Pub Date : 2024-04-16DOI: 10.1038/s41393-024-00993-8
Marc Hohenhaus, Jan-Helge Klingler, Christoph Scholz, Ralf Watzlawick, Ulrich Hubbe, Jürgen Beck, Marco Reisert, Urs Würtemberger, Nico Kremers, Katharina Wolf
Prospective diagnostic study. Anatomical evaluation and graduation of the severity of spinal stenosis is essential in degenerative cervical spine disease. In clinical practice, this is subjectively categorized on cervical MRI lacking an objective and reliable classification. We implemented a fully-automated quantification of spinal canal compromise through 3D T2-weighted MRI segmentation. Medical Center - University of Freiburg, Germany. Evaluation of 202 participants receiving 3D T2-weighted MRI of the cervical spine. Segments C2/3 to C6/7 were analyzed for spinal cord and cerebrospinal fluid space volume through a fully-automated segmentation based on a trained deep convolutional neural network. Spinal canal narrowing was characterized by relative values, across sever segments as adapted Maximal Canal Compromise (aMCC), and within the index segment as adapted Spinal Cord Occupation Ratio (aSCOR). Additionally, all segments were subjectively categorized by three observers as “no”, “relative” or “absolute” stenosis. Computed scores were applied on the subjective categorization. 798 (79.0%) segments were subjectively categorized as “no” stenosis, 85 (8.4%) as “relative” stenosis, and 127 (12.6%) as “absolute” stenosis. The calculated scores revealed significant differences between each category (p ≤ 0.001). Youden’s Index analysis of ROC curves revealed optimal cut-offs to distinguish between “no” and “relative” stenosis for aMCC = 1.18 and aSCOR = 36.9%, and between “relative” and “absolute” stenosis for aMCC = 1.54 and aSCOR = 49.3%. The presented fully-automated segmentation algorithm provides high diagnostic accuracy and objective classification of cervical spinal stenosis. The calculated cut-offs can be used for convenient radiological quantification of the severity of spinal canal compromise in clinical routine.
{"title":"Quantification of cervical spinal stenosis by automated 3D MRI segmentation of spinal cord and cerebrospinal fluid space","authors":"Marc Hohenhaus, Jan-Helge Klingler, Christoph Scholz, Ralf Watzlawick, Ulrich Hubbe, Jürgen Beck, Marco Reisert, Urs Würtemberger, Nico Kremers, Katharina Wolf","doi":"10.1038/s41393-024-00993-8","DOIUrl":"10.1038/s41393-024-00993-8","url":null,"abstract":"Prospective diagnostic study. Anatomical evaluation and graduation of the severity of spinal stenosis is essential in degenerative cervical spine disease. In clinical practice, this is subjectively categorized on cervical MRI lacking an objective and reliable classification. We implemented a fully-automated quantification of spinal canal compromise through 3D T2-weighted MRI segmentation. Medical Center - University of Freiburg, Germany. Evaluation of 202 participants receiving 3D T2-weighted MRI of the cervical spine. Segments C2/3 to C6/7 were analyzed for spinal cord and cerebrospinal fluid space volume through a fully-automated segmentation based on a trained deep convolutional neural network. Spinal canal narrowing was characterized by relative values, across sever segments as adapted Maximal Canal Compromise (aMCC), and within the index segment as adapted Spinal Cord Occupation Ratio (aSCOR). Additionally, all segments were subjectively categorized by three observers as “no”, “relative” or “absolute” stenosis. Computed scores were applied on the subjective categorization. 798 (79.0%) segments were subjectively categorized as “no” stenosis, 85 (8.4%) as “relative” stenosis, and 127 (12.6%) as “absolute” stenosis. The calculated scores revealed significant differences between each category (p ≤ 0.001). Youden’s Index analysis of ROC curves revealed optimal cut-offs to distinguish between “no” and “relative” stenosis for aMCC = 1.18 and aSCOR = 36.9%, and between “relative” and “absolute” stenosis for aMCC = 1.54 and aSCOR = 49.3%. The presented fully-automated segmentation algorithm provides high diagnostic accuracy and objective classification of cervical spinal stenosis. The calculated cut-offs can be used for convenient radiological quantification of the severity of spinal canal compromise in clinical routine.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"62 7","pages":"371-377"},"PeriodicalIF":2.1,"publicationDate":"2024-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41393-024-00993-8.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140561965","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 : 2024-04-12DOI: 10.1038/s41393-024-00994-7
Kathryn Burns, Ryan Solinsky
Cross-sectional study. Determine how well common clinical assessments of level and completeness of injury are correlated with symptoms of autonomic blood pressure instability and secondary medical complications after spinal cord injury (SCI). Academic medical center, United States. Eighty-two individuals with (n = 48) and without (n = 34) SCI had symptoms of autonomic blood pressure instability quantified with the Autonomic Dysfunction Following SCI (ADFSCI) survey. Health histories quantified the secondary medical complications through number of urinary tract infections and hospitalizations in the past year, time to complete bowel program, and lifetime pressure injuries. Regression models were completed to identify strengths of associated correlations. ADFSCI scores were significantly higher in individuals with SCI than controls. Neurological level of injury and ASIA impairment scale were both minimally correlated to symptoms of autonomic blood pressure instability, accounting for only 11.5% of variability in regression models. Secondary medical complications had similar, minimal correlations to level and motor/sensory completeness of SCI (R2 = 0.07 and R2 = 0.03 respectively). Contrasting this, symptoms of blood pressure instability on ADFSCI far outperformed the common clinical motor/sensory bedside exam, with moderately strong correlations to the ranked number of secondary medical complications after SCI (R2 = 0.31). Neurological level of injury and motor/sensory completeness provided limited insights into which individuals with SCI would have blood pressure instability or secondary medical complications. Interestingly, symptoms of blood pressure instability outperform the clinical motor/sensory bedside exam, with higher correlations to secondary medical complications after SCI.
{"title":"Autonomic impairment is not explained by neurological level of injury or motor-sensory completeness","authors":"Kathryn Burns, Ryan Solinsky","doi":"10.1038/s41393-024-00994-7","DOIUrl":"10.1038/s41393-024-00994-7","url":null,"abstract":"Cross-sectional study. Determine how well common clinical assessments of level and completeness of injury are correlated with symptoms of autonomic blood pressure instability and secondary medical complications after spinal cord injury (SCI). Academic medical center, United States. Eighty-two individuals with (n = 48) and without (n = 34) SCI had symptoms of autonomic blood pressure instability quantified with the Autonomic Dysfunction Following SCI (ADFSCI) survey. Health histories quantified the secondary medical complications through number of urinary tract infections and hospitalizations in the past year, time to complete bowel program, and lifetime pressure injuries. Regression models were completed to identify strengths of associated correlations. ADFSCI scores were significantly higher in individuals with SCI than controls. Neurological level of injury and ASIA impairment scale were both minimally correlated to symptoms of autonomic blood pressure instability, accounting for only 11.5% of variability in regression models. Secondary medical complications had similar, minimal correlations to level and motor/sensory completeness of SCI (R2 = 0.07 and R2 = 0.03 respectively). Contrasting this, symptoms of blood pressure instability on ADFSCI far outperformed the common clinical motor/sensory bedside exam, with moderately strong correlations to the ranked number of secondary medical complications after SCI (R2 = 0.31). Neurological level of injury and motor/sensory completeness provided limited insights into which individuals with SCI would have blood pressure instability or secondary medical complications. Interestingly, symptoms of blood pressure instability outperform the clinical motor/sensory bedside exam, with higher correlations to secondary medical complications after SCI.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"62 7","pages":"367-370"},"PeriodicalIF":2.1,"publicationDate":"2024-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140561738","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 : 2024-04-12DOI: 10.1038/s41393-024-00986-7
Ana Clara Portela Hara, Nicole C. Aching, Lucas M. Marques, Sara P. Barbosa, Daniel R. Souza, Felipe Fregni, Linamara R. Battistella, Marcel Simis
Using a cross-sectional design, we extracted sociodemographic and clinical data from 488 Spinal Cord Injury (SCI) patients during their initial assessment before receiving intensive rehabilitation treatment. The primary objectives of this study were to ascertain the prevalence of cognitive impairment in the study sample and specify the key clinical and demographic predictors of cognitive functioning in SCI patients. Lucy Montoro Rehabilitation Institute (LMRI), University of Sao Paulo, Sao Paulo, Brazil. We utilized independent univariate and multivariate regression models with the Montreal Cognitive Assessment (MoCA) scale, adapted for individuals with visual impairment. Moreover, we consider scores from the execution tasks (visuospatial/executive) as the dependent variable. Our findings demonstrate that approximately 80% of the evaluated study sample exhibited cognitive impairment. Through the multivariate regression models, we show that several factors, including age, education, depression levels, and the use of analgesics and/or opioids, are significant predictors of total cognitive scores. These factors are independent of the clinical features associated with SCI, such as age, sex, education, and time since the injury. The results indicate a high prevalence of significant cognitive impairment within the sample, with age, education, depression levels, and the use of analgesics and/or opioids emerging as the primary predictors of total cognitive scores, independent of the clinical features correlated to SCI. These findings hold significant implications for both clinical research and practice, offering valuable guidance for comprehensive management throughout hospitalization and rehabilitation.
{"title":"The role of clinical and demographic predictors for understanding the cognitive impairment in Spinal Cord Injury (SCI) patients","authors":"Ana Clara Portela Hara, Nicole C. Aching, Lucas M. Marques, Sara P. Barbosa, Daniel R. Souza, Felipe Fregni, Linamara R. Battistella, Marcel Simis","doi":"10.1038/s41393-024-00986-7","DOIUrl":"10.1038/s41393-024-00986-7","url":null,"abstract":"Using a cross-sectional design, we extracted sociodemographic and clinical data from 488 Spinal Cord Injury (SCI) patients during their initial assessment before receiving intensive rehabilitation treatment. The primary objectives of this study were to ascertain the prevalence of cognitive impairment in the study sample and specify the key clinical and demographic predictors of cognitive functioning in SCI patients. Lucy Montoro Rehabilitation Institute (LMRI), University of Sao Paulo, Sao Paulo, Brazil. We utilized independent univariate and multivariate regression models with the Montreal Cognitive Assessment (MoCA) scale, adapted for individuals with visual impairment. Moreover, we consider scores from the execution tasks (visuospatial/executive) as the dependent variable. Our findings demonstrate that approximately 80% of the evaluated study sample exhibited cognitive impairment. Through the multivariate regression models, we show that several factors, including age, education, depression levels, and the use of analgesics and/or opioids, are significant predictors of total cognitive scores. These factors are independent of the clinical features associated with SCI, such as age, sex, education, and time since the injury. The results indicate a high prevalence of significant cognitive impairment within the sample, with age, education, depression levels, and the use of analgesics and/or opioids emerging as the primary predictors of total cognitive scores, independent of the clinical features correlated to SCI. These findings hold significant implications for both clinical research and practice, offering valuable guidance for comprehensive management throughout hospitalization and rehabilitation.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"62 6","pages":"336-342"},"PeriodicalIF":2.1,"publicationDate":"2024-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140561964","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 : 2024-04-08DOI: 10.1038/s41393-024-00987-6
Ahmad M. S. Ali, Mohammad A. Mustafa, Omar M. E. Ali, Conor S. Gillespie, George M. Richardson, Simon Clark, Martin J. Wilby, Christopher P. Millward, Nisaharan Srikandarajah
Systematic review. Primary Spinal Intradural Tumours (PSITs) are rare pathologies that can significantly impact quality of life. This study aimed to review patient reported outcomes (PROs) in PSITs. A systematic search of Pubmed and Embase was performed to identify studies measuring PROs in adults with PSITs. PRO results were categorised as relating to Global, Physical, Social, or Mental health. Outcomes were summarised descriptively. Following review of 2382 records, 11 studies were eligible for inclusion (737 patients). All studies assessed surgically treated patients. Schwannoma was the commonest pathology (n = 190). 7 studies measured PROs before and after surgery, the remainder assessed only post-operatively. For eight studies, PROs were obtained within 12 months of treatment. 21 PRO measurement tools were used across included studies, of which Euro-Qol-5D (n = 8) and the pain visual/numerical analogue scale (n = 5) were utilised most frequently. Although overall QoL is lower than healthy controls in PSITs, improvements following surgery were found in Extramedullary tumours (EMT) in overall physical, social, and mental health. Similar improvements were not significant across studies of Intramedullary tumours (IMT). Overall QoL and symptom burden was higher in IMT patients than in brain tumour patients. No studies evaluated the effect of chemotherapy or radiotherapy. Patients with PSITs suffer impaired PROs before and after surgery. This is particularly true for IMTs. PRO reporting in PSITs is hindered by a heterogeneity of reporting and varied measurement tools. This calls for the establishment of a standard set of PROs as well as the use of registries.
{"title":"Patient-reported outcomes in Primary Spinal Intradural Tumours: a systematic review","authors":"Ahmad M. S. Ali, Mohammad A. Mustafa, Omar M. E. Ali, Conor S. Gillespie, George M. Richardson, Simon Clark, Martin J. Wilby, Christopher P. Millward, Nisaharan Srikandarajah","doi":"10.1038/s41393-024-00987-6","DOIUrl":"10.1038/s41393-024-00987-6","url":null,"abstract":"Systematic review. Primary Spinal Intradural Tumours (PSITs) are rare pathologies that can significantly impact quality of life. This study aimed to review patient reported outcomes (PROs) in PSITs. A systematic search of Pubmed and Embase was performed to identify studies measuring PROs in adults with PSITs. PRO results were categorised as relating to Global, Physical, Social, or Mental health. Outcomes were summarised descriptively. Following review of 2382 records, 11 studies were eligible for inclusion (737 patients). All studies assessed surgically treated patients. Schwannoma was the commonest pathology (n = 190). 7 studies measured PROs before and after surgery, the remainder assessed only post-operatively. For eight studies, PROs were obtained within 12 months of treatment. 21 PRO measurement tools were used across included studies, of which Euro-Qol-5D (n = 8) and the pain visual/numerical analogue scale (n = 5) were utilised most frequently. Although overall QoL is lower than healthy controls in PSITs, improvements following surgery were found in Extramedullary tumours (EMT) in overall physical, social, and mental health. Similar improvements were not significant across studies of Intramedullary tumours (IMT). Overall QoL and symptom burden was higher in IMT patients than in brain tumour patients. No studies evaluated the effect of chemotherapy or radiotherapy. Patients with PSITs suffer impaired PROs before and after surgery. This is particularly true for IMTs. PRO reporting in PSITs is hindered by a heterogeneity of reporting and varied measurement tools. This calls for the establishment of a standard set of PROs as well as the use of registries.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"62 6","pages":"275-284"},"PeriodicalIF":2.1,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41393-024-00987-6.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140561736","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}
To determine whether duration of detrusor overactivity (DO) during a cystometric study is an independent predictive factor of upper urinary tract deterioration (UUTD) in patients with traumatic spinal cord injury (TSCI). Retrospective cohort study. A rehabilitation facility in Chiang Mai, Thailand. Data were obtained from medical records of patients who underwent cystometric evaluation at 6–12 months after TSCI. The independent predictor of interest is the duration of DO, which was evaluated by the DO/cystometry ratio (DOratio). Other conventional urodynamic parameters (maximum detrusor pressure, cystometric capacity, bladder compliance, and detrusor-sphincter dyssynergia) and clinical parameters (age, sex, level and severity of injury, comorbidities, bladder emptying method, and history of urinary tract infection) were determined. The outcome was UUTD, which is indicated by chronic kidney disease (GFR < 60 ml/min/1.73 m2), hydronephrosis, and/or vesicoureteral reflux. Multivariable Cox regression analysis was used to determine the independent associations between DOratio and UUTD by adjusting with all other parameters. Medical records of 194 patients with TSCI were included in the study. During a combined total of 1260 follow-up years of those patients, 34 UUTD events were identified, indicating an incidence rate of 27.0 cases per 1000 person-years. After adjusting for all other parameters, a high DOratio (≥0.33) was significantly associated with UUTD (hazard ratio = 3.00 [95% CI: 1.12–7.99], p = 0.025). DOratio may be an independent cystometric predictor of UUTD in patients with TSCI. However, further prospective study is needed prior to applying DOratio as a predictor of UUTD in clinical settings. There was no clinical trial registration since this study is not a clinical trial.
{"title":"Duration of detrusor overactivity as an independent predictive factor of upper urinary tract deterioration in patients with traumatic spinal cord injury: results of a retrospective cohort study","authors":"Pratchayapon Kammuang-lue, Sintip Pattanakuhar, Maysa Sermsuk, Chaisiri Angkurawaranon","doi":"10.1038/s41393-024-00988-5","DOIUrl":"10.1038/s41393-024-00988-5","url":null,"abstract":"To determine whether duration of detrusor overactivity (DO) during a cystometric study is an independent predictive factor of upper urinary tract deterioration (UUTD) in patients with traumatic spinal cord injury (TSCI). Retrospective cohort study. A rehabilitation facility in Chiang Mai, Thailand. Data were obtained from medical records of patients who underwent cystometric evaluation at 6–12 months after TSCI. The independent predictor of interest is the duration of DO, which was evaluated by the DO/cystometry ratio (DOratio). Other conventional urodynamic parameters (maximum detrusor pressure, cystometric capacity, bladder compliance, and detrusor-sphincter dyssynergia) and clinical parameters (age, sex, level and severity of injury, comorbidities, bladder emptying method, and history of urinary tract infection) were determined. The outcome was UUTD, which is indicated by chronic kidney disease (GFR < 60 ml/min/1.73 m2), hydronephrosis, and/or vesicoureteral reflux. Multivariable Cox regression analysis was used to determine the independent associations between DOratio and UUTD by adjusting with all other parameters. Medical records of 194 patients with TSCI were included in the study. During a combined total of 1260 follow-up years of those patients, 34 UUTD events were identified, indicating an incidence rate of 27.0 cases per 1000 person-years. After adjusting for all other parameters, a high DOratio (≥0.33) was significantly associated with UUTD (hazard ratio = 3.00 [95% CI: 1.12–7.99], p = 0.025). DOratio may be an independent cystometric predictor of UUTD in patients with TSCI. However, further prospective study is needed prior to applying DOratio as a predictor of UUTD in clinical settings. There was no clinical trial registration since this study is not a clinical trial.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"62 6","pages":"328-335"},"PeriodicalIF":2.1,"publicationDate":"2024-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140561826","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 : 2024-04-04DOI: 10.1038/s41393-024-00981-y
Chandrasekaran Jayaraman, Chaithanya Krishna Mummidisetty, Arun Jayaraman, Kimberly Pfleeger, Michelle Jacobson, Melissa Ceruolo, Ellora Sen-Gupta, James Caccese, David Chen
Non-interventional, cross-sectional pilot study. To establish the validity and reliability of the BioStamp nPoint biosensor (Medidata Solutions, New York, NY, USA [formerly MC10, Inc.]) for measuring electromyography in individuals with cervical spinal cord injury (SCI) by comparing the surface electromyography (sEMG) metrics with the Trigno wireless electromyography system (Delsys, Natick, MA, USA). Participants were recruited from the Shirley Ryan AbilityLab registry. Individuals aged 18–70 years with cervical SCI were evaluated with the two biosensors to capture activity on upper-extremity muscles during two study sessions conducted over 2 days (day 1–consent alone; day 2–two data collections in same session). Time and frequency metrics were captured, and signal-to-noise ratio was determined for each muscle group. Test-retest reliability was determined using Pearson’s correlation. Validation of the BioStamp nPoint system was based on Bland-Altmann analysis. Among the 11 participants, 30.8% had subacute cervical injury at C5–C6; 53.8% were injured within 1 year of the study. Results from the test-retest reliability assessment revealed that most Pearson’s correlations between the two sensory measurements were strong (≥0.50). The Bland-Altman analysis found values of the signal-to-noise ratio, frequency, and peak amplitude were within the level of agreement. Signal-to-noise ratios ranged from 7.06 to 22.1. In most instances, the performance of the BioStamp nPoint sensors was moderately to strongly correlated with that of the Trigno sensors in all muscle groups tested. The BioStamp nPoint system is a valid and reliable approach to assess sEMG measures in individuals with cervical SCI. The present study was supported by AbbVie Inc.
{"title":"Validity and reliability study of a novel surface electromyography sensor using a well-consolidated electromyography system in individuals with cervical spinal cord injury","authors":"Chandrasekaran Jayaraman, Chaithanya Krishna Mummidisetty, Arun Jayaraman, Kimberly Pfleeger, Michelle Jacobson, Melissa Ceruolo, Ellora Sen-Gupta, James Caccese, David Chen","doi":"10.1038/s41393-024-00981-y","DOIUrl":"10.1038/s41393-024-00981-y","url":null,"abstract":"Non-interventional, cross-sectional pilot study. To establish the validity and reliability of the BioStamp nPoint biosensor (Medidata Solutions, New York, NY, USA [formerly MC10, Inc.]) for measuring electromyography in individuals with cervical spinal cord injury (SCI) by comparing the surface electromyography (sEMG) metrics with the Trigno wireless electromyography system (Delsys, Natick, MA, USA). Participants were recruited from the Shirley Ryan AbilityLab registry. Individuals aged 18–70 years with cervical SCI were evaluated with the two biosensors to capture activity on upper-extremity muscles during two study sessions conducted over 2 days (day 1–consent alone; day 2–two data collections in same session). Time and frequency metrics were captured, and signal-to-noise ratio was determined for each muscle group. Test-retest reliability was determined using Pearson’s correlation. Validation of the BioStamp nPoint system was based on Bland-Altmann analysis. Among the 11 participants, 30.8% had subacute cervical injury at C5–C6; 53.8% were injured within 1 year of the study. Results from the test-retest reliability assessment revealed that most Pearson’s correlations between the two sensory measurements were strong (≥0.50). The Bland-Altman analysis found values of the signal-to-noise ratio, frequency, and peak amplitude were within the level of agreement. Signal-to-noise ratios ranged from 7.06 to 22.1. In most instances, the performance of the BioStamp nPoint sensors was moderately to strongly correlated with that of the Trigno sensors in all muscle groups tested. The BioStamp nPoint system is a valid and reliable approach to assess sEMG measures in individuals with cervical SCI. The present study was supported by AbbVie Inc.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"62 6","pages":"320-327"},"PeriodicalIF":2.1,"publicationDate":"2024-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41393-024-00981-y.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140561731","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 : 2024-04-03DOI: 10.1038/s41393-024-00979-6
Keira E. Tranter, Joanne V. Glinsky, Marsha Ben, Helen Patterson, Lynn Blecher, Jackie Chu, Lisa A. Harvey
Interviews using the benefit-harm trade-off method and an online survey. To determine the smallest worthwhile effect (SWE) of motor training on strength for people with spinal cord injury (SCI). SCI units, Australia. Forty people with recent SCI who had participated in motor training as part of their rehabilitation program (patient participants) and 37 physiotherapists (physiotherapist participants) working in SCI were recruited. The patient participants underwent an iterative process using the benefit-harm trade-off method to determine the SWE of motor training on strength. The physiotherapist participants were given an online survey to determine the SWE for five different scenarios. Both groups considered the SWE of a physiotherapy intervention involving an additional 12 h of motor training for 10 weeks on top of usual care. They were required to estimate the smallest improvement in strength (points on the Total Motor Score of the International Standards for Neurological Classification of SCI) to justify the effort and associated costs, risks or inconveniences of the motor training. The median (interquartile range) smallest improvement in strength that patient and physiotherapist participants deemed worth the effort and associated costs, risks or inconveniences of the motor training was 3 (1–5) points, and 9 (7–13) points, respectively. People with recent SCI are willing to devote 12 h a week for 10 weeks to motor training in addition to their usual care to gain small changes in strength. Physiotherapists wanted to see greater improvements to justify the intervention.
{"title":"Using the benefit-harm trade-off method to determine the smallest worthwhile effect of intensive motor training on strength for people with spinal cord injury","authors":"Keira E. Tranter, Joanne V. Glinsky, Marsha Ben, Helen Patterson, Lynn Blecher, Jackie Chu, Lisa A. Harvey","doi":"10.1038/s41393-024-00979-6","DOIUrl":"10.1038/s41393-024-00979-6","url":null,"abstract":"Interviews using the benefit-harm trade-off method and an online survey. To determine the smallest worthwhile effect (SWE) of motor training on strength for people with spinal cord injury (SCI). SCI units, Australia. Forty people with recent SCI who had participated in motor training as part of their rehabilitation program (patient participants) and 37 physiotherapists (physiotherapist participants) working in SCI were recruited. The patient participants underwent an iterative process using the benefit-harm trade-off method to determine the SWE of motor training on strength. The physiotherapist participants were given an online survey to determine the SWE for five different scenarios. Both groups considered the SWE of a physiotherapy intervention involving an additional 12 h of motor training for 10 weeks on top of usual care. They were required to estimate the smallest improvement in strength (points on the Total Motor Score of the International Standards for Neurological Classification of SCI) to justify the effort and associated costs, risks or inconveniences of the motor training. The median (interquartile range) smallest improvement in strength that patient and physiotherapist participants deemed worth the effort and associated costs, risks or inconveniences of the motor training was 3 (1–5) points, and 9 (7–13) points, respectively. People with recent SCI are willing to devote 12 h a week for 10 weeks to motor training in addition to their usual care to gain small changes in strength. Physiotherapists wanted to see greater improvements to justify the intervention.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"62 6","pages":"314-319"},"PeriodicalIF":2.1,"publicationDate":"2024-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41393-024-00979-6.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140561733","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 : 2024-04-03DOI: 10.1038/s41393-024-00989-4
Auwal Bello Hassan, Auwal Abdullahi, Musa Sani Danazumi
{"title":"A response to “Toward a better understanding and terminology of transcutaneous spinal cord stimulation”","authors":"Auwal Bello Hassan, Auwal Abdullahi, Musa Sani Danazumi","doi":"10.1038/s41393-024-00989-4","DOIUrl":"10.1038/s41393-024-00989-4","url":null,"abstract":"","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"62 6","pages":"273-274"},"PeriodicalIF":2.1,"publicationDate":"2024-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140561734","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 : 2024-04-02DOI: 10.1038/s41393-024-00985-8
Marsha Ben, Federica Tamburella, Matteo Lorusso, Joanne V. Glinsky, Keira E. Tranter, Giorgio Scivoletto, Lynn Blecher, Anneliese Harris, Giovanni Galeoto, Joshua Wan, Lisa A. Harvey
To develop a self-report version of the Walking Index for Spinal Cord Injury II (WISCI II) and to test its reliability and validity. Psychometric study. Spinal cord injury (SCI) rehabilitation centres in Australia and Italy. Eighty people with SCI were recruited from a sample of convenience. Two self-report versions of the WISCI II were developed. Both versions were administered in English at the Australian site, and in Italian at the Italian site through an online platform. The format of the first self-report version (SR-V1) was similar to the original face-to-face WISCI II. The second self-report version (SR-V2) had more questions, but each question required participants to focus on one aspect of walking at a time. Participants completed SR-V1 and SR-V2 with assistance from research physiotherapists on two separate occasions, three to seven days apart. The original WISCI II was then administered through a face-to-face assessment by an independent physiotherapist. The intra-rater reliability and validity of SR-V1 and SR-V2 were determined with intraclass correlation coefficients (ICC) and percent close agreements. The data from the Australian and Italian sites were pooled. The validity and reliability of the two self-report versions were very similar, with SR-V2 performing slightly better than SR-V1. The ICC (95% confidence interval) of SR-V2 was 0.87 (0.81–0.92). The ICC reflecting the agreement between the self-report and the face-to-face WISCI was 0.89 (0.84–0.93). Both versions of the self-report WISCI II provide a reasonable substitute for a face-to-face assessment although therapists preferred SR-V2.
{"title":"A therapist-administered self-report version of the Walking Index for Spinal Cord Injury II (WISCI): a psychometric study","authors":"Marsha Ben, Federica Tamburella, Matteo Lorusso, Joanne V. Glinsky, Keira E. Tranter, Giorgio Scivoletto, Lynn Blecher, Anneliese Harris, Giovanni Galeoto, Joshua Wan, Lisa A. Harvey","doi":"10.1038/s41393-024-00985-8","DOIUrl":"10.1038/s41393-024-00985-8","url":null,"abstract":"To develop a self-report version of the Walking Index for Spinal Cord Injury II (WISCI II) and to test its reliability and validity. Psychometric study. Spinal cord injury (SCI) rehabilitation centres in Australia and Italy. Eighty people with SCI were recruited from a sample of convenience. Two self-report versions of the WISCI II were developed. Both versions were administered in English at the Australian site, and in Italian at the Italian site through an online platform. The format of the first self-report version (SR-V1) was similar to the original face-to-face WISCI II. The second self-report version (SR-V2) had more questions, but each question required participants to focus on one aspect of walking at a time. Participants completed SR-V1 and SR-V2 with assistance from research physiotherapists on two separate occasions, three to seven days apart. The original WISCI II was then administered through a face-to-face assessment by an independent physiotherapist. The intra-rater reliability and validity of SR-V1 and SR-V2 were determined with intraclass correlation coefficients (ICC) and percent close agreements. The data from the Australian and Italian sites were pooled. The validity and reliability of the two self-report versions were very similar, with SR-V2 performing slightly better than SR-V1. The ICC (95% confidence interval) of SR-V2 was 0.87 (0.81–0.92). The ICC reflecting the agreement between the self-report and the face-to-face WISCI was 0.89 (0.84–0.93). Both versions of the self-report WISCI II provide a reasonable substitute for a face-to-face assessment although therapists preferred SR-V2.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"62 6","pages":"307-313"},"PeriodicalIF":2.1,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.com/articles/s41393-024-00985-8.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140561706","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}
Retrospective study. To investigate the risk factors of tracheostomy and decannulation after cervical spinal cord injury (CSCI) and their epidemiological changes over the past 8 years in Beijing Bo’ai Hospital, China Rehabilitation Research Center (CRRC), China. Beijing Bo’ai Hospital, CRRC. We reviewed 8 years of patient data (2013.1.1 to 2020.12.31) at CRRC, focusing on those hospitalized and diagnosed with CSCI. We analyzed changes in demographic and clinical data’s trends. Logistic regression analysis was used to determine factors impacting tracheostomy and decannulation. Finally, 1641 CSCI patients met the inclusion criteria. Over the past 8 years, the proportion of tracheostomized patients with CSCI was 16.3%, and the proportion of successfully decannulated of tracheostomized patients with TCSCI was 77.9%. We found that Traumatic (OR = 1.8, 95% CI = 1.06, 3.22; p = 0.046), Motor level of injury (C5–C8) (OR = 0.32, 95% CI = −1.91,−0.34; p = 0.005), AIS = A/B/C (OR = 22.7/11.1/4.2, 95% CI = 12.16,42.26/5.74,21.56/2.23,7.89; p < 0.001/p < 0.001/p < 0.001), age > 56 (OR = 1.6, 95% CI = 1.04, 2.32; p = 0.031) were the risk factors for tracheostomy. By analyzing the risk factors of decannulation failure in tracheostomized patients with TCSCI through multivariable logistic regression, statistically significant differences were found in age > 45 (OR = 4.1, 95% CI = 1.44, 11.81; p = 0.008), complete injury (OR = 2.7, 95% CI = 1.26, 5.95; p = 0.011), facet dislocation (OR = 2.8, 95% CI = 1.13,7.07; p = 0.027). Recent years have witnessed shifts in the epidemiological characteristics of CSCI. Identifying the factors influencing tracheostomy and decannulation in CSCI can aid in improving patient prognosis.
研究设计回顾性研究：调查中国康复研究中心（CRRC）北京博爱医院在过去8年中颈脊髓损伤（CSCI）后气管切开和拔管的风险因素及其流行病学变化：地点：中国康复研究中心北京博爱医院：我们回顾了中国康复研究中心 8 年（2013.1.1 至 2020.12.31）的患者数据，重点关注住院并确诊为 CSCI 的患者。我们分析了人口统计学和临床数据的变化趋势。采用逻辑回归分析确定影响气管切开和拔管的因素：最终，1641 名 CSCI 患者符合纳入标准。在过去的 8 年中，气管插管的 CSCI 患者比例为 16.3%，气管插管的 TCSCI 患者中成功拔管的比例为 77.9%。我们发现，创伤性（OR = 1.8，95% CI = 1.06，3.22；P = 0.046）、运动水平损伤（C5-C8）（OR = 0.32，95% CI =-1.91，-0.34；P = 0.005）、AIS = A/B/C （OR = 22.7/11.1/4.2, 95% CI = 12.16,42.26/5.74,21.56/2.23,7.89; p 56 (OR = 1.6, 95% CI = 1.04, 2.32; p = 0.031)是气管切开的危险因素。通过多变量逻辑回归分析TCSCI气管插管患者拔管失败的风险因素，发现年龄大于45岁（OR = 4.1，95% CI = 1.44，11.81；P = 0.008）、完全损伤（OR = 2.7，95% CI = 1.26，5.95；P = 0.011）、面神经脱位（OR = 2.8，95% CI = 1.13，7.07；P = 0.027）等因素存在显著统计学差异：近年来，CSCI 的流行病学特征发生了变化。结论：近年来，CSCI 的流行病学特征发生了变化，确定影响 CSCI 中气管切开和拔管的因素有助于改善患者的预后。
{"title":"Long-term trends and risk factors of tracheostomy and decannulation in patients with cervical spinal cord Injury","authors":"Lianjun Gao, Wei Gao, Hongwei Liu, Changbin Liu, Feng Yang, Qimin Wang, Weichao Zhao, Zhaohui Tong","doi":"10.1038/s41393-024-00968-9","DOIUrl":"10.1038/s41393-024-00968-9","url":null,"abstract":"Retrospective study. To investigate the risk factors of tracheostomy and decannulation after cervical spinal cord injury (CSCI) and their epidemiological changes over the past 8 years in Beijing Bo’ai Hospital, China Rehabilitation Research Center (CRRC), China. Beijing Bo’ai Hospital, CRRC. We reviewed 8 years of patient data (2013.1.1 to 2020.12.31) at CRRC, focusing on those hospitalized and diagnosed with CSCI. We analyzed changes in demographic and clinical data’s trends. Logistic regression analysis was used to determine factors impacting tracheostomy and decannulation. Finally, 1641 CSCI patients met the inclusion criteria. Over the past 8 years, the proportion of tracheostomized patients with CSCI was 16.3%, and the proportion of successfully decannulated of tracheostomized patients with TCSCI was 77.9%. We found that Traumatic (OR = 1.8, 95% CI = 1.06, 3.22; p = 0.046), Motor level of injury (C5–C8) (OR = 0.32, 95% CI = −1.91,−0.34; p = 0.005), AIS = A/B/C (OR = 22.7/11.1/4.2, 95% CI = 12.16,42.26/5.74,21.56/2.23,7.89; p < 0.001/p < 0.001/p < 0.001), age > 56 (OR = 1.6, 95% CI = 1.04, 2.32; p = 0.031) were the risk factors for tracheostomy. By analyzing the risk factors of decannulation failure in tracheostomized patients with TCSCI through multivariable logistic regression, statistically significant differences were found in age > 45 (OR = 4.1, 95% CI = 1.44, 11.81; p = 0.008), complete injury (OR = 2.7, 95% CI = 1.26, 5.95; p = 0.011), facet dislocation (OR = 2.8, 95% CI = 1.13,7.07; p = 0.027). Recent years have witnessed shifts in the epidemiological characteristics of CSCI. Identifying the factors influencing tracheostomy and decannulation in CSCI can aid in improving patient prognosis.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"62 6","pages":"300-306"},"PeriodicalIF":2.1,"publicationDate":"2024-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140330133","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：