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spinal patients outcome research trial

Rafael Ekmejian, Pooria Sarrami, Justine M Naylor, Ian A Harris
BACKGROUND: Motorcyclists are a vulnerable road-user population who are overrepresented in traffic injuries. Utilisation of back protectors may be an effective preventive measure for spine injuries in motorcyclists. Since use of back protectors is increasing it is important that clinical evidence supports their use. The study aimed to investigate the current evidence on the ability of back protectors to reduce the rate of back injuries and patient mortality in motorcycle crashes. METHODS: A systematic literature search was conducted using various electronic databases...
October 4, 2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Suzanne L de Kunder, Kim Rijkers, Sander M J van Kuijk, Silvia M A A Evers, Rob A de Bie, Henk van Santbrink
BACKGROUND: With a steep increase in the number of instrumented spinal fusion procedures, there is a need for comparative data to develop evidence based treatment recommendations. Currently, the available data on cost and clinical effectiveness of the two most frequently performed surgeries for lumbar spondylolisthesis, transforaminal lumbar interbody fusion (TLIF) and posterior lumbar interbody fusion (PLIF), are not sufficient. Therefore, current guidelines do not advise which is the most appropriate surgical treatment strategy for these patients...
October 6, 2016: BMC Musculoskeletal Disorders
Carole Vuillerot, D Vincent-Genod, G Thomann, J Coton
OBJECTIVE: Physiotherapists are demanding of valid outcome measures to assess the evolution of their patient's motor functions in order to precisely describe the effects of treatments and the progress of diseases. Hence, several scales such as the motor function measure (MFM) have been developed with the aim to measure, with validity and reproducibility and sensitivity, the motor functions of patients with neuromuscular disease. The originality of our approach is to quantitatively measure the children's motor functions with a low-cost, non-invasive and plug and play technological tool that avoid the uncertain characteristic of human evaluation and increase children's involvement...
September 2016: Annals of Physical and Rehabilitation Medicine
Michael Jones, Julie Gassaway
OBJECTIVE: Peer support is an important adjunct to clinical care for people with disabilities, and may help address barriers to community reintegration. Peers offer positive role models and the benefit of learning from shared experiences of living with disability. Despite potential benefits, peer support is not consistently integrated in the rehabilitation process. This presentation describes three interventions recommended by patients, and directed by peer mentors, to promote successful community transition after rehabilitation for traumatic spinal cord injury (SCI)...
September 2016: Annals of Physical and Rehabilitation Medicine
Katherine E Savage, Christina V Oleson, Gregory D Schroeder, Gursukhman S Sidhu, Alexander R Vaccaro
STUDY DESIGN: Systematic review. OBJECTIVE: To determine the incidence, pathogenesis, and clinical outcomes related to neurogenic fevers following traumatic spinal cord injury (SCI). METHODS: A systematic review of the literature was performed on thermodysregulation secondary to acute traumatic SCI in adult patients. A literature search was performed using PubMed (MEDLINE), Cochrane Central Register of Controlled Trials, and Scopus. Using strict inclusion and exclusion criteria, seven relevant articles were obtained...
September 2016: Global Spine Journal
William Clark, Paul Bird, Peter Gonski, Terrence H Diamond, Peter Smerdely, H Patrick McNeil, Glen Schlaphoff, Carl Bryant, Elizabeth Barnes, Val Gebski
BACKGROUND: We hypothesised that vertebroplasty provides effective analgesia for patients with poorly controlled pain and osteoporotic spinal fractures of less than 6 weeks' duration. The effectiveness of vertebroplasty, using an adequate vertebral fill technique, in fractures of less than 6 weeks' duration has not been specifically assessed by previously published masked trials. METHODS: This was a multicentre, randomised, double-blind, placebo-controlled trial of vertebroplasty in four hospitals in Sydney, Australia...
October 1, 2016: Lancet
Joanne O'Connor, Dorothy McCaughan, Catriona McDaid, Alison Booth, Debra Fayter, Roccio Rodriguez-Lopez, Roy Bowers, Lisa Dyson, Cynthia P Iglesias, Simon Lalor, Rory J O'Connor, Margaret Phillips, Gita Ramdharry
BACKGROUND: Patients who have knee instability that is associated with neuromuscular disease (NMD) and central nervous system (CNS) conditions can be treated using orthoses, such as knee-ankle-foot orthoses (KAFOs). OBJECTIVES: To assess existing evidence on the effectiveness of orthoses; patient perspectives; types of orthotic devices prescribed in the UK NHS; and associated costs. METHODS: Qualitative study of views of orthoses users - a qualitative in-depth interview study was undertaken...
July 2016: Health Technology Assessment: HTA
Dennis G Dyck, Douglas L Weeks, Sarah Gross, Crystal Lederhos Smith, Hilary A Lott, Aimee J Wallace, Sonya M Wood
BACKGROUND: Over 12,000 individuals suffer a spinal cord injury (SCI) annually in the United States, necessitating long-term, complex adjustments and responsibilities for patients and their caregivers. Despite growing evidence that family education and support improves the management of chronic conditions for care recipients as well as caregiver outcomes, few systematic efforts have been made to involve caregivers in psycho-educational interventions for SCI. As a result, a serious gap exists in accumulated knowledge regarding effective, family-based treatment strategies for improving outcomes for individuals with SCI and their caregivers...
2016: BMC Psychology
Ana Maria Munteanu, Simona Cionac Florescu, Denisa Madalina Anastase, Cristian Ioan Stoica
BACKGROUND: Optimal postoperative analgesia is a challenge for the anaesthesiologist, with the ideal combination of methods, drugs, doses and timing of administration still the subject of research. The COX-2 inhibitors are a class of NSAIDs that may provide useful perioperative analgesia but the optimal timing of administration has not been elucidated. OBJECTIVE: We hypothesised that etoricoxib given 1 h before total knee arthroplasty under spinal anaesthesia will decrease the cumulative dose of intravenous and subcutaneous morphine required to maintain pain intensity of 3 or less on a 10-point numerical rating scale (NRS) during the first postoperative 48 h compared with the same dose of etoricoxib given after surgery...
November 2016: European Journal of Anaesthesiology
Setsuro Ogawa, Akio Arakawa, Kazuhiro Hayakawa, Tamotsu Yoshiyama
BACKGROUND AND OBJECTIVE: Limited research exists to support the extrapolation of the analgesic efficacy of pregabalin from one neuropathic pain condition to another. This retrospective analysis evaluated similarities in the efficacy of pregabalin for treating neuropathic pain associated with post-herpetic neuralgia (PHN), diabetic peripheral neuropathy (DPN), and spinal cord injury (SCI) in a Japanese population, as a basis for considering the extrapolation of these data to other neuropathic pain conditions...
July 22, 2016: Clinical Drug Investigation
Hiroko Matsumoto, Brendan Williams, Howard Y Park, Julie Y Yoshimachi, Benjamin D Roye, David P Roye, Behrooz A Akbarnia, John Emans, David Skaggs, John T Smith, Michael G Vitale
INTRODUCTION: The goal of early-onset scoliosis (EOS) treatment is to improve health-related quality of life (HRQoL) for patients and to reduce the burden on their parents or caregivers. The purpose of this study is to develop and finalize the 24-item Early-Onset Scoliosis Questionnaire (EOSQ-24), and examine the validity, reliability, and responsiveness of the EOSQ-24 in measuring patients' HRQoL, the burden on their caregivers, and the burden on their caregiver's finances. The study also established aged-matched normative values for the EOSQ-24...
June 13, 2016: Journal of Pediatric Orthopedics
Linda Hanson, Mitchell Haas, Gert Bronfort, Darcy Vavrek, Craig Schulz, Brent Leininger, Roni Evans, Leslie Takaki, Moni Neradilek
BACKGROUND: Cervicogenic headache is a prevalent and costly pain condition commonly treated by chiropractors. There is evidence to support the effectiveness for spinal manipulation, but the dose of treatment required to achieve maximal relief remains unknown. The purpose of this paper is to describe the methodology for a randomized controlled trial evaluating the dose-response of spinal manipulation for chronic cervicogenic headache in an adult population. METHODS/DESIGN: This is a mixed-methods, two-site, prospective, parallel groups, observer-blind, randomized controlled trial conducted at university-affiliated research clinics in the Portland, OR and Minneapolis, MN areas...
2016: Chiropractic & Manual Therapies
Kevin D'Angelo, John J Triano, Gregory N Kawchuk, Samuel J Howarth
STUDY DESIGN: An in vivo biomechanical study OBJECTIVE.: . The aim of the present study was to quantify and compare the reaction loads for two spinal manipulation therapy (SMT) procedures commonly used for low back pain using a biomechanical computer model. SUMMARY OF BACKGROUND DATA: Contemporary computer-driven rigid linked-segment models (LSMs) have made it feasible to analyze low back kinetics and kinematics during various activities including spinal manipulation therapy (SMT) procedures...
June 6, 2016: Spine
Susan Charlifue, Denise Tate, Fin Biering-Sorensen, Stephen Burns, Yuying Chen, Sophia Chun, Lyn B Jakeman, Robert G Kowalski, Vanessa K Noonan, Philip Ullrich
The objectives of this article are to (1) provide an overview of existing spinal cord injury (SCI) clinical research databases-their purposes, characteristics, and accessibility to users; and (2) present a vision for future collaborations required for cross-cutting research in SCI. This vision highlights the need for validated and relevant data for longitudinal clinical trials and observational and epidemiologic SCI-related studies. Three existing SCI clinical research databases/registries are reviewed and summarized with regard to current formats, collection methods, and uses, including major strengths and weaknesses...
October 2016: Archives of Physical Medicine and Rehabilitation
Peter Abraham, Robert C Rennert, Joel R Martin, Joseph Ciacci, William Taylor, Daniel Resnick, Ekkehard Kasper, Clark C Chen
Low back pain (LBP) is a common medical problem with high morbidity and healthcare costs. The optimal management strategy, including the role of surgical intervention, remains controversial. The Spine Patient Outcomes Research Trials were randomized controlled studies conducted to assess the effectiveness of surgery for three of the most common conditions implicated in LBP: Intervertebral disc herniation, degenerative spondylolisthesis, and spinal stenosis. Despite challenges in data interpretation related to patient cross over, these studies support the efficacy of surgery as treatment for these three common conditions...
2016: Surgical Neurology International
Kameshwar Prasad, Mamta B Singh, Hannah Ryan
BACKGROUND: Tuberculous meningitis is a serious form of tuberculosis (TB) that affects the meninges that cover a person's brain and spinal cord. It is associated with high death rates and with disability in people who survive. Corticosteroids have been used as an adjunct to antituberculous drugs to treat people with tuberculous meningitis, but their role has been controversial. OBJECTIVES: To evaluate the effects of corticosteroids as an adjunct to antituberculous treatment on death and severe disability in people with tuberculous meningitis...
April 28, 2016: Cochrane Database of Systematic Reviews
Shahin Hajibandeh, Shahab Hajibandeh, Stavros A Antoniou, Francesco Torella, George A Antoniou
BACKGROUND: Controversy exists as to whether revascularisation of the left subclavian artery (LSA) confers improved outcomes in patients undergoing thoracic endovascular aortic repair (TEVAR). Even though preemptive revascularisation of the LSA has theoretical advantages, including a reduced risk of ischaemic damage to vital organs, such as the brain and the spinal cord, it is not without risks. Current practice guidelines recommend routine revascularisation of the LSA in patients undergoing elective TEVAR where achievement of a proximal seal necessitates coverage of the LSA, and in patients who have an anatomy that compromises perfusion to critical organs...
2016: Cochrane Database of Systematic Reviews
Shannon R Hinson, Vanda A Lennon, Sean J Pittock
Neuromyelitis optica (NMO) spectrum disorders (SD) represent an evolving group of central nervous system (CNS)-inflammatory autoimmune demyelinating diseases unified by a pathogenic autoantibody specific for the aquaporin-4 (AQP4) water channel. It was historically misdiagnosed as multiple sclerosis (MS), which lacks a distinguishing biomarker. The discovery of AQP4-IgG moved the focus of CNS demyelinating disease research from emphasis on the oligodendrocyte and myelin to the astrocyte. NMO is recognized today as a relapsing disease, extending beyond the optic nerves and spinal cord to include brain (especially in children) and skeletal muscle...
2016: Handbook of Clinical Neurology
Peter Försth, Gylfi Ólafsson, Thomas Carlsson, Anders Frost, Fredrik Borgström, Peter Fritzell, Patrik Öhagen, Karl Michaëlsson, Bengt Sandén
BACKGROUND: The efficacy of fusion surgery in addition to decompression surgery in patients who have lumbar spinal stenosis, with or without degenerative spondylolisthesis, has not been substantiated in controlled trials. METHODS: We randomly assigned 247 patients between 50 and 80 years of age who had lumbar spinal stenosis at one or two adjacent vertebral levels to undergo either decompression surgery plus fusion surgery (fusion group) or decompression surgery alone (decompression-alone group)...
April 14, 2016: New England Journal of Medicine
Jose L Contreras-Vidal, Nikunj A Bhagat, Justin Brantley, Jesus G Cruz-Garza, Yongtian He, Quinn Manley, Sho Nakagome, Kevin Nathan, Su H Tan, Fangshi Zhu, Jose L Pons
OBJECTIVE: Powered exoskeletons promise to increase the quality of life of people with lower-body paralysis or weakened legs by assisting or restoring legged mobility while providing health benefits across multiple physiological systems. Here, a systematic review of the literature on powered exoskeletons addressed critical questions: What is the current evidence of clinical efficacy for lower-limb powered exoskeletons? What are the benefits and risks for individuals with spinal cord injury (SCI)? What are the levels of injury considered in such studies? What are their outcome measures? What are the opportunities for the next generation exoskeletons? APPROACH: A systematic search of online databases was performed to identify clinical trials and safety or efficacy studies with lower-limb powered exoskeletons for individuals with SCI...
June 2016: Journal of Neural Engineering
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