Topics in Spinal Cord Injury Rehabilitation最新文献

{"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":"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":1.4,"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":"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":1.4,"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":"Development, Validity, and Reliability of the Spinal Cord Injury Instrumental Activities of Daily Living Measure (SCI-IADLM).","authors":"Twinkle Luthra, Ishmeet Singh, Lipika Malik","doi":"10.46292/sci25-00139","DOIUrl":"10.46292/sci25-00139","url":null,"abstract":"<p><strong>Background: </strong>Instrumental activities of daily living (IADLs) determine community participation and independence after spinal cord injury (SCI) but are seldom measured with culturally relevant, SCI-specific instruments in India.</p><p><strong>Objectives: </strong>To develop the Spinal Cord Injury Instrumental Activities of Daily Living Measure (SCI-IADLM) for adults with SCI in India and to examine its preliminary content validity, internal consistency, and reliability.</p><p><strong>Methods: </strong>This methodological instrument development study was conducted at the Indian Spinal Injuries Centre, Vasant Kunj, New Delhi. Item generation combined a focused literature review and semi-structured interviews with stakeholders (<i>n</i> = 15). A 3-round content validation using Lawshe's method was conducted with 17 panellists (9 clinicians, 8 individuals with SCI). The final 33-item instrument was pilot-tested in 30 purposively sampled adults with SCI. Internal consistency (Cronbach's α), inter-item correlations, and \"α if item deleted\" analyses were performed. Scale-level content validity index (CVI) was computed. Reliability was calculated by item analysis and test-retest reliability.</p><p><strong>Results: </strong>The SCI-IADLM comprises 33 items across 12 domains including household management, community mobility, communication, financial management, and health management. All retained items exceeded the Lawshe content validity ratio (CVR) threshold for <i>N</i> = 17 (CVR ≥ 0.529); scale-level CVI = 1.00. Pilot testing (<i>n</i> = 30) yielded Cronbach's α = 0.857. Inter-item correlations ranged from -0.426 to 0.852. Deletion of items 4 (care of pets) or 24 (educational participation) would minimally increase α to 0.865; these items were retained for theoretical importance. Participant feedback indicated clarity and acceptability. Test-retest reliability analysis demonstrated high preliminary stability, with an intraclass correlation coefficient (ICC) of 1.00 (95% confidence interval: lower bound 0.99, upper bound 1.00) in the pilot sample.</p><p><strong>Conclusion: </strong>The SCI-IADLM demonstrates strong preliminary content validity and good internal consistency in a pilot sample of adults with SCI in India. Further large-scale multisite psychometric validation (test-retest reliability, factor structure/Rasch analysis, responsiveness, and cross-linguistic adaptation) is necessary.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"32 4","pages":"98-108"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13621280/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149082411","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 an Adaptive Exercise Program on Inflammation After Spinal Cord Injury.","authors":"Amanda A Herrmann, Ella A Chrenka, Lap Pui Chung, Steven D Jackson, Samantha J Sherman, Samuel P Swanson, Ricky L Lopez, Andrew D Rapacz, Aleta L Svitak, Marny T Farrell, Ingrid A Bentley, Srishti Seth, Leah R Hanson","doi":"10.46292/sci25-00102","DOIUrl":"10.46292/sci25-00102","url":null,"abstract":"<p><strong>Background: </strong>Chronic inflammation contributes to cardiovascular and respiratory diseases, the leading causes of death in individuals with spinal cord injury (SCI). People with SCI tend to have higher inflammation levels than able-bodied individuals and are often physically inactive despite the anti-inflammatory benefits of exercise.</p><p><strong>Objectives: </strong>This study evaluated whether an adaptive exercise program could reduce inflammation in individuals with SCI.</p><p><strong>Methods: </strong>Twenty-four individuals with SCI were randomized to either an immediate start (intervention) or delayed start (control) group. The 12-week intervention consisted of 1-hour exercise sessions, 3 times per week, including moderate-intensity aerobic exercise, resistance training, and flexibility exercises.</p><p><strong>Results: </strong>Twenty-four participants (mean age 53), primarily White males, were enrolled. The intervention group demonstrated a 59% greater reduction in IL-6 compared to controls (<i>P</i> = .02), while other biomarkers (CRP, TNF-α, IL-1RA) showed no significant differences. Strength significantly improved in the intervention group; however, no changes were observed in cardiovascular fitness.</p><p><strong>Conclusion: </strong>While the results of the study are mixed, there is some evidence that adaptive exercise could reduce inflammation in individuals with SCI. Future studies with larger samples and longer follow-up periods could explore the maintenance of these effects and their influence on long-term clinical outcomes.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"32 4","pages":"32-45"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13621282/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149082416","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":"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":1.4,"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":"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":"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":1.4,"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 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":"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":1.4,"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":"Validity of Calera^® Sensor for Assessing Core Temperature During Arm Crank Exercise in Individuals with Spinal Cord Injury in a Moderate Thermal Environment.","authors":"Jose Luis Sanchez-Jimenez, Rosa M Cibrian-Ortiz de Anda, Soraya Martin-Manjarres, Maria Teresa Pellicer-Chenoll, Inmaculada Aparicio-Aparicio, Jose Ignacio Priego-Quesada","doi":"10.46292/sci25-00072","DOIUrl":"10.46292/sci25-00072","url":null,"abstract":"<p><strong>Background: </strong>Wearables that allow core temperature to be monitored are an important development for athletes with spinal cord injury (SCI) due to their increased risk of suffering heat-related illness.</p><p><strong>Objectives: </strong>To assess the validity of the Calera^® heat flux sensor compared to ingestible telemetric pills (BodyCap) for monitoring core temperature during a graded exercise test in individuals with SCI and non-SCI participants.</p><p><strong>Methods: </strong>Twenty-one participants were included (SCI, 12; non-SCI, 9). The participants conducted a graded exercise test that consisted of 3-minute stages with 1-minute rest intervals, and core temperature was continuously measured using ingestible telemetric pills and the Calera^® heat flux sensor. Intraclass correlation coefficients (ICC) and bias were calculated to assess agreement between methods, with comparisons made between SCI and non-SCI groups.</p><p><strong>Results: </strong>In non-SCI participants, agreement between the methods was good [ICC = 0.65, <i>P</i> < .001; bias = 0.06 (0.22) °C; 95% CI 0.02 to 0.11 °C], while SCI participants showed poor agreement [ICC = -0.12, <i>P</i> = .93; bias = -0.11 (0.46) °C; 95% CI -0.19 to -0.03 °C]. The percentage of measurements where the mean difference between methods exceeded 0.3 °C was 15% in non-SCI participants and 42% in SCI participants.</p><p><strong>Conclusion: </strong>The Calera^® heat flux sensor is not a valid tool for assessing core temperature in individuals with SCI in moderate thermal environments.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"32 3","pages":"68-77"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13460151/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148713979","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":"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":1.4,"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}

{"title":"Validation of MENTOR Tool to Describe Bowel Dysfunction in Inpatient Rehabilitation Setting.","authors":"James R Wilson, Victoria Alvarenga, Rachel E Cowan, Amanda DeRasmi, Katherine Martinez, Kimberley R Monden, Jeffery W Rankin, Anna Rybińska-Campbell, Jose R Vives Alvarado, Kimberly D Anderson","doi":"10.46292/sci25-00115","DOIUrl":"10.46292/sci25-00115","url":null,"abstract":"<p><strong>Background: </strong>People living with spinal cord injury (SCI) rate neurogenic bowel dysfunction (NBD) as one of the biggest daily challenges. Currently, no validated clinical decision-making tool exists to guide NBD management during the acute/subacute period following SCI, a time highlighted by frequent complications and rapid clinical changes. Previously, the Monitoring Efficacy of NBD Treatment On Response (MENTOR) tool was developed to facilitate shared decision-making between the clinician and the person living with chronic SCI in bowel management.</p><p><strong>Objectives: </strong>To assess MENTOR tool validity in an acute/subacute setting.</p><p><strong>Methods: </strong>Prior to discharge from inpatient rehabilitation, the MENTOR tool was completed by a study member via interview, followed immediately by a clinical evaluation by a study clinician who was masked to the MENTOR results. Concordance between the MENTOR tool and the clinical evaluation was assessed using percent agreement calculations.</p><p><strong>Results: </strong>Two hundred forty participants were enrolled. Significant differences were observed in relation to demographic and clinical factors between various SCI categories and clinical sites. Overall concordance between MENTOR and clinical recommendations was 40.6%. Regardless of factors such as satisfaction score, presence of special attention symptoms, or MENTOR results, \"no change\" was the most common clinician evaluation.</p><p><strong>Conclusion: </strong>Similar concordance for using the MENTOR tool as a clinical decision-making tool in the acute/subacute population as compared to the chronic population was not demonstrated. However, the MENTOR tool may be useful as a screening tool to determine whether a clinician assessment is required.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"32 Suppl 1","pages":"220-231"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13102059/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785487","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}