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}
Retrospective cohort study. To evaluate surgical consistency and clinical outcomes in intramedullary ependymoma (WHO grade II) cases by using X-bar charts as a tool to assess procedural stability. The single institution in Japan. This study included patients who underwent resection of intramedullary ependymomas between 2001 and 2023. All surgeries were performed by one of five board-certified spine surgeons. Operative time was analyzed for stability using X-bar charts. Neurological outcomes were assessed using the modified McCormick Scale (mMS), and regression analysis was performed to evaluate the relationship between operative time and mMS. The study included 144 patients (82 men, 62 women; average age 50.3 ± 14.6 years). Tumors were located at cervical (67.4%) or thoracic (32.6%) levels, averaging 3.0 ± 1.2 vertebrae. The surgeon who performed 71 cases was defined as the experienced surgeon, and the other surgeons performed 10–24 cases, respectively. The mean operative time was 380.6 ± 140.7 min, and 135 cases achieved gross total resection. The average follow-up duration was 6.9 ± 3.9 years. X-bar charts showed surgical stability once the average number of cases exceeded 17. No significant correlation was found between operative time and mMS for any surgeon. Perioperative complications were minimal. X-bar charts are a valuable tool for objectively evaluating surgical stability. In intramedullary ependymoma surgeries, consistency in operative time was achieved after 17 cases, and longer procedures did not adversely affect neurological outcomes. This method could be extended to monitor procedural reliability in other complex surgical interventions.
{"title":"How many cases of spinal intramedullary ependymoma surgery are required to achieve stability? - Analysis using X-bar charts","authors":"Narihito Nagoshi, Kengo Nagashima, Toshiki Okubo, Masahiro Ozaki, Satoshi Suzuki, Kazuki Takeda, Takahito Iga, Morio Matsumoto, Masaya Nakamura, Kota Watanabe","doi":"10.1038/s41393-025-01090-0","DOIUrl":"10.1038/s41393-025-01090-0","url":null,"abstract":"Retrospective cohort study. To evaluate surgical consistency and clinical outcomes in intramedullary ependymoma (WHO grade II) cases by using X-bar charts as a tool to assess procedural stability. The single institution in Japan. This study included patients who underwent resection of intramedullary ependymomas between 2001 and 2023. All surgeries were performed by one of five board-certified spine surgeons. Operative time was analyzed for stability using X-bar charts. Neurological outcomes were assessed using the modified McCormick Scale (mMS), and regression analysis was performed to evaluate the relationship between operative time and mMS. The study included 144 patients (82 men, 62 women; average age 50.3 ± 14.6 years). Tumors were located at cervical (67.4%) or thoracic (32.6%) levels, averaging 3.0 ± 1.2 vertebrae. The surgeon who performed 71 cases was defined as the experienced surgeon, and the other surgeons performed 10–24 cases, respectively. The mean operative time was 380.6 ± 140.7 min, and 135 cases achieved gross total resection. The average follow-up duration was 6.9 ± 3.9 years. X-bar charts showed surgical stability once the average number of cases exceeded 17. No significant correlation was found between operative time and mMS for any surgeon. Perioperative complications were minimal. X-bar charts are a valuable tool for objectively evaluating surgical stability. In intramedullary ependymoma surgeries, consistency in operative time was achieved after 17 cases, and longer procedures did not adversely affect neurological outcomes. This method could be extended to monitor procedural reliability in other complex surgical interventions.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"63 7","pages":"372-376"},"PeriodicalIF":2.2,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144120867","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 : 2025-05-13DOI: 10.1038/s41393-025-01086-w
Susan M. Stoikov, Chau T. D. Do, Kiley J. Pershouse, Claire E. Panagoda, Donna G. Harre, Delena I. Amsters
Descriptive study of a pilot model of care named QuickStart. To describe the eligibility, rehabilitation pathways, team composition, and service delivery of a novel model of care for people with newly acquired spinal cord injuries (SCI). Queensland Spinal Cord Injuries Service, Metro South Health, Queensland, Australia. In April 2022, QuickStart was established with a multidisciplinary team of health professionals to provide early in-reach specialist SCI expertise to individuals with newly acquired spinal cord injury and their treating clinicians. Between July 2022 and June 2024, QuickStart accepted 508 patients who were admitted to a Queensland or northern New South Wales hospital. Patients who received QuickStart support followed one of two pathways: they completed their primary rehabilitation in the Spinal Injuries Unit (SIU) at Princess Alexandra Hospital or at another facility. QuickStart provides specialised SCI support to patients and their treating team via a range of modalities including face-to-face review, telephone and videoconference. Referral numbers increased by 22% from the first year of operation, along with a 38% increase in the average QuickStart caseload. Patients received, on average, 12 occasions of service and a total service provision time of 452 min. All QuickStart patients received referrals to other specialised SCI community services within the Queensland Spinal Cord Injuries Service. QuickStart is a promising model of care that has improved access to specialised SCI expertise for individuals with newly acquired SCI, particularly those who may not have immediate access to specialised rehabilitation services.
研究设计：对一个名为“快速起步”的护理试点模型进行描述性研究。目的：描述新获得性脊髓损伤（SCI）患者的资格、康复途径、团队组成和服务提供的一种新型护理模式。地点：澳大利亚昆士兰州，Metro South Health，昆士兰脊髓损伤服务中心。方法：2022年4月，QuickStart与多学科卫生专业人员团队成立，为新获得性脊髓损伤患者及其治疗临床医生提供早期可及的专业SCI专业知识。结果：在2022年7月至2024年6月期间，快速启动接受了508名在昆士兰州或新南威尔士州北部医院住院的患者。接受快速入门支持的患者遵循以下两种途径之一：他们在亚历山德拉公主医院的脊柱损伤科（SIU）或其他机构完成了初级康复。QuickStart通过面对面审查、电话和视频会议等多种方式为患者及其治疗团队提供专业的脊髓损伤支持。与第一年相比，转诊人数增加了22%，同时快速入门项目的平均工作量增加了38%。患者平均接受服务12次，总服务时间452 min。所有快速入门患者都被转介到昆士兰州脊髓损伤服务中心的其他专业脊髓损伤社区服务。结论：快速启动是一种很有前途的护理模式，它改善了新获得性脊髓损伤患者获得专业脊髓损伤专业知识的机会，特别是那些可能无法立即获得专业康复服务的患者。
{"title":"Providing a QuickStart for people with newly acquired spinal cord injury: a new model of care offering in-reach advice and support","authors":"Susan M. Stoikov, Chau T. D. Do, Kiley J. Pershouse, Claire E. Panagoda, Donna G. Harre, Delena I. Amsters","doi":"10.1038/s41393-025-01086-w","DOIUrl":"10.1038/s41393-025-01086-w","url":null,"abstract":"Descriptive study of a pilot model of care named QuickStart. To describe the eligibility, rehabilitation pathways, team composition, and service delivery of a novel model of care for people with newly acquired spinal cord injuries (SCI). Queensland Spinal Cord Injuries Service, Metro South Health, Queensland, Australia. In April 2022, QuickStart was established with a multidisciplinary team of health professionals to provide early in-reach specialist SCI expertise to individuals with newly acquired spinal cord injury and their treating clinicians. Between July 2022 and June 2024, QuickStart accepted 508 patients who were admitted to a Queensland or northern New South Wales hospital. Patients who received QuickStart support followed one of two pathways: they completed their primary rehabilitation in the Spinal Injuries Unit (SIU) at Princess Alexandra Hospital or at another facility. QuickStart provides specialised SCI support to patients and their treating team via a range of modalities including face-to-face review, telephone and videoconference. Referral numbers increased by 22% from the first year of operation, along with a 38% increase in the average QuickStart caseload. Patients received, on average, 12 occasions of service and a total service provision time of 452 min. All QuickStart patients received referrals to other specialised SCI community services within the Queensland Spinal Cord Injuries Service. QuickStart is a promising model of care that has improved access to specialised SCI expertise for individuals with newly acquired SCI, particularly those who may not have immediate access to specialised rehabilitation services.","PeriodicalId":21976,"journal":{"name":"Spinal cord","volume":"63 6","pages":"285-291"},"PeriodicalIF":2.2,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143982727","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}
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