Journal of Spinal Cord Medicine最新文献

{"title":"Tele-exercise and spinal cord injury: Effects on physical activity, strength, and quality of life.","authors":"Rogerio Virginio Dos Santos, Renato Barroso, José Igor V Oliveira, Luiz Gustavo Teixeira Fabrício Dos Santos, Gabriella Andreeta Figueiredo, Maria Luiza Tanure Alves","doi":"10.1080/10790268.2025.2524225","DOIUrl":"https://doi.org/10.1080/10790268.2025.2524225","url":null,"abstract":"<p><strong>Context: </strong>People with spinal cord injuries (SCI) face barriers to physical activity, which a synchronous tele-exercise program aims to overcome.</p><p><strong>Objective: </strong>To assess strength, physical activity levels, and quality of life in people with SCI following a synchronous tele-exercise program.</p><p><strong>Methods: </strong>Ten people with SCI (T3 = 1; T4 = 2; T6 = 2; T7 = 1; T10 = 2; T12 = 2) participated in a 12-week tele-exercise program, consisting of three weekly sessions focused on strength training. Before and after the intervention, participants underwent a strength test and completed the Physical Activity Scale for Individuals with Physical Disabilities (PASIPD) and the World Health Organization Quality of Life Questionnaire (WHOQOL-BREF). Paired <i>t</i>-tests were applied, except for the psychological domain, which was analyzed using the Wilcoxon test.</p><p><strong>Results: </strong>The results of the strength test showed an increase in the number of repetitions between the pre- (19.7 ± 7.0) and post-intervention moments (25.1 ± 7.3; P<i> </i><<i> </i>0.001). The tele-exercise program identified an increase in the level of physical activity compared to the pre- (3.0 ± 2.0) and post-intervention (6.8 ± 3.4 MET h/week; P = 0.002) moments. In quality of life, there was an increase in scores in all domains: physical, psychological, environmental, and social. Despite the nominal increase, the physical domain showed no differences (P = 0.475).</p><p><strong>Conclusion: </strong>Synchronous tele-exercise is a viable approach for this population, improving strength, physical activity levels, and quality of life in people with SCI.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"1-8"},"PeriodicalIF":1.8,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144651088","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":"The effect of electromyography-triggered electrical stimulation applied to the back extensors muscles on trunk balance and muscle thickness in individuals with complete thoracic spinal cord injury: A randomized controlled trial.","authors":"Handan E N Bayraktar, Meriç Selim Şipal, Elif Yalçın, Medine Kocamanoğlu","doi":"10.1080/10790268.2025.2529641","DOIUrl":"https://doi.org/10.1080/10790268.2025.2529641","url":null,"abstract":"<p><strong>Context: </strong>Impaired activation of the paraspinal muscles in individuals with complete thoracic spinal cord injury (SCI) can result in trunk instability, difficulty performing functional transfers, and an increased risk of falls. Since trunk control plays a central role in seated balance, it has a substantial impact on the ability to carry out activities of daily living and maintain independence.</p><p><strong>Objective: </strong>This study aimed to investigate the effect of electromyography-triggered neuromuscular electrical stimulation (EMG-NMES) applied to multifidus and erector spinae muscles on trunk balance and muscle thickness in individuals with complete thoracic SCI.</p><p><strong>Design: </strong>A randomized controlled trial.</p><p><strong>Setting: </strong>A tertiary rehabilitation center in Ankara, Türkiye.</p><p><strong>Participants: </strong>Fifteen participants with complete thoracic SCI.</p><p><strong>Methods: </strong>Participants were randomized into an experimental group (<i>n</i> = 7) and a control group (<i>n</i> = 8). Both groups were given balance, mobilization, range of motion, and stretching exercises during their hospital stay. EMG-NMES was applied to the trunk muscles of the experimental group during back eccentric exercises 3 times a week for 4 weeks. The control group performed only back eccentric exercises. The primary outcome measures were the trunk control test (TCT) and the modified functional reach test (mFRT). Secondary outcome measures were paraspinal muscle thickness.</p><p><strong>Results: </strong>The primary outcome measures improved significantly more in the experimental group than in the control group. The mean between-group difference in TCT was 1.98 points (95% CI: 0.47-3.49; effect size 0.92; p = 0.014). For mFRT area, the mean difference between groups was 156.63 cm² (95% CI: 80.6-232.6; effect size 2.30; p < 0.001). In the experimental group, the increase in the thickness of the erector spinae and multifidus muscles was significantly greater (p < 0.05).</p><p><strong>Conclusions: </strong>This study found that a four-week EMG-NMES protocol combined with exercise improved trunk balance and functional reach distance in individuals with complete thoracic SCI.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"1-12"},"PeriodicalIF":1.8,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144651089","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":"Gamifying education on addressing real-world barriers, obstacles, and challenges commonly encountered by mobility device users: A convergent mixed-methods feasibility study.","authors":"Sangmi Park, Jorge L Candiotti, Verity Rampulla, Evan J Rafferty, Rosemarie Cooper, Nikitha Deepak, Sivashankar Sivakanthan, Jason Raad, Rory A Cooper","doi":"10.1080/10790268.2025.2503050","DOIUrl":"https://doi.org/10.1080/10790268.2025.2503050","url":null,"abstract":"<p><strong>Context: </strong>Despite significant improvements in the built environment over the past 30 years, barriers and obstacles still make navigating accessible environments challenging. Mobility Device Users (MDUs) typically receive training in controlled settings; however, this training may not adequately prepare them for real-world challenges. To address this gap in training, essential skills were identified and gamified into an educational board game called HERL-Town.</p><p><strong>Objective: </strong>To assess the feasibility of the game as a training tool.</p><p><strong>Design: </strong>A convergent mixed methods design with quantitative data collected using the Model for the Evaluation of Educational Games (MEEGA+) instrument and qualitative data gathered in 12 focus groups.</p><p><strong>Setting: </strong>National Disabled Veterans Winter Sports Clinic (Snowmass Village, Colorado).</p><p><strong>Results: </strong>The analysis included 35 adult MDUs who use ground transportation at least once a week and 15 travel companions who travel regularly with MDUs. Transformed mean scores for all nine MEEGA + dimensions were 55.85, suggesting favorable educational potential and user experience. Content analysis of focus group discussions suggests participants found HERL-Town engaging and educational, though some suggested enhancements to educational content and usability of physical elements of the game.</p><p><strong>Conclusion: </strong>HERL-Town offers a new and novel approach to training essential skills needed to utilize ground transportation effectively. MDUs may know how to operate mobility devices; however, anticipating challenges and identifying strategies for addressing these challenges in real-world environments requires trial and error garnered over an extended period. Gamification of these strategies may help MDUs anticipate these challenges and identify adaptive responses in dynamic environments.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"1-12"},"PeriodicalIF":1.8,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627603","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":"Verification of item difficulty in the Capabilities of Upper Extremity Test using Rasch analysis for individuals with cervical spinal cord injury.","authors":"Kazumasa Jimbo, Kazuhiro Miyata, Hiroshi Yuine, Kousuke Takahama, Tomohiro Yoshimura, Honoka Shiba, Taichi Yasumori, Naohisa Kikuchi, Hideki Shiraishi","doi":"10.1080/10790268.2025.2503047","DOIUrl":"https://doi.org/10.1080/10790268.2025.2503047","url":null,"abstract":"<p><strong>Objective: </strong>The Capabilities of Upper Extremity Test (CUE-T) is a tool that can assess upper limb function in more detail for cervical spinal cord injury (CSCI). This study aimed to determine the degree of difficulty of the CUE-T subtests.</p><p><strong>Design: </strong>This was a cross-sectional study.</p><p><strong>Setting: </strong>This study was conducted with participants from the Chiba Rehabilitation Center in Japan.</p><p><strong>Participants: </strong>A total of 176 data sets were collected from 100 individuals with CSCI (mean age: 59.2 ± 13.8 years; men: 86, women: 14).</p><p><strong>Interventions: </strong>We assessed the structural validity of the CUE-T for CSCI using Rasch analysis based on the Rasch Reporting Guidelines in Rehabilitation Research framework.</p><p><strong>Outcome measures: </strong>CUE-T.</p><p><strong>Results: </strong>The 17 items did not conform to the assumptions of Rasch analysis, such as unidimensionality and local dependence. Therefore, the Rasch analysis was reanalyzed using 10 items, excluding the seven items that were misfit by the item goodness of fit. The most difficult item was the Push Thumb, and the easiest item was Pull.</p><p><strong>Conclusions: </strong>The CUE-T showed good structural validity for 10 items. Indicated the degree of difficulty was similar to the neurological perspective, therefore, it may reflect the clinical practice of upper limb function in CSCI. These results may be useful for setting the difficulty level for rehabilitation of upper limb function in CSCI and for developing better evaluation methods in the future.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"1-9"},"PeriodicalIF":1.8,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144627604","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":"Communicating messages of care and positivity to peers with SCI/D improves loneliness in volunteer letter writers.","authors":"Sherri L LaVela, Kelsey Berryman, Marissa Wirth, Keith Aguina, Brian Bartle, R Lorie Jacob, Charles H Bombardier, Robert W Motl","doi":"10.1080/10790268.2025.2524223","DOIUrl":"https://doi.org/10.1080/10790268.2025.2524223","url":null,"abstract":"<p><strong>Context: </strong>Peer-based volunteering is a potential strategy to alleviate loneliness.</p><p><strong>Objective: </strong>To evaluate the impact of participating as a volunteer letter writer on pre/post-program loneliness outcomes and to examine experiences with participation.</p><p><strong>Methods: </strong>Volunteers with spinal cord injury/dysfunction (SCI/D) participated in a 6-month program writing letters to peers. Mixed methods were used to evaluate volunteers' experiences with the letter writing program. Pre/post loneliness outcomes were examined using a paired t-test. Post-program evaluation included satisfaction, benefit, and negative impact ratings. Qualitative interviews were coded inductively and analyzed using qualitative content analysis.</p><p><strong>Results: </strong>Volunteer peer letter writers (<i>n</i> = 28) were male (82%), had paraplegia (57%) and incomplete injuries (50%). On average they were 55 years of age and injured for 18 years. Volunteer peer letter writers with SCI/D had a statistically significant reduction in loneliness from pre- to post-program (3-item UCLA score 4.0 to 3.7, P = .04). The majority found the program beneficial (72%), with no/neutral negative impacts (93%), and were satisfied (82%). Volunteer peers with SCI/D: (1) liked and felt good about helping others with SCI/D; (2) believed the program provided an opportunity for self-reflection, including awareness and appreciation of their own circumstances and social connections; (3) liked sharing their injury experiences with and being connected to the letter recipient, and (4) found value in the writing process itself.</p><p><strong>Conclusions: </strong>Loneliness was reduced in peer letter writers from pre- to post-program. Volunteers had beneficial and satisfactory experiences. Work to develop and test interventions peer-based volunteering intervention to address loneliness and other psychosocial outcomes is needed.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"1-9"},"PeriodicalIF":1.8,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610213","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":"The relationship between ambulation capacity, spasticity and piriformis muscle thickness in patients with chronic spinal cord injury: A controlled, clinical and sonographic study.","authors":"Özlem Köroğlu, Fatma Özcan, Merve Ö Atar, Onur Kanlioglu, Bilge Yılmaz","doi":"10.1080/10790268.2025.2522496","DOIUrl":"https://doi.org/10.1080/10790268.2025.2522496","url":null,"abstract":"<p><strong>Context: </strong>The main rehabilitation goals for patients with a spinal cord injury (SCI) are to reduce disability, limit impairment, and regain walking ability. Many prognostic factors affect the recovery and ambulation capacity of patients. After SCI, muscles below the lesion level change morphologically.</p><p><strong>Objective: </strong>As the muscle thickness is a significant factor for identifying muscle strength, joint functions and joint torque, the aim of this study was to compare piriformis muscle (PM) maximum thickness in patients with incomplete SCI, with those of a sex, age, weight and height-matched control group. Maximum PM thickness was also compared between cases of incomplete and complete SCI in order to estimate whether spasticity and ambulatory status influence PM thickness after incomplete chronic SCI.</p><p><strong>Methods: </strong>The demographic data, injury characteristics, and clinical findings were recorded for each patient. Muscle thickness was measured using ultrasonography and relationships between PM thickness and demographic and clinical findings were analyzed and compared between the groups.</p><p><strong>Results: </strong>The PM thickness of SCI patients was determined to be significantly lower than that of the healthy control subjects. No significant differences were observed in the comparisons of other values between patients with incomplete SCI and the control group.</p><p><strong>Conclusion: </strong>Significant muscle atrophy of the PM is seen in SCI. There is a need for further investigation of the relationship between muscle size and function, and physiological deficits in skeletal muscle and functional ability after SCI.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"1-7"},"PeriodicalIF":1.8,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610217","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 of venous thromboembolism and bleeding complications for early enoxaparin versus heparin after same-day spine surgery for central cord syndrome: A propensity-matched retrospective cohort study.","authors":"Anthony N Baumann, Robert J Trager, Nathan Cuttica, Shahabeddin Yazdanpanah, Davin C Gong, Daniel Schirtzinger, Jacob C Hoffmann","doi":"10.1080/10790268.2025.2524226","DOIUrl":"https://doi.org/10.1080/10790268.2025.2524226","url":null,"abstract":"<p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Objective: </strong>The primary purpose of this study is to compare the effect of enoxaparin versus heparin on the risk of venous thromboembolism (VTE) after early spine surgery for CCS, hypothesizing no difference in risk.</p><p><strong>Setting: </strong>Multi-site academic centers.</p><p><strong>Methods: </strong>This retrospective propensity-matched cohort study using the TriNetX database included adults (≥18 years) who underwent same-day spine surgery for CCS; divided into cohorts depending on the administration of heparin or enoxaparin within three days after surgery (heparin cohort or enoxaparin cohort, respectively). The primary outcome was the incidence and risk ratio (RR) of VTE with secondary outcomes of the incidence and RR of epidural hematoma (EDH), deep venous thrombosis (DVT), and severe postoperative bleeding (SPOB). Cohorts were matched by multiple confounding variables.</p><p><strong>Results: </strong>There were 1,089 patients (mean age: 59 years; 71% male) in each cohort. Comparing the enoxaparin to heparin cohort through three months after surgery, there was no statistically significant or clinically meaningful difference in risk of VTE (P = 0.607; RR:1.11). There were 52 cases (4.8%) and 47 cases (4.3%) of VTE in the enoxaparin and heparin cohorts, respectively. The median time from surgery to VTE was 14.1 and 12.8 days in the enoxaparin and heparin cohorts, respectively. There was no statistically significant difference in risk of EDH (P = 0.693), DVT (P = 0.677), or SPOB (P = 0.861) between both cohorts.</p><p><strong>Conclusion: </strong>Incidence of VTE through three months after same-day spine surgery for CCS was consistent with the literature, without increased risk of VTE based on the administration of early enoxaparin versus heparin.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"1-10"},"PeriodicalIF":1.8,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610215","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":"A qualitative study uncovering rehabilitation challenges: Perspectives of individuals with spinal cord injury.","authors":"Muna Bhattarai, Sadiksha Karki, Anjita Khadka, Mandira Baniya, Raju Dhakal","doi":"10.1080/10790268.2025.2526252","DOIUrl":"https://doi.org/10.1080/10790268.2025.2526252","url":null,"abstract":"<p><strong>Context: </strong>Rehabilitation is an essential set of interventions to optimize functioning and minimize disability in individuals with spinal cord injuries (IwSCI). However, accessing rehabilitation services presents unique challenges for these individuals, particularly in low- and middle-income countries.</p><p><strong>Objectives: </strong>This study aims to explore the perspectives of IwSCI regarding the challenges they face in accessing effective spinal cord injury (SCI) rehabilitation services in Nepal.</p><p><strong>Methods: </strong>In this qualitative study, 16 participants with SCI were recruited from community settings and a rehabilitation center in Nepal. In-depth interviews were conducted either face-to-face or via cell phone between August and September 2023. The participants' responses were analyzed using a reflexive thematic analysis approach.</p><p><strong>Results: </strong>Qualitative analysis identified five overarching themes concerning the challenges experienced by IwSCI in accessing rehabilitation services in Nepal. Participants highlighted that personal challenges related to finances, education, and health, along with socio-cultural influences and caregiving, shortcomings in healthcare and support systems, limited services and resources within rehabilitation centers, and geographical and infrastructural barriers to accessibility hindered their ability to access or continue rehabilitation services.</p><p><strong>Conclusions: </strong>While rehabilitation is essential for managing secondary conditions improving functionality, and maximizing independence, IwSCI in Nepal experience significant challenges in receiving effective rehabilitation services. Collective efforts from families, communities, rehabilitation centers, and the government are vital to reducing these challenges and enhancing the effectiveness of SCI rehabilitation services in Nepal.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"1-11"},"PeriodicalIF":1.8,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602142","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 tumors misdiagnosed as idiopathic intracranial hypertension: Case report with literature review.","authors":"Zahra Baghestani, Fatemeh Mahjoub, Samaneh Zafarabadi, Mohamad Hosein Mohamadi","doi":"10.1080/10790268.2025.2514323","DOIUrl":"https://doi.org/10.1080/10790268.2025.2514323","url":null,"abstract":"<p><strong>Introduction: </strong>To maintain intracranial pressure (ICP) within the normal range in an intact skull, volumes of cerebrospinal fluid (CSF), blood and brain are tightly regulated. A change in any of these components leads to compensatory changes in the others to maintain normal brain pressure. If compensatory mechanisms fail, raised intracranial pressure (rICP) occurs. Various causes lead to rICP, including focal brain edema (traumatic hematomas, neoplasm, stroke, abscess), diffuse brain edema (encephalitis, meningitis, seizures), disturbances of CSF circulation, vascular malformations, obstruction of major venous sinuses and idiopathic causes. We present a case of melanocytoma that developed rICP, leading to symptoms of rICP, including headache and blurred vision.</p><p><strong>Case report: </strong>One rare cause of rICP can be spinal cord tumors. We describe a patient who presented with isolated symptoms and signs of rICP, such as blurred vision and headache for one year. Her condition was initially misdiagnosed as idiopathic intracranial hypertension (IIH) and venous sinus stenosis. However, after one year, the diagnosis of cervical melanocytoma was confirmed.</p><p><strong>Conclusion: </strong>Spinal cord tumors can rarely present solely with symptoms of increased ICP, leading to a potential misdiagnosis and delay in appropriate treatment. This case highlights the need for vigilance and a thorough diagnostic approach in patients with increased ICP.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"1-9"},"PeriodicalIF":1.8,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610216","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":"Immersive virtual reality for neuropathic pain management in spinal cord injury: A randomized controlled trial.","authors":"J Samson Selvaraj, Henry Prakash, Thomas Anand Augustine, S Samuel Kamalesh Kumar, Senthil Velkumar, J Augustin Amalraj","doi":"10.1080/10790268.2025.2514321","DOIUrl":"https://doi.org/10.1080/10790268.2025.2514321","url":null,"abstract":"<p><strong>Objectives: </strong></p><p><strong>Primary: </strong>To evaluate the efficacy of immersive virtual reality (VR) in reducing neuropathic pain (NP) in individuals with spinal cord injury (SCI).</p><p><strong>Secondary: </strong>To assess the impact of immersive VR on depersonalization symptoms in the SCI population.</p><p><strong>Design: </strong>Double-blind, randomized controlled trial.</p><p><strong>Setting: </strong>Rehabilitation unit of a tertiary care teaching hospital in South India.</p><p><strong>Participants: </strong>Fifty-two individuals with SCI (ASIA A, B, and C) who had a LANSS (Leeds Assessment of Neuropathic Symptoms and Signs) score ≥12 and were on stable pharmacological treatment. Participants were randomized using computer-generated block randomization.</p><p><strong>Interventions: </strong>The intervention group received immersive VR exposure via a head-mounted display, involving virtual tasks such as wheelchair propulsion, cycling, and walking, for 15 min per session, twice daily, five days a week, over two weeks. The control group viewed 2D animated films of equivalent duration using the same device.</p><p><strong>Outcome measures: </strong>Visual Analog Scale (VAS) for neuropathic pain and Cambridge Depersonalization Scale (CDS) for depersonalization.</p><p><strong>Results: </strong>Forty-three participants completed the trial (intervention: <i>n</i> = 23; control: <i>n</i> = 20). The intervention group demonstrated a significant reduction in VAS scores from 59.35 to 37.61 (a 36.63% reduction), while the control group showed a reduction from 59.00 to 48.00 (an 18.64% reduction). The between-group difference in VAS score change was statistically significant. CDS scores also improved significantly in the intervention group compared to the control group.</p><p><strong>Conclusion: </strong>Immersive VR is a promising nonpharmacological, non-invasive intervention for managing neuropathic pain in individuals with SCI. It is associated with improved embodiment and reduced depersonalization symptoms, offering a potential pathway to enhance quality of life. Its portability, minimal adverse effects, and ease of customization make it a viable adjunct to conventional rehabilitation strategies.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"1-13"},"PeriodicalIF":1.8,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610214","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}