Journal of Spinal Cord Medicine最新文献

{"title":"Neuropathic pain development and maintenance and its association with motor recovery after cervical spinal cord injury.","authors":"Kosuke Saita, Masahiko Sumitani, Yurie Koyama, Shurei Sugita, Yoshitaka Matsubayashi, Toru Ogata, Hiroshi Ohtsu, Hirotaka Chikuda","doi":"10.1080/10790268.2024.2309421","DOIUrl":"10.1080/10790268.2024.2309421","url":null,"abstract":"<p><strong>Background: </strong>In our published randomized controlled trial, we revealed that patients with acute ASIA Grade C incomplete cervical spinal cord injury (SCI) who underwent early surgery (within 24 h post-injury) had accelerated motor recovery at six months than those with delayed surgery (>2 weeks post-injury); however, neuropathic pain (NeP) worsened regardless of surgery timing. Here, we conducted <i>post-hoc</i> analyses to intensively assess NeP development and maintenance.</p><p><strong>Methods: </strong>Of 44 patients (median 64.5 years; three female; early intervention, <i>n</i> = 26), NeP was categorized into at-level and below-level pain and evaluated at  two weeks and one year after injury using the Neuropathic Pain Symptom Inventory (NPSI). We compared the two groups based on background characteristics. A mixed-design analysis of variance with sex as a covariate was conducted to analyze motor recovery and Health-related quality of life (HRQOL) in groups with severe (NPSI ≥ 10) or mild (NPSI < 10) pain.</p><p><strong>Results: </strong>Upper and lower limb motor impairments were comparable between both groups regardless of pain severity. Severe at-level pain remained stable and worsened at one year than mild at-level pain; however, the upper- and lower-limb motor scores and HRQOL had comparable recovery. Background characteristics did not affect severity or time course of NeP. Patients with severe below-level pain demonstrated slower lower-limb motor recovery than those with mild below-level pain, whereas HRQOL improved regardless of pain severity.</p><p><strong>Conclusions: </strong>Both at-level and below-level NeP developed and persisted relatively early in the course of traumatic SCI with incomplete motor paralysis; their severities worsened over time or remained severe since onset.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"585-592"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139933864","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 the minimal clinically important difference of the Capabilities of Upper Extremity Test in patients with subacute spinal cord injury.","authors":"Kazumasa Jimbo, Kazuhiro Miyata, Hiroshi Yuine, Kousuke Takahama, Tomohiro Yoshimura, Honoka Shiba, Taichi Yasumori, Naohisa Kikuchi, Hideki Shiraishi","doi":"10.1080/10790268.2023.2273586","DOIUrl":"10.1080/10790268.2023.2273586","url":null,"abstract":"<p><strong>Context: </strong>The number of patients with cervical spinal cord injury (CSCI) is increasing, and the Capabilities of Upper Extremity Test (CUE-T) is recommended for introduction in clinical trials. We calculated the minimal clinically important difference (MCID) of the CUE-T using an adjustment model with an interval of 1 month.</p><p><strong>Design: </strong>This was a prospective study.</p><p><strong>Setting: </strong>This study was conducted with participants from the Chiba Rehabilitation Center in Japan.</p><p><strong>Participants: </strong>The participants were patients with subacute CSCI.</p><p><strong>Interventions: </strong>The CUE-T and spinal cord independence measure (SCIM) III were performed twice within an interval of 1 month.</p><p><strong>Outcome measures: </strong>The MCID was calculated using an adjustment model based on logistic regression analysis. The participants were classified into an improvement group and a non-improvement group based on the amount of change in the two evaluations using the 10-point SCIM III MCID as an anchor.</p><p><strong>Results: </strong>There were 52 participants (56.8 ± 13.5 years old, 45 men/7 women) with complete or incomplete CSCI: 18 in the improvement group and 34 in the non-improvement group. A significant regression equation was obtained when calculating the MCID, and the total, hand, and side scores were 7.7, 2.0, and 3.7 points, respectively.</p><p><strong>Conclusion: </strong>The calculated MCID of the CUE-T in this study was 7.7 points. The results of this study provide useful criteria for implementation in clinical trials. Future studies should use patient-reported outcomes, a more recommended anchor, and calculate the MCID using methods such as the patient's condition.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"613-620"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71488208","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":"Community integration after spinal cord injury rehabilitation: Predictors and causal mediators.","authors":"Alejandro García-Rudolph, Hector Cusso, Carola Carbonell, Sandra Lopez, Laura Pla, Marina Sabaté, Pilar Vazquez, Eloy Opisso, Angels Hervas","doi":"10.1080/10790268.2024.2386738","DOIUrl":"10.1080/10790268.2024.2386738","url":null,"abstract":"<p><strong>Context/objective: </strong>Community integration (CI) is a crucial rehabilitation goal after spinal cord injury (SCI). There is a pressing need to enhance our understanding of the factors associated with CI for individuals with traumatic or non-traumatic etiologies, with the latter being notably understudied. Accordingly, our research explores the associations and potential mediators influencing CI across these populations.</p><p><strong>Setting: </strong>Specialized neurological rehabilitation center.</p><p><strong>Participants: </strong>Community-dwelling individuals who were admitted as inpatients within 3 months post-injury (<i>n</i> = 431, 51.9% traumatic, 48.1% non-traumatic), assessed in relation to community integration within 1-3 years after discharge.</p><p><strong>Outcome measure: </strong>Community Integration Questionnaire (CIQ). Covariates: American Spinal Injury Association Impairment Scale (AIS), Functional Independence Measure (FIM) and Hospital Anxiety and Depression Scale (HADS).</p><p><strong>Results: </strong>Multiple linear regression yielded age, B AIS grade, educational level (< 6 years and <12 years), time since injury to admission, length of stay, HADS-depression at discharge, total FIM at discharge and three social work interventions (support in financial, legal and transportation services) as significant predictors of total CIQ score (Adjusted <i>R</i>² = 41.4). Multiple logistic regression identified age, traumatic etiology, educational level (< 6 years and <12 years), length of stay, HADS depression at discharge, total FIM at discharge and one social work intervention (transportation support) as significant predictors of good community integration, AUC (95% CI): 0.82 (0.75-0.89), Sensitivity:0.76, Specificity:0.73. We identified motor FIM at discharge and motor FIM efficiency as causal mediators of total CIQ.</p><p><strong>Conclusions: </strong>We identified modifiable factors during rehabilitation-functional independence, depression, and social work interventions-that are associated with CI.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"682-693"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141917915","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":"Effect of inpatient rehabilitation on the quality of life and life satisfaction in spinal cord injury.","authors":"Elham Loni, Mahsa Ghorbanzadeh, Fereydoun Layeghi, Sahel Moein, Mahboobeh Bahiraee, Razieh Bidhendi-Yarandi","doi":"10.1080/10790268.2024.2362501","DOIUrl":"10.1080/10790268.2024.2362501","url":null,"abstract":"<p><strong>Objective: </strong>Assess the impact of inpatient rehabilitation on the quality of life and life satisfaction of individuals with spinal cord injury by considering the level of injury.</p><p><strong>Design: </strong>QuasiExperimental study.</p><p><strong>Setting: </strong>Rehabilitation Hospital.</p><p><strong>Participants: </strong>A total of 71 Patients with Spinal cord injury were admitted for rehabilitation.</p><p><strong>Intervention: </strong>The quality of life and life satisfaction of patients were assessed both before and after 63 days of inpatient rehabilitation.</p><p><strong>Main outcome measurements: </strong>Functional independence measure score (FIM), the Short Form-36 (SF-36), and the Life Satisfaction Scale (LSS).</p><p><strong>Result: </strong>The average age of the study population was 34 ± 14 years. At the end of 63 days, significant improvements were observed in FIM, mood, health, physical performance, role physical, role emotional, pain, and total score of LSS (Π - Value <0.05). The variation in FIM changes significantly improved the total LSS score in the thoracic and thoracolumbar subgroups, but not in the cervical group. In addition, the total score of SF36 was improved significantly just in the cervical subgroup (Π = 0.006). No significant correlations were found between SF-36 and LSS scores (before and after the intervention) in relation to marriage, education, and time.</p><p><strong>Conclusion: </strong>In the context of spinal cord injury, inpatient rehabilitation can play a role in improving functional independence which, in turn, impacts certain aspects affecting life satisfaction and the quality of life. It is important to note that the extent of this correlation varies among patients with different injury levels. In some cases, even minor changes, such as those seen in quadriplegic patients, could have a significant impact on their quality of life.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"703-709"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12180312/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141332380","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":"Statement of Retraction.","authors":"","doi":"10.1080/10790268.2025.2506313","DOIUrl":"10.1080/10790268.2025.2506313","url":null,"abstract":"","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"743"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12180313/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144095242","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":"Evaluation of domain-specific vs general purpose GPT models for SCI-related gastrointestinal, cardiovascular and pulmonary complications.","authors":"Alejandro García-Rudolph, David Sanchez-Pinsach, Eloy Opisso","doi":"10.1080/10790268.2024.2420433","DOIUrl":"10.1080/10790268.2024.2420433","url":null,"abstract":"","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"718-719"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12180337/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142677514","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":"Transcutaneous neuromodulation versus oxybutynin for neurogenic detrusor overactivity in persons with spinal cord injury: A randomized, investigator blinded, parallel group, non-inferiority controlled trial.","authors":"Samantak Sahu, Srikumar Venkataraman, Asem Rangita Chanu, U Singh","doi":"10.1080/10790268.2024.2370099","DOIUrl":"10.1080/10790268.2024.2370099","url":null,"abstract":"<p><strong>Study design: </strong>This study is a randomized, investigator-blinded, controlled trial with a non-inferiority design.</p><p><strong>Objective: </strong>To investigate the effectiveness of neuromodulation by transcutaneous electrical stimulation of the somatic afferent nerves of the foot in neurogenic detrusor overactivity (NDO) in persons with spinal cord injury (SCI) and compare its effectiveness with oral oxybutynin.</p><p><strong>Setting: </strong>The study was conducted in a rehabilitation in-patient ward of a tertiary care hospital.</p><p><strong>Methods: </strong>Twenty-nine persons with SCI with NDO, either sex, aged 18 years and above were randomized into two groups, one group receiving oral oxybutynin (5 mg thrice a day for two weeks) and the other transcutaneous electrical stimulation (5 Hz, 200 µs pulse, biphasic, amplitude up to 60 mA, 30 min/day for two weeks). Bladder capacity was evaluated by clinical bladder evaluation (i.e. bladder capacity measured by adding leak volume, voiding volume if any, and post-void residue using a catheter) and cystometric bladder capacity by one-channel cystometry. Maximum cystometric pressure was evaluated by one-channel water cystometry. Data were analyzed with Fisher's Exact, t-test, and Wilcoxon rank sum tests.</p><p><strong>Results: </strong>Bladder capacity improved significantly in the oxybutynin and neuromodulation groups as measured by one-channel water cystometry (136 ml vs. 120.57 ml) and clinical evaluation (138.93 ml vs. 112 ml). The increase in the neuromodulation group achieved the pre-decided non-inferiority margin of 30 ml over the oxybutynin group when measured by one-channel water cystometry but not by clinical evaluation. Maximum cystometric pressure did not significantly improve in either group when compared with the baseline.</p><p><strong>Conclusion: </strong>Transcutaneous neuromodulation and oxybutynin effectively increased bladder capacity in persons with SCI with NDO. Neuromodulation by once-a-day transcutaneous electrical stimulation was non-inferior to thrice-a-day oxybutynin when evaluated by one-channel water cystometry.<b>Trial registration:</b> Clinical Trials Registry India identifier: CTRI/2018/05/013735.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"621-628"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141494084","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":"Predicting inpatient rehabilitation length of stay for adults with traumatic spinal cord injury.","authors":"Tara A Whitten, Adalberto Loyola Sanchez, Bina Gyawali, Elisavet D E Papathanassoglou, Jeffrey A Bakal, Jacqueline A Krysa","doi":"10.1080/10790268.2024.2325165","DOIUrl":"10.1080/10790268.2024.2325165","url":null,"abstract":"<p><strong>Introduction: </strong>Most post-injury traumatic spinal cord injury (TSCI) care occurs in the inpatient rehabilitation setting. The inpatient rehabilitation length of stay (R-LOS) has been shown to be a significant predictor of motor function restoration in persons with TSCI. Due to the complexity, and heterogeneity of individuals with TSCI, the R-LOS is challenging to predict at admission.</p><p><strong>Purpose: </strong>To identify the main predictors of R-LOS and derive an equation to estimate R-LOS in persons with TSCI.</p><p><strong>Methods: </strong>This is a retrospective analysis of data from adults with TSCI from The Rick Hansen Spinal Cord Injury Registry in Alberta, Canada, who received rehabilitation care between May 10, 2005, and January 28, 2020. Multiple linear regression analysis was used to determine significant relationships between R-LOS and measures of participant demographics, length of stay, impairment and injury classification, and comorbidities.</p><p><strong>Results: </strong>The analysis included 736 adults with TSCI from an eligible cohort of 1365. The median R-LOS was 65 days (IQR 39-99 days), ranging from 1 to 469 days. Multivariate linear regression analysis identified two significant predictors of R-LOS, total FIM score and the injury classification. This model was used to derive a R-LOS prediction equation, which explained 34% of the variance in R-LOS.</p><p><strong>Conclusion: </strong>We developed a simple equation to predict R-LOS based on the level of impairment and total FIM scores in persons with TSCI. These data have implications for health system planning, improvement, and innovation, and provide insights to support further research into the predictors of R-LOS, identification of higher-risk individuals.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"593-603"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140102718","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":"On the Move pad - a portable multipurpose pad: User feedback.","authors":"Chang Dae Lee, Rosemarie Cooper, Rory A Cooper","doi":"10.1080/10790268.2024.2364381","DOIUrl":"10.1080/10790268.2024.2364381","url":null,"abstract":"<p><strong>Context/objective: </strong>Hard-shell toilet seats may compromise safety and hinder the participation of individuals at risk for pressure injuries (PIs) when using these facilities away from home in public, hotel, or family/friend restrooms. Moreover, people often add \"wash-cloths\" for additional padding for comfort, and to reduce the risk of PIs due to pressure or shearing on their wheelchairs surfaces. This study investigated the utilization of portable pads, initially designed for toilet use but adaptable to various places and contexts, while examining pad usability.</p><p><strong>Design: </strong>A cross-sectional descriptive survey design.</p><p><strong>Setting: </strong>Inpatient care, outpatient care, and community setting.</p><p><strong>Participants: </strong>45 individuals at risk of PIs.</p><p><strong>Results: </strong>Participants extended the use of these pads beyond toilets, employing them as wheelchair armrest and leg rest pads in other settings. Feedback from a customized questionnaire indicated high levels of usefulness (8.5/10) and ease of use (9.1/10) attributed to the pads. Among the features, the top three favored were ease of use, comfort/cushioning, and function. Participants expressed a desire for a variety of sizes and colors to enable versatile usage and suggested incorporating a pocket for storing small items.</p><p><strong>Conclusions and relevance: </strong>Individuals at risk of PIs require cushioning not only on hard-shell toilet seats, but also for additional padding, protection and enhancing the use of wheelchairs. Rehabilitation professionals can play a crucial role in educating and training both clients and caregivers to understand PI prevention, enabling them to effectively leverage the pads in appropriate situations, thereby enhancing their comfort in their wheelchairs during social engagement.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"710-717"},"PeriodicalIF":1.8,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141318807","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":"Perspectives of veterans with spinal cord injuries and disorders and their providers on impacted healthcare during the COVID-19 pandemic.","authors":"Lance Washington, Marinella Galea, Steven Knezevic, B Jenny Kiratli, Ona Bloom, Jennifer Sippel, Ann M Spungen, Doug Ota, Andrea K Finlay","doi":"10.1080/10790268.2025.2517934","DOIUrl":"https://doi.org/10.1080/10790268.2025.2517934","url":null,"abstract":"<p><strong>Objective: </strong>Veterans with spinal cord injuries and disorders (SCI/D) reported experiencing challenges from disrupted and deferred health services during the COVID-19 pandemic, including disrupted care coordination, supply chain, and essential services, such as wheelchair repair. This study used qualitative methods to examine the perspectives of Veterans with SCI/D (VSCI/D) and SCI/D healthcare providers on how the COVID-19 pandemic impacted health services.</p><p><strong>Design/setting/participants: </strong>Virtual focus groups were conducted with both VSCI/D who received care at the Veterans Health Administration (VHA) and VHA SCI/D providers who provided services for VSCI/D between March 2020 and March 2022.</p><p><strong>Outcome measures: </strong>Topics assessed COVID-19 pandemic experiences including healthcare access and needs, Veteran and provider perspectives of Veterans' experiences during the pandemic, Veterans' coping strategies, and future emergency preparedness strategies.</p><p><strong>Results: </strong>There were 11 Veterans and 11 providers who participated in focus groups. Five themes were identified: (1) challenges with healthcare, care coordination, and homecare; (2) supply chain issues; (3) adapting to virtual platforms for support and therapy; (4) communication and reliable information about COVID-19; and (5) challenges with isolation and limited independence.</p><p><strong>Conclusion: </strong>This study highlights challenges VSCI/D faced during the COVID-19 pandemic. Recommendations to enhance VHA support for VSCI/D during future emergencies include strengthening home care support, system level changes to supply management to be more flexible, and interdisciplinary town halls to transparently share comprehensive information. Virtual peer support groups may address challenges with isolation and limited independence.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"1-11"},"PeriodicalIF":1.8,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144530770","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}