The Journal of Spinal Cord Medicine最新文献

{"title":"Micromonas micros: A rare anaerobic cause of late implant failure following spinal surgery.","authors":"Garret L Sobol,&nbsp;John I Shin,&nbsp;Michael J Vives,&nbsp;Lisa L Dever,&nbsp;Colin B Harris","doi":"10.1080/10790268.2019.1677984","DOIUrl":"https://doi.org/10.1080/10790268.2019.1677984","url":null,"abstract":"<p><p><b>Context:</b> Delayed, postoperative, spine infections are rare, most commonly occurring secondary to fastidious, less virulent pathogens. The etiology may involve a distant infectious focus, not related to the index operation. Patients may present months, or even years postoperatively with pain related to mechanical implant failure, often without additional signs of systemic infection.<b>Findings:</b> We present the case of a 59-year-old male who developed rapid disk degeneration and implant failure seven months following instrumented lumbar fusion surgery. The causal organism was found to be Micromonas micros, an anaerobic bacterium typically located in the oral cavity and associated with periodontal disease. The patient was found to have extensive oral caries, which were presumed to have occurred secondary to poor oral hygiene and his use of fentanyl lozenges for chronic back pain. The patient was treated with revision staged spinal surgery and long-term intravenous antibiotics.<b>Conclusion/clinical relevance:</b> This case highlights an unusual etiology of delayed postoperative spinal implant failure and provides evidence for periodontal disease as a source of hematogenous seeding in postoperative spinal infections. The orthopaedist should also be aware of the potential relationship between poor oral hygiene and the use of high sugar content fentanyl lozenges in treating chronic back pain in these patients.</p>","PeriodicalId":501560,"journal":{"name":"The Journal of Spinal Cord Medicine","volume":" ","pages":"311-315"},"PeriodicalIF":1.7,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/10790268.2019.1677984","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40542486","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":"Restoration of the penile sensory pathway through end-to-side dorsal root neurorrhaphy in rats.","authors":"Hao Zhang,&nbsp;Shuaishuai Chai,&nbsp;Qiufeng Pan,&nbsp;Bing Li","doi":"10.1080/10790268.2020.1778353","DOIUrl":"https://doi.org/10.1080/10790268.2020.1778353","url":null,"abstract":"Objective: Spinal cord injury often leads to the loss of penile sensation, and severely affects the individual’s sexual function. The present study aimed to restore the penile sensory pathway through end-to-side dorsal root (DR) transfer neurorrhaphy in rats, and preliminarily verified the feasibility of the operation. Design: 40 male adult Sprague–Dawley rats were divided into three groups. In the model (n = 20) and resection (n = 10) groups, the right L6 DR, S1 DR, and the contralateral branch of the dorsal nerve of the penis (DNP) were transected. The distal stump of L6 DR in the model group was then anastomosed to the intact L4 DR. The sham group (n = 10) was not subjected to neural damage. Four months later, retrograde and transganglionic neural labeling, morphological examination, immunofluorescence (IF), and ultrastructural observation were carried out to test the reconstruction of the afferent pathway. Reflective erection (RE) was assessed by detecting the intracavernous pressure elicited by DNP stimulation. Results: The neural labeling tests indicated the integrity of the entire rebuilt penile afferent pathway. The morphological studies, IF, and ultrastructural observation showed that the regeneration of L6 axons in the model group was significantly better than that in the resection group; however, it had not reached the level of the sham group. The sham group rats exhibited typical RE following DNP stimulation, while the model and resection groups produced negative results. Conclusion: Our studies demonstrated the feasibility of end-to-side DR transfer neurorrhaphy for restoring the penile sensory pathway in rats.","PeriodicalId":501560,"journal":{"name":"The Journal of Spinal Cord Medicine","volume":" ","pages":"270-279"},"PeriodicalIF":1.7,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/10790268.2020.1778353","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38047996","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":"Sexual health counselling in patients with spinal cord injury: Health care professionals' perspectives.","authors":"Mariam Rassem,&nbsp;Muhammad Siddiqui,&nbsp;Shane Wunder,&nbsp;Keren Ganshorn,&nbsp;Jacqueline Kraushaar","doi":"10.1080/10790268.2020.1786322","DOIUrl":"https://doi.org/10.1080/10790268.2020.1786322","url":null,"abstract":"<p><p><b>Objectives:</b> We aimed to explore barriers to discussing sexual health with spinal cord injured (SCI) patients as perceived by health care professionals, to determine interest and preferences regarding further education in sexual health, and to assess the perceived need for an inpatient Sexual Health Team.<b>Design:</b> Pre and post surveys were completed by attendees following a 1-2 hour educational session on sexual health and SCI, assessing core elements including participant characteristics, confidence levels, and perceptions towards sexual health counselling and education.<b>Setting:</b> Wascana Rehabilitation Centre, a facility in Regina, SK offering inpatient and outpatient rehabilitation services in Saskatchewan.<b>Participants:</b> Eighty-six participants with a mean age of 39 years took part in this study. Among them, nearly half were nurses.<b>Interventions:</b> Educational sessions on SCI patients' sexual health.<b>Outcome Measures:</b> Self-administered surveys.<b>Results:</b> Significant differences were observed between pre- and post-session participant responses regarding their confidence levels (P < 0.001). Most participants (82.1%) had never provided sexual health counselling to SCI patients. The main perceived barrier to lack of sexual health counselling was insufficient training; the preferred learning method was via in-person workshops. The majority (80%) of participants indicated a Sexual Health Team should be created and 39.4% of participants expressed interest in becoming a member of this team.<b>Conclusion:</b> These results support that an educational session may help improve the confidence, knowledge, and perceptions around delivery of sexual health education of SCI patients. Study results suggest a perceived need for a Sexual Health Team and interest from health care professionals to become more involved in sexual health counselling.</p>","PeriodicalId":501560,"journal":{"name":"The Journal of Spinal Cord Medicine","volume":" ","pages":"280-286"},"PeriodicalIF":1.7,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/10790268.2020.1786322","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38141665","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":"Epidemiological features of traumatic spinal cord injury in Beijing, China.","authors":"Jun Liu,&nbsp;Hong-Wei Liu,&nbsp;Feng Gao,&nbsp;Jun Li,&nbsp;Jian-Jun Li","doi":"10.1080/10790268.2020.1793505","DOIUrl":"https://doi.org/10.1080/10790268.2020.1793505","url":null,"abstract":"<p><p><b>Objective:</b> To describe epidemiological features of traumatic spinal cord injury (TSCI) and to conduct a comparison with data from 2002.<b>Design:</b> Retrospective research.<b>Setting:</b> China Rehabilitation Research Center (CRRC), Beijing.<b>Methods:</b> Five hundred and ninety patients with TSCI were admitted to the CRRC from 1st January 2011 to 31st December 2019. We collected data on sex, age, marital status, etiology, occupation, neurological level of injury, and the American Spinal Injury Association Impairment Scale on admission, time of injury and treatment.<b>Results:</b> Statistically significant differences were observed between data from 2002 and the present results (<i>P</i> < 0.001). The mean age of patients with TSCI was 46.3 ± 15.5 years, and the male/female ratio was 4.73:1. The incidence of TSCI increased gradually with age and peaked in the 40-49 age group. The most common occupation was worker (28.6%), followed by office clerk (16.8%) and retired (15.4%). Fall from heights (30.8%), followed by traffic accidents (27.6%) and low falls (25.1%), were the leading etiologies of TSCI. A majority of patients (54.9%) had cervical injuries, 91.9% underwent surgical treatment, and the lowest number of injuries were recorded during winter (19.6%).<b>Conclusion:</b> According to the changes in the epidemiological characteristics of TSCI, preventative strategies should be readjusted. We should pay more attention to the risk of low falls of the elderly. The authors recommend that stricter regulatory practices and safety measures should be developed alongside infrastructure improvements to reduce, and perhaps prevent TSCI.</p>","PeriodicalId":501560,"journal":{"name":"The Journal of Spinal Cord Medicine","volume":" ","pages":"214-220"},"PeriodicalIF":1.7,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/10790268.2020.1793505","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38184282","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":"In utero myelomeningocele repair reduces intensification of inflammatory changes in the dura mater and the skin.","authors":"Agnieszka Pastuszka,&nbsp;Janusz Bohosiewicz,&nbsp;Anita Olejek,&nbsp;Jacek Zamłyński,&nbsp;Ewa Horzelska,&nbsp;Tomasz Koszutski","doi":"10.1080/10790268.2020.1736434","DOIUrl":"https://doi.org/10.1080/10790268.2020.1736434","url":null,"abstract":"<p><p><b>Objective:</b> Chemical and mechanical injury in myelomeningocele (MMC) during the fetal life results in functional disorders of multiple organs. Prenatal MMC repair reduces sequelae of spinal cord injury.<b>Design:</b> Histopathological evaluation of dura mater and skin specimens to assess the severity of inflammatory changes.<b>Setting:</b> Histopathological laboratory and operated patients.<b>Participants:</b> 45 cases (Group I)-intrauterine surgery due to MMC and 42 cases (Group II)-postnatal surgery.<b>Outcome measures:</b> Specimens of the skin and of the dura mater adjacent directly to the uncovered section of the spinal cord were collected for assessment. The specimens were histopathologically evaluated to assess the severity of inflammatory changes.<b>Results:</b> The analysis of the severity of inflammatory changes in the skin and the dura mater showed only small lymphocytic infiltration in 5 fetuses (Group I). Medium and large infiltration in the skin and the dura mater was found in all children who underwent postnatal surgery (Group II). Lymphocytic and granulocytic infiltration in the skin and the dura mater were statistically significantly more prevalent in children who underwent postnatal surgery compared to the group of children who underwent prenatal surgery (P < 0.000003).<b>Conclusions:</b> By reducing the time of exposure to damaging factors, prenatal MMC repair statistically reduces the risk of inflammatory changes in the exposed spinal cord and spinal nerves. Prenatal closure of spina bifida before 24 week of gestation does not reduce the severity of inflammatory changes in the exposed spinal cord.</p>","PeriodicalId":501560,"journal":{"name":"The Journal of Spinal Cord Medicine","volume":" ","pages":"180-185"},"PeriodicalIF":1.7,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/10790268.2020.1736434","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37780323","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":"Experiences of patients and their partners with sexual problems after spinal cord injury: A phenomenological qualitative study.","authors":"Seçil Taylan,&nbsp;İlknur Özkan,&nbsp;Gülden Küçükakça Çelik","doi":"10.1080/10790268.2020.1798136","DOIUrl":"https://doi.org/10.1080/10790268.2020.1798136","url":null,"abstract":"<p><p><b>Objective</b>: This study aimed to examine the experiences of patients and their partners about their sexual lives after Spinal Cord Injury (SCI).<b>Design:</b> This qualitative study was based on Heidegger's hermeneutic phenomenological approach.<b>Setting:</b> The Physical Medicine and Rehabilitation Outpatient Clinic of a city hospital in the Central Anatolia Region in Turkey.<b>Participants</b>: The study consisted of seven female and six male patients with spinal cord injury and their partners.<b>Outcome measures</b>: The textual analysis was carried out in three stages: (1) a naive reading, (2) a structural analysis, and (3) a comprehensive understanding of the text including a discussion. The sample size was calculated by using the criterion sampling technique.<b>Results:</b> As a result of the in-depth interviews with individuals with SCI about their sexual experiences, five themes were derived: (1) first confrontation with SCI, (2) experienced sexual problems, (3) coping, (4) partners' views on sexual problems, and (5) other people.<b>Conclusion</b>: It was found that the sex life of individuals with SCI was negatively affected, they were left helpless in dealing with their problems, and that some patients had difficulties in coping with this condition.</p>","PeriodicalId":501560,"journal":{"name":"The Journal of Spinal Cord Medicine","volume":" ","pages":"245-253"},"PeriodicalIF":1.7,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/10790268.2020.1798136","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38385723","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":"Metastatic intradural extramedullary spinal cord tumor from ovarian cancer: A case report with a literature review.","authors":"Yuki Tajima,&nbsp;Masahito Takahashi,&nbsp;Takuya Kawai,&nbsp;Makoto Higashi,&nbsp;Hideto Sano,&nbsp;Shoichi Ichimura,&nbsp;Hiroaki Kobayashi","doi":"10.1080/10790268.2020.1739380","DOIUrl":"https://doi.org/10.1080/10790268.2020.1739380","url":null,"abstract":"<p><p><b>Context:</b> Metastatic intradural extramedullary spinal cord tumors are extremely rare.<b>Findings:</b> A 76-year-old woman presented with intractable neck pain. Three years earlier, she had been treated for ovarian cancer with bilateral salpingo-oophorectomy. A year later, she underwent resection of a brain metastasis. Magnetic resonance imaging (MRI) showed an encapsulated intradural extramedullary mass at C4-C5. C4-C5 hemilaminectomy, tumor resection, and biopsy were performed. Histological examination of the resection revealed an adenocarcinoma. After surgery, her intolerable neck-shoulder pain was fully resolved, and she had no difficulties with daily living activities. However, two months later, she underwent gamma knife radiosurgery for the recurrent metastatic brain tumor, and four months later, she died from cachexia.<b>Conclusion:</b> Although cases of metastatic intradural extramedullary spinal tumors from ovarian cancer are extremely rare, their possibility should be considered in the differential diagnosis. A history of brain metastases and enhancement on T1-weighted MRI were helpful for making an accurate diagnosis.</p>","PeriodicalId":501560,"journal":{"name":"The Journal of Spinal Cord Medicine","volume":" ","pages":"320-323"},"PeriodicalIF":1.7,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/10790268.2020.1739380","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37763873","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":"Wheelchair backs that support the spinal curves: Assessing postural and functional changes.","authors":"Jessica Presperin Pedersen,&nbsp;Cynthia Smith,&nbsp;Margaret Dahlin,&nbsp;Molly Henry,&nbsp;Janell Jones,&nbsp;Kelly McKenzie,&nbsp;Mitch Sevigny,&nbsp;Lindsey Yingling","doi":"10.1080/10790268.2020.1760530","DOIUrl":"https://doi.org/10.1080/10790268.2020.1760530","url":null,"abstract":"<p><p><b>Objective:</b> To compare outcomes using a wheelchair back designed to support the natural seated spinal curves versus an upholstered back that promotes posterior pelvic tilt and thoracolumbar kyphosis.<b>Design:</b> Cross-over intervention.<b>Setting:</b> Two free-standing spinal cord injury (SCI) model system hospitals.<b>Participants:</b> Fifty adults with motor complete SCI C6-T4, between the ages of 18-60 years who use a manual wheelchair for mobility were recruited from a convenience sample.<b>Intervention:</b> Each participant's wheelchair back support was removed and replaced by an upholstered back and a solid back in randomized order. Postural and functional outcomes, pain, and satisfaction were evaluated using each back.<b>Outcome measures:</b> Seated postural measurements included pelvic angle, spinal angle of kyphosis and linear measurement of spine. Functional outcomes included vertical forward reach, one stroke push, timed forward wheeling, ramp ascent and descent. Numerical pain rating and a satisfaction survey provided input pertaining to both backs.<b>Results:</b> The solid back demonstrated significance in seated postural measurements. Participants using the solid back trended to higher scores in functional outcome measures including vertical forward reach, one stroke push and timed ramp ascent. Participants reported increased satisfaction with comfort and stability with the solid back.<b>Conclusions:</b> This pilot study demonstrated that a wheelchair back, which supports the seated spinal curves improves upright posture, functional reach, and wheelchair propulsion skills. Further research is necessary to demonstrate statistical findings as well as to assess back height and lateral support.</p>","PeriodicalId":501560,"journal":{"name":"The Journal of Spinal Cord Medicine","volume":" ","pages":"194-203"},"PeriodicalIF":1.7,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/10790268.2020.1760530","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37933898","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":"Predicting manual wheelchair initiation movement with EMG activity during over ground propulsion.","authors":"Soufien Chikh,&nbsp;Samuel Boudet,&nbsp;Antonio Pinti,&nbsp;Cyril Garnier,&nbsp;Rawad El Hage,&nbsp;Fairouz Azaiez,&nbsp;Eric Watelain","doi":"10.1080/10790268.2020.1778352","DOIUrl":"https://doi.org/10.1080/10790268.2020.1778352","url":null,"abstract":"<p><p><b>Context/Objective:</b> This is a preliminary study of movement finalities prediction in manual wheelchairs (MWCs) from electromyography (EMG) data. MWC users suffer from musculoskeletal disorders and need assistance while moving. The purpose of this work is to predict the direction and speed of movement in MWCs from EMG data prior to movement initiation. This prediction could be used by MWC to assist users in their displacement by doing a smart electrical assistance based on displacement prediction.<b>Design:</b> Experimental study.<b>Setting:</b> Trained Subject LAMIH Laboratory.<b>Participants:</b> Eight healthy subjects trained to move in manual wheelchairs.<b>Interventions:</b> Subjects initiated the movement in three directions (front, right and left) and with two speeds (maximum speed and spontaneous speed) from two hand positions (on the thighs or on the handrim). A total of 96 movements was studied. Activation of 14 muscles was recorded bilaterally at the deltoid anterior, deltoid posterior, biceps brachii, pectoralis major, rectus abdominis, obliquus externus and erector spinae.<b>Outcome Measures:</b> Prior amplitude, prior time and anticipatory postural adjustments were measured. A hierarchical multi-class classification using logistic regression was used to create a cascade of prediction models. We performed a stepwise (forward-backward) selection of variables using the Bayesian information criterion. Percentages of well-classified movements have been measured through the means of a cross-validation.<b>Results:</b> Prediction is possible using the EMG parameters and allows to discriminate the direction / speed combination with 95% correct classification on the 6 possible classes (3 directions * 2 speeds).<b>Conclusion:</b> Action planning in the static position showed significant adaptability to the forthcoming parameters displacement. The percentages of prediction presented in this work make it possible to envision an intuitive assistance to the initiation of the MWC displacement adapted to the user's intentions.</p>","PeriodicalId":501560,"journal":{"name":"The Journal of Spinal Cord Medicine","volume":" ","pages":"262-269"},"PeriodicalIF":1.7,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/10790268.2020.1778352","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38136103","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":"Sudden stop detection and automatic seating support with neural stimulation during manual wheelchair propulsion.","authors":"Kevin M Foglyano,&nbsp;Lisa M Lombardo,&nbsp;John R Schnellenberger,&nbsp;Ronald J Triolo","doi":"10.1080/10790268.2020.1800278","DOIUrl":"https://doi.org/10.1080/10790268.2020.1800278","url":null,"abstract":"<p><p><b>Objective:</b> Wheelchair safety is of great importance since falls from wheelchairs are prevalent and often have devastating consequences. We developed an automatic system to detect destabilizing events during wheelchair propulsion under real-world conditions and trigger neural stimulation to stiffen the trunk to maintain seated postures of users with paralysis.<b>Design:</b> Cross-over intervention<b>Setting:</b> Laboratory and community settings<b>Participants:</b> Three able-bodied subjects and three individuals with SCI with previously implanted neurostimulation systems<b>Interventions:</b> An algorithm to detect wheelchair sudden stops was developed. This was used to randomly trigger trunk extensor stimulation during sudden stops events<b>Outcome Measures:</b> Algorithm success and false positive rates were determined. SCI users rated each condition on a seven-point Usability Rating Scale to indicate safety.<b>Results:</b> The system detected sudden stops with a success rate of over 93% in community settings. When used to trigger trunk neurostimulation to ensure stability, the implant recipients consistently reported feeling safer (<i>P</i><.05 for 2/3 subjects) with the system while encountering sudden stops as indicated by a 1-3 point change in safety rating.<b>Conclusion:</b> These preliminary results suggest that this system could monitor wheelchair activity and only apply stabilizing neurostimulation when appropriate to maintain posture. Larger scale, unsupervised and longer-term trials at home and in the community are indicated. This system could be generalized and applied to individuals without an implanted stimulation by utilizing surface stimulation, or by actuating a mechanical restraint when necessary, thus allowing unrestricted trunk movements and only restraining the user when necessary to ensure safety.<b>Trial Registration:</b> NCT01474148.</p>","PeriodicalId":501560,"journal":{"name":"The Journal of Spinal Cord Medicine","volume":" ","pages":"204-213"},"PeriodicalIF":1.7,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/10790268.2020.1800278","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38272945","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}