The Journal of Spinal Cord Medicine最新文献

{"title":"A clinical review of the use of Botulinum Toxin type A in managing central neuropathic pain in patients with spinal cord injury.","authors":"Celine Lakra,&nbsp;Helen Cohen","doi":"10.1080/10790268.2020.1848278","DOIUrl":"https://doi.org/10.1080/10790268.2020.1848278","url":null,"abstract":"<p><strong>Context: </strong>Botulinum Toxin type A (BTX-A) has historically been used as a treatment to reduce spasticity. However, its potential to treat neuropathic pain is increasingly being recognized in the literature. This clinical review examines the evidence regarding the use of BTX-A in directly treating neuropathic pain in the spinal cord injured population.</p><p><strong>Methods: </strong>An electronic literature search was conducted in MEDLINE, PubMed and Scopus from inception to May 2020. The key words 'spinal cord injury' AND 'neuropathic pain' AND 'botulinum toxin' AND 'human' were used. The literature search produced a total of 65 results of which 14 duplicates were removed. There was 1 additional paper included following a manual search, providing a total of 52 papers. Taking into account inclusion and exclusion criteria, 2 case reports and 2 randomized control trials were reviewed.</p><p><strong>Results: </strong>While there are multiple studies published on the use of BTX-A to manage neuropathic pain in other patient populations, there is very little published on its potential to treat spinal cord injury-related neuropathic pain. The provisional data provides some evidence that subcutaneous injection of BTX-A may benefit this patient group, although dosing and application schedules remain untested, and information on longer-term complications has yet to be been collected.</p><p><strong>Conclusion: </strong>While early results are interesting, the quality and quantity of research published is not yet high enough to provide formal guidance on the use of BTX-A in treating central neuropathic pain in the spinal cord injury population. Further high-quality research is therefore recommended going forward.</p>","PeriodicalId":501560,"journal":{"name":"The Journal of Spinal Cord Medicine","volume":" ","pages":"651-655"},"PeriodicalIF":1.7,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/10790268.2020.1848278","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38663915","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":"Honokiol exerts protective effects on neural myelin sheaths after compressed spinal cord injury by inhibiting oligodendrocyte apoptosis through regulation of ER-mitochondrial interactions.","authors":"Yong Tan,&nbsp;Haijun Yu,&nbsp;Shanquan Sun,&nbsp;Shengwei Gan,&nbsp;Rui Gong,&nbsp;Ke-Jie Mou,&nbsp;Jun Xue,&nbsp;Shiye Xu,&nbsp;Jiangfeng Wu,&nbsp;Lan Ma","doi":"10.1080/10790268.2021.1890878","DOIUrl":"https://doi.org/10.1080/10790268.2021.1890878","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the effect of honokiol on demyelination after compressed spinal cord injury (CSCI) and it's possible mechanism.</p><p><strong>Design: </strong>Animal experiment study.</p><p><strong>Setting: </strong>Institute of Neuroscience of Chongqing Medical University.</p><p><strong>Interventions: </strong>Total of 69 Sprague-Dawley (SD) rats were randomly divided into 3 groups: sham group (n=15), honokiol group (n=27) and vehicle group (n=27). After established CSCI model by a custom-made compressor successfully, the rats of sham group were subjected to the limited laminectomy without compression; the rats of honokiol group were subjected to CSCI surgery and intraperitoneal injection of 20 mg/kg honokiol; the rats of vehicle group were subjected to CSCI surgery and intraperitoneal injection of an equivalent volume of saline.<b>Outcome measures:</b> The locomotor function of each group was assessed using the Basso, Beattie and Bresnahan (BBB) rating scale. The pathological changes of myelinated nerve fibers of spinal cord in 3 groups were detected by osmic acid staining and transmission electron microcopy (TME). Immunofluorescence and Western blot were used to research the experessions of active caspase-3, caspase-12, cytochrome C and myelin basic protein (MBP) respectively.</p><p><strong>Results: </strong>In the vehicle group, the rats became paralyzed and spastic after injury, and the myelin sheath became swollen and broken down along with decreased number of myelinated nerve fibers. Western blot analysis manifested that active caspase-3, caspase-12 and cytochrome C began to increase 1 d after injury while the expression of MBP decreased gradually. After intervened with honokiol for 6 days, compared with the vehicle group, the locomotor function and the pathomorphological changes of myelin sheath of the CSCD rats were improved with obviously decreased expression of active caspase-3, caspase-12 and cytochrome C.</p><p><strong>Conclusions: </strong>Honokiol may improve locomotor function and protect neural myelin sheat from demyelination via prevention oligodendrocytes (OLs) apoptosis through mediate endoplasmic reticulum (ER)-mitochondria pathway after CSCI.</p>","PeriodicalId":501560,"journal":{"name":"The Journal of Spinal Cord Medicine","volume":" ","pages":"595-604"},"PeriodicalIF":1.7,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/10790268.2021.1890878","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25570407","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":"Tetraplegic obstructive sleep apnoea patients dilate the airway similarly to able-bodied obstructive sleep apnoea patients.","authors":"Alice Hatt,&nbsp;Elizabeth Brown,&nbsp;David J Berlowitz,&nbsp;Fergal O'Donoghue,&nbsp;Hailey Meaklim,&nbsp;Alan Connelly,&nbsp;Graeme Jackson,&nbsp;Kate Sutherland,&nbsp;Peter A Cistulli,&nbsp;Bon San Bonne Lee,&nbsp;Lynne E Bilston","doi":"10.1080/10790268.2020.1829418","DOIUrl":"https://doi.org/10.1080/10790268.2020.1829418","url":null,"abstract":"<p><p><b>Context/objective:</b> Obstructive sleep apnoea (OSA) develops soon after cervical spinal cord injury (SCI) at rates higher than the general population, but the mechanisms are not understood. This study aimed to determine whether OSA in SCI is associated with altered pharyngeal muscle dilatory mechanics during quiet breathing, as has been observed in the non-SCI injured with obstructive sleep apnoea.<b>Design:</b> Cross sectional imaging study.<b>Setting:</b> Medical research institute.<b>Participants:</b> Eight cervical SCI patients with OSA were recruited and compared to 13 able-bodied OSA patients and 12 able-bodied healthy controls of similar age and BMI.<b>Interventions and outcome measures:</b> 3T MRI scans of upper airway anatomy and tagged-MRI to characterize airway muscle motion during quiet breathing were collected for analysis.<b>Results:</b> Considerable variation in the patterns of inspiratory airway muscle motion was observed in the SCI group, with some participants exhibiting large inspiratory airway dilatory motions, and others exhibiting counterproductive narrowing during inspiration. These patterns were not dissimilar to those observed in the able-bodied OSA participants. The increase in airway cross-sectional area of able-bodied control participants was proportional to increase in BMI, and a similar, but not significant, relationship was present in all groups.<b>Conclusion:</b> Despite the limited sample size, these data suggest that SCI OSA patients have heterogeneous pharyngeal dilator muscle responses to the negative pressures occurring during inspiration but, as a group, appear to be more similar to able-bodied OSA patients than healthy controls of similar age and BMI. This may reflect altered pharyngeal pressure reflex responses in at least some people with SCI.</p>","PeriodicalId":501560,"journal":{"name":"The Journal of Spinal Cord Medicine","volume":" ","pages":"536-546"},"PeriodicalIF":1.7,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/10790268.2020.1829418","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38580405","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":"Factors influencing thigh muscle volume change with cycling exercises in acute spinal cord injury - a secondary analysis of a randomized controlled trial.","authors":"Maya G Panisset,&nbsp;Doa El-Ansary,&nbsp;Sarah Alison Dunlop,&nbsp;Ruth Marshall,&nbsp;Jillian Clark,&nbsp;Leonid Churilov,&nbsp;Mary P Galea","doi":"10.1080/10790268.2020.1815480","DOIUrl":"https://doi.org/10.1080/10790268.2020.1815480","url":null,"abstract":"<p><p><b>Objective:</b> To conduct a per-protocol analysis on thigh muscle volume outcomes from the Spinal Cord Injury and Physical Activity (SCIPA) Switch-On Trial.<b>Design:</b> Secondary analysis from an assessor-blind randomized, controlled trial.<b>Setting:</b> Four acute/sub-acute hospitals in Australia and New Zealand.<b>Participants:</b> 24 adults (1 female) within four weeks of motor complete or incomplete spinal cord injury (SCI)<b>Intervention:</b> Functional electrical stimulation-assisted cycling (FESC) or passive cycling (PC) 4x/week for 12 weeks.<b>Outcome Measures:</b> Whole thigh and muscle group volumes calculated from manually segmented MR images.<b>Results:</b> 19/24 participants completed ≥ twelve weeks of the intervention. Five participants experienced hypertrophy (4 FESC; 1 PC) and eight attenuation of atrophy (<20% volume loss) (3 FESC; 5 PC) in thigh muscle volume. Six participants were non-responders, exhibiting atrophy >20% (3 FESC; 3 PC). Mean (SD) change for FESC was -2.3% (25.3%) and PC was -14.0% (12.3%). After controlling for baseline muscle volumes, a strong significant correlation was found between mean weekly exercise frequency and quadriceps and hamstring volumes (r=6.25, P=0.006), regardless of mode. Average watts was highly correlated to quadriceps volumes only (r=5.92, P=0.01), while total number of sessions was strongly correlated with hamstring volumes only (r=5.91, P=0.01).<b>Conclusion:</b> This per-protocol analysis of FESC and PC early after SCI reports a partial response in 42% and a beneficial response in 25% of patients who completed 12 weeks intervention, regardless of mode. Strong correlations show a dose-response according to exercise frequency. Characteristics of non-responders are discussed to inform clinical decision-making.</p>","PeriodicalId":501560,"journal":{"name":"The Journal of Spinal Cord Medicine","volume":" ","pages":"510-521"},"PeriodicalIF":1.7,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/10790268.2020.1815480","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38417817","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":"Prospective analysis of a surgical algorithm to achieve ventilator weaning in cervical tetraplegia.","authors":"Matthew R Kaufman,&nbsp;Thomas Bauer,&nbsp;Stuart Campbell,&nbsp;Kristie Rossi,&nbsp;Andrew Elkwood,&nbsp;Reza Jarrahy","doi":"10.1080/10790268.2020.1829417","DOIUrl":"https://doi.org/10.1080/10790268.2020.1829417","url":null,"abstract":"<p><p><b>Objectives:</b> Chronic ventilator dependency in cervical tetraplegia is associated with substantial morbidity. When non-invasive weaning methods have failed the primary surgical treatment is diaphragm pacing. Phrenic nerve integrity and diaphragm motor units are requirements for effective pacing but may need to be restored for successful weaning. A surgical algorithm that includes: 1. Diaphragm pacing, 2. Phrenic nerve reconstruction, and 3. Diaphragm muscle replacement, may provide the capability of reducing or reversing ventilator dependency in virtually all cervical tetraplegics.<b>Design:</b> Prospective case series.<b>Setting:</b> A university-based hospital from 2015 to 2019.<b>Participants</b>: Ten patients with ventilator-dependent cervical tetraplegia.<b>Interventions</b>: I. Pacemaker alone, II. Pacemaker + phrenic nerve reconstruction, or III. Pacemaker + diaphragm muscle replacement.<b>Outcome measures</b>: Time from surgery to observed reduction in ventilator requirements (↓VR), ventilatory needs as of most recent follow-up [no change (NC), partial weaning (PW, 1-12 h/day), or complete weaning (CW, >12 h/day)], and complications.<b>Results:</b> Both patients in Group I achieved CW at 6-month follow-up. Two patients in Group II achieved CW, and in another two patients PW was achieved, at 1.5-2-year follow-up. The remaining two patients are NC at 6 and 8-month follow-up, respectively. In group III, both patients achieved PW at 2-year follow-up. Complications included mucous plugging (<i>n </i>= 1) and pacemaker malfunction requiring revision (<i>n </i>= 3).<b>Conclusion:</b> Although more investigation is necessary, phrenic nerve reconstruction or diaphragm muscle replacement performed (when indicated) with pacemaker implantation may allow virtually all ventilator-dependent cervical tetraplegics to partially or completely wean.</p>","PeriodicalId":501560,"journal":{"name":"The Journal of Spinal Cord Medicine","volume":" ","pages":"531-535"},"PeriodicalIF":1.7,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/10790268.2020.1829417","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38486269","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":"Shoulder magnetic resonance imaging findings in manual wheelchair users with spinal cord injury.","authors":"Omid Jahanian,&nbsp;Meegan G Van Straaten,&nbsp;Brianna M Goodwin,&nbsp;Ryan J Lennon,&nbsp;Jonathan D Barlow,&nbsp;Naveen S Murthy,&nbsp;Melissa M B Morrow","doi":"10.1080/10790268.2020.1834774","DOIUrl":"https://doi.org/10.1080/10790268.2020.1834774","url":null,"abstract":"<p><p><b>Objective:</b> To investigate the prevalence of rotator cuff and long head of the biceps pathologies in manual wheelchair (MWC) users with spinal cord injury (SCI).<b>Design:</b> Cross-sectional study.<b>Setting:</b> Outpatient clinic at a tertiary medical center.<b>Participants:</b> Forty-four adult MWC users with SCI (36 men and 8 women) with an average age (SD) of 42 (13) years. SCI levels ranged from C6 to L1; complete and incomplete SCI.<b>Outcome Measures:</b> Participants' demographic and anthropometric information, presence of shoulder pain, Wheelchair User's Pain Index (WUSPI) scores, and magnetic resonance imaging findings of shoulder pathologies including tendinopathy, tendon tears, and muscle atrophy.<b>Results:</b> Fifty-nine percent of the participants reported some shoulder pain. The prevalence of any tendinopathy across the rotator cuff and the long head of biceps tendon was 98%. The prevalence of tendinopathy in the supraspinatus was 86%, infraspinatus was 91%, subscapularis was 75%, and biceps was 57%. The majority of tendinopathies had mild or moderate severity. The prevalence of any tears was 68%<b>.</b> The prevalence of tendon tears in the supraspinatus was 48%, infraspinatus was 36%, subscapularis was 43%, and biceps was 12%. The majority of the tears were partial-thickness tears. Participants without tendon tears were significantly younger (P < 0.001) and had been wheelchair user for a significantly shorter time (P = 0.005) than those with tendon tears.<b>Conclusion:</b> Mild and moderate shoulder tendinopathy and partial-thickness tendon tears were highly prevalent in MWC users with SCI. Additionally, the findings of this study suggest that strategies for monitoring shoulder pathologies in this population should not be overly reliant on patient-reported pain, but perhaps more concerned with years of wheelchair use and age.</p>","PeriodicalId":501560,"journal":{"name":"The Journal of Spinal Cord Medicine","volume":" ","pages":"564-574"},"PeriodicalIF":1.7,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/10790268.2020.1834774","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38580831","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":"Cardiac arrhythmias six months following traumatic spinal cord injury.","authors":"Shane J T Balthazaar,&nbsp;Morten Sengeløv,&nbsp;Kim Bartholdy,&nbsp;Lasse Malmqvist,&nbsp;Martin Ballegaard,&nbsp;Birgitte Hansen,&nbsp;Jesper Hastrup Svendsen,&nbsp;Anders Kruse,&nbsp;Karen-Lise Welling,&nbsp;Andrei V Krassioukov,&nbsp;Fin Biering-Sørensen,&nbsp;Tor Biering-Sørensen","doi":"10.1080/10790268.2021.1950453","DOIUrl":"https://doi.org/10.1080/10790268.2021.1950453","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the incidence of cardiac arrhythmias at six months following traumatic spinal cord injury (SCI) and to compare the prevalence of arrhythmias between participants with cervical and thoracic SCI.</p><p><strong>Design: </strong>A prospective observational study using continuous twenty-four-hour Holter monitoring.</p><p><strong>Setting: </strong>Inpatient rehabilitation unit of a university research hospital and patient home setting.</p><p><strong>Participants: </strong>Fifty-five participants with acute traumatic SCI were prospectively included. For each participant, the SCI was characterized according to the International Standards for Neurological Classification of SCI by the neurological level and severity according to the American Spinal Injury Association Impairment Scale.</p><p><strong>Outcome measures: </strong>Comparisons between demographic characteristics and arrhythmogenic occurrences as early as possible after SCI (4 ± 2 days) followed by 1, 2, 3, 4 weeks and 6 month time points of Holter monitoring.</p><p><strong>Results: </strong>Bradycardia (heart rate [HR] <50 bpm) was present in 29% and 33% of the participants with cervical (C1-C8) and thoracic (T1-T12) SCI six months after SCI, respectively. The differences in episodes of bradycardia between the two groups were not significant (P < 0.54). The mean maximum HR increased significantly from 4 weeks to 6 months post-SCI (P < 0.001), however mean minimum and maximum HR were not significantly different between the groups at the six-month time point. There were no differences in many arrhythmias between recording periods or between groups at six months.</p><p><strong>Conclusions: </strong>At the six-month timepoint following traumatic SCI, there were no significant differences in occurrences of arrhythmias between participants with cervical and thoracic SCI compared to the findings observed in the first month following SCI.</p>","PeriodicalId":501560,"journal":{"name":"The Journal of Spinal Cord Medicine","volume":" ","pages":"631-637"},"PeriodicalIF":1.7,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/10790268.2021.1950453","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39208475","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 walking training on risk markers of cardiovascular disease in individuals with chronic spinal cord injury.","authors":"Ramzi A Alajam,&nbsp;Abdulfattah S Alqahtani,&nbsp;Sanghee Moon,&nbsp;Caio V M Sarmento,&nbsp;Jason Frederick,&nbsp;Irina V Smirnova,&nbsp;Wen Liu","doi":"10.1080/10790268.2020.1853332","DOIUrl":"https://doi.org/10.1080/10790268.2020.1853332","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the effects of an 8-week walking training program on glycemic control, lipid profile, and inflammatory markers in individuals with chronic spinal cord injury (SCI).</p><p><strong>Design: </strong>A pilot, single-group, pretest-posttest study.</p><p><strong>Setting: </strong>A neuromuscular research laboratory.</p><p><strong>Participants: </strong>Eleven participants with chronic SCI.</p><p><strong>Intervention: </strong>An 8-week walking training program using a treadmill, a body weight-supported system, and an assistive gait training device.</p><p><strong>Outcome measures: </strong>Levels of glycated hemoglobin (HbA_1c), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), C-reactive protein (CRP), and interleukin-6 were assessed before and after the walking training.</p><p><strong>Results: </strong>Following the walking training, there was a statistically significant decrease in HbA_1c level (<i>P</i><0.01) of uncertain clinical significance. The lipid profile improved after training, as shown by a statistically and clinically significant increase in HDL-C level (<i>P</i><0.01) and a statistically significant decrease in LDL-C level (<i>P</i><0.1) of no clinical significance. The ratio of LDL-C to HDL-C was significantly reduced (<i>P</i><0.01). In regard to inflammatory markers, concentrations of IL-6 showed a significant reduction after training (<i>P</i>=0.05) of unknown clinical significance, while those of CRP trended to decrease (<i>P</i>=0.13).</p><p><strong>Conclusion: </strong>The findings of this pilot study suggest that an 8-week walking training program may produce favorable changes in risk markers of cardiovascular disease in individuals with chronic SCI as shown by clinically meaningful improvements in HDL-C, and small changes in the right direction, but uncertain clinical significance, in HbA1c, LDL-C and IL-6. A randomized controlled trial is needed to compare the effects of walking training on these outcome measures with those of other exercise modalities suitable for this population, and to see if more prolonged exercise exposure leads to favorable parameters of significant size to justify the exercise modality.</p>","PeriodicalId":501560,"journal":{"name":"The Journal of Spinal Cord Medicine","volume":" ","pages":"622-630"},"PeriodicalIF":1.7,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/10790268.2020.1853332","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38818031","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":"Access and engagement with places in the community, and the quality of life among people with spinal cord damage.","authors":"Ali Lakhani,&nbsp;Sanjoti Parekh,&nbsp;David P Watling,&nbsp;Peter Grimbeek,&nbsp;Ross Duncan,&nbsp;Susan Charlifue,&nbsp;Elizabeth Kendall","doi":"10.1080/10790268.2020.1860867","DOIUrl":"https://doi.org/10.1080/10790268.2020.1860867","url":null,"abstract":"<p><strong>Objectives: </strong>This study aims to investigate the association between self-reported accessibility and engagement with health services and places in the community, and quality of life (QOL) for people with spinal cord damage (SCD).</p><p><strong>Design: </strong>Cross-sectional survey.</p><p><strong>Setting: </strong>Community.</p><p><strong>Participants: </strong>Two-hundred and sixty-six people with a SCD residing in Australia (<i>M_age</i> = 62.34, <i>SD_age</i> = 15.95).</p><p><strong>Outcome measure: </strong>The International Spinal Cord Injury Quality of Life Basic Data Set.</p><p><strong>Results: </strong>Univariate regressions demonstrated that accessing a higher number of places in the community was significantly associated with favorable self-reported psychological health (<i>β</i> = .160, P < .01), physical health (<i>β</i> = .144, P < .01), overall well-being (<i>β</i> = .206, P < .01), and QOL (<i>β</i> = .187, P < .01). In contrast, reporting a higher number of inaccessible places was significantly associated with unfavorable self-reported psychological health (<i>β</i> = -.171, P < .01), physical health (<i>β</i> = -.270, P < .001), overall well-being (<i>β</i> = -.238, P < .001), and QOL (<i>β</i> = -.244, P < .001). Being older and living with injury or onset of damage longer were significantly associated with favorable scores across all outcomes (P < .01) except physical health.</p><p><strong>Conclusions: </strong>Community engagement can have a considerable impact on the self-reported health and QOL of people with SCD. Interventions aimed at increasing community engagement, particularly for people who have recently experienced SCD are warranted.</p>","PeriodicalId":501560,"journal":{"name":"The Journal of Spinal Cord Medicine","volume":" ","pages":"522-530"},"PeriodicalIF":1.7,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/10790268.2020.1860867","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38838085","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":"Urinary undiversion by conversion of the incontinent ileovesicostomy to augmentation ileocystoplasty in spinal cord injured patients.","authors":"Patrick J Shenot,&nbsp;Seth Teplitsky,&nbsp;Andrew Margules,&nbsp;Aaron Miller,&nbsp;Akhil K Das","doi":"10.1080/10790268.2020.1829420","DOIUrl":"https://doi.org/10.1080/10790268.2020.1829420","url":null,"abstract":"<p><p><b>Context:</b> Spinal cord injury (SCI) patients with neurogenic bladder and the inability to self-catheterize may require incontinent diversion to provide low-pressure drainage while avoiding the use of indwelling catheters. We demonstrate that in patients with significant functional improvement, the ileovesicostomy can be a reversible form of diversion, with simultaneous bladder augmentation using the same segment of ileum utilized for the ileovesicostomy. Multidisciplinary management should be utilized to assure mastery of intermittent catheterization before urinary undiversion. This technique allows for transition to a regimen of intermittent self-catheterization with excellent functional and urodynamic outcomes.<b>Design:</b> Case Series.<b>Setting:</b> Tertiary care hospital, Philadelphia, Pennsylvania.<b>Participants:</b> Three individuals with an SCI.<b>Interventions:</b> Conversion of bladder management from an incontinent ileovesicostomy to an augmentation ileocystoplasty, with intermittent catheterization.<b>Outcome Measures:</b> Ability to regain urinary continence with preservation of renal function as determined by serum creatinine and renal ultrasound.<b>Results:</b> Three SCI patients who had an incontinent ileovesicostomy developed sufficient functional improvement to intermittently self-catheterize reliably and underwent conversion of ileovesicostomy to ileocystoplasty. For each, the ileovesicostomy channel was taken down and detubularized, then used to create an ileal patch for augmentation ileocystoplasty. Intermittent catheterization was then used for periodic bladder drainage. All achieved large capacity, low-pressure bladders with complete continence and stable creatinine.<b>Conclusion:</b> In motivated SCI patients, it is possible to regain continence by converting the ileovesicostomy into augmentation ileocystoplasty, avoiding the disadvantages of a urostomy. A multidisciplinary collaborative approach facilitates the optimal rehabilitation of SCI individuals.</p>","PeriodicalId":501560,"journal":{"name":"The Journal of Spinal Cord Medicine","volume":" ","pages":"614-621"},"PeriodicalIF":1.7,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/10790268.2020.1829420","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38488046","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}