Pub Date : 2025-06-10DOI: 10.1038/s41393-025-01094-w
Steven Kirshblum, Brittany Snider, Einat Engel-Haber
A narrative review and perspective based on the experience of a single site in the U.S recruiting participants for clinical trials during the subacute phase (2 weeks to 3 months) following a traumatic spinal cord injury (SCI). To discuss challenges and propose strategies for enrolling individuals with SCI in research during the subacute phase within a comprehensive inpatient rehabilitation program. Acute rehabilitation hospitals where patients with SCI typically spend part of the subacute post-injury period. This review draws on the authors’ experience in research recruitment and retention. Key barriers and potential solutions are explored from both a practical and conceptual standpoint. Challenges identified include heterogeneous impairments, older age, higher incidence of incomplete injuries, placement issues, competition among studies, limited patient volume, tight rehabilitation schedules, logistical and medical concerns, and misalignment of research measures with clinical practices. Based on experience and literature review, strategic planning including integration of individuals with lived experience into the study design team, patient education, simplified consent processes, flexible research protocols, collaboration between clinical and research teams, and patient-centered approaches can enhance recruitment efforts. Research recruitment during the subacute phase of SCI presents numerous medical, injury-specific, and systems-based challenges. However, this period remains critical for advancing research influencing long-term outcomes for individuals with SCI. We recommend a collaborative, patient-centered approach that integrates research within clinical care, guided by practical experience and informed by existing literature, which can improve recruitment efforts and ultimately support meaningful advancements in SCI rehabilitation research.
{"title":"Challenges and strategies for spinal cord injury research recruitment in rehabilitation hospitals: a single center perspective","authors":"Steven Kirshblum, Brittany Snider, Einat Engel-Haber","doi":"10.1038/s41393-025-01094-w","DOIUrl":"10.1038/s41393-025-01094-w","url":null,"abstract":"A narrative review and perspective based on the experience of a single site in the U.S recruiting participants for clinical trials during the subacute phase (2 weeks to 3 months) following a traumatic spinal cord injury (SCI). To discuss challenges and propose strategies for enrolling individuals with SCI in research during the subacute phase within a comprehensive inpatient rehabilitation program. Acute rehabilitation hospitals where patients with SCI typically spend part of the subacute post-injury period. This review draws on the authors’ experience in research recruitment and retention. Key barriers and potential solutions are explored from both a practical and conceptual standpoint. Challenges identified include heterogeneous impairments, older age, higher incidence of incomplete injuries, placement issues, competition among studies, limited patient volume, tight rehabilitation schedules, logistical and medical concerns, and misalignment of research measures with clinical practices. Based on experience and literature review, strategic planning including integration of individuals with lived experience into the study design team, patient education, simplified consent processes, flexible research protocols, collaboration between clinical and research teams, and patient-centered approaches can enhance recruitment efforts. Research recruitment during the subacute phase of SCI presents numerous medical, injury-specific, and systems-based challenges. However, this period remains critical for advancing research influencing long-term outcomes for individuals with SCI. We recommend a collaborative, patient-centered approach that integrates research within clinical care, guided by practical experience and informed by existing literature, which can improve recruitment efforts and ultimately support meaningful advancements in SCI rehabilitation research.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"63 7","pages":"385-391"},"PeriodicalIF":2.2,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12237695/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144267161","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 : 2025-06-09DOI: 10.1038/s41393-025-01098-6
Anthony E. Seddio, Sahir S. Jabbouri, Rajiv S. Vasudevan, Michael J. Gouzoulis, Wesley Day, Gwyneth C. Maloy, Arya G. Varthi, Daniel R. Rubio, Jonathan N. Grauer
Retrospective longitudinal cohort study. To characterize: (1) incidence and trends of diving-related spine injuries (DRSI) and diving-related spinal cord injury (DRSCI) in the United States and (2) risk-factors associated with DRSCI. Using a large, national, multi-insurance administrative dataset of over 161 million patients, those who suffered a DRSIs were identified and characterized. Persons who suffered a DRSIs were analyzed from 2010–2021. Estimated annual percentage change (EAPC) was calculated by log-linear regression. For those with DRSCI, risk-factors were assessed by multivariable logistic regression. Of 3829 persons who suffered DRSIs, the cervical spine was most frequently involved (53.0%). EAPCs of DRSIs at the cervical, thoracic, and lumbar spine significantly decreased over the studied years (−4.69, −6.81, and −4.88%, respectively; p < 0.05 for all), while DRSCI demonstrated a nonsignificant trend (p = 0.081). Among the 629 (16.4%) with DRSCI, risk-factors included: prior cervical spine surgery (OR 13.31, p < 0.001), history of cervical spondylolisthesis (OR 5.36, p < 0.001), male sex (OR 2.69, p < 0.001), history of cervical stenosis (OR 2.26, p < 0.001), coastal states (OR 1.38, p = 0.012), higher Elixhauser Comorbidity Index (OR 1.15, p < 0.001), and older age (OR 1.01, p = 0.029). The rate of DRSIs of the cervical, thoracic, and lumbar spine has significantly decreased in recent years in the United States. However, the nonsignificant trend in DRSCI highlights the importance of continued public health initiatives. Among those with DRSCI, several unique risk-factors were identified, laying the foundation for the refinement of current diving injury prevention programs.
{"title":"The incidence and trends of diving-related spine injuries in the United States and risk factors associated with spinal cord injury","authors":"Anthony E. Seddio, Sahir S. Jabbouri, Rajiv S. Vasudevan, Michael J. Gouzoulis, Wesley Day, Gwyneth C. Maloy, Arya G. Varthi, Daniel R. Rubio, Jonathan N. Grauer","doi":"10.1038/s41393-025-01098-6","DOIUrl":"10.1038/s41393-025-01098-6","url":null,"abstract":"Retrospective longitudinal cohort study. To characterize: (1) incidence and trends of diving-related spine injuries (DRSI) and diving-related spinal cord injury (DRSCI) in the United States and (2) risk-factors associated with DRSCI. Using a large, national, multi-insurance administrative dataset of over 161 million patients, those who suffered a DRSIs were identified and characterized. Persons who suffered a DRSIs were analyzed from 2010–2021. Estimated annual percentage change (EAPC) was calculated by log-linear regression. For those with DRSCI, risk-factors were assessed by multivariable logistic regression. Of 3829 persons who suffered DRSIs, the cervical spine was most frequently involved (53.0%). EAPCs of DRSIs at the cervical, thoracic, and lumbar spine significantly decreased over the studied years (−4.69, −6.81, and −4.88%, respectively; p < 0.05 for all), while DRSCI demonstrated a nonsignificant trend (p = 0.081). Among the 629 (16.4%) with DRSCI, risk-factors included: prior cervical spine surgery (OR 13.31, p < 0.001), history of cervical spondylolisthesis (OR 5.36, p < 0.001), male sex (OR 2.69, p < 0.001), history of cervical stenosis (OR 2.26, p < 0.001), coastal states (OR 1.38, p = 0.012), higher Elixhauser Comorbidity Index (OR 1.15, p < 0.001), and older age (OR 1.01, p = 0.029). The rate of DRSIs of the cervical, thoracic, and lumbar spine has significantly decreased in recent years in the United States. However, the nonsignificant trend in DRSCI highlights the importance of continued public health initiatives. Among those with DRSCI, several unique risk-factors were identified, laying the foundation for the refinement of current diving injury prevention programs.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"63 7","pages":"352-358"},"PeriodicalIF":2.2,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258953","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 : 2025-06-07DOI: 10.1038/s41393-025-01087-9
Jean Jacques Wyndaele
Narrative Review. To focus on the knowledge on afferent sensory nervous pathways related to the lower urinary tract (LUT), in individuals with spinal cord injury (SCI). We made a narrative review in which are summarized different primary studies from which conclusions may be drawn in a systematic way and from a holistic point of view, contributed by researcher’s own experience and existing theories. The knowledge on sensation in the LUT has grown during the last decade: advances in the basic science of bladder sensing relating to (a) the bladder wall-urothelial cells, sensory nerves, interstitial cells, and smooth muscle cells and (b) putative chemo/mechanosensors in the urethra-paraneurons or “brush cells” have helped to enlighten the different sensations related to bladder filling and voiding. Clinically there are diverse ways to evaluate the sensory function after SCI. After SCI, most patients retain the ability to be aware of the LUT, through bladder filling sensations, the feeling of passage through the urethra, pain and feeling unstable bladder contractions. They relate to different spinal afferent pathways, and their investigations permit valuable information on the spinal cord’s condition and the completeness of its disruption. Therapeutic advantages to be explored may be to train the sensation awareness, to guide the frequency of CIC, to better determine the role of sacral stimulation. The knowledge on pelvic afferent sensory nervous pathways of the LUT after SCI, offers important diagnostic and therapeutic data.
{"title":"Focus on afferent sensory nervous pathways of the lower urinary tract after SCI. Tribute to Sir Ludwig Guttmann","authors":"Jean Jacques Wyndaele","doi":"10.1038/s41393-025-01087-9","DOIUrl":"10.1038/s41393-025-01087-9","url":null,"abstract":"Narrative Review. To focus on the knowledge on afferent sensory nervous pathways related to the lower urinary tract (LUT), in individuals with spinal cord injury (SCI). We made a narrative review in which are summarized different primary studies from which conclusions may be drawn in a systematic way and from a holistic point of view, contributed by researcher’s own experience and existing theories. The knowledge on sensation in the LUT has grown during the last decade: advances in the basic science of bladder sensing relating to (a) the bladder wall-urothelial cells, sensory nerves, interstitial cells, and smooth muscle cells and (b) putative chemo/mechanosensors in the urethra-paraneurons or “brush cells” have helped to enlighten the different sensations related to bladder filling and voiding. Clinically there are diverse ways to evaluate the sensory function after SCI. After SCI, most patients retain the ability to be aware of the LUT, through bladder filling sensations, the feeling of passage through the urethra, pain and feeling unstable bladder contractions. They relate to different spinal afferent pathways, and their investigations permit valuable information on the spinal cord’s condition and the completeness of its disruption. Therapeutic advantages to be explored may be to train the sensation awareness, to guide the frequency of CIC, to better determine the role of sacral stimulation. The knowledge on pelvic afferent sensory nervous pathways of the LUT after SCI, offers important diagnostic and therapeutic data.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"63 7","pages":"348-351"},"PeriodicalIF":2.2,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144249665","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 : 2025-06-05DOI: 10.1038/s41393-025-01073-1
Jessica L. Dashner, Ulrica Antepohl
Secondary data analysis. To explore differences in participation, secondary health complications, and the use of assistive devices and personal assistance among people with long-term SCI in Sweden and the USA. Community dwelling individuals with SCI in Sweden and USA. Secondary analysis of data collected via PARTS-Mv3 among individuals living with SCI in Sweden (n = 73) and in the USA (n = 45). Descriptive analyses provided information regarding the participants, their participation in activities, and secondary health complications, together with the use of assistive devices and personal assistance. Both samples included more males than females. The mean ages for the Sweden and USA samples were 63.7 and 58, respectively. The mean time since injury was 36.3 years for Sweden and 35.9 for the USA. Perceived health was significantly higher in Sweden (3.80) than in the USA (2.89). The USA sample reported higher occurrence of secondary health complications than Sweden. The amount and type of participation in activities varied between countries, so also the use of assistive devices and personal assistance. Participation differences were identified when comparing individuals with long-term SCI living in Sweden and in the USA. Further explanatory work is needed to determine whether the differences can be attributed to the varying social and health care systems of the two countries. Understanding how cultural differences influence participation can provide valuable information to determine which system is more likely to positively influence the participation of individuals with long-term SCI.
{"title":"Participation in activities among people with long-term spinal cord injury in Sweden and the USA – an explorative study using secondary data analysis","authors":"Jessica L. Dashner, Ulrica Antepohl","doi":"10.1038/s41393-025-01073-1","DOIUrl":"10.1038/s41393-025-01073-1","url":null,"abstract":"Secondary data analysis. To explore differences in participation, secondary health complications, and the use of assistive devices and personal assistance among people with long-term SCI in Sweden and the USA. Community dwelling individuals with SCI in Sweden and USA. Secondary analysis of data collected via PARTS-Mv3 among individuals living with SCI in Sweden (n = 73) and in the USA (n = 45). Descriptive analyses provided information regarding the participants, their participation in activities, and secondary health complications, together with the use of assistive devices and personal assistance. Both samples included more males than females. The mean ages for the Sweden and USA samples were 63.7 and 58, respectively. The mean time since injury was 36.3 years for Sweden and 35.9 for the USA. Perceived health was significantly higher in Sweden (3.80) than in the USA (2.89). The USA sample reported higher occurrence of secondary health complications than Sweden. The amount and type of participation in activities varied between countries, so also the use of assistive devices and personal assistance. Participation differences were identified when comparing individuals with long-term SCI living in Sweden and in the USA. Further explanatory work is needed to determine whether the differences can be attributed to the varying social and health care systems of the two countries. Understanding how cultural differences influence participation can provide valuable information to determine which system is more likely to positively influence the participation of individuals with long-term SCI.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"63 7","pages":"366-371"},"PeriodicalIF":2.2,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12237690/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235290","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}
Longitudinal secondary analysis of observational data. To examine the effectiveness of physical (PT) and occupational therapy (OT) interventions in improving Spinal Cord Independence Measure III (SCIM III) scores among individuals with spinal cord injury (SCI). Two SCI centers in Japan. The content and time of rehabilitation interventions, and International Standards for Neurological Classification of SCI and SCIM III scores, were recorded at nine time points (72 h; 2, 4, and 6 weeks; and 2, 3, 4, 5, and 6 months after injury) for hospitalized individuals with SCI. Overall, 204 participants were included and categorized into four groups based on admission severity. Using a linear mixed-effects model, the effectiveness of PT and OT interventions — defined by the International Spinal Cord Injury Physical Therapy-Occupational Therapy Basic Data Set — was assessed using the SCIM III score as the dependent variable. The following items showed interaction effects between severity and treatment time for the SCIM III score: [Strength training] for PT and OT, and [Standing control activities] and [Gross motor upper extremity] for OT. Intervention effects were observed for [Bed/seated control activities], [Walking and stairs], and [Gross motor upper extremity] for PT, and [Fine motor upper extremity] for OT, regardless of severity. The results suggest that considering the interaction between injury severity and rehabilitation interventions is essential for optimizing treatment plans and determining appropriate intervention timing. These findings may support clinical decision-making and contribute to improving functional outcomes in individuals with SCI.
{"title":"Interaction between injury severity and rehabilitation intervention on independence in activities of daily living in persons with spinal cord injury","authors":"Ryuichiro Koga, Tatsuyuki Kakuma, Hiroaki Sakai, Tetsuo Hayashi, Kensuke Kubota, Satoko Matsumoto, Atsushi Sugyo, Ryosuke Ideta, Ryoichi Watanabe, Yoshito Ehara, Masaaki Yamamoto, Masaaki Kyoya, Yuto Ariji, Satoshi Murai, Ryusei Ifuku, Toru Ogata, Kota Suda, Takeshi Maeda","doi":"10.1038/s41393-025-01092-y","DOIUrl":"10.1038/s41393-025-01092-y","url":null,"abstract":"Longitudinal secondary analysis of observational data. To examine the effectiveness of physical (PT) and occupational therapy (OT) interventions in improving Spinal Cord Independence Measure III (SCIM III) scores among individuals with spinal cord injury (SCI). Two SCI centers in Japan. The content and time of rehabilitation interventions, and International Standards for Neurological Classification of SCI and SCIM III scores, were recorded at nine time points (72 h; 2, 4, and 6 weeks; and 2, 3, 4, 5, and 6 months after injury) for hospitalized individuals with SCI. Overall, 204 participants were included and categorized into four groups based on admission severity. Using a linear mixed-effects model, the effectiveness of PT and OT interventions — defined by the International Spinal Cord Injury Physical Therapy-Occupational Therapy Basic Data Set — was assessed using the SCIM III score as the dependent variable. The following items showed interaction effects between severity and treatment time for the SCIM III score: [Strength training] for PT and OT, and [Standing control activities] and [Gross motor upper extremity] for OT. Intervention effects were observed for [Bed/seated control activities], [Walking and stairs], and [Gross motor upper extremity] for PT, and [Fine motor upper extremity] for OT, regardless of severity. The results suggest that considering the interaction between injury severity and rehabilitation interventions is essential for optimizing treatment plans and determining appropriate intervention timing. These findings may support clinical decision-making and contribute to improving functional outcomes in individuals with SCI.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"63 7","pages":"377-384"},"PeriodicalIF":2.2,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144216990","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 : 2025-05-31DOI: 10.1038/s41393-025-01091-z
Qunya Qi, Ling Wang, Beining Yang, Yulong Jia, Yu Wang, Haotian Xin, Xianglin Guo, Weimin Zheng, Xin Chen, Qian Chen, Fang Li, Jubao Du, Jie Lu, Nan Chen
Cross-sectional study. This study investigates changes in spinal DTI metrics above lesion in children with spinal cord injury without fracture or dislocation (SCIWOFD), aiming to assess DTI’s potential as a diagnostic and evaluative tool for SCIWOFD in children. Xuanwu Hospital, Capital Medical University, China; Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, China. This study included 18 children with SCIWOFD and 12 typically developing (TD) children. SCIWOFD children underwent International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) assessments and MRI with axial spinal cord DTI. DTI data were processed with Diffusion Toolkit and TrackVis, with four levels above the lesion (Level 1 to Level 4). Spinal DTI metrics were extracted, and statistical analysis was performed using multiple linear regression and Pearson correlation. Compared to the TD group, the SCIWOFD group displayed significant changes in DTI metrics at four spinal cord levels. At level 1, FA decreased (p < 0.000), while MD (p < 0.000), AD (p = 0.007), and RD (p < 0.000) increased. Levels 2 and 3 showed decreased FA (level 2: p < 0.000; level 3: p = 0.001) and increased MD (level 2: p = 0.001; level 3: p = 0.029) and RD values (level 2: p < 0.000; level 3:p = 0.001). At level 4, FA decreased (p < 0.000), while RD increased (p = 0.009). At level 1 in the SCIWOFD group, MD (r = −0.534, p = 0.022) and RD (r = −0.569, p = 0.009) correlated with sensory scores. Spinal DTI metrics above the lesion in children with SCIWOFD exhibit gradient changes, with a statistically correlation between the DTI metrics at the rostral edge of the lesion and ISNCSCI sensory scores. DTI metrics may serve as stable, objective indicators for assessing SCIWOFD in children.
{"title":"Using diffusion tensor imaging to assess children with spinal cord injury without fracture or dislocation","authors":"Qunya Qi, Ling Wang, Beining Yang, Yulong Jia, Yu Wang, Haotian Xin, Xianglin Guo, Weimin Zheng, Xin Chen, Qian Chen, Fang Li, Jubao Du, Jie Lu, Nan Chen","doi":"10.1038/s41393-025-01091-z","DOIUrl":"10.1038/s41393-025-01091-z","url":null,"abstract":"Cross-sectional study. This study investigates changes in spinal DTI metrics above lesion in children with spinal cord injury without fracture or dislocation (SCIWOFD), aiming to assess DTI’s potential as a diagnostic and evaluative tool for SCIWOFD in children. Xuanwu Hospital, Capital Medical University, China; Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, China. This study included 18 children with SCIWOFD and 12 typically developing (TD) children. SCIWOFD children underwent International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) assessments and MRI with axial spinal cord DTI. DTI data were processed with Diffusion Toolkit and TrackVis, with four levels above the lesion (Level 1 to Level 4). Spinal DTI metrics were extracted, and statistical analysis was performed using multiple linear regression and Pearson correlation. Compared to the TD group, the SCIWOFD group displayed significant changes in DTI metrics at four spinal cord levels. At level 1, FA decreased (p < 0.000), while MD (p < 0.000), AD (p = 0.007), and RD (p < 0.000) increased. Levels 2 and 3 showed decreased FA (level 2: p < 0.000; level 3: p = 0.001) and increased MD (level 2: p = 0.001; level 3: p = 0.029) and RD values (level 2: p < 0.000; level 3:p = 0.001). At level 4, FA decreased (p < 0.000), while RD increased (p = 0.009). At level 1 in the SCIWOFD group, MD (r = −0.534, p = 0.022) and RD (r = −0.569, p = 0.009) correlated with sensory scores. Spinal DTI metrics above the lesion in children with SCIWOFD exhibit gradient changes, with a statistically correlation between the DTI metrics at the rostral edge of the lesion and ISNCSCI sensory scores. DTI metrics may serve as stable, objective indicators for assessing SCIWOFD in children.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"63 7","pages":"342-347"},"PeriodicalIF":2.2,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144192229","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 : 2025-05-29DOI: 10.1038/s41393-025-01082-0
Clara Dupriez, Antoine Royer, Emiko Naets, Violaine Afzali, Kambiz Minooee Saberi
This is a monocenter, prospective validation study. To assess the validity and reliability of the French version of the Spinal Cord Independence Measure III (SCIM III). This study was conducted in Center for Traumatology and Rehabilitation, Brussels (Belgium). We included eighteen (n = 18) participants with spinal cord injury (SCI), scored according to the International Standards for Neurological Classification of SCI (ISNCSCI). Backward and forward translation of SCIM III was performed. Each participant was scored for the translated SCIM III and Functional Independence Measure (FIM) by three physicians. We evaluate the internal consistency, the intra- and inter-reliability, the validity and the sensitivity to change with Cronbach’s alpha coefficient, Kappa coefficient, intraclass correlation coefficients (ICC), Pearson’s correlation, paired t-test and McNemar test. For the validity, we compared SCIM III scores with those of the FIM. The French SCIM III (frSCIM III) provided excellent internal consistency. Kappa values for inter-reliability were all above 0.60, except for 3 items, and were statistically significant. We found a strong correlation between raters. All the tests showed a very good intra-reliability. frSCIM III and FIM showed very good correlation. There was no significant difference in the sensitivity to change between the frSCIM III and the FIM. The frSCIM III proved to be a consistent, reliable, and valid scale for clinical use. It is the first functional assessment scale validated in French for people with SCI. None
{"title":"Translation and validation of the French version of the spinal cord independence measure III (SCIM III)","authors":"Clara Dupriez, Antoine Royer, Emiko Naets, Violaine Afzali, Kambiz Minooee Saberi","doi":"10.1038/s41393-025-01082-0","DOIUrl":"10.1038/s41393-025-01082-0","url":null,"abstract":"This is a monocenter, prospective validation study. To assess the validity and reliability of the French version of the Spinal Cord Independence Measure III (SCIM III). This study was conducted in Center for Traumatology and Rehabilitation, Brussels (Belgium). We included eighteen (n = 18) participants with spinal cord injury (SCI), scored according to the International Standards for Neurological Classification of SCI (ISNCSCI). Backward and forward translation of SCIM III was performed. Each participant was scored for the translated SCIM III and Functional Independence Measure (FIM) by three physicians. We evaluate the internal consistency, the intra- and inter-reliability, the validity and the sensitivity to change with Cronbach’s alpha coefficient, Kappa coefficient, intraclass correlation coefficients (ICC), Pearson’s correlation, paired t-test and McNemar test. For the validity, we compared SCIM III scores with those of the FIM. The French SCIM III (frSCIM III) provided excellent internal consistency. Kappa values for inter-reliability were all above 0.60, except for 3 items, and were statistically significant. We found a strong correlation between raters. All the tests showed a very good intra-reliability. frSCIM III and FIM showed very good correlation. There was no significant difference in the sensitivity to change between the frSCIM III and the FIM. The frSCIM III proved to be a consistent, reliable, and valid scale for clinical use. It is the first functional assessment scale validated in French for people with SCI. None","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"63 7","pages":"359-365"},"PeriodicalIF":2.2,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144182928","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 : 2025-05-29DOI: 10.1038/s41393-025-01089-7
Stevan Stojic, Serena Affolter, Gertraud Stadler, Stacey A. Missmer, Juergen Pannek, Jivko Stoyanov, Inge Eriks-Hoogland, Janina Lüscher, Marija Glisic
Bibliometric analysis and conceptual framework. To provide a framework for prioritizing sex/gender research in the field of spinal cord injury (SCI), which can help inform and develop future research directions benefiting both women and men affected by SCI. Not applicable We searched the Web of Science Core Collection to identify relevant articles. Data was analyzed using the Bibliometrix and VoSviewer tools to provide a macroscopic overview of sex/gender research trends in the field of SCI research. A framework was developed based on the results of bibliometric analyses and literature scoping, engaging professionals with backgrounds in gender medicine, translational medicine, psychology, clinical epidemiology, SCI, and endocrinology. A total of 1031 documents were included in the analyses. We observed a steady increase in sex/gender related research from 2012, with an annual growth rate of 9.64%. Rehabilitation, epidemiology, obesity, depression, and sex hormones were identified as fundamental and critical topics for advancing sex and gender research in the context of SCI. Among a randomly selected articles, a significant proportion of studies interchangeably used the terms sex and gender. Therefore, we discuss the key overarching themes and terminology that are essential for any study exploring the relevance of sex and gender in health research. We developed a three-step research framework for considering and incorporating sex and gender in research, using SCI as a case in point. The major principles in current paper can benefit everyone interested in studying sex/gender in the context of health in complex and disabling conditions.
研究设计：文献计量分析和概念框架。目的：为脊髓损伤（SCI）领域的性别/性别研究提供一个优先排序的框架，这可以帮助告知和发展有利于女性和男性脊髓损伤患者的未来研究方向。方法：我们检索Web of Science Core Collection检索相关文章。使用Bibliometrix和VoSviewer工具对数据进行分析，以提供SCI研究领域性别/性别研究趋势的宏观概述。基于文献计量分析和文献范围界定的结果，一个框架被开发出来，有性别医学、转化医学、心理学、临床流行病学、脊髓损伤和内分泌学背景的专业人员参与其中。结果：共纳入1031篇文献。我们观察到，从2012年开始，性/性别相关研究稳步增长，年增长率为9.64%。康复、流行病学、肥胖、抑郁和性激素被认为是SCI背景下推进性与性别研究的基础和关键主题。在随机选择的文章中，相当一部分研究交替使用了术语sex和gender。因此，我们讨论了关键的总体主题和术语，这些主题和术语对于任何探索健康研究中性别和社会性别相关性的研究都是必不可少的。我们开发了一个三步研究框架，以SCI为例，考虑并纳入研究中的性别和社会性别。结论：本论文的主要原则可以使每个有兴趣在复杂和残疾条件下的健康背景下研究性/性别的人受益。
{"title":"Mapping sex and gender in the landscape of spinal cord injury research: a bibliometric analysis and research framework","authors":"Stevan Stojic, Serena Affolter, Gertraud Stadler, Stacey A. Missmer, Juergen Pannek, Jivko Stoyanov, Inge Eriks-Hoogland, Janina Lüscher, Marija Glisic","doi":"10.1038/s41393-025-01089-7","DOIUrl":"10.1038/s41393-025-01089-7","url":null,"abstract":"Bibliometric analysis and conceptual framework. To provide a framework for prioritizing sex/gender research in the field of spinal cord injury (SCI), which can help inform and develop future research directions benefiting both women and men affected by SCI. Not applicable We searched the Web of Science Core Collection to identify relevant articles. Data was analyzed using the Bibliometrix and VoSviewer tools to provide a macroscopic overview of sex/gender research trends in the field of SCI research. A framework was developed based on the results of bibliometric analyses and literature scoping, engaging professionals with backgrounds in gender medicine, translational medicine, psychology, clinical epidemiology, SCI, and endocrinology. A total of 1031 documents were included in the analyses. We observed a steady increase in sex/gender related research from 2012, with an annual growth rate of 9.64%. Rehabilitation, epidemiology, obesity, depression, and sex hormones were identified as fundamental and critical topics for advancing sex and gender research in the context of SCI. Among a randomly selected articles, a significant proportion of studies interchangeably used the terms sex and gender. Therefore, we discuss the key overarching themes and terminology that are essential for any study exploring the relevance of sex and gender in health research. We developed a three-step research framework for considering and incorporating sex and gender in research, using SCI as a case in point. The major principles in current paper can benefit everyone interested in studying sex/gender in the context of health in complex and disabling conditions.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"63 7","pages":"333-341"},"PeriodicalIF":2.2,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12237693/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144182826","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 : 2025-05-29DOI: 10.1038/s41393-025-01085-x
Rachel Y. Kim, Olivia M. Biller, M. J. Mulcahey
Functional electrical stimulation and exoskeletons provide direct functional ability but may also have therapeutic effects that improve function when they are turned off or removed. This integrative review aimed to identify functional clinical outcome assessments used to assess therapeutic effects in rehabilitation technologies for persons with spinal cord injuries, to examine the National Institute of Neurological Disorders and Stroke Common Data Elements recommendation level for SCI for each COA, and determine which COAs distinguish between recovery of function and function from compensation. A literature search identified interventional SCI studies using FES and exoskeletons (n = 1006). Text screens resulted in a sample (n = 56) organized by level of evidence, COAs with their measurement properties, type of intervention with involved limbs, the NINDS CDE recommendation level, and if the COAs distinguished recovery from compensation. 56 articles met inclusion criteria. 31 studies involved exoskeletons, 23 studies involved FES, and 2 studies involved both FES and exoskeleton. Within those 56 articles, 38 COAs were identified across all studies, including different versions of the same COA as separate measures. Of these 38 COAs, 24 were PerfOs and 7 were PROs. The most used COAs did not differentiate recovery from compensation. However, 3 COAs were identified as able to discriminate recovery from compensation. Studies on FES and exoskeletons in SCI have precedent to examine therapeutic effects using a variety of functional COAs. Clinical trials in SCI would benefit from COAs with interval scales that assess therapeutic effects that differentiate between recovery and compensation.
{"title":"Evaluating therapeutic effects of exoskeletons and FES in SCI: integrative review of the literature","authors":"Rachel Y. Kim, Olivia M. Biller, M. J. Mulcahey","doi":"10.1038/s41393-025-01085-x","DOIUrl":"10.1038/s41393-025-01085-x","url":null,"abstract":"Functional electrical stimulation and exoskeletons provide direct functional ability but may also have therapeutic effects that improve function when they are turned off or removed. This integrative review aimed to identify functional clinical outcome assessments used to assess therapeutic effects in rehabilitation technologies for persons with spinal cord injuries, to examine the National Institute of Neurological Disorders and Stroke Common Data Elements recommendation level for SCI for each COA, and determine which COAs distinguish between recovery of function and function from compensation. A literature search identified interventional SCI studies using FES and exoskeletons (n = 1006). Text screens resulted in a sample (n = 56) organized by level of evidence, COAs with their measurement properties, type of intervention with involved limbs, the NINDS CDE recommendation level, and if the COAs distinguished recovery from compensation. 56 articles met inclusion criteria. 31 studies involved exoskeletons, 23 studies involved FES, and 2 studies involved both FES and exoskeleton. Within those 56 articles, 38 COAs were identified across all studies, including different versions of the same COA as separate measures. Of these 38 COAs, 24 were PerfOs and 7 were PROs. The most used COAs did not differentiate recovery from compensation. However, 3 COAs were identified as able to discriminate recovery from compensation. Studies on FES and exoskeletons in SCI have precedent to examine therapeutic effects using a variety of functional COAs. Clinical trials in SCI would benefit from COAs with interval scales that assess therapeutic effects that differentiate between recovery and compensation.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"63 7","pages":"323-332"},"PeriodicalIF":2.2,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12237692/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144181895","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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