Journal of Spinal Cord Medicine最新文献

{"title":"Lower red blood cell count is a risk factor for higher D-dimer level in patients with spinal cord injury: A five year retrospective cross-sectional study.","authors":"Jinlong Zhang, Cheng Wang, Chenqqi He, Yonghong Yang","doi":"10.1080/10790268.2025.2452685","DOIUrl":"https://doi.org/10.1080/10790268.2025.2452685","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to elucidate the relationship between red blood cell (RBC) count and D-dimer levels in patients with spinal cord injury, with the goal of identifying potential therapeutic targets for minimizing D-dimer levels.</p><p><strong>Study design: </strong>An observational, retrospective, cross-sectional, single center study.</p><p><strong>Setting: </strong>Individuals with SCI (576 cases) admitted to a rehabilitation medicine department.</p><p><strong>Outcome measures: </strong>After exclusions, we divided the participants (<i>n</i> = 308) into two groups based on their D-dimer levels: Group 1 (≤0.5  mg/L, <i>n</i> = 64) and Group 2 (>0.5  mg/L, <i>n</i> = 244). Key variables such as deep vein thrombosis (DVT), anticoagulant therapy, pulmonary infection, injury characteristics, and hematological parameters were analyzed for their association with RBC counts and D-dimer levels.</p><p><strong>Results: </strong>DVT and anticoagulant therapy emerged as significant covariates. A comprehensive analysis identified a negative linear correlation between RBC counts and D-dimer levels, markedly more pronounced in Group 2. For every 1.00 × 10¹²/L increase in RBC, D-dimer levels decreased by 1.93  mg/L in Group 2, compared to a 0.02  mg/L decrease in Group 1.</p><p><strong>Conclusions: </strong>Higher RBC counts might be associated with lower D-dimer levels in patients with SCI, especially in those with higher initial D-dimer levels. This association highlights a potential therapeutic focus on managing RBC counts to decrease D-dimer level, which may mitigate the risk of DVT formation in patients with SCI.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"1-11"},"PeriodicalIF":1.8,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053750","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":"Changes in mood states during inpatient rehabilitation after spinal cord injury.","authors":"Norma Mazzoli, Erika Piccinelli, Barbara Pasquini, Gaia Bulzamini, Elisa Maietti, Paola Rucci, Flora Morara","doi":"10.1080/10790268.2024.2448041","DOIUrl":"https://doi.org/10.1080/10790268.2024.2448041","url":null,"abstract":"<p><strong>Design: </strong>Retrospective observational study.</p><p><strong>Objective: </strong>To analyze changes in mood states during the acute phase of inpatient rehabilitation for spinal cord injury (SCI) and the factors associated with worse mood states and less improvement.</p><p><strong>Setting: </strong>Spinal unit in Italy.</p><p><strong>Participants: </strong>The study included people with SCI admitted between 2014 and 2019 and treated for psychological problems with a focus on 'emotion processing' and 'emotional adjustment'. The sample included 170 patients (71.8% male, mean age 47.1 ± 16, range 17-78), 46.5% with tetraplegia and 50% with comorbidities.</p><p><strong>Outcome measures: </strong>The Profile of Mood States (POMS) questionnaire was used to assess mood states at baseline and at the end of treatment. Multiple linear regression models were used to identify factors associated with changes in mood states during treatment.</p><p><strong>Results: </strong>At baseline, patients with distress related to SCI diagnosis reported lower levels of vigor, whereas those with distressing life events reported higher levels of anger and confusion-bewilderment. POMS subscales improved significantly by at least 4 points. ASIA Impairment Scale (AIS) C score, living with family of origin, comorbidities and critical events during hospitalization were associated with greater improvements, whereas higher education was associated with less improvement in depressive mood. In tetraplegic patients, higher improvements in depressive mood were associated with greater independence at discharge, whereas in patients with paraplegia, higher improvements in anxiety and vitality were associated with better mobility.</p><p><strong>Conclusion: </strong>Our results indicate that mood states improved in people with SCI receiving a psychological treatment. Socio-demographic and SCI-related characteristics associated with a greater effect of psychological treatment should be considered in order to tailor the intervention.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"1-13"},"PeriodicalIF":1.8,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143034747","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":"Prescription opioid dispensing rates in the 12-months post-discharge after acute spinal cord injury: An observational study.","authors":"Samantha J Borg, David N Borg, Amanda Wheeler, Sridhar Atresh, Timothy Geraghty","doi":"10.1080/10790268.2024.2448043","DOIUrl":"https://doi.org/10.1080/10790268.2024.2448043","url":null,"abstract":"<p><strong>Objectives: </strong>To determine rates of opioid and concomitant antidepressant, anticonvulsant and benzodiazepine dispensing in the post-discharge period, after acute spinal cord injury (SCI).</p><p><strong>Design: </strong>Single-center prospective cohort study with 12-month linked pharmaceutical data.</p><p><strong>Setting: </strong>Community pharmaceutical dispensing.</p><p><strong>Participants: </strong>Patients ≥18 who were diagnosed with a SCI between March 2017 and March 2018.</p><p><strong>Outcome measures: </strong>Rates of dispensing of opioid and concomitant antidepressant, anticonvulsant and benzodiazepine medications in the 12-month post-discharge from a specialist inpatient Spinal Injuries Unit.</p><p><strong>Results: </strong>Sixty-eight participants volunteered for the study. Of the medications dispensed in the 12-months after discharge, 16% were opioids, which were supplied to 56% of participants. Forty-six percent of participants had concurrent dispensing of at least one other medication class of interest (antidepressants, anticonvulsants, or benzodiazepines). Participants with opioids prescribed at discharge were 6.5 times more likely to have been dispensed opioids in the 12-months following discharge compared to those who did not have opioids listed at discharge (OR = 6.5, 95% CI = 2.2, 19.0, P<i> </i>< .001).</p><p><strong>Conclusions: </strong>Longer-term opioid prescribing plus concomitant analgesia and sleep medications in the post-acute period after SCI were common. Chronic opioid use and the polypharmacy observed is concerning, given the potential for dependence, tolerance and increased drug interactions and associated adverse effects. Both issues point to the need for clear discharge instructions for primary care prescribers and regular monitoring to manage pharmacotherapy therapeutic benefits and risks alongside non-medication therapies.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"1-10"},"PeriodicalIF":1.8,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015196","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":"Responsiveness to transcutaneous spinal stimulation for upper extremity recovery following spinal cord injury: A case series exploration of midsagittal tissue bridges.","authors":"Andrew C Smith, Clare Morey, Wesley A Thornton, Jordan R Connor, Dario Pfyffer, Kenneth A Weber Ii, Kristin Will, Candace Tefertiller","doi":"10.1080/10790268.2024.2448046","DOIUrl":"https://doi.org/10.1080/10790268.2024.2448046","url":null,"abstract":"<p><strong>Context: </strong>Transcutaneous spinal stimulation (TSS), applied to the cervical spine, is able to improve voluntary upper extremity strength and function in individuals with cervical spinal cord injury (SCI). While most respond and improve in the presence of TSS, others do not respond as favorably. Midsagittal tissue bridges, adjacent to the lesion, can be observed and measured using T₂-weighted magnetic resonance imaging (MRI), and both ventral and dorsal tissue bridges are associated with recovery following SCI. Tissue bridges may also be important for responding to neuromodulation such as TSS. The purpose of this case series was to explore potential relationships between the presence of tissue bridges and responsiveness to TSS for recovery of upper extremity strength and function in research participants with cervical-level SCI.</p><p><strong>Methods: </strong>This study involved six research participants who completed a clinical trial of rehabilitation paired with TSS to improve upper extremity strength and function. Ventral and dorsal midsagittal tissue bridges were quantified using T₂-weighted MRI.</p><p><strong>Results: </strong>Three participants classified as both strength and function responders showed presence of ventral tissue bridges, while the three strength-only responders did not. The same was found for dorsal tissue bridges, except for one strength-only responder that had a dorsal tissue bridge.</p><p><strong>Conclusions: </strong>The findings of this case series shed light onto the potential importance of midsagittal tissue bridges - a proxy for spared sensorimotor tracts - for responsiveness to TSS for upper extremity recovery following SCI.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"1-7"},"PeriodicalIF":1.8,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015197","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":"Construct validity, responsiveness, and interpretability of the Spinal Cord Injury Functional Ambulation Inventory (SCI-FAI).","authors":"Shinogu Kusano, Kazuhiro Miyata, Kenichi Yoshikawa, Masafumi Mizukami","doi":"10.1080/10790268.2024.2448039","DOIUrl":"https://doi.org/10.1080/10790268.2024.2448039","url":null,"abstract":"<p><strong>Objective: </strong>We investigated the construct validity, responsiveness, and interpretability of the Spinal Cord Injury Functional Ambulation Inventory (SCI-FAI) to determine its usefulness in measuring the functional level of gait.</p><p><strong>Patients and methods: </strong>This was a prospective observational study following the checklist of the Consensus-Based Standards for Selecting Health Measurement Instruments. The SCI-FAI consists of three items: Gait Parameter, Assistive Devices, and Temporal. We recruited 55 patients diagnosed with a spinal cord injury (SCI) in the subacute or chronic phase from Ibaraki Prefectural University of Health Sciences Hospital. Construct validity was clarified by hypothesis testing and the rate of hypothesis verification. We divided responsiveness into subacute and chronic groups and determined the correlation between the changes in the two timepoints of the SCI-FAI and 6-minute walk test. Interpretability involved the calculation of cutoff values for indoor and outdoor walking.</p><p><strong>Results: </strong>Construct validity was confirmed for 12 of the 15 hypotheses, indicating high construct validity. In the subacute group, Gait Parameter and Assistive Devices showed moderate responsiveness. Interpretability showed that the Gait Parameter was perfect in 19 of the 20 subjects who did not need a walking aid when walking. The cutoff value for Gait Parameter for indoor walking was 17.5 points (AUC 0.91) and that for Assistive Devices was 9.5 points (AUC 0.88). The cutoff values for outdoor walking were Gait Parameter 18.5 points (AUC 0.96) and Assistive Devices 10.5 points (AUC 0.94).</p><p><strong>Conclusion: </strong>Our results demonstrated that the SCI-FAI has adequate construct validity, moderate responsiveness in SCI patients in the subacute phase, and interpretability in the gait assessment of individuals with SCIs. Gait Parameter is likely to show a ceiling effect for people with SCIs who can walk without using an upper-limb walking aid.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"1-13"},"PeriodicalIF":1.8,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015194","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":"Patient-reported effects of transcutaneous spinal cord stimulation on spasticity in patients with spinal cord injury.","authors":"Vivien Jørgensen, Anne Birgitte Flaaten, Páll E Ingvarsson, Anne Marie Lannem","doi":"10.1080/10790268.2024.2448044","DOIUrl":"https://doi.org/10.1080/10790268.2024.2448044","url":null,"abstract":"<p><strong>Objectives: </strong>Assess pateint-reported effects of transcutaneous spinal cord stimulation (tSCS) on spasticity after multiple treatment.</p><p><strong>Design: </strong>An uncontrolled prospective case series study.</p><p><strong>Setting: </strong>A rehabilitation hospital.</p><p><strong>Participants: </strong>A convenience sample of hospitalized adults with spinal cord injury (SCI) and lower-body spasticity limiting physical function and/or reducing quality of life (i.e. pain, sleep disturbance).</p><p><strong>Interventions: </strong>Participants received 30 minutes of tSCS (continuous, asymmetrical, biphasic rectangular impulses, 100 Hz) applied for 3-6 consecutive days using NeuroTrac multiTENS® (http://quintet.no). Two electrodes were placed paravertebrally at Th11-Th12 level and two on lower abdomen.</p><p><strong>Outcome measures: </strong>Penn`s Spasm Frequency and Severity Scales were used for quantifying spasticity, Numeric Rating Scales (NRS 0-10) for perceived impact of spasticity on one chosen activity of a daily living, sleep-disturbance, and pain in trunk/lower limbs due to spasticity. The outcome measures were completed through interviews conducted before the first treatment, and immediately after the last treatment.</p><p><strong>Results: </strong>Seventeen people participated; injury levels C6-T12, AIS A-D, and mean age 51 years (SD 14). Fourteen participants reported a clinical important improvement in ADL performance, sleep disturbance and/or a decrease in pain due to spasticity (≥ two points on NRS). Minimal change was reported on Penn`s Spasm frequency and Severity Scales. No adverse events were observed.</p><p><strong>Conclusions: </strong>The majority of the participants perceived clinically relevant improvements on at least one patient-reported outcome measure, and no adverse events were reported. This is a simple and a non-invasive treatment that may have a potential of reducing the troublesome effects of spasticity.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"1-8"},"PeriodicalIF":1.8,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015195","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":"Improving skin screening capabilities for Veterans with spinal cord injuries.","authors":"Christine M Olney, Sara Kemmer, Amy Gravely, Andrew H Hansen, Gary Goldish","doi":"10.1080/10790268.2024.2430079","DOIUrl":"https://doi.org/10.1080/10790268.2024.2430079","url":null,"abstract":"<p><strong>Context: </strong>Clinical Practice Guidelines from the Consortium for Spinal Cord Injury (SCI) Medicine recommend daily self-screening of at-risk skin surfaces, but many Veterans with SCI describe challenges using the standard issue long-handled self-inspection mirror (LSIM).</p><p><strong>Objective: </strong>The objective of this project was to compare the LSIM to a recently developed camera-based self-inspection system (CSIS). User feedback guided iterative engineering to improve and develop the new technology in preparation for transfer to industry.</p><p><strong>Methods: </strong>Five Veterans with spinal cord injury (SCI) volunteered to compare use of a LSIM versus the CSIS to identify purposefully placed stickers with varying letters and colors over their high-risk skin surfaces while lying in bed. Each Veteran also responded to a series of interview questions and completed the QUEST 2.0 questionnaire on satisfaction with assistive technology.</p><p><strong>Results: </strong>Veterans with SCI were able to correctly identify sticker letters and colors with significantly higher fidelity (<i>P</i> = .001 and <i>P</i> = .001 respectively) using the CSIS compared to using LSIM. Further the CSIS, was significantly (<i>P</i> = .004) preferred over the LSIM on the QUEST 2.0. The Cohen's D effect sizes for these paired comparisons were large (for color: 5.7, for sticker letter: 5.0 and QUEST 2.0: 2.6).</p><p><strong>Conclusions: </strong>Improved visualization and satisfaction scores using the newly developed CSIS suggest that adoption of this new technology could improve the quality and acceptance of this skin screening strategy for persons with spinal cord injury.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"1-9"},"PeriodicalIF":1.8,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973029","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":"Respiratory muscle training in people with cervical spinal cord injury - A systematic review.","authors":"Felipe de Oliveira Rodrigues, Marina Martins Pereira Padovani, Bárbara Pereira Lopes, Júlia Araújo de Moura, Ana Cristina Côrtes Gama","doi":"10.1080/10790268.2024.2433839","DOIUrl":"https://doi.org/10.1080/10790268.2024.2433839","url":null,"abstract":"<p><strong>Introduction: </strong>Spinal cord injury is a physiological disruption often caused by trauma, leading to severe physical and psychological effects, including irreversible impairment and disability. Cervical injuries, particularly between C1 and C8, are the most severe, potentially causing diaphragm paralysis and requiring mechanical ventilation. Reduced respiratory muscle strength not only affects respiratory function but also significantly impacts voice, speech, and communication, which are crucial for quality of life.</p><p><strong>Objective: </strong>Conduct a systematic review of the literature on respiratory muscle training protocols in individuals with cervical spinal cord injury and evaluate the methodological quality of scientific publications.</p><p><strong>Methods: </strong>Studies were searched by two independent researchers in the Regional Portal of the Virtual Health Library, EMBASE, SCOPUS and PubMed databases, using the descriptors: \"respiratory muscle strength\", \"breathing training\", and \"cervical spinal cord injury\", with no restriction on the time of publication. Studies containing respiratory muscle strength measurements and respiratory muscle training in people with cervical SCI were included and those that associated other techniques with functional respiratory training, such as electrical stimulation and other complementary techniques were excluded. The studies had the methodological quality (internal and external validity) classified by the PEDro scale (Physiotherapy Evidence Database).</p><p><strong>Results: </strong>Nine studies were identified and considered valid based on the inclusion criteria. The protocols presented varied parameters. The session time ranged from 15 to 45 minutes, the number of sessions per day ranged from 1 to 2, the number of days per week ranged from 3 to 7, and the number of intervention weeks ranged from 4 to 10. Only three studies presented internal and external validity for respiratory muscle training programs.</p><p><strong>Conclusion: </strong>This review identified that respiratory muscle training is an effective intervention to improve respiratory function in people with cervical SCI. However, due to the poor methodological quality of the studies, the effect size of the treatment, as well as the ideal dose and intensity, requires further investigation to better determine its overall effectiveness.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"1-13"},"PeriodicalIF":1.8,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973030","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":"Factors associated with home discharge for individuals with cervical spinal cord injuries: Analysis according to age group.","authors":"Tomohiro Yoshimura, Hiroaki Hayashi, Yusuke Terao, Iwao Kojima, Kazumasa Jimbo, Kousuke Takahama, Taichi Yasumori, Takashi Murayama, Naohisa Kikuchi, Minoru Yamada","doi":"10.1080/10790268.2024.2432732","DOIUrl":"https://doi.org/10.1080/10790268.2024.2432732","url":null,"abstract":"<p><strong>Objective: </strong>To identify the factors associated with home discharge in individuals with cervical spinal cord injuries (cSCI) according to age group.</p><p><strong>Design: </strong>Cross-sectional study.</p><p><strong>Setting: </strong>Hospital or rehabilitation centers specializing in spinal cord injuries in Japan.</p><p><strong>Methods: </strong>The subjects were individuals with cSCI who were registered in the National Spinal Cord Injury Database between April 2000 and March 2019 and hospitalized for rehabilitation purposes. The subjects were stratified into three groups: 18-34 years old (young-aged group), 35-64 years old (middle-aged group), and 65 years and older (old-aged group). Logistic regression analysis was performed to identify the factors associated with home discharge in each age group.</p><p><strong>Results: </strong>In the logistic regression analysis, the variables extracted as factors related to home discharge were: in the young-aged group, independence in bathing (odds ratio [OR]: 4.55), independence in toilet transfer (OR: 4.45), and high cervical (C1-C4) neurological level of injury (OR: 3.16). In the middle-aged group, living with others (OR: 3.36), independence in toilet transfer (OR: 5.74), and independence on stairs (OR: 3.58) were extracted. In the old-aged group, living with others (OR: 14.16), independence in bladder management (OR: 7.74), independence in locomotion (OR: 4.55), and good cognitive function (OR: 2.91) were extracted.</p><p><strong>Conclusion: </strong>These results suggest that the factors associated with home discharge for individuals with cSCI have different characteristics in each age group. Additionally, factors common to all age groups, such as transfers and toileting, were identified. Appropriate support depending on the age group is necessary for home discharge.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"1-7"},"PeriodicalIF":1.8,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973028","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":"End user evaluation of the Canadian Spinal Cord Injury Physical Activity Guidelines: Barriers and facilitators to uptake and dissemination in the United States.","authors":"Kimberley R Monden, Angela Hanks Philippus, Nathan Adams, Charles H Bombardier","doi":"10.1080/10790268.2024.2449291","DOIUrl":"https://doi.org/10.1080/10790268.2024.2449291","url":null,"abstract":"<p><strong>Objective: </strong>To engage U.S. end users to (1) gather information on facilitators and barriers to awareness and adoption of the Canadian Spinal Cord Injury (SCI) Physical Activity (PA) guidelines; (2) inform potential adaptations to the presentation and messaging of the guidelines; and (3) develop recommendations for targeted dissemination strategies to promote awareness in the United States.</p><p><strong>Design: </strong>Multi-method.</p><p><strong>Setting: </strong>Working groups conducted remotely via Zoom and online surveys.</p><p><strong>Participants: </strong>Individuals with lived SCI experience (<i>n</i> = 5), providers/clinical researchers (<i>n</i> = 7), and members of SCI professional or community organisations (<i>n</i> = 6).</p><p><strong>Interventions: </strong>N/A.</p><p><strong>Outcome measures: </strong>N/A.</p><p><strong>Results: </strong>Participants highlighted the need for centralised, credible sources of information on PA. While participants generally viewed the guidelines as appropriate, useable, and acceptable, some questioned their credibility, as they were developed explicitly for Canadians with SCI rather than Americans. To enhance reach and effectiveness, participants suggested dissemination strategies that target specific audiences (i.e. level of functioning, level of injury, current level of PA). They also recommended collaborations with existing trusted community SCI organisations.</p><p><strong>Conclusion: </strong>Findings underscore the need for accessible, centralised, and credible information sources on PA tailored to the needs of the SCI community. Findings also suggest that while the guidelines do not require redevelopment for a U.S. context, they do need customised presentation, such as removing Canadian symbols from the materials, to better suit U.S. audiences. Effective dissemination will benefit from targeted strategies that leverage trusted organisations to reach and engage specific groups, ultimately supporting greater guideline awareness, acceptance, and application across the SCI population.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"1-23"},"PeriodicalIF":1.8,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142973027","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}