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Topics in Spinal Cord Injury Rehabilitation

Christina Calhoun Thielen, Ralph J Marino, Susan Duff, Gary Kaplan, M J Mulcahey
Introduction: A scoping review provides a means to synthesize and present a large body of literature on a broad topic, such as methods for various upper extremity activity-based therapy (ABT) interventions. Objectives: To describe our scoping review protocol to evaluate peer-reviewed articles focused on ABT interventions for individuals with neurologically impaired upper extremities. Methods: At Jefferson College of Health Professions and Sidney Kimmel Medical College at Jefferson, Philadelphia, the authors will follow this protocol to conduct a scoping review by establishing a research question and conducting a search of bibliographic databases to identify relevant studies...
2018: Topics in Spinal Cord Injury Rehabilitation
Ida K Fox, Amanda K Miller, Catherine M Curtin
Background: Recent adaption of nerve transfer surgery to improve upper extremity function in cervical spinal cord injury (SCI) is an exciting development. Tendon transfer procedures are well established, reliable, and can significantly improve function. Despite this, few eligible surgical candidates in the United States undergo these restorative surgeries. Evidence Acquisition: The literature on these procedures was reviewed. Results: Options to improve function include surgery to restore elbow extension, wrist extension, and hand opening and closing function...
2018: Topics in Spinal Cord Injury Rehabilitation
Jirapat Likitlersuang, Ryan Koh, Xinyi Gong, Lazar Jovanovic, Isabel Bolivar-Tellería, Matthew Myers, José Zariffa, César Márquez-Chin
Background: Functional electrical stimulation therapy (FEST) is a promising intervention for the restoration of upper extremity function after cervical spinal cord injury (SCI). Objectives: This study describes and evaluates a novel FEST system designed to incorporate voluntary movement attempts and massed practice of functional grasp through the use of brain-computer interface (BCI) and computer vision (CV) modules. Methods: An EEG-based BCI relying on a single electrode was used to detect movement initiation attempts...
2018: Topics in Spinal Cord Injury Rehabilitation
Kevin L Kilgore, Anne Bryden, Michael W Keith, Harry A Hoyen, Ronald L Hart, Gregory A Nemunaitis, P Hunter Peckham
Background: Spinal cord injury (SCI) occurring at the cervical levels can result in significantly impaired arm and hand function. People with cervical-level SCI desire improved use of their arms and hands, anticipating that regained function will result in improved independence and ultimately improved quality of life. Neuroprostheses provide the most promising method for significant gain in hand and arm function for persons with cervical-level SCI. Neuroprostheses utilize small electrical currents to activate peripheral motor nerves, resulting in controlled contraction of paralyzed muscles...
2018: Topics in Spinal Cord Injury Rehabilitation
Kathryn Dent, Namrata Grampurohit, Christina Calhoun Thielen, Cristina Sadowsky, Loren Davidson, Heather B Taylor, Jackie Bultman, John Gaughan, Ralph J Marino, M J Mulcahey
Background: The Capabilities of Upper Extremity Test (CUE-T) is a spinal cord injury (SCI)-specific instrument based on the CUE Questionnaire (CUE-Q). Objective: To evaluate the psychometric properties of CUE-T in children with cervical SCI and determine the lowest age appropriate for test administration. Method: In this repeated measures multicenter study, 39 youths, mean age 12.3 years and mean time post injury 5.14 years, completed two administrations of the CUE-T. Test-retest reliability, internal consistency, and known groups validity were measured...
2018: Topics in Spinal Cord Injury Rehabilitation
Ralph J Marino, Rebecca Sinko, Anne Bryden, Deborah Backus, David Chen, Gregory A Nemunaitis, Benjamin E Leiby
Background: The Capabilities of Upper Extremity Test (CUE-T) and the Graded Redefined Assessment of Strength, Sensibility and Prehension (GRASSP) were both developed to detect change in upper extremity (UE) function in persons with tetraplegia. Objective: To compare the responsiveness and minimal clinically important difference (MCID) of the CUE-T and the quantitative prehension (QtP) scale of the GRASSP. Methods: Subjects included 69 persons with tetraplegia: 60 with acute and 9 with chronic injuries. Subjects were assessed twice 3 months apart using the CUE-T, QtP-GRASSP, and upper extremity motor scores (UEMS)...
2018: Topics in Spinal Cord Injury Rehabilitation
Lynn A Worobey, Christina K Zigler, Randall Huzinec, Stephanie K Rigot, JongHun Sung, Laura A Rice
Background: Proper transfer technique is associated with improved biomechanics and decreased pain and pathology. However, many users do not use proper technique, and appropriate assessment and training are needed to address these deficits. The transfer assessment instrument (TAI) 4.0 was designed to meet those needs and improve on past versions by removing the need for clinician training, shortening administration time, and simplifying question content. Objectives: Evaluate the psychometric properties of the TAI 4...
2018: Topics in Spinal Cord Injury Rehabilitation
Anne Bryden, Kevin L Kilgore, Gregory A Nemunaitis
Background: More than half of all individuals who sustain a spinal cord injury (SCI) experience some degree of impairment in the upper limb. Functional use of the arm and hand is of paramount importance to these individuals. Fortunately, the number of clinical trials and advanced interventions targeting upper limb function are increasing, generating optimism for improved recovery and restoration after SCI. New interventions for restoring function and improving recovery require more detailed examination of the motor capacities of the upper limb...
2018: Topics in Spinal Cord Injury Rehabilitation
Laura Krisa, Madeline Runyen, Megan Ryan Detloff
There are approximately 17,500 new spinal cord injury (SCI) cases each year in the United States, with the majority of cases resulting from a traumatic injury. Damage to the spinal cord causes either temporary or permanent changes in sensorimotor function. Given that the majority of human SCIs occur in the cervical spinal level, the experimental animal models of forelimb dysfunction play a large role in the ability to translate basic science research to clinical application. However, the variation in the design of clinical and basic science studies of forelimb/upper extremity (UE) function prevents the ease of translation...
2018: Topics in Spinal Cord Injury Rehabilitation
Libak Abou, Gabriel Ribeiro de Freitas, Juliete Palandi, Jocemar Ilha
Background: Evidence of intervention effectiveness depends on, among other things, the use of a common set of valid and reliable measures that are responsive to change and reflect clinically important outcomes. Objective: To identify clinical assessment instruments with properties for measuring unsupported sitting balance in subjects with spinal cord injury (SCI). Methods: Bibliographic databases (PubMed, Science Direct, CINAHL, and Central) were searched for articles with the key words "spinal cord injury," "unsupported sitting," and "outcome assessment" in combination with a specific methodological search filter for each database...
2018: Topics in Spinal Cord Injury Rehabilitation
Daniel Bueno Buker, Cristóbal Castillo Oyarce, Raúl Smith Plaza
Background: Spinal cord injury (SCI) above T6 is followed by a loss of sympathetic supraspinal control of the heart, disturbing the autonomic balance and increasing cardiovascular risk. Heart rate variability (HRV) is a widely used tool for assessing the cardiac autonomic nervous system and positive adaptations after regular exercise in able-bodied subjects. However, adaptations in SCI subjects are not well known. Objectives: To compare HRV between able-bodied and SCI subjects and analyze the effects of chronic and acute exercise on HRV in the SCI group...
2018: Topics in Spinal Cord Injury Rehabilitation
Maryam Zoghi, Mary Galea
Background: The Brain Motor Control Assessment (BMCA) is a surface electromyography (sEMG)-based measure of motor output from the central nervous system during a variety of reflex and voluntary motor tasks. Objective: The aim of this study was to assess the pattern of voluntary movements in patients with spinal cord injury (SCI) to investigate whether BMCA could add more resolution to clinical assessments and the recovery path of these patients. Method: Ten participants were recruited from the Royal Talbot Rehabilitation Centre as part of a multicenter randomized controlled trial...
2018: Topics in Spinal Cord Injury Rehabilitation
Giorgio Scivoletto, Monica Torre, Marco Iosa, Maria Rosaria Porto, Marco Molinari
Background: Complications frequently occur in patients with spinal cord injury (SCI) during acute care or rehabilitation and have an impact on rehabilitation outcomes. Purpose: The aim of this study was to determine the occurrence and risk factors for complications in recently injured SCI patients. Methods : Two hundred fifty patients with traumatic injuries with and without complications were counted for the following dichotomous parameters: gender (male/female), associated lesions (presence/absence), surgery (yes/no), American Spinal Injury Association Impairment Scale (AIS) grade (A/other categories), lesion level (lumbar/other levels), and lesion-to-admission time (less than/longer than 1 month)...
2018: Topics in Spinal Cord Injury Rehabilitation
Marcel W M Post, Janneke Nachtegaal, Sacha A van Langeveld, Maureen van de Graaf, Willemijn X Faber, Ellen H Roels, Coen A M van Bennekom
Background: In the Dutch International Spinal Cord Injury (SCI) Data Sets project, we translated all International SCI Data Sets available in 2012 and created a Dutch SCI Database (NDD). Objective: To describe the number of included patients and completeness of the NDD, and to use the NDD to provide a profile of people with traumatic SCI (T-SCI) and non-traumatic SCI (NT-SCI) in the Netherlands. Methods: The NDD includes patients admitted for their first inpatient rehabilitation after onset of SCI to 1 of the 8 rehabilitation centers with a specialty in SCI rehabilitation in the Netherlands...
2018: Topics in Spinal Cord Injury Rehabilitation
Janneke Nachtegaal, Sacha A van Langeveld, H Slootman, Marcel W M Post
Background: Over the last decade, the International Spinal Cord Injury Data Sets project developed a number of International Spinal Cord Injury Data Sets (ISCIDS) that can be used to collect standardized information on patients with SCI. Objective and Methods: The aim of this article is to describe the process of translating the ISCIDS into Dutch and reaching consensus on a Dutch National SCI Data Set (NDD). The interrater reliability of the NDD and implementation of the NDD at eight rehabilitation centers with a specialty in rehabilitation after SCI in the Netherlands are described...
2018: Topics in Spinal Cord Injury Rehabilitation
Mary Joan Roach, Yuying Chen, Michael L Kelly
Background: Comparisons between patients with penetrating spinal cord injury (PSCI) and blunt spinal cord injury (BSCI) are scarce. Purpose: To describe baseline characteristics and neurological and functional outcomes for patients with BSCI and PSCI. Methods: Participants with BSCI ( n = 5,316) and PSCI ( n = 1,062) were extracted from the Spinal Cord Injury Model Systems database from January 1994 to January 2015. Participant injury and demographic characteristics were recorded. Outcomes were measured using the International Standards for Neurological Classification of Spinal Cord Injury and FIM motor scores...
2018: Topics in Spinal Cord Injury Rehabilitation
Yuying Chen, Hui-Yi Lin, Tung-Sung Tseng, Huacong Wen, Michael J DeVivo
Background: Among people with spinal cord injury (SCI), minorities experience a disproportionately higher burden of diseases. Knowledge of data quality by race/ethnicity will help better design racial health disparity research and understand potential errors/biases. Objective: To investigate racial/ethnic differences in response completeness in a longitudinal SCI database. Methods: This study included 7,507 participants (5,483 non-Hispanic whites, 1,414 non-Hispanic blacks, and 610 Hispanics) enrolled in the National SCI Database who returned for follow-up between 2001 and 2006 and were aged ≥18 years at follow-up...
2018: Topics in Spinal Cord Injury Rehabilitation
Hwasoon Kim, Gary R Cutter, Brandon George, Yuying Chen
Background: One of the most critical threats to the validity of any longitudinal research is the bias caused by study attrition. Prevention efforts should be focused on those individuals at high risk of non-participation to improve the generalizability of study findings. Objective: To identify demographic and clinical factors associated with loss to follow-up (FU) at post-injury years 1 to 35 among 25,871 people with spinal cord injury (SCI) enrolled in the National Spinal Cord Injury Database. Methods: Loss to FU was defined as no research information obtained from participants who were eligible for the planned data collection...
2018: Topics in Spinal Cord Injury Rehabilitation
Tom Tørhaug, Berit Brurok, Jan Hoff, Jan Helgerud, Gunnar Leivseth
Objective : To test whether passive leg cycling (PLC) during arm cycling ergometry (ACE) affects peak oxygen uptake (VO2peak ) differently in individuals with spinal cord injury (SCI) at/above the 6th thoracic vertebra (T6) and below T6. Methods: We conducted a cross-sectional study, analyzed by univariate and multivariate regression models. Between- and within-group differences were examined during (a) ACE only, (b) ACE combined with PLC (ACE-PLC), and (c) ACE combined with functional electrical stimulation cycling (FES hybrid)...
2018: Topics in Spinal Cord Injury Rehabilitation
Candy Tefertiller, Kaitlin Hays, Janell Jones, Arun Jayaraman, Clare Hartigan, Tamara Bushnik, Gail F Forrest
Objective: To assess safety and mobility outcomes utilizing the Indego powered exoskeleton in indoor and outdoor walking conditions with individuals previously diagnosed with a spinal cord injury (SCI). Methods: We conducted a multicenter prospective observational cohort study in outpatient clinics associated with 5 rehabilitation hospitals. A convenience sample of nonambulatory individuals with SCI ( N = 32) completed an 8-week training protocol consisting of walking training 3 times per week utilizing the Indego powered exoskeleton in indoor and outdoor conditions...
2018: Topics in Spinal Cord Injury Rehabilitation
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