Topics in Spinal Cord Injury Rehabilitation最新文献

{"title":"Quantifying Personal Social Networks in Individuals With Traumatic Spinal Cord Injury: A Pilot Study.","authors":"Chloe Slocum, Sahnaz Pirooz, John Corbett, Ross Zafonte, Susan Robinson-Whelan, Lynne Worobey, Michelle Meade, Zachary Rothfeld-Wehrwein, Amar Dhand","doi":"10.46292/sci25-00130","DOIUrl":"10.46292/sci25-00130","url":null,"abstract":"<p><strong>Background: </strong>Individuals who sustain a traumatic spinal cord injury (TSCI) experience life-changing alterations in physiological and psychosocial function. Social connectivity has been shown to influence human health through direct biological and indirect psychosocial mechanisms in the general population. Robust personal social networks have been associated with improved health outcomes and quality of life.</p><p><strong>Objectives: </strong>This study aimed to describe personal social networks quantitatively in a national sample of individuals with TSCI and to explore measures of social connectivity in the context of community transportation resources and loneliness.</p><p><strong>Methods: </strong>We recruited 28 adults with newly sustained TSCI from the inpatient rehabilitation setting at 4 SCI Model Systems sites and adapted the Personal Social Network Survey (PERSNET), a quantitative personal social network assessment tool, to this population. We also collected relevant demographic and clinical information and measured loneliness.</p><p><strong>Results: </strong>Study participant networks reveal a broad range of social structures. Demographic and clinical characteristics reflected aggregate national data on TSCI. Living in geographic areas with greater access to transportation resources was not positively associated with social network size or density or lower loneliness at the time of injury.</p><p><strong>Conclusion: </strong>This is the first study to map personal social networks quantitatively in individuals with TSCI and to examine personal social network size and density in the context of community transportation resources and loneliness. While our study proves that it is feasible to collect personal social network data in the TSCI population, further research must examine the mechanisms by which personal social networks and environmental factors influence health and well-being after SCI.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"32 Suppl 1","pages":"35-43"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13102069/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785455","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":"High-Intensity Interval Training in Individuals with Subacute Motor Incomplete Spinal Cord Injury: An Explorative Randomized Controlled Trial.","authors":"Maxime J van Oort, Ilse J W van Nes, Dick H J Thijssen, Lise M Wilders, Maria T E Hopman, Nelleke G Langerak","doi":"10.46292/sci25-00101","DOIUrl":"https://doi.org/10.46292/sci25-00101","url":null,"abstract":"<p><strong>Background: </strong>Spinal cord injury (SCI) causes major functional limitations. The subacute phase offers a critical window to optimize recovery. High-intensity interval training (HIIT) may improve cardiorespiratory fitness (CRF) in chronic complete SCI, but evidence in subacute incomplete SCI is limited.</p><p><strong>Objectives: </strong>To evaluate the effects of 6 weeks of HIIT on CRF compared with usual care in subacute motor incomplete SCI.</p><p><strong>Methods: </strong>In this explorative randomized controlled trial, participants with subacute incomplete SCI were assigned to HIIT or usual care. HIIT involved 2 to 3 weekly arm-ergometry sessions. Usual care consisted of individualized inpatient rehabilitation fitness, mainly focusing on strength training. Primary outcomes were relative peak oxygen uptake (VO₂peak) and absolute peak power output (PPO), measured by cardiopulmonary exercise testing. Pre-post changes across all participants were analyzed with the Wilcoxon signed-rank test and between-group differences with the Mann-Whitney <i>U</i> test.</p><p><strong>Results: </strong>Of 19 randomized participants, 7/10 completed HIIT (70%), and all 9 completed usual care (100%). Across groups, relative VO₂peak increased from 18.0 (12.5-23.7) to 20.3 (14.4-24.8) mL/kg/min and absolute PPO increased from 63 (35-75) to 73 (45-85) watts post intervention (both <i>P</i> _S = .003), with no between-group differences. A higher proportion of HIIT participants (57%) achieved clinically meaningful VO₂peak improvements compared with usual care (33%).</p><p><strong>Conclusion: </strong>Inpatient rehabilitation, through HIIT or usual care, improved CRF in individuals with subacute motor incomplete SCI. Although between-group differences were not found, a greater proportion of HIIT participants achieved clinically meaningful CRF improvements, suggesting that HIIT may improve CRF in this population.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"32 2","pages":"96-109"},"PeriodicalIF":1.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13215339/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148057560","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":"Meaningful Engagement in Exercise Intervention Research Involving People with Spinal Cord Injury: Seven Practical Recommendations.","authors":"Heather L Gainforth, Alanna Shwed, Alexandra Walters, Kim D Anderson, John Chernesky, Femke Hoekstra, Camilla M Larsen, James Laskin","doi":"10.46292/sci25-00081","DOIUrl":"10.46292/sci25-00081","url":null,"abstract":"<p><strong>Introduction: </strong>Exercise intervention research involving people with spinal cord injury (SCI) has often excluded the perspectives and priorities of people with SCI, contributing to tokenism and misalignment between research and community needs. While consensus-based principles emphasize the importance of meaningful engagement, research teams lack concrete guidance on how to operationalize this engagement in practice.</p><p><strong>Objectives: </strong>To outline 7 consensus-based \"how-to\" recommendations that support research teams in meaningfully engaging research users, including people with SCI, throughout the design, delivery, evaluation, and dissemination of exercise intervention research.</p><p><strong>Methods: </strong>A multidisciplinary authorship team with extensive experience in SCI research and engagement co-developed the recommendations through a series of collaborative meetings. The team synthesized insights from lived experience, engagement literature, and pragmatic examples. Minimum expectations were defined through internal consensus using an online survey and iterative team discussions.</p><p><strong>Results: </strong>Seven recommendations were developed to emphasize flexibility and iteration: (1) adopt a principled and relational approach to engagement; (2) engage early and often with diverse research users; (3) commit to supporting a safe, welcoming, and inclusive environment; (4) establish shared decision-making processes; (5) recognize, compensate, and credit diverse forms of expertise; (6) utilize communication practices that are clear, accessible, and responsive; and (7) regularly reflect on, evaluate, and iterate engagement.</p><p><strong>Conclusion: </strong>These recommendations serve as baseline expectations to support research teams in avoiding tokenism and embedding meaningful engagement into exercise intervention research. Implementation requires individual, team, and system-level change. Sustained, non-tokenistic engagement depends not only on procedural guidance but also on institutional supports and shifts in academic culture.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"32 2","pages":"5-18"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13215351/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148057591","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":"Beyond One Size Fits All: Identifying Distinct Resilience Profiles in Spinal Cord Injury.","authors":"Angela Hanks Philippus, Mary D Sammel, Allan V Prochazka, Kimberley R Monden","doi":"10.46292/sci25-00108","DOIUrl":"10.46292/sci25-00108","url":null,"abstract":"<p><strong>Background: </strong>Resilience plays a critical role in adaptation following spinal cord injury (SCI), yet there is no consensus on how resilience is defined or measured. Current unidimensional approaches may miss important patterns in resilience responses that could inform targeted interventions.</p><p><strong>Objectives: </strong>To identify distinct subgroups of individuals with SCI based on resilience patterns using latent class analysis (LCA) and examine their associations with demographic, injury-related, and psychosocial factors.</p><p><strong>Methods: </strong>We conducted a cross-sectional analysis of 10,634 adults with SCI from the National SCI Model System Database who completed the Spinal Cord Injury-Quality of Life Resilience short form (SCI-QOL-R-SF) between 2016 and 2021. LCA identified response patterns across the 8 SCI-QOL-R-SF items. Polytomous logistic regression examined factors related to class membership. Linear regression assessed relationships between resilience classes and life satisfaction and depression symptoms.</p><p><strong>Results: </strong>A 3-class solution provided optimal fit: high resilience (40.5%), medium resilience (38.4%), and low resilience (21.1%). Classes demonstrated a clear gradient pattern of responses from \"always\" to \"sometimes\" on the SCI-QOL items. Significant predictors of class membership included sex, age, employment status, self-care behaviors, health status, time since injury, and social support. Resilience class was the strongest predictor of both life satisfaction (accounting for 14% of variance) and depression symptoms (12.2% of variance), with large effect sizes between classes.</p><p><strong>Conclusion: </strong>Distinct resilience patterns exist among individuals with SCI and strongly predict psychosocial outcomes. These findings support tailored interventions targeting specific resilience profiles to improve life satisfaction and reduce depression in this population.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"32 Suppl 1","pages":"137-148"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13102065/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785438","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":"Mixed-Methods Evaluation of the Pilot True Grit SCI Residential Program for Young Adults with Spinal Cord Injury.","authors":"Keara McNair, Aaron Dallman, Kassandra Boyd, Corinne Calvanico","doi":"10.46292/sci25-00107","DOIUrl":"10.46292/sci25-00107","url":null,"abstract":"<p><strong>Background: </strong>Young adults with spinal cord injury (SCI) face unique challenges during the transition to adulthood, including limited access to community-based programs that address participation, independence, and resilience.</p><p><strong>Objectives: </strong>To evaluate the pilot True Grit SCI program, a 5-day residential camp designed to support the transition to adulthood for young adults with SCI.</p><p><strong>Methods: </strong>This qualitatively driven, embedded mixed-methods study employed a realist evaluation framework guided by social cognitive theory. Six male participants with SCI (ages 16-20 years) attended the July 2024 pilot program. Quantitative measures included the Goal Attainment Scale (GAS), SCI-QOL Resilience Short Form, and Pediatric Measure of Participation (PMoP), administered at baseline and 3-month follow-up. Qualitative data were collected through semi-structured post-camp interviews. Data were analyzed descriptively and thematically, with integration through triangulation.</p><p><strong>Results: </strong>All participants demonstrated progress toward individualized goals, with mean GAS improvement of +1.67 (<i>SD</i> 0.82). Resilience outcomes varied, with 3 participants improving and 3 declining. Participation scores increased modestly, with the largest gains among those with lower baseline scores. Qualitative analysis identified 4 themes: building community and belonging, shared experiences foster confidence to try new things, overcoming barriers and redefining identity, and envisioning futures and inspiring others. Integration of findings demonstrated that peer-supported, structured programming both reinforced observed goal attainment and contextualized variable resilience outcomes.</p><p><strong>Conclusion: </strong>The evaluation of the True Grit SCI pilot suggests that short-term residential programming demonstrated the potential to promote resilience, participation, and self-efficacy among young adults with SCI. Variability in follow-up highlights the need for ongoing community supports to sustain gains.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"32 3","pages":"56-67"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13460073/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148714019","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":"Bladder and Bowel Dysfunction, Cognitive Appraisals of Disability, and Life Satisfaction in Individuals With Pediatric-Onset Spinal Cord Injury.","authors":"Olivia E Clark, Kyle Deane, Lawrence C Vogel, Kathy Zebracki","doi":"10.46292/sci25-00068","DOIUrl":"10.46292/sci25-00068","url":null,"abstract":"<p><strong>Background: </strong>Individuals with pediatric-onset spinal cord injury (SCI) represent a distinct group; management can be more complex than in adult-onset SCI. Changing medical needs, transfer of responsibility, and cognitive appraisals of disability may all impact life satisfaction in pediatric-onset SCI. Further, bladder/bowel management over many years may be time-consuming and socially disruptive. Cognitive appraisal of disability has been linked to life satisfaction and functioning in pediatric-onset SCI.</p><p><strong>Objectives: </strong>This study examines associations between bladder/bowel accidents, bowel management, cognitive appraisals, and life satisfaction in pediatric-onset SCI.</p><p><strong>Methods: </strong>Part of a larger study, 180 adults who sustained SCI age ≤18 and received treatment at a pediatric rehabilitation hospital system were interviewed. Participants were 55.6% male, 83.3% White, 38.6 years at interview, and 13.1 years at injury; 66.1% had complete injury, and 51.1% had paraplegia. Participants reported demographics/medical needs via semi-structured interview. Cognitive appraisals and life satisfaction were assessed using Appraisals of DisAbility Primary and Secondary Scale-Short Form and Satisfaction with Life Scale. Pairwise correlations with all constructs of interest and multivariable linear regressions using bowel program duration and cognitive appraisals as predictors of life satisfaction were conducted.</p><p><strong>Results: </strong>Correlations align with literature suggesting associations between bladder accident frequency/bowel program duration and negative appraisals of disability (<i>r</i> = .17-.22, <i>P</i> < .05) and bowel program duration and reduced life satisfaction (<i>r</i> = -.29, <i>P</i> < .01). Increased bowel program duration is associated with reduced growth and resilience appraisals (<i>r</i> = .32, <i>P</i> < .001). Regressions indicate that increased bowel program duration and negative appraisals (fearful despondency, overwhelming disbelief, negative perceptions) are associated with reduced life satisfaction (<i>R</i> ² = .12-.24).</p><p><strong>Conclusion: </strong>Findings suggest interventions targeting bowel management efficiency and cognitive appraisals may improve life satisfaction in this population.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"32 1","pages":"136-144"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12926792/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147285438","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":"Longitudinal Impact of Time and Negative Health Events on Physical Independence and Social Participation After Spinal Cord Injury.","authors":"Philip S Requejo, Susan Robinson-Whelen, Lisa Lighthall Haubert, Lynn A Worobey, Kim D Anderson, Kimberley R Monden, Michelle Meade, James S Krause","doi":"10.46292/sci25-00128","DOIUrl":"10.46292/sci25-00128","url":null,"abstract":"<p><strong>Background: </strong>Many individuals aging with spinal cord injury (SCI) experience health complications that threaten independence and participation. However, little is known about how negative health events (NHEs) and time since injury shape long-term functional and psychosocial outcomes for individuals with SCI.</p><p><strong>Methods: </strong>Participants were from a national longitudinal dataset of over 13,000 participants from the SCI Model Systems. Participants had 2 or more follow-up assessments of functional and psychosocial outcomes (CHART-SF and SWLS) and NHEs (composite of pain interference, rehospitalization, perceived health decline, and poor self-rated health). Multilevel modeling assessed the effects of time since injury, NHEs, and their interactions on functional and psychosocial outcomes. Latent profile analysis (LPA) was used to identify functional and psychosocial profiles under differing NHE burden.</p><p><strong>Results: </strong>Greater NHE burden predicted significant declines across all CHART-SF domains and SWLS (<i>P</i> < .001), whereas time since injury showed small or nonsignificant effects once NHEs were accounted for. Although NHEs adversely affected all groups, baseline functioning and the magnitude of decline varied by demographic and injury characteristics. LPA identified a 4-class solution, including a subgroup (11%) showing high functioning and life satisfaction despite elevated NHE burden, reflecting adaptive stability.</p><p><strong>Conclusion: </strong>NHEs-not aging alone -are key drivers of decline. However, a meaningful subgroup demonstrates adaptive stability despite significant health adversity, which is characteristic of resilience. Understanding and facilitating mechanisms that foster such adaptive capacity (e.g., psychosocial coping, support, behavioral adaptations) may inform individualized approaches for successful aging with SCI.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"32 Suppl 1","pages":"24-34"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13102060/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785416","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":"A Practical Guide for Researchers Prescribing Exercise to Improve Fitness and Health Outcomes in Individuals Living with Spinal Cord Injury.","authors":"Daniel D Hodgkiss, Jennifer L Maher, Rasmus Kopp Hansen, Gary J Farkas, James J Laskin, Mark S Nash, Glen M Davis, Tom E Nightingale","doi":"10.46292/sci25-00077","DOIUrl":"10.46292/sci25-00077","url":null,"abstract":"<p><p>Exercise is fundamental to promoting fitness and health in individuals living with spinal cord injury (SCI). Yet, real-world implementation of evidence-based exercise guidelines in this population has been limited. This guide presents a practical approach to exercise prescription for individuals living with SCI. Whilst it is tailored for researchers prescribing and delivering an exercise intervention in either rehabilitation or community settings with SCI participants, healthcare professionals and people living with SCI may also find this information helpful. Drawing upon the latest consensus-based recommendations and current literature, this guide emphasizes individualized exercise prescription for researchers using the frequency, intensity, time, type, volume, and progression (i.e., FITT-VP) principles alongside appropriate methods for exercise intensity monitoring. A brief overview of considerations related to safety and equipment is presented. Ultimately, this practical guide (with accompanying step-by-step checklist) aims to support researchers by summarizing current best practice exercise prescription approaches to improve fitness and health among individuals living with SCI.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"32 2","pages":"34-55"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13215353/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148057470","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 Impact of Marital Status on 20-Year Participation Trajectories in Individuals with Spinal Cord Injury.","authors":"Devyn E Smith, Yue Cao, Brielle D Grant, James S Krause","doi":"10.46292/sci25-00091","DOIUrl":"10.46292/sci25-00091","url":null,"abstract":"<p><strong>Background: </strong>Social participation following spinal cord injury (SCI) is associated with improved quality of life, but it may decline with age. While marital status supports greater social participation, the long-term impact as individuals age remains unclear.</p><p><strong>Objectives: </strong>To identify the relationship of marital status with participation trajectories using 20 years of longitudinal data.</p><p><strong>Methods: </strong>We conducted a cohort study of 343 participants with SCI who completed a self-report assessment 5 times in 2003, 2008, 2013, 2018, and 2023. Conditional growth models were used to assess trajectories of 4 participation indicators over the 5 repeated measurements.</p><p><strong>Results: </strong>At baseline, those married or cohabitating (MC) had more work hours per week, more hours out of bed per day, and more nights away from home last year than those divorced, separated, or widowed (DSW). We did not find significant differences between DSW and single individuals at baseline. Average scores declined across all 4 participation indicators over the 20 years, but the MC's rate of change for days out of the house declined slower compared to DSW. MC individuals also spent more hours out of bed than DSW across all time points, with both groups showing similar rates of decline over time, suggesting that MC individuals maintained a relative advantage despite the overall decrease.</p><p><strong>Conclusion: </strong>Our study showed declines in participation across all marital status groups, but critically a slower rate of decline for MC individuals, and they maintained higher participation levels at each time of measurement.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"32 4","pages":"46-55"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13621284/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149082463","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 Tidal Volume Strategies in Subacute Cervical Spinal Cord Injury: A Pilot Randomized Trial.","authors":"Radha Korupolu, Argyrios Stampas, Shrasti Lohiya, Isaac Hernandez Jimenez, Andrew Park, Marie-Françoise J Doursout, Matthew Davis, Randi Thompson, Elizabeth Gillespie, Claudia Pedroza, James J Fenton","doi":"10.46292/sci25-00090","DOIUrl":"10.46292/sci25-00090","url":null,"abstract":"<p><strong>Objectives: </strong>To assess feasibility of comparing moderate-low (8-10 mL/kg predicted body weight [PBW]) tidal volume (mLVT) versus moderate-high (14-16 mL/kg PBW) tidal volume (mHVT) strategies, and to generate exploratory data on respiratory outcomes and systemic inflammation in individuals with subacute cervical spinal cord injury (SCI) requiring mechanical ventilation (MV).</p><p><strong>Methods: </strong>In a randomized comparative effectiveness pilot trial at 2 inpatient rehabilitation hospitals, adults (≥18 years) with traumatic cervical SCI on MV were randomized to mLVT or mHVT. The primary outcome was feasibility (recruitment, adherence, retention). Secondary outcomes included pneumonia, other pulmonary complications, ventilator-free days (VFDs), and weaning success at discharge. Exploratory outcomes were changes in inflammatory markers (IL-6, IL-8, TNF-α, IL-1β). Bayesian regression models estimated relative risks (RR) and posterior probabilities.</p><p><strong>Results: </strong>Thirty participants (15 per group) were enrolled. Recruitment and retention rates were 76% and 100%. VT adherence was higher in mLVT (87% vs. 73%). Exploratory analyses suggested estimated risks of pneumonia and pulmonary complications in mLVT were RR 1.71 (95% credible interval [CrI] 0.64, 4.75; posterior probability = 0.86) and RR 1.57 (CrI 0.76, 3.33; posterior probability = 0.89), respectively. Median VFDs were greater in mLVT (12 vs. 7 days; posterior probability = 0.70). Weaning success was similar (73%). Trends in inflammatory markers favored mLVT, with greater reductions in IL-6, IL-8, and TNF-α.</p><p><strong>Conclusions: </strong>This trial supports the feasibility of comparing mLVT and mHVT strategies in subacute cervical SCI. Findings should be interpreted as hypothesis-generating and primarily serve to inform outcome selection and sample size calculations for a definitive trial.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"32 4","pages":"1-19"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13621288/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149082377","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}