Topics in Spinal Cord Injury Rehabilitation最新文献

{"title":"Association of Meeting Physical Activity Guidelines With Psychosocial and Health Outcomes in Spinal Cord Injury.","authors":"Kimberley R Monden, Angela Hanks Philippus, Nidhi Pai, Carrie Shogren, Erjia Cui, Jesse L Kowalski, Abby Welch, Amanda A Herrmann, Leah R Hanson, Ronald K Reeves, Shraddha Srivastava, Amanda DeRasmi, Kim D Anderson, Elizabeth R Felix, Suzanne Groah, Ana Valeria Aguirre Guemez, Katherine Martinez, Leslie R Morse, Lynn Worobey","doi":"10.46292/sci25-00120","DOIUrl":"10.46292/sci25-00120","url":null,"abstract":"<p><strong>Background: </strong>Physical inactivity is highly prevalent among individuals with spinal cord injury (SCI), contributing to secondary health conditions and reduced quality of life (QOL).</p><p><strong>Objectives: </strong>To examine the independent associations between adherence to SCI cardiorespiratory fitness guidelines and health and psychosocial outcomes, while controlling for relevant covariates.</p><p><strong>Method: </strong>We conducted a multisite, cross-sectional study of adults with traumatic SCI stratified by self-reported leisure-time physical activity: no activity (28%), some activity (41%), and met guidelines (26%). Multivariable regression models analyzed associations between physical activity (PA) group and outcomes of hospitalization, self-perceived health, resilience (SCI-QOL Resilience), pain, depression (PHQ-8), QOL (SWLS), and social integration (CHART-SF).</p><p><strong>Results: </strong>The study included 361 participants (no activity, 28%; some activity, 41%; met guidelines, 26%). Meeting PA guidelines was associated with better self-perceived health (odds ratio [OR] 2.79, <i>P</i> < .001) and higher resilience (β = 1.78, <i>P</i> = .04) compared to the No Activity group. However, hospitalization risk was unexpectedly higher for both the Some Activity (risk ratio [RR] 1.93, <i>P</i> = .005) and Met Guidelines (RR 1.75, <i>P</i> = .03) groups. After adjusting for covariates, PA was not significantly associated with pain, depression, QOL, or social integration; instead, higher income was consistently associated with better outcomes in these domains.</p><p><strong>Conclusion: </strong>Adherence to SCI exercise guidelines is associated with enhanced self-perceived health and resilience. However, PA alone was not associated with broader psychosocial outcomes in this model, where socioeconomic factors such as income appeared to play a significant explanatory role.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"32 Suppl 1","pages":"103-117"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13102076/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785449","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":"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":1.4,"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":"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":"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":1.4,"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":"A Bedside Score Predicts One-Year Walking Recovery in AIS C Spinal Cord Injury: A Multisite Cohort Study.","authors":"Andrew C Smith, Jeffrey Kepple, Kenneth A Weber, Wesley A Thornton, Jordan R Connor, Jesse Villines, Candace Tefertiller, Andrew Park, Jeffrey Berliner, Christina Draganich","doi":"10.46292/sci26-00004","DOIUrl":"10.46292/sci26-00004","url":null,"abstract":"<p><strong>Background: </strong>Walking recovery after American Spinal Injury Association Impairment Scale (AIS) C spinal cord injury (SCI) remains difficult to predict.</p><p><strong>Objectives: </strong>This study aimed to validate the prognostic value of quadriceps strength for future walking and to develop and test a simplified bedside clinical prediction rule (CPR) for walking recovery in AIS C SCI.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study using Spinal Cord Injury Model Systems data. Neurological examinations were performed at rehabilitation admission. Predictors included binary indicators of ≥3/5 muscle strength for key myotomes (L2, L3, L4, S1) and age cutoffs (≥50, ≥65 years). Logistic regression coefficients were scaled into an integer-based bedside score with 3 categories: likely walk, likely no walk, and uncertain. Model performance was evaluated using a random 20% holdout test set. A total of 1414 adults initially classified as AIS C were included; 40% achieved walking recovery at 1 year.</p><p><strong>Results: </strong>Quadriceps strength ≥3/5 was significantly associated with walking recovery (<i>P</i> < .0001) but demonstrated modest diagnostic accuracy when considered alone. In the CPR training set, 9% were categorized as likely walk and 7% as likely no walk, with accuracy 81%, sensitivity 92%, specificity 72%, positive predictive value 72%, and negative predictive value 92%, with similar performance in the test set. A large proportion of patients remained uncertain.</p><p><strong>Conclusion: </strong>A simple bedside score combining lower extremity strength and age offers clinically useful early risk stratification for individuals with AIS C SCI. Prospective validation and refinement are needed to improve classification of indeterminate cases. The CPR is available at: aiscwalkingcpr.org.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"32 4","pages":"91-97"},"PeriodicalIF":1.4,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13621286/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149082239","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":"Perspectives on Barriers to Use and Benefits of Functional Electrical Stimulation From Australians and New Zealanders With SCI and Clinicians and Researchers in the Field.","authors":"Anne E Palermo, Edward Gorgon, Antonio Vecchio, Lisa Tedesco Triccas, Euan McCaughey, Maggie Donovan-Hall","doi":"10.46292/sci24-00013","DOIUrl":"10.46292/sci24-00013","url":null,"abstract":"<p><strong>Objectives: </strong>To document, through a survey, perceptions of functional electrical stimulation (FES) from people with spinal cord injury (SCI) and carers, clinicians, and researchers (CCR).</p><p><strong>Methods: </strong>Online questionnaires were completed in Australia and New Zealand from December 1, 2021 to August 31, 2022. Subgroups included people with SCI who have used FES, people with SCI who have not used FES, CCRs who have used FES, and CCRs who have not used FES. Frequencies and percentages of subgroup data were calculated for all questions. Open-ended responses were analyzed with inductive content analysis.</p><p><strong>Results: </strong>Ninety-nine responses (70 people with SCI, 29 CCR) were analyzed. Out of the 99 responses, 47 people with SCI and 27 CCRs had used or currently use FES. Muscle strength was the most frequently reported benefit by people with SCI and CCRs who use(d) FES. Lack of training was the most frequently reported barrier to FES by people with SCI (85% of question responders) and CCRs (94%) who had used FES. People with SCI (95%) who had not used FES reported access as a barrier. The leading priorities for future research include improved ease of use for people with SCI (60% people with SCI) and clinical guidelines (48% CCR). Qualitative findings supported the quantitative findings.</p><p><strong>Conclusion: </strong>This survey identified access as a barrier to FES and echoed benefits (strength) and barriers (training) reported in previous research. Ameliorating the barriers and investigating the areas of future research identified in this study will ultimately improve FES uptake in SCI rehabilitation.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"31 1","pages":"100-112"},"PeriodicalIF":1.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11848137/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143504721","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":"Leisure-time Physical Activity in People with Spinal Cord Injury: A Population-based Community Sample.","authors":"Paul K Watson, James W Middleton, Mohit Arora, Camila Quel De Oliveira, Robert Heard, Andrew Nunn, Tim Geraghty, Ruth Marshall, Glen M Davis","doi":"10.46292/sci24-00007","DOIUrl":"10.46292/sci24-00007","url":null,"abstract":"<p><strong>Objectives: </strong>To examine leisure-time physical activity (LTPA) volume in the Australian spinal cord injury (SCI) population while exploring its associations with sociodemographic and injury-related characteristics.</p><p><strong>Methods: </strong>This study was a cross-sectional analysis of the Australian cohort of the International Spinal Cord Injury Survey. The study included 1579 participants aged 18 years or older with an SCI. Analyses included summary statistics, analysis of variance, and regression modelling.</p><p><strong>Results: </strong>Approximately 58% (<i>n</i> = 863) of participants reported some participation in LTPA. The average (<i>SD</i>) total LTPA per week was 333 (318) minutes. Males, younger people, traumatically injured individuals, participants with less time since their injury, and those who required less assistance to ambulate reported between 50% and 200% more engagement in LTPA than their counterparts. Only 204 (13%) participants were compliant with the current SCI-specific physical activity guidelines for fitness improvement. Sociodemographic and injury-related characteristics explained a 2.9% variance for total LTPA, but the model was statistically insignificant.</p><p><strong>Conclusion: </strong>Participation in LTPA in the Australian SCI population was low, and not enough activity was performed at intensities that elicit healthful change. These data add to the growing body of LTPA and physical activity data for the global SCI population. The trends of physical inactivity are globally consistent. Some sociodemographic variables and injury-related characteristics influence the volume and type of LTPA performed, but their effect is mild. Urgent attention is warranted to improve LTPA volume globally.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"31 2","pages":"76-87"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12199567/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530247","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":"Peripheral Vascular Dysfunction Following Spinal Cord Injury: A Systematic Review and Meta-Analysis.","authors":"Thomas Thordarson, Tiev Miller, Martín Calderón-Juárez, Ali Hosseinzadeh, Raza Malik, Rahul Sachdeva, Andrei V Krassioukov","doi":"10.46292/sci24-00036","DOIUrl":"10.46292/sci24-00036","url":null,"abstract":"<p><strong>Background: </strong>Spinal cord injury (SCI) has been shown to impact vascular function and increase the risk of cardiovascular disease (CVD). However, data are limited regarding prognostic factors for identifying subclinical CVD risk in individuals with SCI.</p><p><strong>Objectives: </strong>To identify maladaptive structural and functional changes to central and peripheral vasculature resulting from SCI and to assess the effect of SCI on these parameters relative to able-bodied comparators.</p><p><strong>Methods: </strong>This review was prospectively registered. A systematic search was performed using PRISMA guidelines. Bias was assessed using the ROBINS-I and AHRQ tools. Studies reporting structural or functional changes to vasculature following SCI were included. Data on participant and injury characteristics, outcomes, and assessments used were extracted. Meta-analyses were conducted for adequately powered subgroups based on outcome type, measurement site, and level of injury.</p><p><strong>Results: </strong>A total of 49 studies involving 1026 individuals with SCI and 941 able-bodied comparators were included. Most studies described injury level and severity using standardized impairment classifications. Subgroup analyses showed significantly reduced arterial diameter, compliance, endothelial function, blood flow volume, and high-density lipoprotein (HDL) cholesterol concentration among people with SCI compared to controls. Intima-media thickness, arterial stiffness, shear rate, and blood glucose and triglyceride concentrations were significantly greater for people with SCI compared to controls. Additional subgroup analyses were underpowered.</p><p><strong>Conclusion: </strong>This review synthesizes the current literature reporting central and peripheral vasculature outcomes in people with SCI and able-bodied controls. Between-group differences were observed for several structural and functional vascular outcomes, which suggests that SCI has a significant impact on multiple subclinical CVD risk factors.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"31 2","pages":"88-103"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12202987/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530248","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":"Exploring the Landscape of Biomarkers in Spinal Cord Injury.","authors":"Paulina S Scheuren, Bethany R Kondiles, Angela R Filous, Ona E Bloom, Diana S-L Chow, Edelle C Field-Fote, Patrick Freund, James D Guest, Brian K Kwon, Nikos Kyritsis, Chris Leptak, Monica A Perez, Matthew Szapacs, Christopher R West, Keith Tansey, Jane T C Hsieh, Linda Jones","doi":"10.46292/sci24-00076","DOIUrl":"10.46292/sci24-00076","url":null,"abstract":"<p><p>Despite considerable progress in spinal cord injury (SCI) research, there remains a pressing need for interventions that effectively restore neurological function after injury beyond that which occurs spontaneously. A major steppingstone towards the development of effective therapies for SCI is the ability to accurately predict recovery and identify individuals who are most likely to respond to intervention. Currently, the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) remains the primary tool for assessing neurological impairment after injury. However, based on the inherent limitations of the ISNCSCI exam, accurate and sensitive biomarkers are required. Understanding the role of biomarkers in SCI is crucial for improving diagnosis, prognosis, and treatment strategies. In 2024, the Spinal Cord Outcome Partnership Endeavour (SCOPE) sponsored a precourse at the American Spinal Injuries Association (ASIA) meeting. The international panel discussed the scope, utility, and application of biomarkers in SCI clinical trials and clinical practice. This article summarizes key insights from this discussion, highlighting the value of various types of biomarkers, ranging from molecular and cellular markers to those reflecting neural circuits, systems, and movement. We also summarize the context of using different types of biomarkers and their application in research versus clinical practice. While there are currently no FDAqualified SCI biomarkers, the development of reliable biomarkers holds the potential to accelerate the pace of discovery and enable more precise approaches to treatment.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"31 2","pages":"1-12"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12199613/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530246","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: Case Examples Reinforcing Concepts From the 2019 Revision.","authors":"Brittany Snider, Steven Kirshblum, Ruediger Rupp, Christian Schuld, Fin Biering-Sorensen, Stephen Burns, James Guest, Linda Jones, Andrei Krassioukov, Gianna Rodriguez, Mary Schmidt Read, Keith Tansey, Kristen Walden","doi":"10.46292/sci24-00049","DOIUrl":"10.46292/sci24-00049","url":null,"abstract":"<p><strong>Background: </strong>The International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) is the most widely accepted system for characterizing sensorimotor impairments after spinal cord injury (SCI). There have been a number of ISNCSCI revisions, with the most recent edition published in 2019. Newer concepts, including the revised definitions of the zones of partial preservation (ZPPs) and documentation of non-SCI conditions, require training and practice for successful utilization. The International Standards Committee developed an ISNCSCI workbook of 26 practice cases, each with detailed explanations of the correct classification components. In this article, we present seven cases, which were selected from the workbook to reinforce the changes implemented in 2019.</p><p><strong>Methods: </strong>Hypothetical ISNCSCI cases were created to illustrate important classification rules, definitions, and nuances. All cases were reviewed by members of the American Spinal Injury Association (ASIA) International Standards Committee, and if any discrepancies were identified, they were discussed until a consensus was reached. To confirm agreement, cases were also entered into online algorithms, which are compliant with the 2019 ISNCSCI revision. The seven cases in this article highlight newer classification concepts and include a discussion of key elements.</p><p><strong>Cases: </strong>Each case reinforces the revised definitions of the ZPPs, such as the applicability of sensory ZPPs in all injuries without sensory sacral sparing and applicability of motor ZPPs in all injuries without voluntary anal contraction (VAC). Non-SCI-related impairments and their impact on the classification are reviewed in Cases 4-7.</p><p><strong>Conclusion: </strong>The seven cases presented in this article feature key concepts from the 2019 ISNCSCI revision. These cases, as well as the full ISNCSCI workbook, can serve as valuable training tools to improve classification accuracy.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"31 3","pages":"1-14"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12376161/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973829","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":"Association of Hallucinogen Use With Psychosocial Outcomes: Secondary Analysis of the Spinal Cord Injury Model Systems Database.","authors":"Kayleigh Crane, Angela Hanks Philippus, Jennifer Coker, Jesse L Kowalski, Kimberley R Monden","doi":"10.46292/sci24-00082","DOIUrl":"10.46292/sci24-00082","url":null,"abstract":"<p><strong>Background: </strong>Individuals with spinal cord injuries (SCI) experience depression at rates up to 5 times higher than the general population. Although research on hallucinogens for treating depression is growing, no studies have specifically focused on individuals with SCI.</p><p><strong>Objectives: </strong>To identify factors associated with hallucinogen use and explore the relationship between hallucinogen use and psychosocial outcomes (i.e., depression and quality of life [QOL]) among individuals with SCI.</p><p><strong>Methods: </strong>This exploratory, retrospective cross-sectional study design used data from 9976 participants in the Spinal Cord Injury Model Systems (SCIMS) National Database (NDB) between 2016 and 2021. The study outcomes were depression (Patient Health Questionnaire-9 [PHQ-9]) and QOL (Satisfaction with Life Scale [SWLS]). Hallucinogen use, measured by the WHO ASSIST 2, was dichotomized into some use versus no use.</p><p><strong>Results: </strong>Overall, 65 participants (0.7%) reported some hallucinogen use in the prior 3 months. Multivariable logistic regression analysis showed that younger age, male sex, fall(s) in the previous year, and sleep disturbances were all associated with hallucinogen use. In multivariable linear regression, hallucinogen use was significantly associated with higher PHQ-9 scores (effect size [ES] 0.558) but was not significantly related to SWLS scores (ES 0.149).</p><p><strong>Conclusion: </strong>This is the first study to identify demographic, injury, and psychosocial factors associated with hallucinogen use among individuals with SCI and to explore its relation to depression and QOL. These findings provide a foundation for future, fully powered studies aimed at determining the effect of hallucinogen use in the SCI population.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"31 4","pages":"160-174"},"PeriodicalIF":1.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12629206/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145565866","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}