The Journal of Spinal Cord Medicine最新文献

{"title":"The effectiveness of community-based upper body exercise programs in persons with chronic paraplegia and manual wheelchair users: A systematic review.","authors":"Renata Matheus Willig,&nbsp;Ivo Garcia,&nbsp;Nádia Souza Lima da Silva,&nbsp;Rui Corredeira,&nbsp;Joana Carvalho","doi":"10.1080/10790268.2020.1782608","DOIUrl":"https://doi.org/10.1080/10790268.2020.1782608","url":null,"abstract":"<p><p><b>Context:</b> Physical activity has been beneficial to health, functional independence and quality of life in individuals with spinal cord injury. However, there is no consensus concerning the effects of community-based upper-body exercise for people with paraplegia who use a manual wheelchair.<b>Objective:</b> Conduct a systematic review of evidence of upper-body exercise effects able to be developed in a community-setting, on both functional independence and quality of life, for individuals with chronic paraplegia who use a manual wheelchair.<b>Methods:</b> PubMed, Scopus, Ebsco, SportDiscus and Web of Science databases were browsed, searching for studies that combined words as paraplegia, exercise, functional independence and quality of life and their synonyms, published from January/1998 to December/2018 in English. PEDro scale and the Cochrane tool analyzed methodological quality and risk of bias, respectively.<b>Results:</b> Four studies were selected out of 4004. Studies conducted aerobic arm-ergometer and resistance training predominantly at home. Upper-limb functionality and wheelchair propulsion assessed functional independence, but only the first presented positive effects after resistance training. Resistance and aerobic arm-ergometer training seemed to improve health-related and subjective quality of life.<b>Conclusion:</b> Studies have shown low methodological quality and high risk of bias. Aerobic arm-ergometer and resistance training were the most upper-body exercises used. Resistance training improved functional independence while both types of exercise induced positive effects on quality of life. Future studies with uniform and high-quality methodology should be conducted with exercise in community-dwelling people with paraplegia who use a manual wheelchair.</p>","PeriodicalId":501560,"journal":{"name":"The Journal of Spinal Cord Medicine","volume":" ","pages":"24-32"},"PeriodicalIF":1.7,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/10790268.2020.1782608","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38134644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acupuncture combined with moxibustion promote the recovery of spinal cord injury in correlation with Shh/Gli-1 signaling pathway.","authors":"Li-Li-Qiang Ding,&nbsp;Song-Feng Hu,&nbsp;Xing-Wei He,&nbsp;Peng Zhang,&nbsp;Fen-Fen Zhao,&nbsp;Ting-Ping Liu,&nbsp;Qin Zhang,&nbsp;Fan He,&nbsp;Ying Yu,&nbsp;Peng Xiong,&nbsp;Chang-Kang Wang","doi":"10.1080/10790268.2020.1766900","DOIUrl":"https://doi.org/10.1080/10790268.2020.1766900","url":null,"abstract":"<p><p><b>Objective:</b> Acupuncture combined with moxibustion (AM) therapy has been applied to treat spinal cord injury (SCI), but the underlying mechanism is unclear. The present study aimed to confirm the effect and mechanism of AM treatment on the recovery of SCI.<b>Design:</b> Male Sprague-Dawley rats were used to establish the SCI model by impact method. SCI rat models were subjected to AM treatment at <i>Dazhui</i> (GV14) and <i>Jiaji</i> points (T7-T12), <i>Yaoyangguan</i> (GV3), <i>Zusanli</i> (ST36) and <i>Ciliao</i> (BL32).<b>Outcome measures:</b> Motor function and cell apoptosis in rats after SCI. The mRNA and protein expression levels of Shh and Gli-1 were determined by real-time quantitative polymerase chain reaction, western blot and immunohistochemistry.<b>Results:</b> After AM treatment, the hindlimb motor function of SCI rats was significantly increased than the SCI group at 7, 9, 11, 14 days (P < 0.05). AM treatment 7 d and 14 d significantly preserved the nissl-stained positive neurons and significantly decreased number of apoptotic cells, compared to that of SCI 7 and 14 d groups (P < 0.05). AM treatment improved the mRNA protein levels of Shh and Gli-1 after 7 and 14 days treatment compared to the SCI group (P < 0.05).<b>Conclusion:</b> AM could improve the expression of Shh and Gli-1 in injured spinal cord of rats. That could be part of underlying mechanisms of AM treatment including recover motor function and preserve the neuron cells and alleviate the apoptosis of nerve cells in rats after SCI.</p>","PeriodicalId":501560,"journal":{"name":"The Journal of Spinal Cord Medicine","volume":" ","pages":"106-116"},"PeriodicalIF":1.7,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/10790268.2020.1766900","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37963461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Swallowing rehabilitation following spinal injury: A case series.","authors":"Shaolyn Dick,&nbsp;Jess Thomas,&nbsp;Jessica McMillan,&nbsp;Kelly Davis,&nbsp;Anna Miles","doi":"10.1080/10790268.2020.1762828","DOIUrl":"https://doi.org/10.1080/10790268.2020.1762828","url":null,"abstract":"<p><p><b>Context/objective:</b> Swallowing difficulties (dysphagia) are well recognized after spinal injury. There are no published rehabilitation efficacy studies to date. This study explored viability and outcomes of swallowing rehabilitation programs for four patients with persisting dysphagia.<b>Design:</b> Prospective, quantitative experimental longitudinal case series.<b>Setting:</b> Spinal rehabilitation unit or patients' homes.<b>Interventions:</b> Four patients engaged in a 6-week (3×weekly) individualized progressive rehabilitation program.<b>Outcome measures:</b> Objective videofluoroscopic measures of timing and displacement and a validated self-reported questionnaire - the Eating Assessment Tool (EAT-10) were taken pre-therapy, immediately post-therapy and EAT-10 was repeated at 3 months. Feeling and fatigue scale scores were taken before and after each therapy session.<b>Results:</b> Patients (63, 67 yr, 67 yr, 76 yr; 3 male) had varying spinal diagnoses (2 traumatic, all involving the C-spine) and length of dysphagia (6 weeks, 6 weeks, 12 weeks, 10 yr). Common physiological impairments across all patients were: reduced maximum hyoid displacement, reduced pharyngeal constriction and reduced pharyngoesophageal segment maximum opening. Therapy programs were well received with 100% compliance. Participants made quantitative improvements in their videofluoroscopic measures of timing and displacement. Three out of four participants were able to have their percutaneous endoscopic gastrostomies (PEG) removed. EAT-10 scores significantly improved for all patients (<i>P</i> < .001). Poor upper limb function and restricted neck flexion prohibited some exercises.<b>Conclusions:</b> For many patients following spinal injury, dysphagia resolves during the acute phase of post-surgery recovery. For some, significant pharyngeal impairments persist. This case series demonstrates potential to regain functional swallowing following a 6-week tailored rehabilitation program. High-quality research exploring efficacy of rehabilitation programs are warranted.</p>","PeriodicalId":501560,"journal":{"name":"The Journal of Spinal Cord Medicine","volume":" ","pages":"65-75"},"PeriodicalIF":1.7,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/10790268.2020.1762828","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37965950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Takotsubo cardiomyopathy in a chronic spinal cord injury patient with autonomic dysreflexia: A case report.","authors":"Maria Pollifrone,&nbsp;Seema Sikka,&nbsp;Rita Hamilton","doi":"10.1080/10790268.2020.1724355","DOIUrl":"https://doi.org/10.1080/10790268.2020.1724355","url":null,"abstract":"<p><p><b>Context:</b> Takotsubo cardiomyopathy (TC) is a transient stress-induced cardiomyopathy with left ventricular dysfunction of unknown etiology. A well accepted theory for the pathophysiology of TC is attributed to a massive catecholamine release [1]. This case report will review a chronic tetraplegia patient who was diagnosed with TC after a severe episode of autonomic dysreflexia (AD). He experiences mild episodes of AD several times a day; however, he had never experienced the severity of symptoms that was associated with this episode which led to his hospitalization. Autonomic dysreflexia is a syndrome of imbalanced sympathetic input secondary to loss of descending central sympathetic control in spinal cord injury due to noxious stimuli below the level of the injury, which occurs when the injury level is at thoracic level 6 (T6) or above [2].<b>Findings:</b> In this specific case, it is presumed that the massive catecholamine release associated with this severe AD episode resulted in TC. Although TC has been diagnosed after other instances of acute stress, it is unknown for it to be diagnosed after AD in a chronic setting.<b>Clinical Relevance:</b> The long-term effects of AD have not been well studied, and this case illustrates the importance of education to recognize and manage AD in the spinal cord patient who frequently has episodes of AD.</p>","PeriodicalId":501560,"journal":{"name":"The Journal of Spinal Cord Medicine","volume":" ","pages":"1026-1029"},"PeriodicalIF":1.7,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/10790268.2020.1724355","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37631484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of intensity-matched exercise at different intensities on inflammatory responses in able-bodied and spinal cord injured individuals.","authors":"Eduardo da Silva Alves,&nbsp;Ronaldo Vagner Thomatiele Dos Santos,&nbsp;Fábio Santos de Lira,&nbsp;Alexandre Aparecido Almeida,&nbsp;Kate Edwards,&nbsp;Mateus Benvenutti,&nbsp;Sergio Tufik,&nbsp;Marco Túlio De Mello","doi":"10.1080/10790268.2020.1752976","DOIUrl":"https://doi.org/10.1080/10790268.2020.1752976","url":null,"abstract":"<p><p><b>Objective:</b> To compare the effects of intensity-matched acute exercise at different intensities on proinflammatory and anti-inflammatory cytokines between able-bodied (AB) and spinal cord injured (SCI) individuals.<b>Design:</b> Non-Randomized Controlled Trial.<b>Setting:</b> Community settings in São Paulo - Brazil.<b>Participants:</b> Eight AB and nine SCI paraplegic.<b>Interventions:</b> Participants underwent three exercise sessions at different relative intensities: at ventilatory threshold 1 intensity (VT1), 15% below VT1, and 15% above VT1. Similar energy expenditures were established from exercises with different intensities for each volunteer. The AB group was tested on a conventional treadmill, whereas the SCI group was tested on a treadmill adapted for wheelchair use. Blood samples were collected at baseline, immediately after, and 30 min after the exercise sessions.<b>Outcome measures:</b> Interleukin 1 receptor antagonist, interleukin 1 beta, interleukin 2, interleukin 4, interleukin 6, interleukin 10 and tumoral necrosis factor alpha were measured.<b>Results:</b> When groups were compared, interleukin - 2 was found higher, whereas interleukin - 4 and interleukin - 10 were found lower in the SCI group at all collection times in the three exercise intensities (all <i>P</i> < 0.05). Interleukin - 1 receptor antagonist was found higher immediately after exercise at VT1, 15% above VT1 and 30 min after 15% below VT1 in the AB group (all <i>P</i> < 0.05). In the AB group, an increase in interleukin - 6 immediately after the exercise at VT1 compared with baseline was found (<i>P</i> = 0.01).<b>Conclusion:</b> Individuals with SCI may have to perform physical exercise at a higher volume or energy expenditure than AB individuals to obtain similar anti-inflammatory benefits of acute exercise.<b>Trial registration:</b> Uniform Trial Number identifier: U1111-1232-8142.</p>","PeriodicalId":501560,"journal":{"name":"The Journal of Spinal Cord Medicine","volume":" ","pages":"920-930"},"PeriodicalIF":1.7,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/10790268.2020.1752976","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37842218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Timing and pattern of readmission in individuals with spinal cord injury in the setting of a specialized medical home.","authors":"Shivayogi V Hiremath,&nbsp;Mendel Kupfer,&nbsp;Marci Ruediger","doi":"10.1080/10790268.2021.1883959","DOIUrl":"https://doi.org/10.1080/10790268.2021.1883959","url":null,"abstract":"<p><strong>Background: </strong>The rate of readmission in individuals with spinal cord injury (SCI) is known to be high (28% to 45%) during the first year post-injury and post-rehabilitation. However, there are several critical gaps in our knowledge including the timing pattern of medical complications and the pattern of health complications associated with readmissions.</p><p><strong>Objective: </strong>To identify the timing and pattern of complications associated with hospital readmissions in individuals with traumatic SCI and non-traumatic spinal cord disorders (SCI) post-discharge from an inpatient rehabilitation facility (IRF).</p><p><strong>Design: </strong>Secondary analysis of a three year prospective cohort study.</p><p><strong>Setting: </strong>An SCI medical home.</p><p><strong>Participants: </strong>Individuals who were readmitted (<i>n</i> = 53) within the first year (<i>N</i> = 176) post-discharge from an IRF.</p><p><strong>Interventions: </strong>N/A.</p><p><strong>Outcome measures: </strong>Timing and pattern of all-cause hospital readmissions.</p><p><strong>Results: </strong>Eighty one percent of the readmitted patients experienced readmission within the first six months after discharge, and 36% of the initial readmissions occurred within 30 days of discharge from an IRF. The trend line for the timing of the first readmission post-discharge from an IRF was curvilinear, with a sharp decrease in the number of new patients readmitted for months 1-7 and then a slight increase between 9 and 12 months. Urological and respiratory complications were related to repeat readmissions.</p><p><strong>Conclusion: </strong>The patient is at the greatest risk of readmission in the first 6 months, with a secondary increase in risk at 9 months. Possible reasons may include reduction in in-home and outpatient therapy and skilled nursing over the first year post-SCI.</p>","PeriodicalId":501560,"journal":{"name":"The Journal of Spinal Cord Medicine","volume":" ","pages":"896-901"},"PeriodicalIF":1.7,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/10790268.2021.1883959","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25385258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Handrim forces during wheelies performance in able-bodied and SCI subjects.","authors":"Didier Pradon,&nbsp;Claire Marchiori,&nbsp;Nicolas Roche,&nbsp;Eric Watelain","doi":"10.1080/10790268.2020.1747893","DOIUrl":"https://doi.org/10.1080/10790268.2020.1747893","url":null,"abstract":"<p><p><b>Context:</b> Manual wheelchair users must be able to carry out wheelies in order to tackle obstacles in the outdoor environment. To date, no studies have compared balance variables and forces exerted on the handrim during a stationary wheelie between able bodied and spinal cord injury subjects.<b>Objectives:</b> To compare the distribution of forces applied to the handrim and the center of pressure displacement during a stationary wheelie between able-bodied (AB) subjects and manual wheelchair users with spinal cord injury (SCI).<b>Design:</b> Prospective experimental study.<b>Setting:</b> A university hospital laboratory.<b>Participants:</b> 27 participants (14 AB and 13 SCI).<b>Outcome Measure:</b> Each participant performed 3 stationary wheelies of 60 s duration using a wheelchair equipped with an instrumented wheel. Two force platforms were used to calculate the displacement of the center of pressure (DCOP).<b>Results:</b> Median group DCOP amplitude in the anteroposterior axis was smaller and less variable in the AB (19.6 mm [8.1,49.6]) than the SCI (14.9 mm [7.6,141.1]) group. Forces applied to the handrim only differed significantly between the AB (6 N [-13.8,16.6]) and SCI groups (2.7 N [-12.1 21.9]) in the posteroanterior axis.<b>Conclusions:</b> The results showed that the participants with SCI exerted greater PA forces on the handrim, moreover, the direction of force was opposite to that of the AB group, suggesting that the SCI group used a proactive balance strategy while the AB group used a retroactive strategy. The results suggest that the direction of force applied should be considered when teaching individuals to perform wheelies.</p>","PeriodicalId":501560,"journal":{"name":"The Journal of Spinal Cord Medicine","volume":" ","pages":"985-991"},"PeriodicalIF":1.7,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/10790268.2020.1747893","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37842213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Relationship between ultrasonographically low-echoic lesions under the skin, wheelchair sitting time, and interface pressure on ischial region in individuals with chronic spinal cord injury.","authors":"Shinji Kawasaki,&nbsp;Yukihide Nishimura,&nbsp;Yoshi-Ichiro Kamijo,&nbsp;Hiroyasu Uenishi,&nbsp;Taro Nakamura,&nbsp;Ken Kouda,&nbsp;Yumi Koike,&nbsp;Takeshi Nakamura,&nbsp;Fumihiro Tajima","doi":"10.1080/10790268.2020.1746873","DOIUrl":"https://doi.org/10.1080/10790268.2020.1746873","url":null,"abstract":"<p><p><b>Objective:</b> To determine the relationship between physical findings, wheelchair sitting time, and interface pressure on ischial region in subjects with spinal cord injury (SCI).<b>Design:</b> Cross-sectional study.<b>Setting:</b> Rehabilitation center in Japan.<b>Participants:</b> Manual wheelchair users with chronic SCI (<i>n </i>= 45).<b>Interventions:</b> Pressure ulcers (PU) were diagnosed by inspection, palpation, and ultrasonography. Self-reports were obtained on wheelchair sitting time and pressure mapping was recorded while the subject was seated on the wheelchair.<b>Outcome measures:</b> Subjects were divided into those with ultrasonographically low-echoic lesions (PU-positive group, <i>n </i>= 11) and no such lesions (PU-negative group, <i>n </i>= 34). Outcome measures included wheelchair sitting time and interface pressure at bilateral ischial regions.<b>Results:</b> Using ultrasonography, 13 low-echoic lesions were identified in 11 subjects of the PU-positive group. The pressure duration was longer and interface pressure was significantly higher in subjects of the PU-positive group compared with those of the PU-negative group (<i>P </i>< 0.05 and <i>P </i>< 0.001, respectively).<b>Conclusions:</b> This is the first study to evaluate the interrelationship between physical findings, sitting time, and ultrasonographically measured interface pressure on ischial region area in subjects with spinal cord injury. To prevent pressure ulcers, we recommend avoidance of prolonged wheelchair sitting and measures that can reduce the interface pressure. These variables should be carefully tailored to the needs of the individual subjects with SCI.</p>","PeriodicalId":501560,"journal":{"name":"The Journal of Spinal Cord Medicine","volume":" ","pages":"978-984"},"PeriodicalIF":1.7,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/10790268.2020.1746873","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37963515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlation of neurological level and sweating level of injury in persons with spinal cord injury.","authors":"Michelle Trbovich,&nbsp;Ashley Ford,&nbsp;Yubo Wu,&nbsp;Wouter Koek,&nbsp;Jill Wecht,&nbsp;Dean Kellogg","doi":"10.1080/10790268.2020.1751489","DOIUrl":"https://doi.org/10.1080/10790268.2020.1751489","url":null,"abstract":"<p><p><b>Objective:</b> Thermoregulatory dysfunction after spinal cord injury (SCI) impairs quality of life and predisposes persons to life-threatening sequela of heat-related illness (HRI) in conditions of high ambient temperature. SCI clinicians currently have no objective way to predict which persons are at greatest risk of HRI. Evaporative cooling via sweating is the body's most efficient mechanism of heat dissipation. The relationship between the neurological level of injury (NLOI) and the degree of sudomotor dysfunction is not well defined. This study examines the relationship between the NLOI and sweating level of injury (SwLOI). This information can assist SCI clinicians in identifying individuals with SCI who have most impaired sudomotor function and thus highest risk of HRI.<b>Design:</b> Observational.<b>Setting:</b> Human physiology laboratory.<b>Participants:</b> 10 persons with tetraplegia (TP), 14 with paraplegia (PP) and 10 able-bodied (AB).<b>Intervention:</b> Passive heat stress (1°C rise in core temperature) with sweat responses (SR) quantified with the starch iodine test.<b>Outcome measures:</b> The most caudal dermatomal level in which sweating was visualized was recorded as the SwLOI, which was compared to the NLOI. Minimum, maximum and median differences between NLOI and SwLOI were calculated.<b>Results:</b> Persons with tetraplegia demonstrated no SR. Persons with paraplegia demonstrated SR at a median of 1 level below NLOI. Able-bodied controls demonstrated sweating on all skin surface areas.<b>Conclusions:</b> Persons with motor complete tetraplegia lack evaporative cooling capacity through SR during passive heat stress predisposing them to HRI. Meanwhile, persons with paraplegia sweat on average 1 dermatomal level below their NLOI.</p>","PeriodicalId":501560,"journal":{"name":"The Journal of Spinal Cord Medicine","volume":" ","pages":"902-909"},"PeriodicalIF":1.7,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/10790268.2020.1751489","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37855190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Appraisals of disability and psychological adjustment in veterans with spinal cord injuries.","authors":"Matthew Russell,&nbsp;Herb Ames,&nbsp;Callie Dunn,&nbsp;Sarah Beckwith,&nbsp;Sally A Holmes","doi":"10.1080/10790268.2020.1754650","DOIUrl":"https://doi.org/10.1080/10790268.2020.1754650","url":null,"abstract":"<p><p><b>Context/Objective:</b> Following a spinal cord injury or disability (SCI/D), cognitive appraisals are a marker of psychological adjustment. The present study evaluated the clinical utility and discriminant validity of the Appraisals of DisAbility Primary and Secondary Scale - Short Form (ADAPSS-sf). The ADAPSS-sf was evaluated on 1. identification of individuals experiencing poor psychological adjustment and 2. prediction of life satisfaction beyond measures of emotional distress.<b>Design:</b> A retrospective study was completed using ROC analyses and odds ratios to identify the clinical utility of the ADAPSS-sf. In addition, blocked hierarchical regression explored the ADAPSS-sf predictive characteristics for satisfaction with life beyond measures of emotional distress.<b>Setting:</b> Veteran's Health Administration SCI Center.<b>Participants:</b> Ninety outpatient veterans with SCI/Ds.<b>Outcome Measures:</b> Measures of psychological adjustment post-SCI/D included the PHQ-9, GAD-7, PC-PTSD, and the Diener Satisfaction with Life Scale (SWLS). The ADAPSS-sf was used as a measure of cognitive appraisals.<b>Results:</b> Results indicated the ADAPSS-sf is effective in identification of poor psychological adjustment, P < .001. Diagnostic odds ratios and ADAPSS-sf cut scores were selected to prioritize sensitivity (7.17, ≤ 11), specificity (68.25, ≥ 22), or a balance of the two (16.32, ≤ 19). Hierarchical regression indicated the ADAPSS-sf accounted for unique variance in life satisfaction beyond measures of emotional distress, (Δ<i>R</i>² = .20, <i>β</i> = -.66, <i>t</i>(89) = 6.54, P < .001).<b>Conclusion:</b> Results indicated SCI/D specific appraisals are predictive of concurrent poor psychological adjustment and provide insight into satisfaction with life beyond measures of emotional distress.</p>","PeriodicalId":501560,"journal":{"name":"The Journal of Spinal Cord Medicine","volume":" ","pages":"958-965"},"PeriodicalIF":1.7,"publicationDate":"2021-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/10790268.2020.1754650","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37933899","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}