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Spina cord injury

Amanda E Chisholm, Raed A Alamro, Alison M M Williams, Tania Lam
BACKGROUND: Robotic overground gait training devices, such as the Ekso, require users to actively participate in triggering steps through weight-shifting movements. It remains unknown how much the trunk muscles are activated during these movements, and if it is possible to transfer training effects to seated balance control. This study was conducted to compare the activity of postural control muscles of the trunk during overground (Ekso) vs. treadmill-based (Lokomat) robotic gait training, and evaluate changes in seated balance control in people with high-thoracic motor-complete spinal cord injury (SCI)...
April 11, 2017: Journal of Neuroengineering and Rehabilitation
Jalesh N Panicker
PURPOSE OF REVIEW: Lower urinary tract and sexual dysfunction are commonly reported sequelae of neurologic disease and have a significant impact on quality of life. This article presents an up-to-date summary of the clinical presentation, investigations, and treatment options for urogenital dysfunction in patients with neurologic disease. RECENT FINDINGS: The pattern of lower urinary tract dysfunction is influenced by the site of the neurologic lesion. The risk for developing upper urinary tract damage is considerably less in patients with slowly progressive nontraumatic neurologic disorders, as compared to those with spinal cord injury or spina bifida...
April 2017: Continuum: Lifelong Learning in Neurology
Jolanta Zieba, Amanda Miller, Oleg Gordiienko, George M Smith, Barbara Krynska
Myelomeningocele (MMC) is the most common and severe disabling type of spina bifida resulting in the exposure of vulnerable spinal cord to the hostile intrauterine environment. In this study, we sought to examine the cellular content of fetal amniotic fluid (AF) in MMC and explore a correlation between these cells and pathological development of MMC. MMC was induced in fetal rats by exposing pregnant mothers to all-trans retinoic acid and AF samples were collected before term. Cells were isolated from AF samples and morphologically and phenotypically characterized in short-term cultures...
2017: PloS One
Marjanne den Braber-Ymker, Martin Lammens, Michel J A M van Putten, Iris D Nagtegaal
Neurogenic bowel dysfunction occurs in a large percentage of adult patients with spina bifida (SB) and spinal cord injury (SCI), significantly affecting their quality of life. Although bowel motility is autonomously regulated by the enteric nervous system (ENS), disruption of the modulation of the ENS by extrinsic innervation as present in many patients with SB and SCI might lead to motility disorders. In order to gain insight in the pathophysiology, we studied histological changes of the neuromuscular structures in the colon of SB and SCI patients...
February 2017: Virchows Archiv: An International Journal of Pathology
Ramesha Papanna, Lovepreet K Mann, Saul Snowise, Yisel Morales, Sanjay P Prabhu, Scheffer C G Tseng, Raymond Grill, Stephen Fletcher, Kenneth J Moise
OBJECTIVES: The objective of our study was to test the hypothesis that in utero repair of surgically created spina bifida in a sheep model using cryopreserved human umbilical cord (HUC) patch improves neurological outcome. METHODS: Spina bifida with myelotomy was surgically created in timed pregnant ewes at gestational day (GD) 75. The fetuses were randomly assigned to unrepaired versus HUC and treated at GD 95 and then delivered at GD 140. Neurological evaluation was performed using the Texas Spinal Cord Injury Scale (TSCIS), bladder control using ultrasound, and the hindbrain herniation...
July 2016: American Journal of Perinatology Reports
Subramanian Vaidyanathan, Azi Samsudin, Gurpreet Singh, Peter L Hughes, Bakul M Soni, Fahed Selmi
INTRODUCTION: Paraplegic patients are at greater risk of developing complications following ureteroscopic lithotripsy because of urine infection associated with neuropathic bladder, difficulties in access due to altered anatomy of urinary bladder and urethra, spinal curvature, spasticity, and contractures. We report the occurrence of large subcapsular hematoma following ureteroscopy and discuss lessons we learn from this case. CASE REPORT: A 48-year-old male patient with spina bifida underwent ureteroscopy with laser lithotripsy and ureteric stenting for left ureteric stone and staghorn calculus with hydronephrosis; laser lithotripsy was repeated after 3 months; both procedures were performed by a senior urologist and did not result in any complications...
2016: International Medical Case Reports Journal
Anton Emmanuel, Gayathri Kumar, Peter Christensen, Stuart Mealing, Zenia M Størling, Frederikke Andersen, Steven Kirshblum
BACKGROUND: People suffering from neurogenic bowel dysfunction (NBD) and an ineffective bowel regimen often suffer from fecal incontinence (FI) and related symptoms, which have a huge impact on their quality of life. In these situations, transanal irrigation (TAI) has been shown to reduce these symptoms and improve quality of life. AIM: To investigate the long-term cost-effectiveness of initiating TAI in patients with NBD who have failed standard bowel care (SBC)...
2016: PloS One
Andrea C Betts, Katherine Froehlich-Grobe
BACKGROUND: Despite disparities in obesity between those with and without disability, there is limited evidence to guide weight loss intervention in people with impaired mobility (IM), particularly those with severe impairments. OBJECTIVE: Examine the usability, feasibility, and effectiveness of adapting an existing evidence-based weight loss program for people with IM. METHODS: In this single-group pre-test post-test pilot study, 10 overweight or obese individuals with permanent IM (e...
January 2017: Disability and Health Journal
Heshmatollah Sofimajidpour, Pooya Kolahghoci, Fardin Gharibi
PURPOSE: To investigate technical problems, complications and stone clearance rate in patients with spinal neuropathy who had undergone percutaneous nephrolithotomy. MATERIALS AND METHODS: This cross-sectional study was done between 2004 and 2013 on 29 patients with both spinal cord neuropathy and kidney stones who were chosen for percutaneous nephrolithotomy in Sanandaj city, Iran. The data were obtained from patients' medical records and were documented in a researcher-made checklist...
June 28, 2016: Urology Journal
Brad E Dicianno, John Lovelace, Pamela Peele, Christopher Fassinger, Patricia Houck, Alexandra Bursic, Michael L Boninger
OBJECTIVE: To determine whether an evidence-based wellness program for individuals with spina bifida (SB) and spinal cord injury (SCI) would improve health outcomes and patient experience of care, result in a positive return on investment (ROI), and provide evidence for scalability. DESIGN: non-randomized, non-controlled cohort study; two years of enrollment SETTING: Academic hospital-based outpatient physiatry clinic partnered with an insurance division within an integrated healthcare delivery and financing system PARTICIPANTS: Sixty nine individuals with SB and SCI were consented, 4 were excluded, and the remaining 65 participated in the intervention...
June 13, 2016: Archives of Physical Medicine and Rehabilitation
Jordi Miró, Rocío de la Vega, Ester Solé, Mélanie Racine, Mark P Jensen, Santiago Gálan, Joyce M Engel
PURPOSE: The purpose of this study is to identify the cutoffs that are most suitable for classifying average and worst pain intensity as being mild, moderate, or severe in young people with physical disabilities. METHOD: Survey study using a convenience sample of 113 young people (mean age = 14.19; SD = 2.9; age range: 8-20) with physical disabilities (namely, spinal cord injury, cerebral palsy, spina bifida, limb deficiency (acquired or congenital), or neuromuscular disease)...
June 13, 2016: Disability and Rehabilitation
Antonio Pelliccia, Filippo M Quattrini, Maria Rosaria Squeo, Stefano Caselli, Franco Culasso, Mark S Link, Antonio Spataro, Marco Bernardi
BACKGROUND: Sport participation (SP) of individuals with impairments has recently grown exponentially. Scarce scientific data, however, exist regarding cardiovascular (CV) risk associated with competitive SP. OBJECTIVE: Assessing the prevalence of CV abnormalities and the risk for SP in Paralympic athletes (PA). METHODS: PA (n=267; 76% men), aged 35±9 years, engaged in 18 sport disciplines, with a spectrum of lesions including: spinal cord injury (paraplegia and spina bifida) (n=116); amputation, poliomyelitis, cerebral palsy and other neuromuscular and/or skeletal disorders (Les autres) or visual impairment (n=151) entered the study...
September 2016: British Journal of Sports Medicine
Juliette Hascoet, Andrea Manunta, Charlène Brochard, Alexis Arnaud, Mireille Damphousse, Hélène Menard, Jacques Kerdraon, Hubert Journel, Isabelle Bonan, Sylvie Odent, Benjamin Fremond, Laurent Siproudhis, Xavier Gamé, Benoit Peyronnet
CONTEXT: Bladder management in spina bifida patients relies on clean intermittent catheterization and oral antimuscarinics with a significant failure rate. The efficacy of intradetrusor injections of botulinum toxin has been confirmed in patients with spinal cord injury or multiple sclerosis but not in patients with myelomeningocele. OBJECTIVE: To conduct a systematic review of current evidence regarding the efficacy of intra-detrusor injections of Botulinum Toxin A (BTX-A) in spina bifida patients with neurogenic detrusor overactivity (NDO) refractory to antimuscarinics...
March 2017: Neurourology and Urodynamics
Ronak A Gor, Jenna R Katorski, Sean P Elliott
PURPOSE OF REVIEW: Neurogenic bowel dysfunction (NBoD) commonly affects patients with spina bifida, cerebral palsy, and spinal cord injury among other neurologic insults. NBoD is a significant source of physical and psychosocial morbidity. Treating NBoD requires a diligent relationship between patient, caretaker, and provider in establishing and maintaining a successful bowel program. A well designed bowel program allows for regular, predictable bowel movements and prevents episodes of fecal incontinence...
July 2016: Current Opinion in Urology
Lorenz Leitner, Sharmistha Guggenbühl-Roy, Stephanie C Knüpfer, Matthias Walter, Marc P Schneider, Jure Tornic, Ulla Sammer, Ulrich Mehnert, Thomas M Kessler
BACKGROUND: Intradetrusor onabotulinumtoxinA (BoNT-ONA) injections have become a well-established therapy for refractory neurogenic detrusor overactivity (NDO). However, little is known about long-term outcome and patients' adherence to this treatment. OBJECTIVE: To assess long-term outcomes of intradetrusor BoNT-ONA injections and patients' adherence to treatment. DESIGN, SETTING, AND PARTICIPANTS: A consecutive series of 52 patients who underwent first intradetrusor BoNT-ONA injections for refractory NDO >10 yr ago were evaluated retrospectively and prospectively at a single university spinal cord injury (SCI) centre...
September 2016: European Urology
Catherine J Harris, Gary E Lemack
PURPOSE OF REVIEW: Neurogenic bladder dysfunction results from a variety of neurologic pathologies and can lead to significant patient morbidity and mortality. This article reviews the evaluation, surveillance and management of patients with spinal cord injury, multiple sclerosis, spina bifida and Parkinson's disease. RECENT FINDINGS: Recent studies of patients with neurogenic bladder have highlighted their risk for potentially preventable urologic complications ranging from renal failure to urinary tract infections...
July 2016: Current Opinion in Urology
Xinyu Guan, Yali Liu, Lianjun Gao, Linhong Ji, Rencheng Wang, Mingliang Yang, Run Ji
OBJECTIVE: To investigate trunk muscle activity patterns in a person with thoracic spinal cord injury when walking with different un-powered exoskeletons, and to explore how different un-powered exoskeletons affect trunk muscle activity patterns. CASE REPORT: Data were recorded from a subject with complete spinal cord injury at T10, using an electromyography system on 4 pairs of trunk muscles and a motion capture system simultaneously. RESULTS: The participant generated large muscle force to laterally bend and rotate trunk, and swung his leg through the moments generated, not only by trunk flexion and extension, but by trunk rotation...
April 2016: Journal of Rehabilitation Medicine
John T Stoffel
Detrusor sphincter dyssynergia (DSD) is the urodynamic description of bladder outlet obstruction from detrusor muscle contraction with concomitant involuntary urethral sphincter activation. DSD is associated with neurologic conditions such as spinal cord injury, multiple sclerosis, and spina bifida and some of these neurogenic bladder patients with DSD may be at risk for autonomic dysreflexia, recurrent urinary tract infections, or upper tract compromise if the condition is not followed and treated appropriately...
February 2016: Translational Andrology and Urology
Hye-Sung Park, Edwin Morrison, Cheng Lo, James Leong
Myelomeningocele, also known as spina bifida, is the commonest form of neural tube defect in which both meninges and spinal cord herniate through a large vertebral defect. It may be located at any spinal level; however; lumbosacral involvement is most common. After birth, the closure of spinal lesion is preferably undertaken in the first 48 hours to minimize the risk of injury and central nervous system infection. Relatively small skin defects overlying the dural repair may be directly closed. However, larger defects require reconstructive closure...
September 2016: Annals of Plastic Surgery
Limin Liao
Neurogenic bladder (NB) or neurogenic lower urinary tract dysfunction (NLUTD), a dysfunction of the urinary bladder and urethra due to disease of the central nervous system or peripheral nerves, is a major global medical and social problem. Numerous nervous system abnormalities, such as: stroke, Alzheimer's and Parkinson's diseases, traumatic spinal cord injury, spinal cord tumors, congenital spina bifida, and diabetes, can cause NB/NLUTD. There are two major types of bladder control problems associated with NB/NLUTD: the bladder becomes either overactive or underactive depending on the nature, level, and extent of nerve damage...
2015: International Journal of Molecular Sciences
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