Journal of Spinal Cord Medicine最新文献

{"title":"Predicting chronic pain two years following a spinal cord injury: Longitudinal study on the reciprocal role of acute pain and PTSD symptoms.","authors":"Karni Ginzburg, Hila Greener, Moshe Bondi, Gabi Zeilig, Ruth Defrin","doi":"10.1080/10790268.2024.2361552","DOIUrl":"10.1080/10790268.2024.2361552","url":null,"abstract":"<p><strong>Objectives: </strong>To examine a) the development of PTSD symptoms and pain over five months post-spinal cord injury (SCI); b) the directional effects of PTSD symptoms and pain across five months post-SCI; and c) the prediction of chronic pain two-years post-SCI by PTSD symptoms and pain severity in the first five months post-SCI.</p><p><strong>Study design: </strong>Two-year longitudinal study.</p><p><strong>Setting: </strong>: Individuals with an SCI admitted to the Department of Neurological Rehabilitation (N = 65).</p><p><strong>Outcome measures: </strong>: PTSD symptoms and pain were evaluated at 1.5 months (T1), three months (T2), and five months (T3) post-SCI. Chronic pain was evaluated at 24 months post-SCI (follow-up).</p><p><strong>Results: </strong>Seventy-five percent of participants reported chronic pain at follow-up. Pain severity at T1 and T2 predicted PTSD symptoms at T2 and T3, respectively. PTSD symptoms at T2 predicted pain severity at T3. Individuals with chronic pain at follow-up had reported more PTSD symptoms at T1, T2, and T3 than those without pain. A multivariate model yielded two significant indirect paths: a) PTSD symptoms at T1 predicted chronic pain severity at follow-up through PTSD symptoms at T2 and T3, and b) pain severity at T1 predicted chronic pain severity at follow-up through pain severity at T2 and T3.</p><p><strong>Conclusions: </strong>Both pain and PTSD in the acute post-SCI phase are markers for chronic pain two years later. PTSD and chronic pain exhibit a complex, reciprocal relationship across time that contributes to pain chronicity. Identifying individuals at risk and implementing interventions targeting both pain and PTSD symptoms during the acute phase may prevent their chronification.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"405-414"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12035952/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141447485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Urinary tract infections and urinary bladder health experiences of persons with spinal cord injury in a Canadian province: A mixed methods study showcasing infection prevention as health inequity case.","authors":"Jocelyn Brady, Adalberto Loyola-Sanchez, Steven Crochetiere, Rob MacIsaac, Erika Kulik, Yoshino Okuma, Marcy Cwiklewich, Magda Mouneimne, Tanya McFaul, Zahra Bhatia, Raj Parmar, Chester Ho, Hardeep Kainth, Jason Knox, Rebecca Charbonneau","doi":"10.1080/10790268.2023.2287253","DOIUrl":"10.1080/10790268.2023.2287253","url":null,"abstract":"<p><strong>Context/objective: </strong>Urinary tract infections (UTIs) are one of the most frequent secondary complications among people with spinal cord injury (SCI). The prevention and management of UTIs is prioritized by stakeholders across Canada. The purpose of this study was to gain an in-depth understanding of the urinary bladder (bladder) management experiences of people with SCI in Alberta communities, especially how UTIs are experienced and managed.</p><p><strong>Design: </strong>Convergent mixed methods parallel databases variant.</p><p><strong>Setting: </strong>Communities across Alberta, Canada.</p><p><strong>Participants: </strong>39 survey participants and 19 interview participants, all with SCI.</p><p><strong>Methods: </strong>One-on-one phone semi-structured interviews analyzed using thematic analysis. Quantitative surveys included demographic, multichoice, and Likert Scale questions analyzed using descriptive analysis. Both methods explored people with SCI's experiences with bladder management and UTIs. Qualitative and quantitative results were integrated through a comparison joint display table and meta-inferences.</p><p><strong>Outcome measures: </strong>Qualitative themes and descriptive statistics further integrated as mixed core-statements.</p><p><strong>Results: </strong>Bladder routine is central to daily life and maintaining bladder health, avoiding UTIs, is the priority. Several health inequities are related to (1) financial barriers dictating how bladder is managed, (2) low perceived support for appropriate bladder management, (3) low healthcare access to appropriate UTI management and (4) low providers' capacity to support bladder management and build trust with persons with SCI.</p><p><strong>Conclusion: </strong>Action is required to address identified health inequities, including improvement of financial support, like appropriate catheter coverage, decrease barriers to access appropriate care and improvement of providers' capacity to address SCI bladder care.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"499-511"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12035949/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139485171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular autonomic function in middle-aged people with long-term cervical and upper thoracic spinal cord injuries.","authors":"Mattias Hill, Sophie Jörgensen, Gunnar Engström, Margaretha Persson, Pyotr G Platonov, Viktor Hamrefors, Jan Lexell","doi":"10.1080/10790268.2024.2403791","DOIUrl":"10.1080/10790268.2024.2403791","url":null,"abstract":"<p><strong>Objectives: </strong>To examine cardiovascular autonomic function in middle-aged people with long-term cervical and upper thoracic spinal cord injury (SCI) compared with the general population, and explore if the neurological level of injury (NLI) is related to cardiovascular autonomic function.</p><p><strong>Design: </strong>Population-based cross-sectional study with matched controls.</p><p><strong>Setting: </strong>Outpatient SCI unit in Southern Sweden.</p><p><strong>Participants: </strong>Twenty-five individuals (20% women, mean age 58 years and mean time since injury 28 years, NLI C2-T6, American Spinal Injury Association Impairment Scale A-C) from the Swedish SPinal Cord Injury Study on Cardiopulmonary and Autonomic Impairment (SPICA). Matched controls were obtained from the population-based Swedish CArdioPulmonary bioImage Study (SCAPIS) at a ratio of 5:1.</p><p><strong>Interventions: </strong>Not applicable.</p><p><strong>Outcome measures: </strong>24 h electrocardiography and deep breathing tests. 24 h ambulatory blood pressure (BP) monitoring and orthostatic BP tests.</p><p><strong>Results: </strong>In individuals with SCI compared with controls, heart rate variability (24h mean SD of the normal-to-normal interval 112 ms vs 145 ms, P < 0.001) and diastolic orthostatic BP increase (2.0 and 9.4 mmHg, P < 0.001), were significantly lower, whereas BP variability was significantly higher (24h mean systolic SD_BP 17.8 mmHg vs 15.7 mmHg, P = 0.029). Circadian patterns of heart rate variability and BP (lack of nocturnal dip) were significantly different among the individuals with SCI than controls. Higher NLI was significantly (P < 0.05) correlated with impairments to various cardiovascular autonomic function variables.</p><p><strong>Conclusions: </strong>This exploratory study indicates that cardiovascular autonomic function is impaired in middle-aged people with long-term cervical and upper thoracic SCI compared with the general non-SCI population, and more pronounced with a higher NLI. Future research is needed to understand the pathophysiological mechanisms underlying these impairments, and the prognostic significance for individuals with SCI.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier: NCT03515122.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"447-460"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12035942/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142401787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nuances of gender affirming therapy for transgender women with spinal cord injury.","authors":"Deanna Claus, Darryl Etter, Stephanie Cowherd Ryder","doi":"10.1080/10790268.2024.2396644","DOIUrl":"10.1080/10790268.2024.2396644","url":null,"abstract":"<p><strong>Case description: </strong>56-year-old transgender woman with new spinal cord injury (SCI) on gender affirming hormonal therapy (GAHT) with estrogen and spironolactone.</p><p><strong>Findings: </strong>After her injury, estrogen and spironolactone were discontinued, for blood clots and hypotension, respectively. Alternative options were explored.</p><p><strong>Clinical relevance: </strong>Little is known about GAHT in SCI for transgender women. Shared decision making should be used to navigate risks, benefits, and alternative options.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"542-544"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12035933/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142121004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Taking risk to heart: An evaluation of cardiometabolic risk and screening guideline adherence in outpatients with spinal cord injury.","authors":"Luxshmi Nageswaran, Dalton L Wolfe, Laura J Graham, Emma A Bateman","doi":"10.1080/10790268.2024.2420142","DOIUrl":"10.1080/10790268.2024.2420142","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate cardiometabolic disease (CMD) in outpatients with spinal cord injury/disease (SCI/D). The study aims were to (1) estimate the prevalence of CMD risk factors in a cohort of Canadian adults with SCI/D; (2) assess whether the frequency of CMD screening aligns with evidence-based guidelines; and (3) gain a preliminary understanding of the barriers to CMD screening and/or treatment within a rehabilitation program setting.</p><p><strong>Design: </strong>Quality improvement initiative involving chart review extracting the presence of and frequency of screening for four CMD risk factors (obesity, hypertension, dyslipidemia, diabetes mellitus). Values were compared to evidence-based guidelines for CMD risk identification and management. Root cause analysis and focused interviews were conducted with clinic staff to identify barriers.</p><p><strong>Setting: </strong>Academic, tertiary rehabilitation hospital.</p><p><strong>Participants: </strong>Consecutive outpatients with SCI/D from October 2020 to December 2021 (<i>n</i> = 73).</p><p><strong>Results: </strong>43.8% of outpatients sampled had established CMD (≥3 risk factors) and 94.5% had at least one risk factor. Obesity was the most prevalent (82.2%), followed by dyslipidemia (71.7%), hypertension (46.5%), and diabetes mellitus (34.8%). Hypertension and obesity screening were completed at 14.3% and 10.4% of appointments. The frequency of dyslipidemia and diabetes mellitus screening could not be determined. Eighteen barriers to timely CMD screening and treatment intensification were identified.</p><p><strong>Conclusions: </strong>The prevalence of CMD risk factors in outpatients with SCI/D was high. While approximately two of every five outpatients had established CMD, adherence to screening guidelines was poor. These findings reinforce the need for strategies to improve screening and reduce preventable harm from CMD in this vulnerable population.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"482-492"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12035929/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142803126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association between locus of control and general mental health in patients with lumbar spinal cord injury: A cross-sectional study.","authors":"Amir Bazrafshan, Moein Fahimy, Hamid Reza Farpour, Amin Sayyadi, Alireza Heiran","doi":"10.1080/10790268.2024.2426309","DOIUrl":"10.1080/10790268.2024.2426309","url":null,"abstract":"<p><strong>Background: </strong>Spinal cord injuries (SCIs) are major sources of socioeconomic burdens and are still rising globally. SCIs also cause several personal sufferings in both physical and psychological aspects. Individuals' reactions following a traumatic incident can vary based on the severity and nature of the damage, as well as their psychological dispositions. Locus of control (an individual's belief in his/her ability to control the outcome of events surrounding them) is an important factor in determining individuals' quality of life (QoL) in the aftermath of an incident.</p><p><strong>Methods: </strong>We conducted a cross-sectional study to investigate the association between locus of control and general health in patients with lumbar SCI. This study was carried out on 108 patients with lumbar SCI using the Rotter's Locus of Control Scale and the General Health questionnaires, as well as demographic data.</p><p><strong>Results: </strong>Patients with an internal locus of control had a significantly better general health score than those with an external locus of control (32 vs. 38.5; <i>P</i> < 0.0001). There was a moderate positive correlation between general health and locus of control score (R = 0.575; <i>P</i> < 0.0001). Also, employed patients had a significantly more internal locus of control score compared to unemployed patients (7 vs. 8; <i>P</i> = 0.004).</p><p><strong>Conclusion: </strong>Scores of locus of control and general health are significantly correlated, and internal locus of control could lead to better general mental health in patients with lumbar SCI. Although there is a need for more studies with better study designs to approve of this association, the results of this study emphasize the importance of interventions targeting locus of control, improving socio-economic conditions, and rehabilitation measures in improving the general health of these patients.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"493-498"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12035920/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142689398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Breast and cervical cancer screening in females with spinal cord injury: A systematic review and meta-analysis.","authors":"Inge Eriks-Hoogland, Mide Veseli-Abazi, Lorena Müller, Chlirim Abazi, Brittany Snider, Jakob Evers, Jürgen Pannek, Vanessa Seijas","doi":"10.1080/10790268.2024.2408056","DOIUrl":"10.1080/10790268.2024.2408056","url":null,"abstract":"<p><strong>Context: </strong>Breast and cervical cancer are among the most common types of cancer, with breast cancer being a leading cause of death in females. Participation in preventive cancer screening is thought to be lower for females with spinal cord injury (SCI) compared to the general population, which could lead to late diagnosis and increased mortality.</p><p><strong>Objective: </strong>To summarize evidence on the prevalence of breast and cervical cancer, adherence to cancer screening recommendations, and factors influencing participation in preventive programs among females with SCI.</p><p><strong>Methods: </strong>Systematic searches were conducted in PubMed, Embase, a guideline repository, and two SCI-specific websites for articles published between 1990 and 2023. The risk of bias was assessed using different critical appraisal tools. Fixed-effects meta-analysis estimated differences in adherence to mammography and Pap testing recommendations between females with and without SCI. Prospero registration: CRD42023481362.</p><p><strong>Results: </strong>We identified 15 studies, mainly from high-income countries, with a cumulative study population of 9,565 people. No studies evaluated cervical or breast cancer prevalence in females with SCI. Meta-analysis found females with SCI had 1.4 times the odds of not having a recent mammogram and 1.8 times the odds of not having a recent pap test, compared to females without SCI. Barriers included environmental, attitudinal, financial, and informal factors.</p><p><strong>Conclusion: </strong>There is no information on the prevalence of cervical or breast cancer in females with SCI. Participation in breast and cervical cancer screening is lower among females with SCI. Physical inaccessibility of health care and lack of provider knowledge were the main barriers.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"461-481"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12035938/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142669934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characteristics of the gut microbiome of Swiss elite athletes with a spinal cord injury: An exploratory study.","authors":"Ezra Valido, Alessandro Bertolo, Anneke Hertig-Godeschalk, Joelle Leonie Flueck, Belinda Ruettimann, Marija Glisic, Jivko Stoyanov","doi":"10.1080/10790268.2023.2265610","DOIUrl":"10.1080/10790268.2023.2265610","url":null,"abstract":"<p><strong>Objectives: </strong>To illustrate and explore associations between the gut microbiome and spinal cord injury (SCI) characteristics, physical training, dietary intake, body composition, and blood biomarkers of elite Swiss athletes.</p><p><strong>Design and setting: </strong>Baseline data analysis of athletes with SCI who participated in a pilot trial (NCT04659408) in the Swiss Paraplegic Center, Nottwil, Switzerland.</p><p><strong>Participants: </strong>Elite athletes, five males, and six females, with SCI who competed internationally.</p><p><strong>Outcome measures: </strong>We conducted a differential abundance analysis and measured the alpha and beta diversity of the gut microbiome.</p><p><strong>Results: </strong>The athletes' median age was 34.5 years. Six had traumatic SCI and five had a spina bifida. The athletes competed in para-cycling (5), wheelchair athletics (3), and wheelchair tennis (3). A higher duration of training per week was positively associated with <i>Akkermansia</i> and <i>Akkermansiaceae</i> but negatively associated with <i>Prevotellaceae</i>. <i>Muribaculaceae</i> was negatively associated with the average number of trainings per week. Waist circumference is negatively associated with <i>Butyricimonas</i>. Significant differences in the alpha diversity were found with sex, gastrointestinal quality of life index (GIQLI) scores, total caloric intake, total fat intake, total carbohydrate intake, and high-sensitivity C-reactive protein (hs-CRP). Beta diversity differences were found with impairment of the sympathetic nervous system of the gut at the genus level and HbA1c at the family level.</p><p><strong>Conclusions: </strong>This study provides insight into the gut microbiome of athletes with SCI. Our results were similar to those found in athletes without SCI. Further replication is needed to confirm the relationships of organisms observed in the gut of athletes with SCI.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"376-384"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12035930/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139425895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nerve transfer for upper extremity reanimation in people with spinal cord injury: A 2-year follow-up case series.","authors":"Silvia Olivi, Paola Paglierani, Elisa Maietti, Paola Rucci, Gaia Musumeci, Carlotte Kiekens, Jacopo Visani, Carlo Sacco","doi":"10.1080/10790268.2024.2344313","DOIUrl":"10.1080/10790268.2024.2344313","url":null,"abstract":"<p><strong>Objective: </strong>To describe the 2-year functional outcomes of nerve transfer (NT) for upper extremity reanimation.</p><p><strong>Study design: </strong>A prospective case series.</p><p><strong>Setting: </strong>A highly specialized rehabilitation hospital for spinal cord injury (SCI) in Italy.</p><p><strong>Intervention: </strong>Upper limb nerve transfer (32 NTs, 15 upper limbs).</p><p><strong>Participants: </strong>Twelve male individuals with traumatic SCI (AIS A or B, neurological level from C4 to C7) were enrolled; 24-month follow-up data were available for 11.</p><p><strong>Outcome measures: </strong>We evaluated the strength recovery of recipient muscles through the Medical Research Council (MRC) Scale for Muscle Strength. Upper limb function and independence were assessed with the Graded Redefined Assessment of Strength Sensibility and Prehension (GRASSP) test version 1 and the Spinal Cord Independent Measure III (SCIM III). Patient satisfaction was also evaluated.</p><p><strong>Results: </strong>After 24 months, median MRC scores (range) were: triceps 2 (1-2); extensor digitorum communis 3 (1-4); extensor pollicis longus 2.5 (1-4); flexor digitorum profundus 2 (0-4); flexor pollicis longus 2 (0-4). No complication occurred. GRASSP prehension ability and prehension performance total scores significantly improved at 24 months from 1 (0-4) to 2 (0-7) and from 1 (0-8) to 5 (0--22), respectively. The SCIM III self-care sub-scale score improved at 24-month follow-up (<i>p</i> = 0.009).This study has important limitations, including a limited generalizability of the results and a small sample size that does not allow definitive conclusions to be drawn. A large multicenter prospective study is needed to confirm our findings.</p><p><strong>Conclusions: </strong>NT represents a functional surgery option with few complications for the resuscitation of upper limbs in persons with tetraplegia.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"395-404"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12035925/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140859314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting motor recovery in tetraplegia during inpatient rehabilitation by motor unit action potentials and stimulated manual motor testing.","authors":"James R Wilson, David Y Balser, Gregory A Nemunaitis, Kim D Anderson","doi":"10.1080/10790268.2025.2452687","DOIUrl":"10.1080/10790268.2025.2452687","url":null,"abstract":"<p><strong>Study design: </strong>Diagnostic Study.</p><p><strong>Objectives: </strong>Early prognosis for recovery in traumatic cervical spinal cord injury resulting in tetraplegia may further guide rehabilitation and surgical interventions. This study assesses the feasibility and potential of using stimulated manual motor testing (SMMT) and needle electromyography (EMG) to predict gains in strength during acute inpatient rehabilitation.</p><p><strong>Setting: </strong>Single academic inpatient rehabilitation facility (IRF).</p><p><strong>Methods: </strong>Muscles with weak strength (manual motor test (MMT) <3) were assessed for lower motor neuron (LMN) integrity by SMMT using surface electrodes. Muscles without clinical strength (MMT=0) using SMMT and EMG. Correlations and prognostic models assessed the association and prediction of these measures with improvement in MMT values over 4 weeks.</p><p><strong>Results: </strong>The missing data rate for SMMT and motor unit action potential (MUAP) testing was 9.5% and 24%, respectively. Wilcoxon Rank Sum tests of 4-week MMT changes with MUAP presence (P = 3.89×10^-6) and SMMT improvement (P = 0.0156) were statistically significant, but the Spearman Rank Correlation Coefficient of changes in SMMT with MMT changes was not (P = 0.817). The receiver operating characteristic (ROC) Area Under the Curve (AUC) for combined MUAP and SMMT predictors of MMT improvement was 0.732, with an optimal sensitivity of 41.9% (95% CI 25.8% to 58.1%) and specificity of 90.3% (95% CI 84.5% to 96.1%). This model was superior to univariate models.</p><p><strong>Conclusions: </strong>With pragmatic compromises in test administration to reduce attrition, measuring the presence of voluntary MUAP and improvement in SMMT during acute rehabilitation retains value in predicting motor improvement in 4 weeks.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"385-394"},"PeriodicalIF":1.8,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12035928/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}