Journal of Spinal Cord Medicine最新文献

{"title":"Evaluation and management of autonomic functions in patients with spinal cord injury: A scoping review.","authors":"Ram Lochan Yadav, Jessica Catherine Martin, Mary Pauline Galea","doi":"10.1080/10790268.2025.2485509","DOIUrl":"https://doi.org/10.1080/10790268.2025.2485509","url":null,"abstract":"<p><strong>Context: </strong>Individuals with high-level spinal cord injury (SCI) face serious cardiovascular (CV) autonomic complications, contributing to increased mortality and morbidity. The assessment of CV autonomic function in SCI is challenging and varies widely across studies, with no clear or definitive interventions to restore hemodynamic stability or prevent complications.</p><p><strong>Objectives: </strong>This review outlines available clinical data on measuring and managing CV autonomic dysfunction after SCI and identifies gaps in these domains.</p><p><strong>Methods: </strong>A scoping review was conducted, using a search strategy targeting broad keywords related to SCI, autonomic function parameters, and management from six relevant databases, as well as reference lists and gray literatures.</p><p><strong>Results: </strong>Of 2,749 articles identified, 92 were included. Studies categorized CV autonomic complications by acute and chronic stages. High-level SCI was commonly associated with bradycardia, low BP, orthostatic hypotension, and autonomic dysreflexia, compared to lower thoracic SCI. However, the correlation between these complications and SCI completeness was unclear. Various measurement methods were used, including 24-hour ambulatory BP monitoring (ABPM), ECG derivatives, heart rate variability, sympathetic skin response, cold pressor test, head-up tilt, the International Standards to document Autonomic Function following SCI (ISAFSCI) and the Autonomic Dysfunction Following SCI (ADFSCI) tools. Of these, 24-hour ABPM demonstrated superiority in identifying diurnal variation and activity effects on CV conditions. Studies reported mixed outcomes for both pharmacological and non-pharmacological management of CV complications.</p><p><strong>Conclusion: </strong>Research gaps persist, especially in sub-acute stages and in standardized tools for assessing CV autonomic dysfunction. Chronic complications have a long-term impact on health and CV disease risk. While promising methodologies exist, such as 24-hour ABPM and questionnaire-based assessments, further refinement is needed. Comprehensive management strategies should also be developed. This includes emerging techniques like spinal neuromodulation, which require extensive research and clinical trials.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"1-61"},"PeriodicalIF":1.8,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hybrid assistive limb treatment for patients with severe cervical and thoracic myelopathy due to ossification of the posterior longitudinal ligament and ligamentum flavum: Feasibility, safety, and efficacy in the acute and chronic phases.","authors":"Yuichiro Soma, Shigeki Kubota, Hideki Kadone, Yukiyo Shimizu, Masao Koda, Yasushi Hada, Yoshiyuki Sankai, Masashi Yamazaki","doi":"10.1080/10790268.2024.2448047","DOIUrl":"https://doi.org/10.1080/10790268.2024.2448047","url":null,"abstract":"<p><strong>Objective: </strong>To assess the feasibility, safety, and efficacy of hybrid assistive limb (HAL) training in patients with varying levels of gait impairment caused by ossification of the posterior longitudinal ligament (OPLL) or ligamentum flavum (OLF).</p><p><strong>Design: </strong>Prospective study.</p><p><strong>Setting: </strong>July 2014 to May 2019; in - and out-patient rehabilitation unit. Participants: Twenty-five patients with varying levels of ossified lesions and acute, subacute, or chronic postoperative OPLL or OLF.</p><p><strong>Interventions: </strong>Ten HAL training sessions (sixty min) in total; three times per week (acute/subacute patients) or one time per two months (chronic patients).</p><p><strong>Outcome measures: </strong>Walking Index for Spinal Cord Injury, American Spinal Injury Association (ASIA) Impairment Scale, ASIA motor score, Functional Independence Measure (FIM) motor score for activities of daily living, Berg Balance Scale, and Japanese Orthopedic Association score. Walking capabilities, including gait speed, step length, and cadence, were assessed using 10-meter and 2-minute walking tests (10/2MWT).</p><p><strong>Results: </strong>All patients completed 10 HAL training sessions without severe adverse events. In the acute/subacute group, all measures showed significant improvements, except the 2MWT. In the chronic group, the gait speed, step length, and ASIA motor, FIM motor, and 2MWT scores significantly improved. Baseline and after-10-sessions estimated marginal means were compared for the acute, subacute, and chronic groups. All items were significant in the acute/subacute groups. In the chronic group, gait speed, step length, ASIA motor score, and 2MWT results were significant.</p><p><strong>Conclusion: </strong>HAL treatment is feasible, safe, and effective in patients with different degrees of ossified lesions, specifically in those with OPLL or OLF.<b>Trial Registration:</b> UMIN000014336.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"1-9"},"PeriodicalIF":1.8,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors related to traumatic spinal cord injury outcomes: An analysis of the US National Trauma Data Bank.","authors":"Alexa R Lauinger, Samuel Blake, Alan Fullenkamp, Gregory M Polites, Paul M Arnold","doi":"10.1080/10790268.2024.2417118","DOIUrl":"https://doi.org/10.1080/10790268.2024.2417118","url":null,"abstract":"<p><strong>Introduction: </strong>Traumatic spinal cord injuries (TSCIs) are associated with high morbidity rates that can affect motor, sensory, and autonomic function. SCIs commonly result from sports, motor vehicle accidents, and other blunt traumas.</p><p><strong>Objective: </strong>To determine risk factors for in-hospital mortality, in-hospital complications, and increased length of stay (LOS) following TSCI.</p><p><strong>Methods: </strong>Data from the United States (US) National Trauma Data Bank (NTDB) from 2017 to 2021 was collected and used to assess risk factors for increased in-hospital mortality, complications, and hospital length of stay. Univariable analysis was completed on the 2017-2018 data. Variable importance was calculated, and a logistic regression was performed using the most important variables. Internal and external validation was completed using a testing cohort and 2020-2021 data.</p><p><strong>Results: </strong>Spinal fusion was associated with decreased mortality but increased complications and LOS. Increased age and injury severity score was associated with increased mortality, complications, and LOS, while the emergency department Glasgow Coma Score was inversely related to all outcomes. Each model had moderate to high prediction ability based on internal area under the curves (AUCs) ranging from 0.757 to 0.899 and external AUCs between 0.744 and 0.884.</p><p><strong>Conclusion: </strong>Understanding the factors that contribute to poorer outcomes following TSCI can help inform physicians of best treatment practices and patient prognosis. We highlighted five risk factors that correlate with short-term patient outcomes. Future research will further explore how treatment can impact both short - and long-term outcomes.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"1-10"},"PeriodicalIF":1.8,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health-related outcomes of different levels of physical activity among individuals with spinal cord injuries: An exploratory cross-sectional study.","authors":"Kazuki Kaneda, Noriaki Maeda, Takumi Nagao, Ayano Ishida, Tsubasa Tashiro, Shogo Tsutsumi, Satoshi Arima, Makoto Komiya, Yukio Urabe","doi":"10.1080/10790268.2025.2460302","DOIUrl":"https://doi.org/10.1080/10790268.2025.2460302","url":null,"abstract":"<p><strong>Background: </strong>The necessary and optimal physical activity for individuals with spinal cord injury remains unclear, and the development of interventions adapted to the needs of individuals with spinal cord injury is inadequate.</p><p><strong>Objective: </strong>To investigate the implications and health-related outcomes of different levels of physical activity on individuals with spinal cord injuries.</p><p><strong>Methods: </strong>The participants comprised 67 individuals, aged 18-65 years, with spinal cord injuries, who resided in Japan. Participants' demographic information was obtained, and their activities of daily living independence, physical activity level, mental health status, lifestyle, and social capital were assessed using online questionnaires. Participants were divided into three groups, based on their level of physical activity. Outcome measures were compared among the participants for different PA levels using one-way ANOVA. And, Pearson's product-moment correlation coefficient was used to examine the relationships between different levels of PA and the other outcome measures.</p><p><strong>Results: </strong>A one-way analysis of variance demonstrated a significant interaction between sports time, exercise time, the International Physical Activity Questionnaire-Short Form score, and Health-Related Social Capital among the groups. Participants with low activity correlated negatively with sports time and health practice index, and positively with exercise time and psychological distress. Participants with moderate activity also showed a positive correlation with exercise time and distress.</p><p><strong>Conclusions: </strong>The differences observed in the sports time emphasize the potential benefits of higher physical activity levels among individuals with spinal cord injuries and the existence of challenges associated with different levels of physical activity.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"1-7"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spinal cord injury and male infertility: Effect of the inflammasome proteins on semen quality.","authors":"Karla Pacheco de Melo, Giovana Salla Siqueira de Souza, Emad Ibrahim, Charles M Lynne, Nancy L Brackett, Ricardo Pimenta Bertolla, Mariana Camargo","doi":"10.1080/10790268.2025.2472095","DOIUrl":"https://doi.org/10.1080/10790268.2025.2472095","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate seminal plasma levels of Biglycan, Cystatin-S, β-2 microglobulin and inflammasome proteins and to investigate their role in seminal toxicity in men with spinal cord injury (SCI).</p><p><strong>Study design: </strong>cross-sectional study.</p><p><strong>Setting: </strong>Miami Project to Cure Paralysis - University of Miami / Miller School of Medicine and Federal University of Sao Paulo.</p><p><strong>Participants: </strong>Eight men with spinal cord injury and eight men without spinal cord injury (controls).</p><p><strong>Intervention: </strong>none. Outcome measures: semen analysis as per WHO 2010 guidelines; seminal plasma ELISA for IL-1β, IL-18 and caspase-1; and Western blotting for Biglycan, β-2microglobulin and Cystatin-S proteins.</p><p><strong>Results: </strong>Proteins from the inflammasome complex are elevated in men with SCI, as previously described. In addition, β-2-microgobulin, Cystatin-S and two different isoforms of Byglican are elevated in men with SCI.</p><p><strong>Conclusion: </strong>a different pathway to activate the inflammasome complex is present in men with spinal cord injury. This pathway can be a potential target for new interventions in the future.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"1-7"},"PeriodicalIF":1.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Priming with transcutaneous spinal direct current stimulation followed by robotic exoskeleton gait training in individuals with spinal cord injury: A case series.","authors":"Marcie Kern, Catherine Velasquez-Ignacio, Taimoor Afzal, Shih-Chiao Tseng, Gerard E Francisco, Shuo-Hsiu Chang","doi":"10.1080/10790268.2025.2479955","DOIUrl":"https://doi.org/10.1080/10790268.2025.2479955","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the safety and feasibility of repeated transcutaneous spinal direct current stimulation (tsDCS) as priming strategy during exoskeleton-assisted locomotor training in individuals with SCI and evaluate potential neurophysiologic and functional gait changes.</p><p><strong>Study design: </strong>Case series experimental design.</p><p><strong>Setting: </strong>Research laboratory at a post-acute rehabilitation hospital.</p><p><strong>Participants: </strong>Four participants with chronic incomplete SCI.</p><p><strong>Interventions: </strong>Four participants with chronic incomplete SCI received three weeks of training consisting of two types of interventions after baseline (A): 20-minute tsDCS (anode or cathode) applied over the spinous processes of T10 followed by 20-minute exoskeleton-assisted locomotor training (B, B1, B2) and 20-minute exoskeleton-assisted locomotor training (C, C1, C2). Each phase consisted of five consecutive intervention sessions. Two participants underwent sequence A-B1-C-B2 and two sequence A-C1-B-C2. Soleus Hoffmann Reflex (H-reflex) and gait speed (10-m walk test) were assessed on the first and fifth days of training for each training type.</p><p><strong>Outcome measures: </strong>Adverse skin reactions or other events, H-reflex (Hmax/Mmax ratio), and gait speed (10-m walk test).</p><p><strong>Results: </strong>No adverse events occurred. All participants tolerated tsDCS with no negative effects on their skin. Participants demonstrated varied responses in their H/M ratios after tsDCS followed by exoskeleton-assisted locomotor training as well as after exoskeleton-assisted locomotor training. No consistent pattern can be identified in this case series. Three participants showed an increase in gait speed after tsDCS combined with exoskeleton-assisted locomotor training.</p><p><strong>Conclusions: </strong>Noninvasive repeated spinal stimulation can safely be used in individuals with incomplete SCI. Further large-scale research is necessary to determine the efficacy of tsDCS for priming the spinal cord in facilitating recovery of gait in individuals with SCI.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"1-8"},"PeriodicalIF":1.8,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Occupational balance and caregiver burden among caregivers of individuals with spinal cord injuries.","authors":"Asma Hemmati Qaracheh, Mahnaz Hejazi-Shirmard, Alireza Akbarzadeh Baghban, Mehdi Rezaee","doi":"10.1080/10790268.2025.2472097","DOIUrl":"https://doi.org/10.1080/10790268.2025.2472097","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the occupational balance, caregiver burden, and factors affecting them in caregivers of individuals with spinal cord injuries in Iran.</p><p><strong>Design: </strong>A cross-sectional study with multiple linear regression analyses to specify factors related to occupational balance and caregiver burden.</p><p><strong>Settings: </strong>Community-dwelling individuals with spinal cord injury (SCI).</p><p><strong>Participants: </strong>A convenience sample of 84 individuals with SCI.</p><p><strong>Interventions: </strong>Not applicable.</p><p><strong>Measures: </strong>The Occupational Balance Questionnaire-11, Caregiver Burden Scale (CBS), and Hospital Anxiety and Depression Scale (HADS) were used to assess the occupational balance, caregiver burden, and stress/anxiety levels of the caregivers, respectively. Functional independence, anxiety/depression levels, and the participants' ability for self-management were evaluated using the Barthel index, HADS, Partners In Health (PIH), and Patient Activation Measure (PAM), respectively.</p><p><strong>Results: </strong>There was a positive and significant correlation between the self-management skills of the participants and their independence in daily activities with their caregivers' occupational balance. A negative and significant correlation was found between the individuals' self-management skills and their independence in daily activities with caregiver burden. In addition, a significant correlation existed between the anxiety and depression of the participants and their caregivers with occupational balance and caregiver burden. Finally, there was a negative and significant correlation between occupational balance and caregiver burden (P<i> </i>≤ 0.05).</p><p><strong>Conclusion: </strong>This study demonstrated that factors such as participants' self-management skills, their independence in daily activities, and the level of anxiety and depression in participants and caregivers affect the occupational balance and burden experienced by caregivers of individuals with SCIs.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"1-6"},"PeriodicalIF":1.8,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility and impact of a Water Specific Therapy program in individuals with subacute incomplete spinal cord injury: A non-randomized controlled trial.","authors":"Raquel Menchero, Inés Martínez-Galán, Mónica Alcobendas-Maestro, Helena Romay-Barrero, Araceli Fernández-Maestra, Javier Güeita-Rodríguez","doi":"10.1080/10790268.2025.2472098","DOIUrl":"10.1080/10790268.2025.2472098","url":null,"abstract":"<p><strong>Objectives: </strong>To study the feasibility of a Water Specific Therapy (WST) program in subjects with incomplete spinal cord injury (iSCI) and <6 months since injury. Secondary: To analyze the impact on balance and gait.</p><p><strong>Design: </strong>Pilot study with single-subject repeated-measures.</p><p><strong>Setting: </strong>Rehabilitation center.</p><p><strong>Participants: </strong>Twelve individuals with subacute (≤6 months) motor iSCI (T1-L5).</p><p><strong>Intervention: </strong>WST program comprising 18 sessions, 40-minute-long, including warm up, balance training, aerobic exercises, and cool-down, monitored via the Rating of Perceived Effort scale.</p><p><strong>Outcome measures: </strong>Feasibility was assessed through adherence to treatment, safety and attrition rate. Self-perceived improvement (balance, gait, and lower limb strength) and difficulties encountered by physical therapists were also evaluated. Secondary outcomes included the Berg Balance Scale (BBS), Timed Up and Go test, 10-meter walk test (10-MWT), 6-minute walk test (6-MWT), and Walking Index for Spinal Cord Injury II (WISCI-II).</p><p><strong>Results: </strong>Adherence to treatment reached 83%, with only two unrelated dropouts. No adverse effects were recorded, deeming the treatment safe. Self-perceived improvements were noted by 88.9% of subjects, with moderate and substantial gains in the three reported variables. Physiotherapists referred difficulties in reaching intensity targets, prompting program adaptations. Statistical significance (P < 0.05) was reached in BBS, 10-MWT, 6-MWT and WISCI-II outcomes.</p><p><strong>Conclusion: </strong>WST is a feasible, safe, well-accepted method for treating subacute iSCI, potentially enhancing gait and balance in these subjects. Individualized program adaptations may be required. Controlled studies are warranted to determine it is effectiveness.<b>Trial registration:</b> ClinicalTrials.gov identifier: NCT03962218..</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"1-9"},"PeriodicalIF":1.8,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"'She didn't know what to do with me': The experience of seeking community mental health support after spinal cord injury.","authors":"Katherine A Finlay, Phoebe Brook-Rowland, Margaret Tilley","doi":"10.1080/10790268.2025.2479957","DOIUrl":"https://doi.org/10.1080/10790268.2025.2479957","url":null,"abstract":"<p><strong>Context/objectives: </strong>Adults with spinal cord injury in the UK do not currently have specialized access to SCI-informed community-based mental health support, despite their elevated risk of mental health decline. The lack of SCI-informed therapeutic support may increase the likelihood of mental health treatment failure. This study sought to qualitatively explore the experience of accessing, or attempting to access, generic (non-SCI-informed) mental health support when living with a spinal cord injury.</p><p><strong>Design: </strong>Qualitative, exploratory study using thematic analysis.</p><p><strong>Setting: </strong>Community-based sample in the UK.</p><p><strong>Participants: </strong>Twenty people with spinal cord injury (10 female, 10 male) were recruited from a UK-based, SCI-specific support charity.</p><p><strong>Interventions: </strong>Semi-structured interviews (mean length = 83 min, SD = 13.5 min).</p><p><strong>Outcome measures: </strong>9-item semi-structured interview schedule, addressing mental health service use.</p><p><strong>Results: </strong>Three themes were identified: (1) Therapeutic timeliness; (2) A disconnect with standard services; and (3) Successful systems for support. The inpatient-to-outpatient transition represents a critical time window during which mental health is vulnerable to decline, requiring responsive access to mental health services throughout the lifespan. The lack of tailored, SCI-informed mental health services inhibits therapeutic engagement and limits perceived treatment outcomes.</p><p><strong>Conclusions: </strong>Without SCI-informed care, generic mental health service referrals risk early termination of support and treatment disengagement. Mental health treatment withdrawal is initiated by both patients and their allocated healthcare professionals. This study demonstrates an evident need to develop programs for people with SCI to train as (peer) mental health practitioners, and to develop SCI-specific training modules for mental health care practitioners.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"1-9"},"PeriodicalIF":1.8,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical validation of a rule-based decision tree algorithm for classifying hip movements in people with spinal cord injury.","authors":"Susanne Lillelund Sørensen, Matthijs Lipperts, Jørgen Feldbæk Nielsen, Erhard Næss-Schmidt","doi":"10.1080/10790268.2025.2472096","DOIUrl":"https://doi.org/10.1080/10790268.2025.2472096","url":null,"abstract":"<p><strong>Objective: </strong>To assess a rule-based decision tree algorithm's performance for classifying and counting specific hip flexion repetitions in able-bodied people and to validate the algorithm's efficacy for people with spinal cord injury (SCI). Alternative placement of the accelerometer was tested.</p><p><strong>Study design: </strong>A validation study.</p><p><strong>Setting: </strong>Specialized SCI center in Denmark.</p><p><strong>Methods: </strong>Ten able-bodied people and 10 people with SCI were recruited. All participants completed a 15-minute predefined protocol with the following movements: hip flexion in supine 90°, 45° and 20°, hip abduction, pelvic lift, transfer from supine to sitting, sit-to-stand, transfer to a wheelchair, pushed in a wheelchair, Motomed cycling, walking and steps in Nustep fitness trainer. All wore accelerometers on the thigh and a chest-mounted GoPro camera to establish ground truth.</p><p><strong>Results: </strong>Confusion matrixes showed that able-bodied people's activities and specific hip movements can be classified and the number of repetitions counted with 0.86 accuracy. The algorithm's performance did not change substantially depending on the position of the accelerometer. For people with movement deficits caused by SCI, the accuracy lowered to 0.66 but could be improved to 0.79 for classifying and counting this population's activities/movements overall.</p><p><strong>Conclusion: </strong>The algorithm tested could classify specific hip movements and other activities in the SCI population. This method using a single accelerometer may be applied in clinical trials for people with SCI to objectively assess the change in the number of repetitions over time of hip flexion movements, walking and sit-to-stand activities and to some extent hip abduction and pelvic lift.<b>Trial registration:</b> ClinicalTrials.gov NCT05558254. Registered 28th September 2022.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"1-10"},"PeriodicalIF":1.8,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}