Study design: Guideline adaptation study using the ADAPTE method.
Objective: The aim of this study was the development and validation of a Danish clinical practice guideline for PU/PI prevention and treatment for people with SCI through adaptation of existing guidelines.
Methods: The ADAPTE method is a systematic framework used to adapt existing clinical practice guidelines to a new context, such as a different healthcare setting or population. This method ensures that the adapted guidelines are relevant, evidence-based, and practical for the specific context in which they will be implemented.
Setting: Relevant stakeholders and treatment units within the Danish healthcare system involved in the rehabilitation, treatment, and care of people with SCI.
Results: The adaptation yielded 22 topics and 121 recommendations, which underwent external review. Stakeholders gave positive feedback and qualified the recommendations. However, they also highlighted challenges in implementation due to the complexity of PU/PI prevention and treatment and organizational issues within the Danish healthcare system.
Conclusions: This study has resulted in the development of a comprehensive Danish clinical practice guideline tailored specifically for the prevention and treatment of PU/PI among people with SCI within the Danish healthcare system. The external review emphasizes the imperative for continuous research aimed at strengthening evidence-based approaches to both prevention and treatment. Furthermore, it highlights the necessity for systematic dissemination strategies to facilitate the integration of the guideline into clinical practice.
{"title":"Development of a clinical practice guideline on pressure ulcers in people with spinal cord injuries inspired by the ADAPTE method.","authors":"Knaerke Soegaard, Dimitri Beeckman, Sofie Verhaeghe, Fin Biering-Sørensen, Jens Ahm Sørensen","doi":"10.1038/s41393-024-01051-z","DOIUrl":"https://doi.org/10.1038/s41393-024-01051-z","url":null,"abstract":"<p><strong>Study design: </strong>Guideline adaptation study using the ADAPTE method.</p><p><strong>Objective: </strong>The aim of this study was the development and validation of a Danish clinical practice guideline for PU/PI prevention and treatment for people with SCI through adaptation of existing guidelines.</p><p><strong>Methods: </strong>The ADAPTE method is a systematic framework used to adapt existing clinical practice guidelines to a new context, such as a different healthcare setting or population. This method ensures that the adapted guidelines are relevant, evidence-based, and practical for the specific context in which they will be implemented.</p><p><strong>Setting: </strong>Relevant stakeholders and treatment units within the Danish healthcare system involved in the rehabilitation, treatment, and care of people with SCI.</p><p><strong>Results: </strong>The adaptation yielded 22 topics and 121 recommendations, which underwent external review. Stakeholders gave positive feedback and qualified the recommendations. However, they also highlighted challenges in implementation due to the complexity of PU/PI prevention and treatment and organizational issues within the Danish healthcare system.</p><p><strong>Conclusions: </strong>This study has resulted in the development of a comprehensive Danish clinical practice guideline tailored specifically for the prevention and treatment of PU/PI among people with SCI within the Danish healthcare system. The external review emphasizes the imperative for continuous research aimed at strengthening evidence-based approaches to both prevention and treatment. Furthermore, it highlights the necessity for systematic dissemination strategies to facilitate the integration of the guideline into clinical practice.</p>","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142802286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Retrospective study. To investigate the outcomes and influencing factors of tracheostomy decannulation (TD) in persons with traumatic cervical spinal cord injury (SCI). China Rehabilitation Research Center (CRRC) in Beijing, China. From January 2017 to December 2021, 365 persons with traumatic cervical SCI were admitted to the China Rehabilitation Research Center. During hospitalization, tracheostomy patients were enrolled and divided into the TD group and non-TD group. Demographic and clinical data, as well as functional assessments, were collected and recorded for all persons. The factors influencing TD were analyzed using both univariate and multivariate logistic regression. A total of 78 persons with traumatic cervical SCI from CRRC were enrolled in this study. Of these, 48 persons (61.5%) underwent successful decannulation, with a median time of 93.5 days (IQR: 62.0–143.8 days). Multivariate logistic regression revealed that AIS A (P = 0.021, OR: 5.378, 95% CI, 1.287–22.474) and Charlson comorbidity index (CCI) (P = 0.003, OR: 1.836, 95% CI, 1.230–2.740) were significant risk factors of reduced success in TD. PEF in the TD group was 145.44 ± 50.56 L/min. Middle-aged and young persons with traumatic cervical SCI at C3 to C5 neurological level did not satisfy the criterion of PEF (over 160 L/min), but they can still attempt tracheostomy decannulation. AIS A and a high CCI will reduce the success rate of tracheostomy decannulation in persons suffering from traumatic cervical SCI.
{"title":"The influencing factors for tracheostomy decannulation after traumatic cervical spinal cord injury: a retrospective study","authors":"Yongqi Xie, Weichao Zhao, Run Peng, Liang Zhang, Yunxiao Jia, Mingliang Yang, Lianjun Gao","doi":"10.1038/s41393-024-01048-8","DOIUrl":"10.1038/s41393-024-01048-8","url":null,"abstract":"Retrospective study. To investigate the outcomes and influencing factors of tracheostomy decannulation (TD) in persons with traumatic cervical spinal cord injury (SCI). China Rehabilitation Research Center (CRRC) in Beijing, China. From January 2017 to December 2021, 365 persons with traumatic cervical SCI were admitted to the China Rehabilitation Research Center. During hospitalization, tracheostomy patients were enrolled and divided into the TD group and non-TD group. Demographic and clinical data, as well as functional assessments, were collected and recorded for all persons. The factors influencing TD were analyzed using both univariate and multivariate logistic regression. A total of 78 persons with traumatic cervical SCI from CRRC were enrolled in this study. Of these, 48 persons (61.5%) underwent successful decannulation, with a median time of 93.5 days (IQR: 62.0–143.8 days). Multivariate logistic regression revealed that AIS A (P = 0.021, OR: 5.378, 95% CI, 1.287–22.474) and Charlson comorbidity index (CCI) (P = 0.003, OR: 1.836, 95% CI, 1.230–2.740) were significant risk factors of reduced success in TD. PEF in the TD group was 145.44 ± 50.56 L/min. Middle-aged and young persons with traumatic cervical SCI at C3 to C5 neurological level did not satisfy the criterion of PEF (over 160 L/min), but they can still attempt tracheostomy decannulation. AIS A and a high CCI will reduce the success rate of tracheostomy decannulation in persons suffering from traumatic cervical SCI.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"63 1","pages":"43-48"},"PeriodicalIF":2.1,"publicationDate":"2024-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142676825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-15DOI: 10.1038/s41393-024-01049-7
Mucahit Atasoy, Eser Kalaoglu, Omer Faruk Bucak, Evrim Coskun
Survey study To understand the priorities and expectations of individuals with disabilities caused by spinal cord injuries(SCI) who require long-term inpatient rehabilitation at a rehabilitation hospital. Başakşehir Çam and Sakura City Hospital, İstanbul, Türkiye This cross-sectional clinical study included individuals over the age of 18 with SCI who had previously been hospitalized in a rehabilitation hospital. The 18-question survey, titled “What should a rehabilitation hospital be like according to persons with spinal cord injuries?” was administered to individuals hospitalized in the inpatient service of Çam Sakura City Hospital. It was also disseminated to people with SCI through social media. The participants’ demographic data was recorded. The survey was completed by 120 participants, comprising 70 males and 50 females. The mean age was 37.47 ± 11.63 years. The time since the SCI was less than one year for 20 individuals and more than one year for 100 individuals. The results showed that robotic rehabilitation and psychological support were the most requested rehabilitation domains, while interest in sexual rehabilitation was less than that in other rehabilitation domains. Furthermore, in the correlation analysis, elderly participants indicated that there should be more specialized services and outpatient clinics exclusive to the SCI. The study revealed a striking trend – participants expressed a strong desire for SCI-specific rehabilitation units and robotic rehabilitation. Additionally, the significance and necessity of sexual rehabilitation should be conveyed to people with SCI.
{"title":"“What should a rehabilitation hospital be like?” Priorities and expectations of people with spinal cord injury in Türkiye","authors":"Mucahit Atasoy, Eser Kalaoglu, Omer Faruk Bucak, Evrim Coskun","doi":"10.1038/s41393-024-01049-7","DOIUrl":"10.1038/s41393-024-01049-7","url":null,"abstract":"Survey study To understand the priorities and expectations of individuals with disabilities caused by spinal cord injuries(SCI) who require long-term inpatient rehabilitation at a rehabilitation hospital. Başakşehir Çam and Sakura City Hospital, İstanbul, Türkiye This cross-sectional clinical study included individuals over the age of 18 with SCI who had previously been hospitalized in a rehabilitation hospital. The 18-question survey, titled “What should a rehabilitation hospital be like according to persons with spinal cord injuries?” was administered to individuals hospitalized in the inpatient service of Çam Sakura City Hospital. It was also disseminated to people with SCI through social media. The participants’ demographic data was recorded. The survey was completed by 120 participants, comprising 70 males and 50 females. The mean age was 37.47 ± 11.63 years. The time since the SCI was less than one year for 20 individuals and more than one year for 100 individuals. The results showed that robotic rehabilitation and psychological support were the most requested rehabilitation domains, while interest in sexual rehabilitation was less than that in other rehabilitation domains. Furthermore, in the correlation analysis, elderly participants indicated that there should be more specialized services and outpatient clinics exclusive to the SCI. The study revealed a striking trend – participants expressed a strong desire for SCI-specific rehabilitation units and robotic rehabilitation. Additionally, the significance and necessity of sexual rehabilitation should be conveyed to people with SCI.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"63 1","pages":"38-42"},"PeriodicalIF":2.1,"publicationDate":"2024-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142639644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1038/s41393-024-01046-w
Teodora Bojanic, Euan J. McCaughey, Harrison T. Finn, Peter Humburg, Rachel A. McBain, Bonsan B. Lee, Simon C. Gandevia, Claire L. Boswell-Ruys, Jane E. Butler
Single centre training study. To investigate, in a group of people with spinal cord injury (SCI), the effect of transcutaneous functional electrical stimulation of the abdominal muscles (abdominal FES) during cough training on blood pressure (BP), and how it is affected by injury characteristics and alters over time. Laboratory and community. Sixteen participants with SCI (C4-T5) underwent 25 of abdominal FES cough training (5 sets of 10 stimulated coughs) over 6 weeks as part of a previously published study on the effect of abdominal FES training on cough. Systolic BP (SBP), diastolic BP (DBP) and calculated mean arterial pressure (MAP) were measured at the completion of each set. Abdominal FES coughing resulted in an average ~30% acute increase in BP from initial resting BP across all sessions in almost all participants (p < 0.001). However, the increase in BP during abdominal FES coughs from rest reduced over the 25 sessions of training by ~35% for SBP, MAP and DBP (p = 0.024, p = 0.013 and p = 0.042, respectively). There was no meaningful change in resting BP over time (p = 0.935, p = 0.705 and p = 0.988, respectively). Overall, increases in BP during abdominal FES coughs were greatest for those with chronic injuries and cervical injuries. Transcutaneous abdominal FES during cough training acutely increases BP. However, the magnitude of the increase is reduced after 25 sessions of training. Abdominal FES may offer a solution to combat orthostatic hypotension, but its effectiveness may diminish over time.
{"title":"The effect of abdominal functional electrical stimulation on blood pressure in people with high level spinal cord injury","authors":"Teodora Bojanic, Euan J. McCaughey, Harrison T. Finn, Peter Humburg, Rachel A. McBain, Bonsan B. Lee, Simon C. Gandevia, Claire L. Boswell-Ruys, Jane E. Butler","doi":"10.1038/s41393-024-01046-w","DOIUrl":"10.1038/s41393-024-01046-w","url":null,"abstract":"Single centre training study. To investigate, in a group of people with spinal cord injury (SCI), the effect of transcutaneous functional electrical stimulation of the abdominal muscles (abdominal FES) during cough training on blood pressure (BP), and how it is affected by injury characteristics and alters over time. Laboratory and community. Sixteen participants with SCI (C4-T5) underwent 25 of abdominal FES cough training (5 sets of 10 stimulated coughs) over 6 weeks as part of a previously published study on the effect of abdominal FES training on cough. Systolic BP (SBP), diastolic BP (DBP) and calculated mean arterial pressure (MAP) were measured at the completion of each set. Abdominal FES coughing resulted in an average ~30% acute increase in BP from initial resting BP across all sessions in almost all participants (p < 0.001). However, the increase in BP during abdominal FES coughs from rest reduced over the 25 sessions of training by ~35% for SBP, MAP and DBP (p = 0.024, p = 0.013 and p = 0.042, respectively). There was no meaningful change in resting BP over time (p = 0.935, p = 0.705 and p = 0.988, respectively). Overall, increases in BP during abdominal FES coughs were greatest for those with chronic injuries and cervical injuries. Transcutaneous abdominal FES during cough training acutely increases BP. However, the magnitude of the increase is reduced after 25 sessions of training. Abdominal FES may offer a solution to combat orthostatic hypotension, but its effectiveness may diminish over time.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"63 1","pages":"31-37"},"PeriodicalIF":2.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41393-024-01046-w.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142565091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-30DOI: 10.1038/s41393-024-01047-9
Elina Johansson, Eerika Koskinen, Mika Helminen, Aki Vainionpää, Teemu M. Luoto
Prospective cohort study. To study the mortality rates of TSCI patients compared to matched controls and to examine possible TSCI-related mortality risk factors and causes of death. Oulu and Tampere University Hospital, Finland. All consecutive patients with a new TSCI were included in a prospective study (n = 344, 2012-16). All patients were followed until death or the end of 2019. Patients were compared to a control group formed by randomly choosing gender, age, municipality, and calendar time-matched controls (5 controls/TSCI patient). Standardized mortality ratios (SMR) were calculated using general population mortality rates. Mortality information was extracted from the Statistics of Finland (Helsinki, Finland). TSCI patients had an increased mortality (SMR = 2.9) compared with the Finnish population. During the observation period, 26% of TSCI patients and 12% of the matched controls died. Of the TSCI patient deaths, 51% occurred within the first two years postinjury. Increased age, severity of TSCI (as per International SCI Core Data Set) and fall were related to mortality (p < 0.05). The two most common etiologies of death were: circulatory (30%), and pulmonary diseases (28%). Pneumonia was the single most frequent disease leading to death among TSCI patients. During the first years after injury, the mortality of the patients with TSCI is double compared to the controls. Most deaths occur within two years postinjury. Elderly patients with more severe fall-related injury have the highest mortality risk. Circulatory diseases and pulmonary diseases, especially pneumonia, are the foremost causes of death after TSCI.
{"title":"Mortality and causes of death of traumatic spinal cord injury in Finland","authors":"Elina Johansson, Eerika Koskinen, Mika Helminen, Aki Vainionpää, Teemu M. Luoto","doi":"10.1038/s41393-024-01047-9","DOIUrl":"10.1038/s41393-024-01047-9","url":null,"abstract":"Prospective cohort study. To study the mortality rates of TSCI patients compared to matched controls and to examine possible TSCI-related mortality risk factors and causes of death. Oulu and Tampere University Hospital, Finland. All consecutive patients with a new TSCI were included in a prospective study (n = 344, 2012-16). All patients were followed until death or the end of 2019. Patients were compared to a control group formed by randomly choosing gender, age, municipality, and calendar time-matched controls (5 controls/TSCI patient). Standardized mortality ratios (SMR) were calculated using general population mortality rates. Mortality information was extracted from the Statistics of Finland (Helsinki, Finland). TSCI patients had an increased mortality (SMR = 2.9) compared with the Finnish population. During the observation period, 26% of TSCI patients and 12% of the matched controls died. Of the TSCI patient deaths, 51% occurred within the first two years postinjury. Increased age, severity of TSCI (as per International SCI Core Data Set) and fall were related to mortality (p < 0.05). The two most common etiologies of death were: circulatory (30%), and pulmonary diseases (28%). Pneumonia was the single most frequent disease leading to death among TSCI patients. During the first years after injury, the mortality of the patients with TSCI is double compared to the controls. Most deaths occur within two years postinjury. Elderly patients with more severe fall-related injury have the highest mortality risk. Circulatory diseases and pulmonary diseases, especially pneumonia, are the foremost causes of death after TSCI.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"63 1","pages":"24-30"},"PeriodicalIF":2.1,"publicationDate":"2024-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41393-024-01047-9.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142547551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-28DOI: 10.1038/s41393-024-01043-z
Meriç Selim ŞİPAL
{"title":"Correspondence to “Walking improvement in chronic incomplete spinal cord injury with exoskeleton robotic training (WISE): a randomized controlled trial”","authors":"Meriç Selim ŞİPAL","doi":"10.1038/s41393-024-01043-z","DOIUrl":"10.1038/s41393-024-01043-z","url":null,"abstract":"","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"62 12","pages":"721-722"},"PeriodicalIF":2.1,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523116","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-28DOI: 10.1038/s41393-024-01044-y
D. J. Edwards, A. Jayaraman
{"title":"Response: Use of the WISCI-II score in assessing outcome of intensive robot-assisted gait training in spinal cord injury","authors":"D. J. Edwards, A. Jayaraman","doi":"10.1038/s41393-024-01044-y","DOIUrl":"10.1038/s41393-024-01044-y","url":null,"abstract":"","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"62 12","pages":"675-675"},"PeriodicalIF":2.1,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41393-024-01044-y.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142523117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-26DOI: 10.1038/s41393-024-01045-x
Jeanne M. Zanca, Carol M. Gibson-Gill, Joyce Williams, Tomicka McMillion, John T. Morris, Marcel P. Dijkers
Qualitative analysis of focus group data. Identifying barriers to and facilitators of learning to direct one’s own care as a person with tetraplegia due to spinal cord injury (SCI). Community, in New Jersey and Georgia, USA. Three focus groups of veterans and civilians with SCI, involving 26 people with chronic (≥1 year) tetraplegia due to SCI who provided direction to caregivers on a daily basis. Content analysis was used to identify barriers and facilitators. Challenges to learning to direct one’s care included: (1) lack of acceptance of lasting effects of SCI; (2) not yet understanding one’s body post-SCI; (3) embarrassment; (4) being overwhelmed with information; (5) differences between the inpatient rehabilitation setting and the “real world”; (6) lack of capable and willing assistants; and (7) hesitance to criticize caregivers. Factors that helped participants become successful directors of care included: (1) experience living with SCI; (2) being observant; (3) communicating effectively; (4) developing confidence to advocate for one’s own needs; (5) learning when to “let go” and when to speak up; and (6) learning from peers. Direction of care is a complex skill that is developed over time, and requires awareness of one’s needs and preferences, self-confidence, and strong communication skills. Rehabilitation clinicians’ efforts to prepare people with SCI to direct their own care effectively should cultivate awareness of one’s body, identify strategies for communicating successfully with caregivers, and provide opportunities for practice of care direction skills and discussion with experienced peers.
{"title":"Learning to direct one’s care: barriers and facilitators reported by people with tetraplegia","authors":"Jeanne M. Zanca, Carol M. Gibson-Gill, Joyce Williams, Tomicka McMillion, John T. Morris, Marcel P. Dijkers","doi":"10.1038/s41393-024-01045-x","DOIUrl":"10.1038/s41393-024-01045-x","url":null,"abstract":"Qualitative analysis of focus group data. Identifying barriers to and facilitators of learning to direct one’s own care as a person with tetraplegia due to spinal cord injury (SCI). Community, in New Jersey and Georgia, USA. Three focus groups of veterans and civilians with SCI, involving 26 people with chronic (≥1 year) tetraplegia due to SCI who provided direction to caregivers on a daily basis. Content analysis was used to identify barriers and facilitators. Challenges to learning to direct one’s care included: (1) lack of acceptance of lasting effects of SCI; (2) not yet understanding one’s body post-SCI; (3) embarrassment; (4) being overwhelmed with information; (5) differences between the inpatient rehabilitation setting and the “real world”; (6) lack of capable and willing assistants; and (7) hesitance to criticize caregivers. Factors that helped participants become successful directors of care included: (1) experience living with SCI; (2) being observant; (3) communicating effectively; (4) developing confidence to advocate for one’s own needs; (5) learning when to “let go” and when to speak up; and (6) learning from peers. Direction of care is a complex skill that is developed over time, and requires awareness of one’s needs and preferences, self-confidence, and strong communication skills. Rehabilitation clinicians’ efforts to prepare people with SCI to direct their own care effectively should cultivate awareness of one’s body, identify strategies for communicating successfully with caregivers, and provide opportunities for practice of care direction skills and discussion with experienced peers.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"63 1","pages":"16-23"},"PeriodicalIF":2.1,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142508287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-14DOI: 10.1038/s41393-024-01041-1
Alisha W. Sial, Stone Sima, Rajpal Narulla, Nashwa Najib, Mark Davies, Ashish D. Diwan
Degenerative Cervical Myelopathy (DCM) is a chronic progressive condition of the cervical spine that leads to compression of the spinal cord. It is the most common cause of spinal cord dysfunction in adults, and it occurs due to age-related changes or genetically associated pathologies. DCM is a clinical and radiological diagnosis and presents with a spectrum of symptoms ranging from neck pain and stiffness to paralysis. While neck pain is prevalent amongst patients attending specialist clinics, its predictive value for DCM is limited. This paper focuses on elucidating the relationship between DCM and chronic neck pain, and we discuss the underlying aetiology and broader neurological implications in the context of the literature. The progression of DCM can be slow and insidious with symptoms worsening gradually over time. Neck pain should not be discounted in the evaluation of DCM.
{"title":"Is neck pain a marker for something serious? Like myelopathy","authors":"Alisha W. Sial, Stone Sima, Rajpal Narulla, Nashwa Najib, Mark Davies, Ashish D. Diwan","doi":"10.1038/s41393-024-01041-1","DOIUrl":"10.1038/s41393-024-01041-1","url":null,"abstract":"Degenerative Cervical Myelopathy (DCM) is a chronic progressive condition of the cervical spine that leads to compression of the spinal cord. It is the most common cause of spinal cord dysfunction in adults, and it occurs due to age-related changes or genetically associated pathologies. DCM is a clinical and radiological diagnosis and presents with a spectrum of symptoms ranging from neck pain and stiffness to paralysis. While neck pain is prevalent amongst patients attending specialist clinics, its predictive value for DCM is limited. This paper focuses on elucidating the relationship between DCM and chronic neck pain, and we discuss the underlying aetiology and broader neurological implications in the context of the literature. The progression of DCM can be slow and insidious with symptoms worsening gradually over time. Neck pain should not be discounted in the evaluation of DCM.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"62 12","pages":"718-720"},"PeriodicalIF":2.1,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41393-024-01041-1.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142475183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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