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Topics in Spinal Cord Injury Rehabilitation

Anbesaw Selassie, Yue Cao, Lee L Saunders
BACKGROUND: A gap exists in the current knowledge regarding the epidemiology of traumatic spinal cord injury (TSCI) in a statewide population. OBJECTIVE: To describe population-based epidemiology and trend of TSCI in persons 22 years and older in South Carolina over a 15-year period from 1998 through 2012. METHODS: Data on patients with TSCI were obtained from ongoing statewide TSCI surveillance and follow-up registry. Deaths were ascertained by linking surveillance files and the multiple cause-of-death dataset...
2015: Topics in Spinal Cord Injury Rehabilitation
Lee L Saunders, Anbesaw Selassie, Yue Cao, Kathy Zebracki, Lawrence C Vogel
BACKGROUND: Traumatic spinal cord injury (SCI) that occurs in children and adolescents who are still developing represents a different challenge than SCI in adults. However, information on the epidemiology and incidence of SCI in a population-based cohort is lacking. OBJECTIVE: To describe the epidemiology of pediatric SCI in a population-based cohort in the United States and to assess trend in incidence over a 15-year period (1998-2012). METHODS: Children and adolescents (0-21 years) with SCI were identified through the South Carolina SCI Surveillance Registry using hospital discharge records from 1998 to 2012...
2015: Topics in Spinal Cord Injury Rehabilitation
Philip Santos Requejo, Sara J Mulroy, Puja Ruparel, Patricia E Hatchett, Lisa Lighthall Haubert, Valerie J Eberly, JoAnne K Gronley
BACKGROUND: Shoulder loading during manual wheelchair propulsion (WCP) contributes to the development of shoulder pain in individuals with spinal cord injury (SCI). OBJECTIVE: To use regression analysis to investigate the relationships between the hand contact angle (location of the hand on the pushrim at initial contact and release during the push phase of the WCP cycle) with propulsion characteristics, pushrim forces, and shoulder kinetics during WCP in individuals with paraplegia...
2015: Topics in Spinal Cord Injury Rehabilitation
Lynn A Worobey, Yen-Sheng Lin, Alicia M Koontz, Michael L Boninger
BACKGROUND: A large percentage of individuals with spinal cord injury (SCI) report shoulder pain that can limit independence and quality of life. The pain is likely related to the demands placed on the shoulder by transfers and propulsion. Shoulder pathology has been linked to altered scapular mechanics; however, current methods to evaluate scapular movement are invasive, require ionizing radiation, are subject to skin-based motion artifacts, or require static postures. OBJECTIVE: To investigate the feasibility of applying 3-dimensional ultrasound methods, previously used to look at scapular position in static postures, to evaluate dynamic scapular movement...
2015: Topics in Spinal Cord Injury Rehabilitation
C Scott Bickel, Ceren Yarar-Fisher, Edward T Mahoney, Kevin K McCully
BACKGROUND: Neuromuscular electrical stimulation (NMES), often referred to as functional electrical stimulation (FES), has been used to activate paralyzed skeletal muscle in people with spinal cord injury (SCI). The goal of NMES has been to reverse some of the dramatic losses in skeletal muscle mass, to stimulate functional improvements in people with incomplete paralysis, and to produce some of the health benefits associated with exercise. OBJECTIVE: The purpose of this brief review is to describe a quantifiable resistance training form of NMES developed by Gary A...
2015: Topics in Spinal Cord Injury Rehabilitation
Jenna C Gibbs, B Catharine Craven, Cameron Moore, Lehana Thabane, Jonathan D Adachi, Lora M Giangregorio
BACKGROUND: Understanding the related fates of muscle density and bone quality after chronic spinal cord injury (SCI) is an important initial step in determining endocrine-metabolic risk. OBJECTIVE: To examine the associations between muscle density and indices of bone quality at the distal lower extremity of adults with chronic SCI. METHODS: A secondary data analysis was conducted in 70 adults with chronic SCI (C2-T12; American Spinal Injury Association Impairment Scale [AIS] A-D; ≥2 years post injury)...
2015: Topics in Spinal Cord Injury Rehabilitation
Therese E Johnston, Ralph J Marino, Christina V Oleson, Mary Schmidt-Read, Christopher M Modlesky
CASE PRESENTATION: A man with chronic paraplegia sustained a distal femur fracture following an unrelated fall while enrolled in a study examining musculoskeletal changes after 6 months of cycling with functional electrical stimulation (FES). After healing, he restarted and completed the study. MANAGEMENT AND OUTCOME: Study measures included areal bone mineral density, trabecular bone microarchitecture, cortical bone macroarchitecture, serum bone formation/resorption markers, and muscle volume...
2015: Topics in Spinal Cord Injury Rehabilitation
Karen L Troy, Leslie R Morse
BACKGROUND: Spinal cord injury (SCI) is associated with a rapid loss of bone mass, resulting in severe osteoporosis and a 5- to 23-fold increase in fracture risk. Despite the seriousness of fractures in SCI, there are multiple barriers to osteoporosis diagnosis and wide variations in treatment practices for SCI-induced osteoporosis. METHODS: We review the biological and structural changes that are known to occur in bone after SCI in the context of promoting future research to prevent or reduce risk of fracture in this population...
2015: Topics in Spinal Cord Injury Rehabilitation
W Dalton Dietrich
It was an honor for me to present the 2014 G. Heiner Sell Memorial Lecture at the annual American Spinal Injury Association (ASIA) meeting in San Antonio. For this purpose, I provided a comprehensive review of the scope of research targeting discovery and translational and clinical investigations into spinal cord injury (SCI) research. Indeed, these are exciting times in the area of spinal cord research and clinical initiatives. Many laboratories and clinical programs throughout the world are publishing data related to the pathophysiology of SCI and new strategies for protecting and promoting recovery in both animal models and humans...
2015: Topics in Spinal Cord Injury Rehabilitation
Swati Mehta, Stacey Guy, Tracey Lam, Robert Teasell, Eldon Loh
OBJECTIVE: To systematically review and assess the effectiveness and safety of antidepressants for neuropathic pain among individuals with spinal cord injury (SCI). METHODS: A systematic search was conducted using multiple databases for relevant articles published from 1980 to April 2014. Randomized controlled trials (RCTs) involving antidepressant treatment of neuropathic pain with ≥ 3 individuals and ≥ 50% of study population with SCI were included. Two independent reviewers selected studies based on inclusion criteria and then extracted data...
2015: Topics in Spinal Cord Injury Rehabilitation
Zane Dodd, Simon Driver, Ann Marie Warren, Shelley Riggs, Mike Clark
BACKGROUND: Spinal cord injury (SCI) can cause psychological consequences that negatively affect quality of life. It is increasingly recognized that factors such as resilience and social support may produce a buffering effect and are associated with improved health outcomes. However the influence of adult attachment style on an individual's ability to utilize social support after SCI has not been examined. OBJECTIVE: The purpose of this study was to examine relationships between adult romantic attachment perceived social support depression and resilience in individuals with SCI...
2015: Topics in Spinal Cord Injury Rehabilitation
Zahra Khazaeipour, Seyedeh-Mohadeseh Taheri-Otaghsara, Maryam Naghdi
BACKGROUND: Depression is a common psychological problem that decreases life satisfaction and quality of life in people with spinal cord injury (SCI). OBJECTIVE: The aim of this study was to investigate the prevalence of depression after SCI and its association with pathophysiological, demographic, and socioeconomic factors, including sex, age, level of injury, financial status, and suicidal thoughts. METHODS: This was a cross-sectional study of 134 adults (≥ 18 years old) with SCI who were referred to the Brain and Spinal Cord Injury Research Center (BASIR) clinic, Tehran University of Medical Sciences, for outpatient rehabilitation...
2015: Topics in Spinal Cord Injury Rehabilitation
Meaghan M Lynch, Zachary McCormick, Brian Liem, Geneva Jacobs, Peter Hwang, Thomas George Hornby, Leslie Rydberg, Elliot J Roth
BACKGROUND: Energy required for able-bodied individuals to perform common activities is well documented, whereas energy associated with daily activities among people with spinal cord injury (SCI) is less understood. OBJECTIVE: To determine energy expended during several basic physical tasks specific to individuals with paraplegia due to motor-complete SCI. METHODS: Sixteen adults with motor-complete SCI below T2 level and duration of paraplegia greater than 3 months were included...
2015: Topics in Spinal Cord Injury Rehabilitation
Nicole D DiPiro, Katy D Holthaus, Patrick J Morgan, Aaron E Embry, Lindsay A Perry, Mark G Bowden, Chris M Gregory
BACKGROUND: Lower extremity strength has been reported to relate to walking ability, however, the relationship between voluntary lower extremity muscle function as measured by isokinetic dynamometry and walking have not been thoroughly examined in individuals with incomplete spinal cord injury (iSCI). OBJECTIVE: To determine the extent to which measures of maximal voluntary isometric contraction (MVIC) and rate of torque development (RTD) in the knee extensor (KE) and plantar flexor (PF) muscle groups correlate with self-selected overground walking speed and spatiotemporal characteristics of walking...
2015: Topics in Spinal Cord Injury Rehabilitation
Nicholas Evans, Clare Hartigan, Casey Kandilakis, Elizabeth Pharo, Ismari Clesson
BACKGROUND: Lower extremity robotic exoskeleton technology is being developed with the promise of affording people with spinal cord injury (SCI) the opportunity to stand and walk. The mobility benefits of exoskeleton-assisted walking can be realized immediately, however the cardiorespiratory and metabolic benefits of this technology have not been thoroughly investigated. OBJECTIVE: The purpose of this pilot study was to evaluate the acute cardiorespiratory and metabolic responses associated with exoskeleton-assisted walking overground and to determine the degree to which these responses change at differing walking speeds...
2015: Topics in Spinal Cord Injury Rehabilitation
Allan J Kozlowski, Thomas N Bryce, Marcel P Dijkers
BACKGROUND: Powered exoskeletons have been demonstrated as being safe for persons with spinal cord injury (SCI), but little is known about how users learn to manage these devices. OBJECTIVE: To quantify the time and effort required by persons with SCI to learn to use an exoskeleton for assisted walking. METHODS: A convenience sample was enrolled to learn to use the first-generation Ekso powered exoskeleton to walk. Participants were given up to 24 weekly sessions of instruction...
2015: Topics in Spinal Cord Injury Rehabilitation
Ajax Yang, Pierre Asselin, Steven Knezevic, Stephen Kornfeld, Ann M Spungen
BACKGROUND: Individuals with spinal cord injury (SCI) often use a wheelchair for mobility due to paralysis. Powered exoskeletal-assisted walking (EAW) provides a modality for walking overground with crutches. Little is known about the EAW velocities and level of assistance (LOA) needed for these devices. OBJECTIVE: The primary aim was to evaluate EAW velocity, number of sessions, and LOA and the relationships among them. The secondary aims were to report on safety and the qualitative analysis of gait and posture during EAW in a hospital setting...
2015: Topics in Spinal Cord Injury Rehabilitation
Clare Hartigan, Casey Kandilakis, Skyler Dalley, Mike Clausen, Edgar Wilson, Scott Morrison, Steven Etheridge, Ryan Farris
BACKGROUND: Loss of legged mobility due to spinal cord injury (SCI) is associated with multiple physiological and psychological impacts. Powered exoskeletons offer the possibility of regained mobility and reversal or prevention of the secondary effects associated with immobility. OBJECTIVE: This study was conducted to evaluate mobility outcomes for individuals with SCI after 5 gait-training sessions with a powered exoskeleton, with a primary goal of characterizing the ease of learning and usability of the system...
2015: Topics in Spinal Cord Injury Rehabilitation
Leila Laleh, Sahar Latifi, Davood Koushki, Marzieh Matin, Abbas Norouzi Javidan, Mir Saeed Yekaninejad
BACKGROUND: Patients with spinal cord injury (SCI) deal with various restrictive factors regarding their clothing, such as disability and difficulty with access to shopping centers. OBJECTIVE: We designed a questionnaire to assess attention to clothing and impact of its restrictive factors among Iranian patients with SCI (ACIRF-SCI). METHODS: The ACIRF-SCI has 5 domains: functional, medical, attitude, aesthetic, and emotional. The first 3 domains reflect the impact of restrictive factors (factors that restrict attention to clothing), and the last 2 domains reflect attention to clothing and fashion...
2015: Topics in Spinal Cord Injury Rehabilitation
Peter W New, Louise Dillon
BACKGROUND: Urodynamics (UDs) are routine in traumatic spinal cord injury (SCI), but there are few reports regarding nontraumatic spinal cord myelopathy (SCM) patients. PURPOSE: To describe the neurogenic bladder and UD outcomes in SCM patients and determine whether the UD recommendations result in clinically important changes to bladder management. METHODS: This retrospective case study examined a series of SCM patients admitted to a spinal rehabilitation service who underwent UDs between January 1, 2000 and June 30, 2010...
2015: Topics in Spinal Cord Injury Rehabilitation
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