"abstract":"<p><strong>Background: </strong>The SCI Model System centers collect SCI-QOL Participation in Social Roles and Activities and Satisfaction with Social Roles and Activities short forms data, which contributes to lengthy research follow-up interviews. Collaborators sought to abbreviate interviews without compromising measurement properties.</p><p><strong>Objectives: </strong>To (1) evaluate psychometric characteristics of 2 SCI-QOL short forms, (2) identify items exhibiting differential item functioning related to injury or demographic characteristics, and (3) recommend abbreviated short forms.</p><p><strong>Methods: </strong>We obtained data from the National Spinal Cord Injury Model Systems Database and used rating scale software to evaluate measurement properties, dimensionality, and differential item functioning. We removed items systematically until we produced 2 abbreviated short forms of the measures with acceptable measurement properties.</p><p><strong>Results: </strong>For the Participation short form, a sample of 4148 individuals yielded a person-separation reliability of .82 with adequate measurement properties albeit one misfitting item. The decision to remove 2 items was guided by Rasch analysis results and supported by qualitative evaluation of item relevance. Eight items yielded a person reliability of .79 and adequate measurement properties. For the Satisfaction short form, positively and negatively worded items provoked dimensionality. Retaining the positively worded items yielded person reliability of .84.</p><p><strong>Conclusion: </strong>An 8-item Participation and a 5-positive-item Satisfaction short form reduce respondent and interviewer burden while preserving adequate measurement properties. Investigators can select from a variable-length computer adaptive version, 10-item short forms, or abbreviated short forms to measure these constructs based on burden considerations and tolerance for measurement error.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"32 Suppl 1","pages":"44-57"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13102080/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785385","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":"Neuropathic Pain Severity Is Associated With Opioid Use in Adults With Traumatic Spinal Cord Injury: A Spinal Cord Injury Model System Study.","authors":"Leslie R Morse, Thomas N Bryce, Argyrios Stampas, Lisa Haubert, Susan Charlifue, Kevin Dalal, Ricardo A Battaglino, Nguyen Nguyen, Richard Goldstein, Elizabeth R Felix","doi":"10.46292/sci25-00129","DOIUrl":"10.46292/sci25-00129","url":null,"abstract":"<p><strong>Objectives: </strong>To identify biopsychosocial factors associated with opioid use for neuropathic pain in adults with SCI.</p><p><strong>Methods: </strong>We studied 283 adults with SCI who were enrolled in a collaborative project at 1 of 6 participating SCI Model System centers. Using International Spinal Cord Injury Pain Basic and Extended Data Sets, participants were asked about pain, current and prior pain medication use in the past year, and nonpharmacological pain treatment use in the past year, for up to 3 pain conditions. The relationship between active opioid use and neuropathic pain severity, adjusting for relevant clinical and demographic characteristics, was examined using logistic regression using odds ratios (OR) and 95% confidence intervals (CI).</p><p><strong>Results: </strong>There were 104 opioid users and 179 nonusers. In multivariable regression models, employment was associated with a 33% reduction in opioid use compared to unemployment. Opioid users were more likely to use anti-epileptics, a combination of cannabis and anti-epileptics, or a combination of anti-epileptics and nonsteroidal anti-inflammatory drugs than nonusers. Individuals with paraplegia were almost twice as likely to use opioids compared to those with tetraplegia. After adjusting for these factors, the odds of using opioids increased 10% with every 1-point increase in reported worst neuropathic pain severity (0-10 numeric rating scale). This model has good ability to discriminate between opioid users and nonusers based on the area under the curve (AUC) of 0.74.</p><p><strong>Conclusions: </strong>We have developed a biopsychosocial base model of opioid use in adults with chronic pain after SCI with good predictive performance cross-sectionally and identified key potential risk factors for opioid use.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"32 Suppl 1","pages":"118-126"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13102057/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785492","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}