Journal of Spinal Cord Medicine最新文献

{"title":"Bridging clinical capacity and functional performance: Clinical predictors of independence in advanced wheelchair skills after spinal cord injury.","authors":"Eunhye Kim, Hyun-Jin Kim, Areum Jeong, Hyosun Kweon, Jung Hwan Kim","doi":"10.1080/10790268.2026.2697598","DOIUrl":"https://doi.org/10.1080/10790268.2026.2697598","url":null,"abstract":"<p><strong>Context: </strong>Advanced wheelchair skills (ramp, railing, curb, wheelie) are essential for mobility after spinal cord injury (SCI), but predictors of discharge independence remain unclear.</p><p><strong>Objective: </strong>To identify admission predictors of improvement and discharge independence in advanced wheelchair skills after SCI.</p><p><strong>Methods: </strong>We retrospectively analyzed 150 inpatients with SCI (2016-2023) at a single rehabilitation hospital with admission and discharge assessments for four advanced wheelchair skills. For each skill, participants were classified as Group 1 (no improvement or decline and remained dependent), Group 2 (improved but remained dependent), or Group 3 (achieved or maintained independence). Admission variables were compared across groups, and multinomial logistic regression used Group 3 as the reference.</p><p><strong>Results: </strong>In adjusted models, older age increased the odds of Group 1 and Group 2 classifications compared with Group 3; for wheelie, ORs were 1.08 and 1.09 per year, respectively (both P < 0.001). Greater upper-extremity strength was associated with reduced odds of Group 1 classification for wheelie (OR 0.43, 95% CI 0.21-0.87) and ramp (OR 0.44, 95% CI 0.25-0.78), but not for railing or curb. Longer post-injury duration was associated with lower odds of a dependent outcome for curb (OR 0.998 per day, P < 0.05). In unadjusted comparisons, outcome-group distributions differed by age group, neurological level, and AIS grade.</p><p><strong>Conclusions: </strong>Older age was associated with dependent outcomes across skills, whereas upper-extremity strength favored independence in wheelie and ramp only. These findings support incorporating age and task-relevant upper-limb capacity into goal setting and training prioritization; prospective studies should quantify training exposure and goal priorities.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"1-11"},"PeriodicalIF":1.3,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148680910","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":"Enhancing practical skills in spinal cord injury physiotherapy education using a case-based mobile virtual patient: A randomized mixed-methods study.","authors":"Levent Çetinkaya, Serkan Yildirim, Ilke Keser, Hafize Keser","doi":"10.1080/10790268.2026.2702191","DOIUrl":"https://doi.org/10.1080/10790268.2026.2702191","url":null,"abstract":"<p><strong>Context: </strong>Developing practical skills and clinical reasoning in complex conditions such as spinal cord injury (SCI) is a central goal of physiotherapy education; however, opportunities for repeated practice with real patients are often limited, highlighting the potential value-based mobile virtual patient applications.</p><p><strong>Objective: </strong>To evaluate whether a case-based mobile virtual patient application, used to supplement traditional teaching, was associated with higher practical examination performance in SCI education, and to explore students' perceptions of usability and educational value.</p><p><strong>Design: </strong>Explanatory sequential mixed-methods study with a randomized post-test-only controlled quantitative phase followed by qualitative analysis of open-ended responses.</p><p><strong>Setting: </strong>Neurological Rehabilitation course in an undergraduate physiotherapy and rehabilitation program.</p><p><strong>Participants: </strong>Eighty-three eligible undergraduate physiotherapy students were randomly assigned to experimental (n = 42) or control (n = 41) groups.</p><p><strong>Interventions: </strong>Both groups received the same face-to-face instruction; only the experimental group had access to the case-based mobile application with interactive decision prompts and structured feedback.</p><p><strong>Outcome measures: </strong>Practical skills were assessed in a post-test-only practical examination using a standardized checklist; Functional Neuroanatomy final exam score served as a contextual indicator of prior academic performance, and open-ended responses from the experimental group were categorized and summarized by frequency.</p><p><strong>Results: </strong>Baseline academic performance did not differ between groups (t(81) = 1.445, P > 0.05). The experimental group achieved significantly higher practical examination scores than the control group (M = 26.57 vs. 22.63; t(81) = 3.741, P < 0.001; Cohen's d = 0.819), indicating a large effect. Qualitative findings indicated perceived benefits for theory-practice integration, learning flexibility, case-based clinical decision-making, and confidence, alongside challenges related to small-screen use and content density.</p><p><strong>Conclusion: </strong>When integrated alongside traditional instruction, a case-based mobile virtual patient application was associated with higher practical examination performance in SCI education and may support skill acquisition and student engagement within physiotherapy curricula.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"1-12"},"PeriodicalIF":1.3,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148664819","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":"Using the SPIKES protocol to deliver prognostic information on ambulation potential after complete spinal cord injury: Effects on coping strategies.","authors":"Zuhal Ozisler, Fatma Kumbara, Asli Turan, Elif Yalcin","doi":"10.1080/10790268.2026.2696688","DOIUrl":"https://doi.org/10.1080/10790268.2026.2696688","url":null,"abstract":"<p><strong>Context/objective: </strong>Delivering prognostic information about ambulation after spinal cord injury (SCI) is a sensitive yet essential responsibility. This study aimed to evaluate the effect of the SPIKES protocol on coping strategies in individuals with neurologically complete SCI, and to explore their experiences and expectations regarding breaking bad news (BBN) in Turkey.</p><p><strong>Design: </strong>Matched comparative study.</p><p><strong>Setting: </strong>Tertiary-level SCI rehabilitation clinic.</p><p><strong>Participants: </strong>Twenty-five individuals with neurologically complete SCI were included in the intervention group and received prognostic information using the SPIKES protocol. Twenty-seven matched controls who had completed inpatient rehabilitation at other centers were included for comparison.</p><p><strong>Interventions: </strong>Structured delivery of ambulation prognosis using the SPIKES protocol.</p><p><strong>Outcome measures: </strong>Coping strategies were assessed using the Spinal Cord Lesion-Related Coping Strategies Questionnaire (SCL-CSQ).</p><p><strong>Results: </strong>94.2% of all participants expressed a desire to receive prognostic information even if unfavorable, with 36.7% preferring to receive it during acute care. Participants' expectations did not differ by demographic characteristics (P > 0.05). Individuals with paraplegia showed a higher preference to receive information regarding ambulation prognosis during acute care than individuals with tetraplegia (45.7% vs. 14.3%; P = 0.039). Participants in the SPIKES group demonstrated higher acceptance, fighting spirit, and total coping scores than controls (P < 0.05), with no significant difference in social reliance.</p><p><strong>Conclusion: </strong>Most individuals with neurologically complete SCI preferred to receive prognostic information, even when unfavorable. In this pilot study, structured communication using the SPIKES protocol was associated with more adaptive coping strategies; further studies are warranted to confirm these findings.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"1-9"},"PeriodicalIF":1.3,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148664917","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 reduced life expectancy in patients aged 65 and older with traumatic spinal cord injury.","authors":"María Urrea-Ballesteros, Joint Guimbard-Pérez, José Ramón Muñoz-Rodríguez, Miguel Peral-Alarma, Andrés Barriga-Martín","doi":"10.1080/10790268.2026.2699544","DOIUrl":"https://doi.org/10.1080/10790268.2026.2699544","url":null,"abstract":"<p><strong>Context/objective: </strong>Traumatic spinal cord injury (TSCI) in older adults is increasingly associated with falls and high mortality. This study aimed to estimate the life expectancy deficit associated with TSCI in patients aged ≥65 years and to identify predictors of mortality.</p><p><strong>Design: </strong>Prospective cohort study.</p><p><strong>Setting: </strong>National Hospital for Paraplegics (Toledo, Spain).</p><p><strong>Participants: </strong>Consecutive patients aged ≥65 years with TSCI admitted between 2009 and 2024 (n = 369).</p><p><strong>Outcome measures: </strong>Mortality and life expectancy deficit compared with age-matched national life tables, as well as the identification of mortality predictors.</p><p><strong>Results: </strong>The mean age at injury was 73 ± 5.7 years, and 71.5% were men. Falls were the main cause of injury (74.3%), and subaxial cervical lesions were the most frequent (65.6%). Overall mortality was 51.5%, with a mean estimated survival of 7.66 years. In the Cox model, older age at injury (HR = 1.054; P < 0.001), anticoagulant therapy (HR = 1.811; P = 0.002), and COPD (HR = 2.138; P = 0.015) independently increased mortality risk, whereas higher SCIM scores at discharge (HR = 0.975; P < 0.001) were associated with improved survival. Patients with complete and cervical injuries showed the shortest survival times. The life expectancy deficit attributable to TSCI decreased from 13.0 years in patients aged 65-69 years to approximately 3 years in those aged ≥80 years.</p><p><strong>Conclusion: </strong>TSCI in older adults is associated with high mortality and reduced life expectancy, particularly in complete and cervical injuries. Functional independence was associated with improved survival.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"1-11"},"PeriodicalIF":1.3,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148664873","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":"Perceived mental health needs among LGBTQ+ adults living with spinal cord injuries and disorders.","authors":"Megan Neal, Andrea L Nevedal, Shane Lamba, Allison R Warren, Joseph Goulet, B Jenny Kiratli","doi":"10.1080/10790268.2026.2689811","DOIUrl":"https://doi.org/10.1080/10790268.2026.2689811","url":null,"abstract":"<p><strong>Context/objective: </strong>People living with spinal cord injuries and disorders (SCI/D) are at heightened risk for depression, anxiety, and post-traumatic stress disorder, yet frequently encounter barriers to mental health care. Lesbian, gay, bisexual, transgender, queer individuals and those with related identities (LGBTQ+) also experience elevated mental health disparities and marginalization in clinical settings. As no prior studies have assessed the mental health of LGBTQ+ people with SCI/D, this study sought to examine how members of this population describe their mental health needs, including barriers and facilitators to fulfilling them.</p><p><strong>Design: </strong>Qualitative, exploratory study using rapid directed content analysis.</p><p><strong>Setting: </strong>Community-based sample across the US.</p><p><strong>Participants: </strong>Thirty-two LGBTQ+ adults with SCI/D.</p><p><strong>Interventions: </strong>Semi-structured interviews.</p><p><strong>Outcome measures: </strong>Interviews addressing mental health needs.</p><p><strong>Results: </strong>Participants emphasized the need for affirming clinical and social support that addressed their LGBTQ+ identities and disability experiences. They stressed the importance of providers who saw them as individuals through an intersectional lens. Competence with both LGBTQ+ and SCI/D issues was considered essential. Providers who were members of the LGBTQ+ and/or SCI/D communities were valued for their relatability and deeper understanding. Participants also requested therapeutic support groups that addressed both LGBTQ+ and SCI/D concerns. Social support from friends, partners, families (<i>i.e.</i> chosen, legal, and/or biological), and communities was also crucial. Peers with shared lived experiences provided companionship as well as invaluable emotional, informational, and tangible support.</p><p><strong>Conclusion: </strong>LGBTQ+ adults living with SCI/D identified affirming clinical care and social support as critical to their mental health. Findings highlight the importance of developing intersectional, person-centered clinical and social resources that meet this unique population's needs holistically.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"1-14"},"PeriodicalIF":1.3,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148594057","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 scoping review characterizing nutrition outcomes in adults with spinal cord injuries and disorders.","authors":"Priya Iyer, On Kiu Choi, Chenxi Yan, Gary J Farkas, Kanchana Ekanayake, Sherri L LaVela","doi":"10.1080/10790268.2026.2701579","DOIUrl":"https://doi.org/10.1080/10790268.2026.2701579","url":null,"abstract":"<p><strong>Objectives: </strong>This scoping review aimed to characterize the range of nutrition outcomes and identify the measurement tools and approaches used in spinal cord injuries and disorders (SCI/D) research.</p><p><strong>Background: </strong>Individuals with SCI/D experience significant nutrition-related health challenges, yet the diversity and inconsistency in reported nutrition outcomes across research limit evidence synthesis and practical application.</p><p><strong>Method: </strong>A search strategy employing JBI methodology focused on studies in the English language meeting predefined criteria was applied across six databases: MEDLINE, CINAHL, Cochrane Central, Scopus, EMBASE, and PsycINFO. The synthesis of common nutrition outcomes and measurement approaches included frequency counts and percentages. Outcomes were categorized using the Nutrition Care Process and Dietetic Outcomes Toolkit frameworks. Findings were reported following the PRISMA-Extension for Scoping Reviews guidelines.</p><p><strong>Results: </strong>Of 195 included studies, most were from the United States (52%; <i>n</i> = 102), with the highest research outputs seen from 2010 to 2020. The most reported outcomes were related to clinical and health status (<i>n</i> = 181; 93%), particularly body composition and biochemical markers such as weight, body mass index, and lipid profiles. Dietary assessment outcomes appeared in 35% (<i>n</i> = 68) of studies, with macronutrient and energy intake most frequently assessed. However, only 10% (<i>n</i> = 20) of studies reported outcomes related to nutrition knowledge or behaviors, and just 11% (<i>n</i> = 22) addressed psychosocial factors. Measurement tools varied widely across studies. Objective measures were commonly used for body composition, while dietary intake assessments often relied on self-report methods prone to bias. Few studies used validated instruments or gold-standard tools such as DXA or diet quality indices.</p><p><strong>Conclusion: </strong>There is substantial variability in nutrition outcomes and measurement tools across SCI/D research, with critical gaps in nutrition outcomes in behavioral and psychosocial domains. Establishing a core nutrition dataset with validated, standardized measures is essential to advance research quality, comparability, and clinical translation in this population.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"1-20"},"PeriodicalIF":1.3,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148581045","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":"Eating behavior, diet quality, mental health, and functional outcomes in individuals with spinal cord injury.","authors":"Kübra Tel Adigüzel, Zuhal Özişler, Nazlı Bengü İlter, Emre Adigüzel","doi":"10.1080/10790268.2026.2697605","DOIUrl":"https://doi.org/10.1080/10790268.2026.2697605","url":null,"abstract":"<p><strong>Context/objective: </strong>We hypothesized that individuals with chronic spinal cord injury would exhibit altered eating behaviors and lower diet quality, which would be associated with higher levels of psychological distress and decreased functional independence.</p><p><strong>Design: </strong>Cross-sectional study.</p><p><strong>Setting: </strong>Tertiary Physical Medicine and Rehabilitation Hospital.</p><p><strong>Participants: </strong>Fifty individuals with chronic SCI and 50 age- and sex-matched healthy controls were included.</p><p><strong>Interventions: </strong>Not applicable.</p><p><strong>Outcome measures: </strong>Eating behaviors were assessed using the Adult Eating Behavior Questionnaire (AEBQ), psychological distress using the Depression Anxiety Stress Scale-21 (DASS-21), diet quality using the Healthy Eating Index-2015 (HEI-2015), and functional independence using the Spinal Cord Independence Measure III (SCIM-III).</p><p><strong>Results: </strong>The groups were comparable in age, sex, marital status, and anthropometric measures (<i>P</i> > 0.05). Most patients had paraplegia (78.0%) and incomplete SCI (62.0%). Median time since injury was 11.5 months (IQR, 6.0-21.25), and mean total SCIM-III score was 59.0 ± 20.9. Emotional Overeating and Satiety Responsiveness scores were significantly higher in the SCI group than in the control group (<i>P</i> = 0.001 and <i>P</i> = 0.003, respectively). In unadjusted analyses, several AEBQ domains showed nominal associations with DASS-21 scores; however, none remained statistically significant after correction for multiple testing. In regression analyses, higher BMI and stress were associated with greater Emotional Overeating. For Satiety Responsiveness, anxiety and female sex remained significant predictors, whereas associations with BMI and stress were not consistent in sensitivity analyses.</p><p><strong>Conclusion: </strong>Individuals with chronic SCI showed altered eating behaviors and lower diet quality compared with healthy controls. Associations between eating behavior and psychological distress should be interpreted cautiously and confirmed in larger studies.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"1-13"},"PeriodicalIF":1.3,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148563675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health profiles, environmental barriers, and functional outcomes among individuals with spinal cord injury in Lebanon: A cross-sectional study.","authors":"Nour El Hoda Saleh, Youssef El Zein, Sleiman Fneish, Youssef Joubran, Mohammad Tabboush, Ibrahim Naim, Khaled Mouchref, Linda Abou-Abbas, Dalia Khachman, Salem Hannoun, Samar Rachidi","doi":"10.1080/10790268.2026.2699548","DOIUrl":"https://doi.org/10.1080/10790268.2026.2699548","url":null,"abstract":"<p><strong>Context/objective: </strong>Spinal cord injury (SCI) in Lebanon represents a major public health challenge compounded by prolonged economic collapse, healthcare fragmentation, and conflict-related instability. In the absence of a national SCI registry, this study aimed to characterize health status, environmental barriers, functioning, and quality of life (QoL) of individuals living with SCI in Lebanon using the internationally standardized International spinal cord injury (InSCI) framework.</p><p><strong>Design: </strong>Cross-sectional survey study.</p><p><strong>Setting: </strong>Community and rehabilitation settings across five Lebanese governorates.</p><p><strong>Participants: </strong>A total of 81 adults with chronic SCI were recruited between March and October 2025 through purposive convenience sampling. The sample was predominantly male (77.1%), with a mean age of 39.7 years; 68.7% had paraplegia.</p><p><strong>Interventions: </strong>Not applicable.</p><p><strong>Outcome measures: </strong>Data were collected using the Leb-InSCI questionnaire, a culturally adapted instrument based on the International SCI Survey and the WHO International Classification of Functioning, Disability, and Health (ICF). Measures included the SCI Secondary Condition Scale (SCI-SCS), Self-Report Spinal Cord Independence Measure (SCIM-III), Short Form Nottwil Environmental Factors Inventory (NEFI-SF), InSCI Mental Health and Vitality items, EQ-5D-5L, and SF-36 Health Survey.</p><p><strong>Results: </strong>A substantial treatment gap for secondary complications was identified. Chronic pain (53.6%) and spasticity (34.5%) were highly prevalent, yet 88.1% and 50.0% of affected individuals, respectively, reported receiving no clinical intervention. Environmental barriers were pervasive, with 58.4% reporting extreme difficulty using public transportation and more than half identifying inaccessible infrastructure as a major restriction to community participation. Marked vocational exclusion was also observed, as only 19.8% were engaged in paid employment despite approximately 60% expressing willingness to work. Physical health-related QoL scores were low (SF-36 Physical Component Summary: 32.02), whereas comparatively higher mental health scores (44.97) suggested relative psychological resilience, potentially supported by family networks.</p><p><strong>Conclusion: </strong>Individuals with SCI in Lebanon experience persistent unmet healthcare needs, environmental exclusion, and socioeconomic marginalization. These findings highlight the urgent need for specialized multidisciplinary rehabilitation services, improved access to treatment for secondary conditions, enforcement of accessibility and universal design policies, and inclusive employment strategies to support long-term community reintegration and quality of life.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"1-18"},"PeriodicalIF":1.3,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148563050","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 and sleep-disordered breathing among individuals with spinal cord injury: A scoping review.","authors":"Samuel David Williamson, Magnus Møller Andersen, Sophie Lykkegaard Ravn","doi":"10.1080/10790268.2026.2696692","DOIUrl":"10.1080/10790268.2026.2696692","url":null,"abstract":"<p><strong>Context: </strong>Scoping review.</p><p><strong>Objective: </strong>To map the empirical literature evaluating respiratory muscle training (RMT) on objectively measured sleep-disordered breathing (SDB) outcomes in individuals with spinal cord injury (SCI).</p><p><strong>Methods: </strong>Seven databases were searched for original empirical studies evaluating RMT and objective SDB outcomes among individuals with SCI. Additional searches were performed in Google Scholar and PEDro. Studies were independently double-screened at two consecutive levels, and relevant data from the included studies were extracted. A narrative synthesis of results was performed.</p><p><strong>Results: </strong>Six studies met the inclusion criteria. Interventions included standalone inspiratory training, combined inspiratory and expiratory training, and \"triple-combined\" protocols involving additional oropharyngeal exercises. While case-based reports demonstrated clinically significant reductions in global SDB indices, larger experimental trials, such as exploratory and feasibility-oriented designs, found no significant between-group differences in objective SDB severity or nocturnal oxygenation. However, a randomized pilot trial suggested that combined RMT and oropharyngeal exercises could significantly reduce upper airway collapsibility. Equally, a prospective cohort study found that participants achieving gains in maximal inspiratory pressure showed modest improvements in nocturnal gas exchange.</p><p><strong>Conclusion: </strong>The assembled research suggests that RMT is insufficient as a standalone intervention for treating objective SDB outcomes in heterogeneous SCI cohorts. Given the sparse and methodologically heterogeneous evidence base, further standardized, high-quality longitudinal studies are required to determine the potential role of RMT in managing and treating SDB following SCI.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"1-13"},"PeriodicalIF":1.3,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148563353","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":"Study of neurological and functional outcomes in individuals with iatrogenic spinal cord injury.","authors":"Aashish Ghodke, Mahak Baid, Naveen Kumar, Alok Gadkari","doi":"10.1080/10790268.2026.2668227","DOIUrl":"https://doi.org/10.1080/10790268.2026.2668227","url":null,"abstract":"<p><strong>Objective: </strong>Spinal cord injury (SCI) can result in serious disability and requires a high level of medical care. The aim of this study is to determine the incidence and common causes of iatrogenic SCI and to assess the neurological and functional recovery at two years post injury.</p><p><strong>Design: </strong>This was a retrospective study.</p><p><strong>Setting: </strong>Single-center study in a dedicated spinal cord injury center conducted between April 2013 and March 2017.</p><p><strong>Participants: </strong>All patients admitted with postoperative iatrogenic SCI.</p><p><strong>Interventions: </strong>The study reviewed details of the initial surgical procedure leading to iatrogenic SCI, along with the neurological and functional outcomes.</p><p><strong>Outcome measures: </strong>The neurological outcome was assessed using ASIA Impairment Scale (AIS) while the functional outcome was assessed by the Spinal Cord Independence Measure (SCIM) scale.</p><p><strong>Results: </strong>The mean age was 57.3 ± 19.0 years, with 55.8% over 60 years. The leading causes of iatrogenic SCI were ischemic insult following vascular procedures (18.6%), inadequate spinal decompression (13.9%), mechanical pressure from postoperative hematoma or pseudomeningocele (11.6%). In 37.2% of cases, no definitive cause was identified.Partial recovery was observed at 2 years (AIS A: 5, B: 2, C: 12, D: 8, E: 1). Functional independence improved significantly as indicated by the rise in SCIM scores. At 2-year follow-up, 39.5% individuals regained some ambulation. Bladder and bowel function normalized in 34.8% and 41.8% individuals respectively. Persistent neuropathic pain and muscle spasms were reported in 10 and 8 patients, respectively.</p><p><strong>Conclusion: </strong>Although there may be varied etiologies for iatrogenic SCI, a rapid and thorough workup and prompt intervention ensures the best chance of neurological recovery.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"1-9"},"PeriodicalIF":1.3,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148563397","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}