Journal of Spinal Cord Medicine最新文献

{"title":"Burden and risk stratification of osteoporosis in traumatic spinal cord injury: Evidence from a national claims database.","authors":"Hyun-Jin Kim, Ji Sun Lim, Onyoo Kim","doi":"10.1080/10790268.2026.2697597","DOIUrl":"https://doi.org/10.1080/10790268.2026.2697597","url":null,"abstract":"<p><strong>Objective: </strong>spinal cord injury (SCI) is associated with rapid bone loss and a high risk of osteoporosis-related complications. However, population-level data describing the burden of clinically recognized osteoporosis among individuals with SCI are limited. This study aimed to estimate the nationwide burden of medically attended osteoporosis and to identify high-risk subgroups among individuals with traumatic SCI in Korea.</p><p><strong>Design: </strong>Nationwide retrospective claims-based cohort study.</p><p><strong>Methods: </strong>Using National Health Insurance Service claims data from 2010 to 2019, individuals with traumatic SCI were identified based on ICD-10 diagnostic codes and healthcare utilization criteria. Osteoporosis was operationally defined as clinically recognized osteoporosis, identified through ICD-10 codes (M80-M82) accompanied by repeated inpatient or outpatient encounters. Demographic, socioeconomic, and disability-related factors associated with osteoporosis were examined using multinomial logistic regression.</p><p><strong>Results: </strong>In 2019, 12.0% of individuals with SCI had medically attended osteoporosis, a prevalence substantially higher than that observed in the general population (5.5%). The burden of osteoporosis increased with age and was markedly higher in women (26.2%) than in men (6.6%). After adjustment for demographic and disability-related factors, older age (≥65 years), female sex (adjusted odds ratio (OR) 4.02, 95% CI 3.19-5.07), health insurance status, and internal organ disability were independently associated with higher odds of osteoporosis.</p><p><strong>Conclusion: </strong>This nationwide claims-based study demonstrates a substantial burden of clinically recognized osteoporosis among individuals with traumatic SCI, with pronounced disparities by age, sex, and disability type. These findings highlight high-risk subgroups that may benefit from targeted screening and preventive strategies within SCI care, even in the absence of bone mineral density measurements.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"1-11"},"PeriodicalIF":1.3,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148563626","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":"Comparison of synchronous telerehabilitation and home-based upper limb resistance exercise programs in people with paraplegia: A randomized, controlled, double-blind study.","authors":"Nurgül Dürüstkan Elbaşi, Yunus Emre Tütüneken, Hacer Önen Tekin, Tolga Aksu, Okan Akay, Sena Yilmaz, Zeynep Olgaç","doi":"10.1080/10790268.2026.2657701","DOIUrl":"https://doi.org/10.1080/10790268.2026.2657701","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the effectiveness of synchronous telerehabilitation-based resistance exercises on upper limb function in people with paraplegia.</p><p><strong>Setting: </strong>Rehabilitation interventions were conducted either synchronously via telerehabilitation or through unsupervised home-based programs in participants' residential environments.</p><p><strong>Participants: </strong>Twenty-one people with paraplegia, aged 18-60, who were partially or fully wheelchair-dependent and had sufficient upper limb function and access to online communication tools.</p><p><strong>Interventions: </strong>Both groups followed the same resistance exercise program (3 times/week for 6 weeks). The telerehabilitation group performed exercises under real-time remote supervision of a physiotherapist, while the control group completed an unsupervised home-based exercise program.</p><p><strong>Outcome measures: </strong>Primary outcomes included upper limb muscle strength assessed via handheld dynamometry, physical performance measured by the 20-Meter Wheelchair Push Test, and physical activity levels evaluated using the Physical Activity Scale for Individuals with Physical Disabilities.</p><p><strong>Results: </strong>Significant within-group improvements were observed in the Study Group for shoulder and wrist strength, mobility performance, and physical activity levels (P < 0.01). However, no statistically significant between-group differences were observed post-intervention (P > 0.05).</p><p><strong>Conclusion: </strong>Synchronous telerehabilitation-based resistance exercises significantly enhanced upper limb strength, mobility, and activity levels in people with paraplegia. Comparable post-treatment outcomes between groups suggest that structured home-based exercise programs may also be effective when appropriately designed and supported.<b>Trial registration:</b> ClinicalTrials.gov identifier: NCT07115693.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"1-10"},"PeriodicalIF":1.3,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148563672","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":"Cross-cultural adaptation, validation, and reliability of the Turkish version of the spinal cord injury Pain Instrument.","authors":"Yunus Emre Tütüneken, Nurgül Dürüstkan Elbaşi","doi":"10.1080/10790268.2026.2687278","DOIUrl":"https://doi.org/10.1080/10790268.2026.2687278","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to translate and culturally adapt the spinal cord injury Pain Instrument (SCIPI) into Turkish and assess its validity and reliability for screening neuropathic pain (NP) in people with spinal cord injury (SCI).</p><p><strong>Design: </strong>A prospective cross-sectional study.</p><p><strong>Setting: </strong>The study was carried out at the Istinye University Physiotherapy and Rehabilitation Application and Research Center.</p><p><strong>Participants: </strong>Forty people with SCI.</p><p><strong>Interventions: </strong>Not applicable.</p><p><strong>Outcome measures: </strong>Internal consistency (Cronbach's α), test-retest reliability (ICC), and construct validity (correlation with Douleur Neuropathique 4 [DN4] and Visual Analogue Scale [VAS]) were evaluated. Bland-Altman analysis assessed measurement agreement.</p><p><strong>Results: </strong>The T-SCIPI exhibited acceptable internal consistency (α = 0.778) and excellent test-retest reliability across all items (ICC = 0.871-0.965). Bland-Altman analysis indicated no systematic bias. Construct validity was confirmed by strong correlations with DN4 (r = 0.747, P < 0.001) and VAS pain intensity (r = 0.684, P < 0.001). No floor or ceiling effects were detected.</p><p><strong>Conclusion: </strong>The T-SCIPI is a valid, reliable, and culturally appropriate tool for screening NP in Turkish-speaking people with SCI. Its brevity and ease of administration enhance its utility in clinical practice and research, facilitating early NP identification and management in this population.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier: NCT06990243..</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"1-8"},"PeriodicalIF":1.3,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148431421","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":"Functional recovery and variability in response to spinal cord transcutaneous stimulation combined with activity-based training: Insights from a multi-case study.","authors":"Fan Zhang, Manikandan Ravi, Steven Kirshblum, Gail F Forrest","doi":"10.1080/10790268.2026.2672828","DOIUrl":"10.1080/10790268.2026.2672828","url":null,"abstract":"<p><strong>Objective: </strong>Spinal cord transcutaneous stimulation (scTS) combined with activity-based training (ABT) has shown promise for improving upper limb function after cervical spinal cord injury (SCI). However, factors underlying variability in functional recovery remain unclear. This study examined the functional recovery and inter-individual variability in response to scTS + ABT in individuals with chronic cervical SCI.</p><p><strong>Design and setting: </strong>Preliminary multi-case study with pre- and post-intervention evaluations conducted in a rehabilitation laboratory.</p><p><strong>Participants: </strong>Five male adults with chronic cervical SCI (C3-C7; AIS A-D).</p><p><strong>Interventions: </strong>All participants received scTS delivered over cervical/thoracic segments combined with upper limb ABT. Intervention dosage ranged from 16 to 54 sessions (60 min per session, 2-3 sessions per week).</p><p><strong>Outcome measures: </strong>The Graded Redefined Assessment of Strength, Sensibility, and Prehension (GRASSP), handgrip and elbow flexion strength, Neuromuscular Recovery Scale (NRS), and Modified Functional Reach Test (MFRT). Spinally evoked potentials (SEP) were recorded in one participant to evaluate spinal excitability changes.</p><p><strong>Results: </strong>All participants demonstrated improvements in at least one GRASSP subdomain, with the most consistent gains observed in strength. NRS and MFRT outcomes also improved, indicating enhanced trunk stability and upper limb control. Moderate-to-strong positive correlations (ρ = 0.67-1.0) were found between intervention dosage and functional gains, although confidence intervals were broad. SEP analysis revealed increased slope and reduced activation thresholds of recruitment curves, suggesting enhanced spinal excitability.</p><p><strong>Conclusion: </strong>scTS + ABT led to measurable functional improvements across participants; however, substantial variability was observed, likely influenced by injury characteristics and training dosage. Given the small sample size, participant heterogeneity, and lack of long-term follow-up, these findings should be interpreted as preliminary. Further controlled studies are warranted to evaluate the efficacy of individualized neuromodulation strategies for optimizing upper limb recovery after cervical SCI.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"1-14"},"PeriodicalIF":1.3,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148431503","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":"Low-dose epidural anesthesia for autonomic dysreflexia prevention in individuals with high-risk cervical spinal cord injury undergoing transurethral procedures: A retrospective case series.","authors":"Wei Xiong, Hui-Ling Cong, Qiang Wang, Lei Wan","doi":"10.1080/10790268.2026.2687277","DOIUrl":"10.1080/10790268.2026.2687277","url":null,"abstract":"<p><strong>Context: </strong>Autonomic dysreflexia (AD) is a life-threatening condition frequently triggered during transurethral procedures in individuals with cervical spinal cord injury (SCI). General anesthesia (GA) does not consistently prevent AD in this population, and optimal anesthetic management remains uncertain.</p><p><strong>Findings: </strong>We report five male individuals with C4-C6 SCI, American Spinal Injury Association Impairment Scale (AIS) grade A/B with documented AD during daily catheterization who underwent transurethral procedures under low-dose epidural anesthesia (EA). Lumbar EA was performed with ropivacaine 0.2%-0.5% (4-10 mL). Sensory level testing was not possible; blockade adequacy was inferred from spasticity control and hemodynamic stability. No individual developed intraoperative AD, defined as an acute increase in systolic blood pressure (BP) of >20 mmHg above baseline in response to surgical stimuli. All procedures (four bladder lithotripsies, one bladder neck incision) were completed uneventfully. Systolic BP remained within 20 mmHg of baseline in four individuals; one individual with preoperative anxiety showed BP reduction to stable levels. No clinically significant hypotension or tachycardia occurred. One individual received atropine for transient bradycardia, which resolved promptly.</p><p><strong>Conclusion/clinical relevance: </strong>Low-dose EA was associated with an absence of intraoperative AD in five individuals with high-risk cervical spinal cord injury, with stable hemodynamics and effective spasticity control. No adverse hemodynamic instability was observed, in contrast to our previous experience with GA. While preliminary, these findings suggest EA warrants further investigation as a prophylactic strategy for AD in this population.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"1-6"},"PeriodicalIF":1.3,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148413616","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":"Robotic-assisted gait training for spinal cord injury neuropathic pain: A systematic review.","authors":"Conor White, Samantha Klus, Wing Hai Ho, Lily Barrett, Orlaith Doherty, Olive Lennon","doi":"10.1080/10790268.2025.2503049","DOIUrl":"10.1080/10790268.2025.2503049","url":null,"abstract":"<p><strong>Context: </strong>Neuropathic pain (NP), can be a debilitating consequence of spinal cord injury. Robotic-assisted gait training (RAGT) is an effective rehabilitation tool, but emerging evidence suggests it may prove an effective treatment for NP post-SCI.</p><p><strong>Objective: </strong>This systematic review aims to synthesize the available evidence examining RAGT for pain reduction post-SCI, focusing on NP.</p><p><strong>Methods: </strong>Six databases were searched from inception to February 18th 2025, using search strings addressing: SCI and RAGT. No date or study type restrictions applied. Studies with SCI populations, delivering RAGT and measuring pain outcomes were included. Meta-analyses were conducted for pain intensity, pain interference (PI) and HRQoL outcomes. Certainty of evidence (COE) was assessed using GRADE criteria.</p><p><strong>Results: </strong>Thirty two studies (n = 567) (6 RCTs) met eligibility criteria. No RCT mandated pain as an inclusion criterion. Meta-analysis of 6 RCTs (n = 174) identified no effect for RAGT over other interventions for outcomes of overall pain intensity (SMD = 0.03 [-0.40, 0.46]; P = 0.90), non-specified pain-type intensity (SMD = 0.08 [-0.39, 0.55]; P = 0.74) and in one RCT reporting NP intensity (SMD = -0.46 [-1.61, 0.70]; P = 0.44). Meta-analysis identified no difference between RAGT and comparators for outcomes of HRQoL (3 RCTs (n = 69): SMD = 0.15 [-0.33,0.62]; P = 0.54) and PI (2 RCTs (n = 53): SMD = -0.1 [-0.64,0.44]; P = 0.71). Very-low COE for pain intensity & PI and low COE for HRQoL were assigned.</p><p><strong>Conclusions: </strong>Very limited studies and inconclusive evidence supports RAGT for the reduction of NP post-SCI. Future RCTs of RAGT that recruit patients with moderate-to-severe NP at baseline are required.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"635-661"},"PeriodicalIF":1.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13295081/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235789","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 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":"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":"677-683"},"PeriodicalIF":1.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13295109/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recurrence of neurogenic heterotopic ossification after surgical excision and preventive strategies: A systematic review and meta-analysis.","authors":"Arash Azhideh, Howard Chansky, Maryam Yousefiasl, Sara Haseli, Peyman Mirghaderi, Nicholas M Hernandez, Reza Elahi, Ali Nabipoor, David Camacho, Majid Chalian","doi":"10.1080/10790268.2025.2571821","DOIUrl":"10.1080/10790268.2025.2571821","url":null,"abstract":"<p><strong>Objectives: </strong>Neurogenic heterotopic ossification (NHO) is extra-skeletal bone formation induced by neurologic conditions such as spinal cord injury (SCI) and traumatic brain injury (TBI). The definite treatment of established NHO is surgery and the most common complication of surgery is recurrence. This study compared three common postsurgical tertiary prevention strategies: radiotherapy, pharmacological treatment, and no additional intervention.</p><p><strong>Materials and methods: </strong>Comprehensive searches on PubMed, Embase, Web of Science, and Cochrane Library were conducted until June 2023. Studies' quality was assessed using the MINORS tool, and the rate of NHO recurrence was pooled and compared through random-effects meta-analysis (Dersimonian-Laird). Inclusion criteria involved patients who underwent NHO removal surgery with subcategories based on recurrence prevention strategy: pharmacologic, radiotherapy, and no additional treatment.</p><p><strong>Results: </strong>In total, 18 studies (n = 937 subjects) were included. Overall prevalence of recurrence (95% CI) was 12.40% (7.49%, 19.82%) with pharmacologic therapy at 9.34% (2.26%, 31.43%), radiotherapy at 15.71% (8.92%, 26.19%), and no additional treatment at 13.55% (6.73%, 25.39%). While no significant differences were observed among the interventions (P > 0.05), pharmacologic therapy exhibited a trend as the most effective method, followed by radiotherapy and no additional treatment.</p><p><strong>Conclusion: </strong>This study found no significant differences in recurrence rates among treatment groups but noted fewer NHO recurrences with combined pharmacology and surgery in recent studies (after 2000), suggesting potential efficacy of postoperative pharmacotherapy for high-risk patients, though limitations like non-controlled studies and heterogeneity warrant caution.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"762-774"},"PeriodicalIF":1.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13295111/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145356656","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":"Recovery rate of functional motor independence during inpatient rehabilitation after traumatic cervical spinal cord injury predicts functional status at years 1 and 5 after surgery: A multicenter, longitudinal cohort study.","authors":"Benjamin M Abraham, Anant Naik, Asdrubal Falavigna, James Harrop, Scott L Zuckerman, Paul M Arnold","doi":"10.1080/10790268.2025.2566561","DOIUrl":"10.1080/10790268.2025.2566561","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Cervical traumatic spinal cord injury (SCI) is a devastating condition that can result in tetraplegia. Early surgical decompression and rehabilitative efforts in cervical SCI patients has been shown to improve neurological outcomes. In this study, we sought to evaluate the impact of various factors at the time of injury and throughout the rehabilitative period on motor functional independence after 1 and 5 years after injury in patients undergoing cervical spinal cord decompression.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A longitudinal, retrospective cohort study from the multicenter spinal cord injury Model Systems (SCIMS) database was conducted on patients who presented between 1998 and 2011 with motor Functional Independence Measure (mFIM) scores at rehabilitation admission (RA) and discharge (DC) from inpatient rehabilitation (IPR), year 1, and year 5. Patients who had undergone surgical decompression with neurological levels of injury limited to the cervical region and those with American Spinal Injury Association (ASIA) Impairment Scale (AIS) grades of A and B were included. The mFIM score was utilized to calculate changes in mFIM (ΔmFIM) scores over each respective time period. Multivariable logistical regression was performed to identify longitudinal predictors associated with functional independence controlling for demographics, SCI etiology and level, vertebral bony fracture/dislocation, associated injuries, AIS grade, and discharge disposition.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 351 patients were included. A majority were 15-29 years old (53.6%) and 80.1% male. Vehicular-related etiologies (49.9%) were most commonly implicated as the mechanism of cervical SCI. Most patients were AIS grade A at the time of RA (66.4%), with an average time from injury to RA of 19 days (IQR 11-32) for all patients. A total of 131 patients required ventilatory support at the time of RA, and of those, only 12 eventually became FI by year 5. Although the number of patients requiring ventilatory support decreased from 131 to 20 by year 5, no additional patients became FI if they required support at the time of DC or year 1. By 1 year, 43 (12.3%) patients achieved functional independence, and an additional 12 (3.42%) achieved functional independence by year 5. Although those with AIS B injuries (aOR = 5.23, P = 0.0014) and AIS improvement (aOR = 5.14, P = 0.0004) had a greater likelihood of FI by year 1, year 1 FI was more strongly predicted by greater ΔmFIM score during a shorter IPR time period (ΔmFIM score during IPR, aOR = 14.2, P &lt; 0.0001). While AIS grade and AIS improvement were no longer predictive of year 5 FI (P &gt; 0.09 for both), the ΔmFIM score during IPR remained as the strongest predictor towards achieving FI by year 5 (aOR = 23.1, P &lt; 0.0001). Furthermore, a stratified analysis of those patients who did not achieve FI at year 1 revealed that the ΔmFIM score during IPR was an even greater predictor of FI at year 5 ","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"662-676"},"PeriodicalIF":1.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13295123/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147357471","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":"Impact of a photovoice intervention on fall-related psychological variables, participation levels and quality of life in chronic spinal cord injury.","authors":"James Sessford, Anita Kaiser, Katherine Chan, Mohammad Alavinia, Oda Al-Anizi, Hardeep Singh, Sarah Munce, Kristin E Musselman","doi":"10.1080/10790268.2025.2593079","DOIUrl":"10.1080/10790268.2025.2593079","url":null,"abstract":"<p><strong>Context: </strong>Falling is common after spinal cord injury (SCI). Falls can cause a fear of falling and reduced participation in activities. Interventions that target falls self-efficacy may change fall-related behaviors, such as reduced participation.</p><p><strong>Objective: </strong>The primary objective was to investigate the impact of a photovoice intervention on falls self-efficacy in individuals with chronic SCI. The secondary objectives were to examine the effects of photovoice on participation, quality of life, fear of falling and falls.</p><p><strong>Methods: </strong>Convergent mixed methods study with 34 adults with chronic SCI; 17 used a wheelchair (WC) and 17 ambulated (AM). The six-week, virtual photovoice intervention focused on fall prevention and consisted of photo-assignments, individual interviews and group meetings facilitated by a peer mentor. The primary measures were questionnaires of falls self-efficacy and falling concern. The secondary measures included questionnaires of participation, quality of life and fear of falling, and number of falls. Quantitative data were compared over time for WC and AM groups separately with a repeated measures ANOVA or Friedman's test. Semi-structured interviews and thematic analysis were used to collect and analyze qualitative data. A joint display merged quantitative and qualitative findings.</p><p><strong>Results: </strong>Scores did not change over time for both groups (p≥0.109) with the exception of participation. The AM group's participation scores were significantly improved three months post-intervention (p≤0.028). Overall, divergence between quantitative and qualitative data was observed, with some participants describing improvements in self-efficacy and quality of life.</p><p><strong>Conclusions: </strong>A photovoice intervention focused on fall prevention may benefit ambulatory individuals with chronic SCI.<b>Trial registration:</b> ClinicalTrials.gov identifier: NCT04864262.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"785-798"},"PeriodicalIF":1.3,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13295121/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145783730","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}