首页 > 最新文献

Topics in Spinal Cord Injury Rehabilitation最新文献

英文 中文
Data Safety Monitoring Boards: Overview of Structure and Role in Spinal Cord Injury Studies 数据安全监测委员会:脊髓损伤研究中的结构和作用概述
IF 2.9 Q2 Medicine Pub Date : 2024-06-03 DOI: 10.46292/sci23-00084
Andrew R. Blight, James D. Guest, James Hamer, Jane T.C. Hsieh, Linda Jones, David S.K. Magnuson, Kimberley Pfleeger
This paper provides an overview of the history, composition, organization, responsibilities, and regulatory requirements of Data Safety Monitoring Boards (DSMB), with particular reference to the context of clinical trials in spinal cord injury. It is intended to help potential members of such boards and those undertaking the design of new clinical trials to understand the important role of the DSMB in safeguarding the integrity of complex trials, promoting safety, and countering potential bias. An independent DSMB helps to protect research subjects by providing study oversight and serves as an additional step to assure that clinical trials are performed to existing and appropriate standards. The DSMB must meet on a regular schedule, diligently evaluate all the information it receives, and report in a timely and decisive manner. Members must be free of significant conflicts of interest throughout the study and be adequately trained and experienced to serve their roles within the group. DSMB service can be a valuable learning experience and a gratifying opportunity to participate in advancing medicine and helping to maintain and improve the standards of research.
本文概述了数据安全监控委员会(DSMB)的历史、组成、组织、职责和监管要求,特别是在脊髓损伤临床试验方面。本文旨在帮助此类委员会的潜在成员和承担新临床试验设计的人员了解 DSMB 在保障复杂试验的完整性、提高安全性和消除潜在偏见方面的重要作用。独立的 DSMB 通过提供研究监督来帮助保护研究对象,同时也是确保临床试验按照现有的适当标准进行的额外步骤。DSMB 必须定期召开会议,认真评估收到的所有信息,并及时果断地提交报告。成员必须在整个研究过程中没有重大利益冲突,并接受过充分的培训,经验丰富,能够胜任小组内的工作。DSMB 服务是一次宝贵的学习经历,也是一次参与医学进步、帮助维持和提高研究标准的令人欣慰的机会。
{"title":"Data Safety Monitoring Boards: Overview of Structure and Role in Spinal Cord Injury Studies","authors":"Andrew R. Blight, James D. Guest, James Hamer, Jane T.C. Hsieh, Linda Jones, David S.K. Magnuson, Kimberley Pfleeger","doi":"10.46292/sci23-00084","DOIUrl":"https://doi.org/10.46292/sci23-00084","url":null,"abstract":"This paper provides an overview of the history, composition, organization, responsibilities, and regulatory requirements of Data Safety Monitoring Boards (DSMB), with particular reference to the context of clinical trials in spinal cord injury. It is intended to help potential members of such boards and those undertaking the design of new clinical trials to understand the important role of the DSMB in safeguarding the integrity of complex trials, promoting safety, and countering potential bias. An independent DSMB helps to protect research subjects by providing study oversight and serves as an additional step to assure that clinical trials are performed to existing and appropriate standards. The DSMB must meet on a regular schedule, diligently evaluate all the information it receives, and report in a timely and decisive manner. Members must be free of significant conflicts of interest throughout the study and be adequately trained and experienced to serve their roles within the group. DSMB service can be a valuable learning experience and a gratifying opportunity to participate in advancing medicine and helping to maintain and improve the standards of research.","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141268606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Sexual Activity in Adults with Pediatric-Onset Spinal Cord Injury: Injury, Demographic, and Lifestyle Factors 小儿脊髓损伤成人的性活动:损伤、人口统计学和生活方式因素
IF 2.9 Q2 Medicine Pub Date : 2024-05-01 DOI: 10.46292/sci23-00086
Justine Stewart, Kyle C. Deane, Deanna Tuttle, Alexis Ortiz, K. Chlan, Kathy Zebracki
Sexual development is a complex process of understanding oneself as a sexual being. Youth with spinal cord injury (SCI) navigate the typical phases of sexual development along with the physical and psychological sequelae of an SCI. As youth with SCI progress from adolescence to emerging adulthood, sexual activity—physical intimacy and sexual intercourse—is an important milestone. The aims of the study were to (1) describe frequency of physical intimacy among adults with pediatric-onset SCI and (2) identify injury, demographic, and lifestyle factors that predict frequency of physical intimacy. Adults with pediatric-onset SCI who were former patients within a North American pediatric hospital system (N = 277) completed a structured telephone interview that included medical and sociodemographic information and standardized measures of psychological functioning. Participants rated physical intimacy and sexual intercourse frequency on a 5-point Likert scale, with a response of monthly, weekly, or daily classified as regular frequency and never or yearly as irregular frequency. Bivariate and multivariate analyses were conducted with physical intimacy frequency as the primary outcome. Of the participants, 55% engaged in physical intimacy and 49% engaged in sexual intercourse with regular frequency. In logistic regression analyses, living independently of parents, being married, and higher perceived social integration increased likelihood of regular frequency of physical intimacy. Injury severity and secondary medical complications were not significant independent predictors of frequency of physical intimacy. Half of adults with pediatric-onset SCI engage in regular physical intimacy; this is below the estimates for the general population. Psychosocial factors are stronger contributors to physical intimacy frequency than SCI-related factors. Health care providers and researchers should focus on barriers to social integration and development of social relationships as factors that influence physical intimacy in this population.
性发育是一个复杂的过程,是了解自己作为性存在的过程。患有脊髓损伤(SCI)的青少年在经历典型的性发育阶段的同时,还要面对脊髓损伤带来的生理和心理后遗症。当患有脊髓损伤的青少年从青春期步入成年期时,性活动--身体亲密接触和性交--是一个重要的里程碑。 本研究的目的是:(1)描述患有小儿型 SCI 的成年人发生身体亲密行为的频率;(2)确定预测身体亲密行为频率的损伤、人口统计学和生活方式因素。 曾在北美一家儿科医院系统就诊的患有小儿型 SCI 的成年人(N = 277)完成了一次结构化电话访谈,访谈内容包括医疗和社会人口信息以及心理功能的标准化测量。受试者用 5 点李克特量表对身体亲密关系和性交频率进行评分,每月、每周或每天的回答为定期频率,从未或每年的回答为不定期频率。以身体亲密频率为主要结果进行了二元和多元分析。 在参与者中,55% 的人有定期的身体亲密行为,49% 的人有定期的性交行为。在逻辑回归分析中,独立于父母生活、已婚和社会融合度较高的人增加了定期发生身体亲密行为的可能性。受伤严重程度和继发性医疗并发症并不是身体亲密频率的重要独立预测因素。 半数患有小儿重症肌无力的成年人会定期进行身体亲密接触,这一比例低于普通人群的估计值。与 SCI 相关因素相比,社会心理因素对身体亲密行为频率的影响更大。医疗服务提供者和研究人员应将重点放在社会融合和社会关系发展的障碍上,将其作为影响该人群身体亲密关系的因素。
{"title":"Sexual Activity in Adults with Pediatric-Onset Spinal Cord Injury: Injury, Demographic, and Lifestyle Factors","authors":"Justine Stewart, Kyle C. Deane, Deanna Tuttle, Alexis Ortiz, K. Chlan, Kathy Zebracki","doi":"10.46292/sci23-00086","DOIUrl":"https://doi.org/10.46292/sci23-00086","url":null,"abstract":"\u0000 \u0000 Sexual development is a complex process of understanding oneself as a sexual being. Youth with spinal cord injury (SCI) navigate the typical phases of sexual development along with the physical and psychological sequelae of an SCI. As youth with SCI progress from adolescence to emerging adulthood, sexual activity—physical intimacy and sexual intercourse—is an important milestone.\u0000 \u0000 \u0000 \u0000 The aims of the study were to (1) describe frequency of physical intimacy among adults with pediatric-onset SCI and (2) identify injury, demographic, and lifestyle factors that predict frequency of physical intimacy.\u0000 \u0000 \u0000 \u0000 Adults with pediatric-onset SCI who were former patients within a North American pediatric hospital system (N = 277) completed a structured telephone interview that included medical and sociodemographic information and standardized measures of psychological functioning. Participants rated physical intimacy and sexual intercourse frequency on a 5-point Likert scale, with a response of monthly, weekly, or daily classified as regular frequency and never or yearly as irregular frequency. Bivariate and multivariate analyses were conducted with physical intimacy frequency as the primary outcome.\u0000 \u0000 \u0000 \u0000 Of the participants, 55% engaged in physical intimacy and 49% engaged in sexual intercourse with regular frequency. In logistic regression analyses, living independently of parents, being married, and higher perceived social integration increased likelihood of regular frequency of physical intimacy. Injury severity and secondary medical complications were not significant independent predictors of frequency of physical intimacy.\u0000 \u0000 \u0000 \u0000 Half of adults with pediatric-onset SCI engage in regular physical intimacy; this is below the estimates for the general population. Psychosocial factors are stronger contributors to physical intimacy frequency than SCI-related factors. Health care providers and researchers should focus on barriers to social integration and development of social relationships as factors that influence physical intimacy in this population.\u0000","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141135321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Considerations for Contraception Following Spinal Cord Injury: A Systematic Review 脊髓损伤后避孕的注意事项:系统回顾
IF 2.9 Q2 Medicine Pub Date : 2024-05-01 DOI: 10.46292/sci23-00081
Lauren M. Hall, Chinenye C. Nnoromele, Amber Trujillo Lalla, Claudia B. Hentschel, Chloe Slocum
Counseling and education on women's health, specifically contraception, following spinal cord injury (SCI) is an important component of care for women with SCI. While a plethora of available contraceptive options exists, research in this area is scarce. This systematic review assesses the quality and quantity of research on contraception for individuals with SCI. Literature searches of three medical databases were performed to identify articles that addressed contraception and family planning for women with SCI. Articles were then screened in a two-stage selection process and evaluated for content. Of 165 articles, 21 were identified that fit the inclusion criteria. The majority (66%) of articles were literature reviews or professional practice guidelines. Fourteen (66%) included information on short-acting hormonal oral contraception, 11 (52%) included information on long-acting reversible contraception, 15 (71%) included information on barrier methods, 6 (29%) included information on fertility awareness, 9 (43%) included information on permanent contraception, and one (5%) included information on emergency contraception. This systematic review demonstrates a paucity of evidence-based information on contraception tailored to women with SCI. It highlights a need for research and comprehensive guidelines on primary and emergency contraception in this population.
脊髓损伤(SCI)后的妇女健康咨询和教育,特别是避孕,是脊髓损伤妇女护理的重要组成部分。虽然有大量可用的避孕方法,但这方面的研究却很少。 本系统性综述评估了有关 SCI 患者避孕的研究质量和数量。 我们对三个医学数据库进行了文献检索,以确定涉及 SCI 女性避孕和计划生育的文章。然后对文章进行了两阶段筛选,并对内容进行了评估。 在 165 篇文章中,有 21 篇符合纳入标准。大部分文章(66%)为文献综述或专业实践指南。14篇(66%)包含了短效激素口服避孕药的相关信息,11篇(52%)包含了长效可逆避孕药的相关信息,15篇(71%)包含了屏障避孕法的相关信息,6篇(29%)包含了生育意识的相关信息,9篇(43%)包含了永久性避孕药的相关信息,1篇(5%)包含了紧急避孕药的相关信息。 本系统综述表明,针对患有 SCI 的女性的循证避孕信息非常缺乏。它强调了对这一人群进行初级避孕和紧急避孕方面的研究和全面指导的必要性。
{"title":"Considerations for Contraception Following Spinal Cord Injury: A Systematic Review","authors":"Lauren M. Hall, Chinenye C. Nnoromele, Amber Trujillo Lalla, Claudia B. Hentschel, Chloe Slocum","doi":"10.46292/sci23-00081","DOIUrl":"https://doi.org/10.46292/sci23-00081","url":null,"abstract":"\u0000 \u0000 \u0000 Counseling and education on women's health, specifically contraception, following spinal cord injury (SCI) is an important component of care for women with SCI. While a plethora of available contraceptive options exists, research in this area is scarce.\u0000 \u0000 \u0000 \u0000 This systematic review assesses the quality and quantity of research on contraception for individuals with SCI.\u0000 \u0000 \u0000 \u0000 Literature searches of three medical databases were performed to identify articles that addressed contraception and family planning for women with SCI. Articles were then screened in a two-stage selection process and evaluated for content.\u0000 \u0000 \u0000 \u0000 Of 165 articles, 21 were identified that fit the inclusion criteria. The majority (66%) of articles were literature reviews or professional practice guidelines. Fourteen (66%) included information on short-acting hormonal oral contraception, 11 (52%) included information on long-acting reversible contraception, 15 (71%) included information on barrier methods, 6 (29%) included information on fertility awareness, 9 (43%) included information on permanent contraception, and one (5%) included information on emergency contraception.\u0000 \u0000 \u0000 \u0000 This systematic review demonstrates a paucity of evidence-based information on contraception tailored to women with SCI. It highlights a need for research and comprehensive guidelines on primary and emergency contraception in this population.\u0000","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141132774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Lived Experiences of Sexuality and Sexual Functioning in Males with SCI: A Mixed-Methods Study 患有 SCI 的男性对性和性功能的生活体验:一项混合方法研究
IF 2.9 Q2 Medicine Pub Date : 2024-05-01 DOI: 10.46292/sci23-00082
Rachel Lai, Rory McKerchar, Max J. Western, Ryan Flannigan, Andrei V. Krassioukov, Stacy Elliott, Tom E. Nightingale
Sexual dysfunction is highly prevalent in males with spinal cord injury (SCI) and has been recognized to be a key recovery priority. This cross-sectional, mixed-methods study aimed to investigate the major themes linked to sexual functioning in males with chronic (>1 year) SCI. Twenty male participants with SCI, aged 25 to 59 years, completed validated questionnaires exploring sexual function/satisfaction and health-related quality of life and a semi-structured interview with an experienced sexual medicine physician. Sex hormone concentrations and metabolic biomarkers, along with body composition and habitual physical activity levels, were assessed. Interview recordings were transcribed and thematic analysis performed using combined COM-B (Capability, Opportunity, Motivation, and Behavior) and biopsychosocial models to identify and organize major contributors and barriers to sexual functioning. Metabolic and hormonal biomarkers largely fell within normal physiological ranges despite reduced sexual functioning reported in our cohort (19/20 participants reported some degree of erectile dysfunction). Qualitative analysis of interview transcripts revealed 24 themes. Adaptability was important for improving sexual satisfaction. Attraction and attentiveness to sex and partners remained stable over time, while the desire for intimacy increased post injury. Sexual social norms, and comparisons to the able-bodied population, provided challenges for sexual activity and partnership. Environmental concerns regarding access to sexual health resources and accessible physical spaces during intimacy were relevant. Mood disorders and general life stressors negatively impacted sexual desire, while physical activity encouraged sexual activity. By considering a holistic view of sexuality in males with SCI, we identified key contributors and barriers to sexual functioning for the cohort studied.
性功能障碍在脊髓损伤(SCI)男性患者中非常普遍,已被认为是康复过程中的一个关键优先事项。 这项横断面混合方法研究旨在调查与慢性(1 年以上)SCI 男性患者性功能相关的主要问题。 20 名年龄在 25 岁至 59 岁之间的男性 SCI 患者完成了关于性功能/满意度和健康相关生活质量的有效问卷,并与一名经验丰富的性医学医生进行了半结构化访谈。此外,还对性激素浓度、代谢生物标志物、身体成分和习惯性体育锻炼水平进行了评估。对访谈记录进行了转录,并结合 COM-B(能力、机会、动机和行为)和生物心理社会模型进行了主题分析,以确定和整理影响性功能的主要因素和障碍。 尽管我们的队列中报告了性功能减退的情况(19/20 的参与者报告了某种程度的勃起功能障碍),但代谢和荷尔蒙生物标志物基本上处于正常生理范围内。对访谈记录的定性分析揭示了 24 个主题。适应性对于提高性满意度非常重要。随着时间的推移,对性和伴侣的吸引力和关注度保持稳定,而受伤后对亲密关系的渴望则有所增加。性社会规范以及与健全人群的比较给性活动和性伙伴关系带来了挑战。在亲密关系中,获得性健康资源和无障碍物理空间的环境问题也与此相关。情绪障碍和一般生活压力对性欲产生了负面影响,而体育活动则鼓励了性活动。 通过全面考虑患有 SCI 的男性的性行为,我们为所研究的人群确定了性功能的主要促成因素和障碍。
{"title":"Lived Experiences of Sexuality and Sexual Functioning in Males with SCI: A Mixed-Methods Study","authors":"Rachel Lai, Rory McKerchar, Max J. Western, Ryan Flannigan, Andrei V. Krassioukov, Stacy Elliott, Tom E. Nightingale","doi":"10.46292/sci23-00082","DOIUrl":"https://doi.org/10.46292/sci23-00082","url":null,"abstract":"\u0000 \u0000 \u0000 Sexual dysfunction is highly prevalent in males with spinal cord injury (SCI) and has been recognized to be a key recovery priority.\u0000 \u0000 \u0000 \u0000 This cross-sectional, mixed-methods study aimed to investigate the major themes linked to sexual functioning in males with chronic (>1 year) SCI.\u0000 \u0000 \u0000 \u0000 Twenty male participants with SCI, aged 25 to 59 years, completed validated questionnaires exploring sexual function/satisfaction and health-related quality of life and a semi-structured interview with an experienced sexual medicine physician. Sex hormone concentrations and metabolic biomarkers, along with body composition and habitual physical activity levels, were assessed. Interview recordings were transcribed and thematic analysis performed using combined COM-B (Capability, Opportunity, Motivation, and Behavior) and biopsychosocial models to identify and organize major contributors and barriers to sexual functioning.\u0000 \u0000 \u0000 \u0000 Metabolic and hormonal biomarkers largely fell within normal physiological ranges despite reduced sexual functioning reported in our cohort (19/20 participants reported some degree of erectile dysfunction). Qualitative analysis of interview transcripts revealed 24 themes. Adaptability was important for improving sexual satisfaction. Attraction and attentiveness to sex and partners remained stable over time, while the desire for intimacy increased post injury. Sexual social norms, and comparisons to the able-bodied population, provided challenges for sexual activity and partnership. Environmental concerns regarding access to sexual health resources and accessible physical spaces during intimacy were relevant. Mood disorders and general life stressors negatively impacted sexual desire, while physical activity encouraged sexual activity.\u0000 \u0000 \u0000 \u0000 By considering a holistic view of sexuality in males with SCI, we identified key contributors and barriers to sexual functioning for the cohort studied.\u0000","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141139619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Breastfeeding Following Spinal Cord Injury: Consumer Guide for Mothers 脊髓损伤后的母乳喂养:母亲消费指南
IF 2.9 Q2 Medicine Pub Date : 2024-05-01 DOI: 10.46292/sci23-00080
Andrei V. Krassioukov, Stacy Elliott, Shea Hocaloski, Olga Krassioukova-Enns, Karen Hodge, Stephanie Gillespie, Sherry Caves, Teri Thorson, Lindsay Alford, Melanie Basso, Laura McCracken, Amanda Lee, Kim Anderson, Elena Andretta, H. Chhabra, Claes Hultling, C. Rapidi, Fin-Biering Sorensen, Ineta Zobina, Francois Theron, Allison Kessler, F. Courtois, Maryam Berri
The World Health Organization (WHO) recommends that infants be breastfed exclusively for the first 6 months of age. However, there are few resources available on the effects a spinal cord injury (SCI) can have for breastfeeding mothers. It is difficult to find information to address the unique challenges women with SCI experience when planning or trying to breastfeed. Our international team, including women with SCI, health care providers, and SCI researchers, aims to address the information gap through the creation of this consumer guide. The purpose of this consumer guide is to share the most common issues women with SCI experience during breastfeeding and provide information, practical suggestions, recommendations, and key resources in lay language. General information about breastfeeding is available on the internet, in books, or from friends and health care providers. We do not intend to repeat nor replace general breastfeeding information or medical advice. Breastfeeding for mothers with SCI is complex and requires a team of health care providers with complementary expertise. Such a team may include family physician, obstetrician, physiatrist, neurologist, occupational and physical therapist, lactation consultant, midwife, and psychologist. We hope this consumer guide can serve as a quick reference guide for mothers with SCI planning of trying to breastfeed. This guide will also be helpful to health care providers as an educational tool.
世界卫生组织(WHO)建议在婴儿出生后的头 6 个月内采用纯母乳喂养。然而,有关脊髓损伤(SCI)对母乳喂养母亲的影响的资料却很少。在计划或尝试母乳喂养时,脊髓损伤妇女会遇到独特的挑战,因此很难找到相关信息来应对这些挑战。我们的国际团队(包括 SCI 女性患者、医疗服务提供者和 SCI 研究人员)旨在通过编写本消费者指南来填补信息空白。本消费者指南旨在分享患有 SCI 的妇女在母乳喂养期间遇到的最常见问题,并以通俗易懂的语言提供信息、实用建议、推荐和关键资源。有关母乳喂养的一般信息可从互联网、书籍或朋友和医疗服务提供者处获得。我们无意重复或取代一般的母乳喂养信息或医疗建议。为患有 SCI 的母亲进行母乳喂养是一项复杂的工作,需要一个由具有互补专业知识的医疗服务提供者组成的团队。这样的团队可能包括家庭医生、产科医生、理疗师、神经科医生、职业和物理治疗师、哺乳顾问、助产士和心理学家。我们希望这份消费者指南可以作为患有 SCI 并计划尝试母乳喂养的母亲的快速参考指南。作为一种教育工具,本指南也将对医疗保健提供者有所帮助。
{"title":"Breastfeeding Following Spinal Cord Injury: Consumer Guide for Mothers","authors":"Andrei V. Krassioukov, Stacy Elliott, Shea Hocaloski, Olga Krassioukova-Enns, Karen Hodge, Stephanie Gillespie, Sherry Caves, Teri Thorson, Lindsay Alford, Melanie Basso, Laura McCracken, Amanda Lee, Kim Anderson, Elena Andretta, H. Chhabra, Claes Hultling, C. Rapidi, Fin-Biering Sorensen, Ineta Zobina, Francois Theron, Allison Kessler, F. Courtois, Maryam Berri","doi":"10.46292/sci23-00080","DOIUrl":"https://doi.org/10.46292/sci23-00080","url":null,"abstract":"\u0000 The World Health Organization (WHO) recommends that infants be breastfed exclusively for the first 6 months of age. However, there are few resources available on the effects a spinal cord injury (SCI) can have for breastfeeding mothers. It is difficult to find information to address the unique challenges women with SCI experience when planning or trying to breastfeed. Our international team, including women with SCI, health care providers, and SCI researchers, aims to address the information gap through the creation of this consumer guide. The purpose of this consumer guide is to share the most common issues women with SCI experience during breastfeeding and provide information, practical suggestions, recommendations, and key resources in lay language. General information about breastfeeding is available on the internet, in books, or from friends and health care providers. We do not intend to repeat nor replace general breastfeeding information or medical advice. Breastfeeding for mothers with SCI is complex and requires a team of health care providers with complementary expertise. Such a team may include family physician, obstetrician, physiatrist, neurologist, occupational and physical therapist, lactation consultant, midwife, and psychologist. We hope this consumer guide can serve as a quick reference guide for mothers with SCI planning of trying to breastfeed. This guide will also be helpful to health care providers as an educational tool.","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141143368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Motherhood after Spinal Cord Injury: Breastfeeding, Autonomic Dysreflexia, and Psychosocial Health: Clinical Practice Guidelines 脊髓损伤后的母亲:母乳喂养、自主神经反射障碍和社会心理健康:临床实践指南
IF 2.9 Q2 Medicine Pub Date : 2024-05-01 DOI: 10.46292/sci23-00079
Andrei V. Krassioukov, Stacy Elliott, Shea Hocaloski, Olga Krassioukova-Enns, Karen Hodge, Stephanie Gillespie, Sherry Caves, Teri Thorson, Lindsay Alford, Melanie Basso, Laura McCracken, Amanda Lee, Kim Anderson, Elena Andretta, H. Chhabra, Claes Hultling, C. Rapidi, Fin-Biering Sørensen, Ineta Zobina, Francois Theron, Allison Kessler, F. Courtois, Maryam Berri
The World Health Organization (WHO) recommends that children be breastfed exclusively for the first 6 months of age. This recommendation may prove challenging for women with spinal cord injury (SCI) who face unique challenges and barriers to breastfeeding due to the impact of SCI on mobility and physiology. Tailored provision of care from health care professionals (HCPs) is important in helping women navigate these potential barriers. Yet, HCPs often lack the confidence and SCI-specific knowledge to meet the needs of mothers with SCI. An international panel of clinicians, researchers, consultants, and women with lived experience was formed to create an accessible resource that can address this gap. A comprehensive survey on breastfeeding complications, challenges, resources, and quality of life of mothers with SCI was conducted, along with an environmental scan to evaluate existing postpartum guidelines and assess their relevance and usability as recommendations for breastfeeding after SCI. Building on this work, this article provides evidence-based recommendations for HCPs, including but not limited to general practitioners, obstetricians, pediatricians, physiatrists, lactation consultants, nurses, midwives, occupational therapists, and physiotherapists who work with prospective and current mothers with SCI.
世界卫生组织(WHO)建议在婴儿出生后的头 6 个月内只用母乳喂养。由于脊髓损伤(SCI)对行动和生理的影响,脊髓损伤妇女在母乳喂养方面面临着独特的挑战和障碍。医疗保健专业人员(HCP)提供的有针对性的护理对于帮助妇女克服这些潜在障碍非常重要。然而,医护人员往往缺乏信心和 SCI 相关知识,无法满足患有 SCI 的母亲的需求。我们成立了一个由临床医生、研究人员、顾问和有生活经验的妇女组成的国际小组,以创建一个可访问的资源来弥补这一不足。我们就母乳喂养的并发症、挑战、资源以及患有 SCI 的母亲的生活质量进行了全面调查,同时还进行了环境扫描,以评估现有的产后指南,并评估其作为 SCI 后母乳喂养建议的相关性和可用性。在这项工作的基础上,本文为高级保健人员(包括但不限于全科医生、产科医生、儿科医生、物理治疗师、哺乳顾问、护士、助产士、职业治疗师和物理治疗师)提供了以证据为基础的建议,这些高级保健人员的工作对象是未来和目前患有 SCI 的母亲。
{"title":"Motherhood after Spinal Cord Injury: Breastfeeding, Autonomic Dysreflexia, and Psychosocial Health: Clinical Practice Guidelines","authors":"Andrei V. Krassioukov, Stacy Elliott, Shea Hocaloski, Olga Krassioukova-Enns, Karen Hodge, Stephanie Gillespie, Sherry Caves, Teri Thorson, Lindsay Alford, Melanie Basso, Laura McCracken, Amanda Lee, Kim Anderson, Elena Andretta, H. Chhabra, Claes Hultling, C. Rapidi, Fin-Biering Sørensen, Ineta Zobina, Francois Theron, Allison Kessler, F. Courtois, Maryam Berri","doi":"10.46292/sci23-00079","DOIUrl":"https://doi.org/10.46292/sci23-00079","url":null,"abstract":"The World Health Organization (WHO) recommends that children be breastfed exclusively for the first 6 months of age. This recommendation may prove challenging for women with spinal cord injury (SCI) who face unique challenges and barriers to breastfeeding due to the impact of SCI on mobility and physiology. Tailored provision of care from health care professionals (HCPs) is important in helping women navigate these potential barriers. Yet, HCPs often lack the confidence and SCI-specific knowledge to meet the needs of mothers with SCI. An international panel of clinicians, researchers, consultants, and women with lived experience was formed to create an accessible resource that can address this gap. A comprehensive survey on breastfeeding complications, challenges, resources, and quality of life of mothers with SCI was conducted, along with an environmental scan to evaluate existing postpartum guidelines and assess their relevance and usability as recommendations for breastfeeding after SCI. Building on this work, this article provides evidence-based recommendations for HCPs, including but not limited to general practitioners, obstetricians, pediatricians, physiatrists, lactation consultants, nurses, midwives, occupational therapists, and physiotherapists who work with prospective and current mothers with SCI.","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141140921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The Effect of 12 Weeks of Rebound Therapy Exercise Training on Walking Ability of Spinal Cord Injury Patients 12 周反弹疗法运动训练对脊髓损伤患者行走能力的影响
IF 2.9 Q2 Medicine Pub Date : 2024-04-15 DOI: 10.46292/sci23-00078
Morteza Sadeghi, Gholam Ali Ghasemi, Mohammad Taghi Karimi
Walking ability is a crucial factor for recovery and rehabilitation of spinal cord injury (SCI) patients. The aim of this study was to investigate the effect of 12 weeks of rebound therapy on walking parameters in SCI patients. Thirty members of Isfahan Spinal Cord Injury Association participated in this experimental study using a convenience sampling method. This study was approved by the ethics committee of the University of Isfahan (IR.UI.REC.1400.118). The participants were randomly assigned to control and rebound groups using a matched randomization method. Data were collected before and after 12 weeks of rebound therapy exercise (three sessions per week) in the walking laboratory, using a seven-camera 3D motion capturing system (Qualisys motion analysis). The final data were analyzed using repeated measures ANOVA in SPSS software (significance level p < .05). Rebound therapy training significantly improved all dependent variables (p < .05) except hip rotation, indicating its effectiveness for enhancing walking ability. Given the importance of walking function, we recommend the use of rebound therapy training as an exercise rehabilitation method for spinal cord injury patients.
行走能力是脊髓损伤(SCI)患者康复的关键因素。 本研究旨在调查 12 周反弹疗法对 SCI 患者行走参数的影响。 伊斯法罕脊髓损伤协会的 30 名成员采用方便抽样法参与了这项实验研究。这项研究获得了伊斯法罕大学伦理委员会的批准(IR.UI.REC.1400.118)。采用匹配随机法将参与者随机分配到对照组和反弹组。使用七摄像头三维运动捕捉系统(Qualisys 运动分析),在步行实验室收集反弹疗法运动(每周三次)前后 12 周的数据。最终数据采用 SPSS 软件的重复测量方差分析(显著性水平 p < .05)。 除髋关节旋转外,反弹疗法训练明显改善了所有因变量(p < .05),这表明反弹疗法对提高行走能力非常有效。 鉴于行走功能的重要性,我们建议将反弹疗法训练作为脊髓损伤患者的运动康复方法。
{"title":"The Effect of 12 Weeks of Rebound Therapy Exercise Training on Walking Ability of Spinal Cord Injury Patients","authors":"Morteza Sadeghi, Gholam Ali Ghasemi, Mohammad Taghi Karimi","doi":"10.46292/sci23-00078","DOIUrl":"https://doi.org/10.46292/sci23-00078","url":null,"abstract":"\u0000 \u0000 Walking ability is a crucial factor for recovery and rehabilitation of spinal cord injury (SCI) patients.\u0000 \u0000 \u0000 \u0000 The aim of this study was to investigate the effect of 12 weeks of rebound therapy on walking parameters in SCI patients.\u0000 \u0000 \u0000 \u0000 Thirty members of Isfahan Spinal Cord Injury Association participated in this experimental study using a convenience sampling method. This study was approved by the ethics committee of the University of Isfahan (IR.UI.REC.1400.118). The participants were randomly assigned to control and rebound groups using a matched randomization method. Data were collected before and after 12 weeks of rebound therapy exercise (three sessions per week) in the walking laboratory, using a seven-camera 3D motion capturing system (Qualisys motion analysis). The final data were analyzed using repeated measures ANOVA in SPSS software (significance level p < .05).\u0000 \u0000 \u0000 \u0000 Rebound therapy training significantly improved all dependent variables (p < .05) except hip rotation, indicating its effectiveness for enhancing walking ability.\u0000 \u0000 \u0000 \u0000 Given the importance of walking function, we recommend the use of rebound therapy training as an exercise rehabilitation method for spinal cord injury patients.\u0000","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140703810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Bowel and Bladder Dysfunction after SCI: A Comparison between India and Canada 脊髓损伤后的肠道和膀胱功能障碍:印度与加拿大的比较
IF 2.9 Q2 Medicine Pub Date : 2024-01-24 DOI: 10.46292/sci23-00058
Aliza Hirsch, Nishu Tyagi, Shakti Goel, H. S. Chhabra, Nader Fallah, Vanessa K. Noonan, Shikha Sehrawat, Aditya Saini, Aniket Barnwal, Andrei V. Krassioukov
The inclusion of people living with spinal cord injury (SCI) in research has allowed for an informed understanding of priorities of recovery of which bowel dysfunction and bladder dysfunction have been continuously identified. Research has also demonstrated the global disparities in SCI outcomes particularly when comparing high- and low-income countries. Currently, there is a lack of direct comparison between countries when assessing SCI outcomes. This is an exploratory study to better understand bowel and bladder dysfunction amongst individuals with SCI in India and Canada. Data from 33 participants were analyzed. Participants completed an online questionnaire assessing demographic information and the Neurogenic Bowel Dysfunction (NBD) score, Wexner score, Neurogenic Bladder Symptom Score (NBSS), and the Incontinence Quality of Life Instrument (I-QOL). Continuous data were compared using t tests. For not normally distributed data, the independent Mann-Whitney U test was used. Categorical variables were evaluated for association using Fisher's exact or chi-square test, depending on the sample size. Independent Mann-Whitney U test demonstrated that the Canadian participants had poorer bowel function with higher total NBD scores (p = .007) and less frequent bowel movements (p = .036), and they were more likely to experience uneasiness, headaches, and perspiration during bowel movements (p < .001). NBSS results indicated a small but significantly higher proportion of the Indian participants were unsatisfied or unhappy with their bladder function (p = .049). The distribution of Wexner and I-QOL scores were the same across countries. Potential explanations for differences include lifestyle, management, financial resources, patient and caregiver education, and societal pressures, which are all heavily influenced by cultural, geographical, and economic circumstances.
将脊髓损伤(SCI)患者纳入研究范围,有助于了解康复的优先事项,其中肠道功能障碍和膀胱功能障碍已被不断确认。研究还表明,全球脊髓损伤(SCI)的治疗效果存在差异,尤其是在比较高收入国家和低收入国家时。目前,各国在评估 SCI 结果时缺乏直接比较。 这是一项探索性研究,旨在更好地了解印度和加拿大 SCI 患者的肠道和膀胱功能障碍情况。 研究分析了 33 名参与者的数据。参与者填写了一份在线问卷,评估人口统计学信息、神经源性肠道功能障碍 (NBD) 评分、韦克斯纳评分、神经源性膀胱症状评分 (NBSS) 和尿失禁生活质量工具 (I-QOL)。连续性数据采用 t 检验进行比较。对于非正态分布数据,则采用独立的曼-惠特尼 U 检验。根据样本量的大小,使用费雪精确检验或卡方检验对分类变量的关联性进行评估。 独立曼-惠特尼 U 检验表明,加拿大参与者的排便功能较差,NBD 总分较高(p = .007),排便次数较少(p = .036),他们在排便时更容易感到不适、头痛和出汗(p < .001)。NBSS 结果表明,对自己的膀胱功能不满意或不开心的印度参与者比例虽小,但明显较高(p = .049)。Wexner评分和I-QOL评分在各国的分布情况相同。 造成差异的潜在原因包括生活方式、管理、经济资源、患者和护理人员教育以及社会压力,这些因素都深受文化、地理和经济环境的影响。
{"title":"Bowel and Bladder Dysfunction after SCI: A Comparison between India and Canada","authors":"Aliza Hirsch, Nishu Tyagi, Shakti Goel, H. S. Chhabra, Nader Fallah, Vanessa K. Noonan, Shikha Sehrawat, Aditya Saini, Aniket Barnwal, Andrei V. Krassioukov","doi":"10.46292/sci23-00058","DOIUrl":"https://doi.org/10.46292/sci23-00058","url":null,"abstract":"\u0000 \u0000 The inclusion of people living with spinal cord injury (SCI) in research has allowed for an informed understanding of priorities of recovery of which bowel dysfunction and bladder dysfunction have been continuously identified. Research has also demonstrated the global disparities in SCI outcomes particularly when comparing high- and low-income countries. Currently, there is a lack of direct comparison between countries when assessing SCI outcomes.\u0000 \u0000 \u0000 \u0000 This is an exploratory study to better understand bowel and bladder dysfunction amongst individuals with SCI in India and Canada.\u0000 \u0000 \u0000 \u0000 Data from 33 participants were analyzed. Participants completed an online questionnaire assessing demographic information and the Neurogenic Bowel Dysfunction (NBD) score, Wexner score, Neurogenic Bladder Symptom Score (NBSS), and the Incontinence Quality of Life Instrument (I-QOL). Continuous data were compared using t tests. For not normally distributed data, the independent Mann-Whitney U test was used. Categorical variables were evaluated for association using Fisher's exact or chi-square test, depending on the sample size.\u0000 \u0000 \u0000 \u0000 Independent Mann-Whitney U test demonstrated that the Canadian participants had poorer bowel function with higher total NBD scores (p = .007) and less frequent bowel movements (p = .036), and they were more likely to experience uneasiness, headaches, and perspiration during bowel movements (p < .001). NBSS results indicated a small but significantly higher proportion of the Indian participants were unsatisfied or unhappy with their bladder function (p = .049). The distribution of Wexner and I-QOL scores were the same across countries.\u0000 \u0000 \u0000 \u0000 Potential explanations for differences include lifestyle, management, financial resources, patient and caregiver education, and societal pressures, which are all heavily influenced by cultural, geographical, and economic circumstances.\u0000","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139599229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Cerebrovascular Reactivity Following Spinal Cord Injury. 脊髓损伤后的脑血管反应。
IF 2.9 Q2 Medicine Pub Date : 2024-01-01 Epub Date: 2024-05-23 DOI: 10.46292/sci23-00068
Alexander Mark Weber, Tom E Nightingale, Michael Jarrett, Amanda H X Lee, Olivia Lauren Campbell, Matthias Walter, Samuel J E Lucas, Aaron Phillips, Alexander Rauscher, Andrei V Krassioukov

Background: Spinal cord injuries (SCI) often result in cardiovascular issues, increasing the risk of stroke and cognitive deficits.

Objectives: This study assessed cerebrovascular reactivity (CVR) using functional magnetic resonance imaging (fMRI) during a hypercapnic challenge in SCI participants compared to noninjured controls.

Methods: Fourteen participants were analyzed (n = 8 with SCI [unless otherwise noted], median age = 44 years; n = 6 controls, median age = 33 years). CVR was calculated through fMRI signal changes.

Results: The results showed a longer CVR component (tau) in the grey matter of SCI participants (n = 7) compared to controls (median difference = 3.0 s; p < .05). Time since injury (TSI) correlated negatively with steady-state CVR in the grey matter and brainstem of SCI participants (RS = -0.81, p = .014; RS = -0.84, p = .009, respectively). Lower steady-state CVR in the brainstem of the SCI group (n = 7) correlated with lower diastolic blood pressure (RS = 0.76, p = .046). Higher frequency of hypotensive episodes (n = 7) was linked to lower CVR outcomes in the grey matter (RS = -0.86, p = .014) and brainstem (RS = -0.89, p = .007).

Conclusion: Preliminary findings suggest a difference in the dynamic CVR component, tau, between the SCI and noninjured control groups, potentially explaining the higher cerebrovascular health burden in SCI individuals. Exploratory associations indicate that longer TSI, lower diastolic blood pressure, and more hypotensive episodes may lead to poorer CVR outcomes. However, further research is necessary to establish causality and support these observations.

背景:脊髓损伤(SCI脊髓损伤(SCI)通常会导致心血管问题,增加中风和认知障碍的风险:本研究使用功能磁共振成像(fMRI)评估 SCI 参与者在高碳酸血症挑战期间的脑血管反应性(CVR),并与未受伤的对照组进行比较:分析了 14 名参与者(n = 8 名 SCI 患者[除非另有说明],中位年龄 = 44 岁;n = 6 名对照组,中位年龄 = 33 岁)。通过 fMRI 信号变化计算 CVR:结果显示,与对照组相比,SCI 参与者(n = 7)灰质中的 CVR 分量(tau)更长(中位数差异 = 3.0 秒;p < .05)。损伤后时间(TSI)与 SCI 参与者灰质和脑干的稳态 CVR 呈负相关(RS = -0.81,p = .014;RS = -0.84,p = .009)。SCI 组脑干中较低的稳态 CVR(n = 7)与较低的舒张压相关(RS = 0.76,p = .046)。低血压发作频率越高(n = 7),灰质(RS = -0.86,p = .014)和脑干(RS = -0.89,p = .007)的CVR结果越低:初步研究结果表明,SCI 组和非损伤对照组的动态 CVR 成分 tau 存在差异,这可能是 SCI 患者脑血管健康负担较重的原因。探索性关联表明,较长的TSI、较低的舒张压和较多的低血压发作可能会导致较差的CVR结果。然而,要确定因果关系并支持这些观察结果,还需要进一步的研究。
{"title":"Cerebrovascular Reactivity Following Spinal Cord Injury.","authors":"Alexander Mark Weber, Tom E Nightingale, Michael Jarrett, Amanda H X Lee, Olivia Lauren Campbell, Matthias Walter, Samuel J E Lucas, Aaron Phillips, Alexander Rauscher, Andrei V Krassioukov","doi":"10.46292/sci23-00068","DOIUrl":"10.46292/sci23-00068","url":null,"abstract":"<p><strong>Background: </strong>Spinal cord injuries (SCI) often result in cardiovascular issues, increasing the risk of stroke and cognitive deficits.</p><p><strong>Objectives: </strong>This study assessed cerebrovascular reactivity (CVR) using functional magnetic resonance imaging (fMRI) during a hypercapnic challenge in SCI participants compared to noninjured controls.</p><p><strong>Methods: </strong>Fourteen participants were analyzed (<i>n</i> = 8 with SCI [unless otherwise noted], median age = 44 years; <i>n</i> = 6 controls, median age = 33 years). CVR was calculated through fMRI signal changes.</p><p><strong>Results: </strong>The results showed a longer CVR component (tau) in the grey matter of SCI participants (<i>n</i> = 7) compared to controls (median difference = 3.0 s; <i>p</i> < .05). Time since injury (TSI) correlated negatively with steady-state CVR in the grey matter and brainstem of SCI participants (<i>R</i><sub>S</sub> = -0.81, <i>p</i> = .014; <i>R</i><sub>S</sub> = -0.84, <i>p</i> = .009, respectively). Lower steady-state CVR in the brainstem of the SCI group (<i>n</i> = 7) correlated with lower diastolic blood pressure (<i>R</i><sub>S</sub> = 0.76, <i>p</i> = .046). Higher frequency of hypotensive episodes (<i>n</i> = 7) was linked to lower CVR outcomes in the grey matter (<i>R</i><sub>S</sub> = -0.86, <i>p</i> = .014) and brainstem (<i>R</i><sub>S</sub> = -0.89, <i>p</i> = .007).</p><p><strong>Conclusion: </strong>Preliminary findings suggest a difference in the dynamic CVR component, tau, between the SCI and noninjured control groups, potentially explaining the higher cerebrovascular health burden in SCI individuals. Exploratory associations indicate that longer TSI, lower diastolic blood pressure, and more hypotensive episodes may lead to poorer CVR outcomes. However, further research is necessary to establish causality and support these observations.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11123610/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141155629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Predicting Complete versus Incomplete Long-Term Functional Independence after Acute AIS Grade D Spinal Cord Injury: A Prospective Cohort Study. 急性 AIS D 级脊髓损伤后完全与不完全长期功能独立的预测:一项前瞻性队列研究
IF 2.4 Q1 REHABILITATION Pub Date : 2024-01-01 Epub Date: 2024-08-08 DOI: 10.46292/sci23-00090
Antoine Dionne, Andréane Richard-Denis, Jean-Marc Mac-Thiong

Background: The proportion of patients with American Spinal Injury Association Impairment Scale (AIS) grade D traumatic spinal cord injuries (tSCI) is increasing. Although initial motor deficits can be relatively mild, some individuals fail to recover functional independence.

Objectives: This study aims to identify factors associated with failure to reach complete functional independence after AIS grade D tSCI.

Methods: An observational prospective cohort study was conducted at a level 1 trauma center specialized in SCI care. A prospective cohort of 121 individuals with an AIS-D tSCI was considered. The baseline characteristics, length of acute stay, need for inpatient rehabilitation, and 12-month functional status were assessed. Univariate and classification and regression tree (CART) analyses were performed to identify factors associated with reaching complete versus incomplete functional independence (defined as perfect total SCIM III score at 12-month follow-up).

Results: There were 69.3%, 83.3%, and 61.4% individuals reaching complete independence in self-care, respiration/sphincter management, and mobility, respectively. A total of 64 individuals (52%) reached complete functional independence in all three domains. In the CART analysis, we found that patients are more likely to achieve complete functional independence when they have a baseline motor score ≥83 (65% individuals) and if they present fewer medical comorbidities (70% individuals if Charlson Comorbidity Index [CCI] ≤4).

Conclusion: About half of individuals with AIS grade D tSCI can expect complete long-term functional independence. It is important to recognize early during acute care individuals with baseline motor score <83 or a high burden of comorbidities (CCI ≥5) to optimize their rehabilitation plan.

背景:美国脊髓损伤协会损伤量表(AIS)D级创伤性脊髓损伤(tSCI)患者的比例正在增加。虽然最初的运动障碍可能相对较轻,但有些患者无法恢复功能独立性:本研究旨在确定 AIS D 级创伤性脊髓损伤后未能达到完全功能独立的相关因素:在一家专门从事 SCI 护理的一级创伤中心开展了一项前瞻性队列观察研究。研究考虑了121名AIS-D级tSCI患者的前瞻性队列。研究人员对患者的基线特征、急性期住院时间、住院康复需求以及12个月的功能状态进行了评估。通过单变量和分类及回归树(CART)分析,确定达到完全或不完全功能独立(定义为随访12个月时SCIM III总分满分)的相关因素:在生活自理、呼吸/括约肌管理和行动能力方面,分别有69.3%、83.3%和61.4%的患者达到完全独立。共有 64 人(52%)在所有三个领域都达到了完全功能独立。在CART分析中,我们发现,如果患者的基线运动评分≥83分(65%的患者),且合并症较少(如果Charlson合并症指数[CCI]≤4,70%的患者),则更有可能实现完全功能独立:结论:约半数患有 AIS D 级 tSCI 的患者有望实现完全的长期功能独立。重要的是,在急性期护理过程中应及早识别基线运动评分为 D 级的患者。
{"title":"Predicting Complete versus Incomplete Long-Term Functional Independence after Acute AIS Grade D Spinal Cord Injury: A Prospective Cohort Study.","authors":"Antoine Dionne, Andréane Richard-Denis, Jean-Marc Mac-Thiong","doi":"10.46292/sci23-00090","DOIUrl":"10.46292/sci23-00090","url":null,"abstract":"<p><strong>Background: </strong>The proportion of patients with American Spinal Injury Association Impairment Scale (AIS) grade D traumatic spinal cord injuries (tSCI) is increasing. Although initial motor deficits can be relatively mild, some individuals fail to recover functional independence.</p><p><strong>Objectives: </strong>This study aims to identify factors associated with failure to reach complete functional independence after AIS grade D tSCI.</p><p><strong>Methods: </strong>An observational prospective cohort study was conducted at a level 1 trauma center specialized in SCI care. A prospective cohort of 121 individuals with an AIS-D tSCI was considered. The baseline characteristics, length of acute stay, need for inpatient rehabilitation, and 12-month functional status were assessed. Univariate and classification and regression tree (CART) analyses were performed to identify factors associated with reaching complete versus incomplete functional independence (defined as perfect total SCIM III score at 12-month follow-up).</p><p><strong>Results: </strong>There were 69.3%, 83.3%, and 61.4% individuals reaching complete independence in self-care, respiration/sphincter management, and mobility, respectively. A total of 64 individuals (52%) reached complete functional independence in all three domains. In the CART analysis, we found that patients are more likely to achieve complete functional independence when they have a baseline motor score ≥83 (65% individuals) and if they present fewer medical comorbidities (70% individuals if Charlson Comorbidity Index [CCI] ≤4).</p><p><strong>Conclusion: </strong>About half of individuals with AIS grade D tSCI can expect complete long-term functional independence. It is important to recognize early during acute care individuals with baseline motor score <83 or a high burden of comorbidities (CCI ≥5) to optimize their rehabilitation plan.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11317641/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141976854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Topics in Spinal Cord Injury Rehabilitation
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1