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Student Competition (Technology Innovation) ID 1972228 学生竞赛(科技创新) ID 1972228
IF 2.9 Q1 REHABILITATION Pub Date : 2023-09-01 DOI: 10.46292/sci23-1972228s
Nicholas Zhao, J. Zariffa
Upper limb rehabilitation after cervical spinal cord injury is vital for regaining independence. Hand function assessments are critical for upper limb rehabilitation, but are unable to accurately reflect performance in the individual’s home environment. Video from wearable cameras (egocentric video), paired with deep learning, can assess hand function during activities of daily living (ADLs) at home. Previous studies have focused on analyzing quantitative aspects of hand usage, but there has yet to be a study that uses deep neural networks to assess the quality of hand usage from egocentric video. To train a deep neural network to predict hand function assessment scores from egocentric video. The dataset used contained egocentric videos of ADLs performed by 17 participants with AIS grades from A-D in a home simulation laboratory. Tasks were annotated with scores adapted from the Graded Redefined Assessment of Strength Sensibility and Prehension (GRASSP). The annotated video was then used to train and validate a SlowFast neural network to predict GRASSP scores, using leave-one-subject-out cross validation. Model performance was evaluated by mean absolute error, accuracy, and F1 score. The model was optimized with a hyperparameter sweep. The top performing model demonstrated a mean absolute error of 0.52±0.19, an accuracy of 0.55±0.14, and F1 score of 0.55±0.16, on an ordinal scale from 1 to 5. These results demonstrate that automated assessment of hand function is possible by applying deep learning to egocentric video. Future work should expand the model to larger datasets with more variability.
颈部脊髓损伤后的上肢康复对于恢复自理能力至关重要。手部功能评估对上肢康复至关重要,但无法准确反映个人在家庭环境中的表现。来自可穿戴摄像头的视频(以自我为中心的视频)与深度学习相结合,可以评估在家中进行日常生活活动(ADL)时的手部功能。以往的研究侧重于分析手部使用的定量方面,但尚未有研究利用深度神经网络来评估自我中心视频中手部使用的质量。 目的是训练一个深度神经网络,以预测来自自我中心视频的手部功能评估得分。 使用的数据集包含 17 名 AIS 等级为 A-D 的参与者在家庭模拟实验室中进行 ADL 的自我中心视频。这些任务都标注了改编自力量感受性和预知能力分级评估(GRASSP)的分数。然后,利用注释视频对 SlowFast 神经网络进行训练和验证,以预测 GRASSP 分数。模型性能通过平均绝对误差、准确率和 F1 分数进行评估。通过超参数扫描对模型进行了优化。 表现最好的模型的平均绝对误差为 0.52±0.19,准确度为 0.55±0.14,F1 分数为 0.55±0.16(从 1 到 5)。 这些结果表明,通过将深度学习应用于以自我为中心的视频,可以实现手部功能的自动评估。未来的工作应将该模型扩展到具有更大变异性的更大数据集。
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引用次数: 0
Poster (Clinical/Best Practice Implementation) ID 1981325 海报(临床/最佳实践实施) ID 1981325
IF 2.9 Q1 REHABILITATION Pub Date : 2023-09-01 DOI: 10.46292/sci23-1981325s
Laura M. Oldford, Lauren E. Casey, Samuel Campbell, S. McCullum, Erica J. de Passillé, Colleen M. O’Connell
Many barriers prevent those with spinal cord injury or disease (SCI/D) from adhering to recommended exercise guidelines, thus increasing risks of secondary health conditions. Mainstream technology options, such as virtual reality (VR), have the potential to facilitate needed exercise participation. However, further research on VR exercise modalities is needed to determine feasibility, effectiveness and to ultimately guide practice recommendations. The goal of this pilot feasibility study was to determine whether VR exergaming is non-inferior to the current standard of care (SoC) upper extremity aerobic exercise for individuals with SCI/D. 25 participants with SCI/D completed 10-minute exercise sessions with either VR or the SoC, and after a rest break, then completed 10 minutes of exercise with the other modality. Primary outcomes of heart rate (HR) and rate of perceived exertion (RPE) were collected at baseline, 5 minutes into exercise, and at 10 min (end of the exercise session) for each modality. Secondary exploratory measures included a Numeric Pain Rating Scale measured pre- and post- each exercise session, and a post-study likeability survey. There were no significant differences in HR or RPE between virtual reality exergaming and the standard of care, and 100% of participants preferred the VR over SoC for the exercise. VR exergaming was non-inferior to the SoC for short duration upper extremity exercise in those with SCI/D. Implementing VR for patients with SCI/D should be studied further to observe the longer term effect on cardiovascular health and to determine feasibility and compliance for home use.
许多障碍阻碍脊髓损伤或疾病(SCI/D)患者遵守推荐的运动指南,从而增加了继发健康问题的风险。虚拟现实(VR)等主流技术方案具有促进所需运动参与的潜力。然而,还需要进一步研究 VR 运动模式,以确定其可行性和有效性,并最终指导实践建议。 这项试验性可行性研究的目的是确定 VR 游戏是否不逊于目前针对 SCI/D 患者的上肢有氧运动标准(SoC)。 25 名患有 SCI/D 的参与者在完成 10 分钟的 VR 或 SoC 锻炼后,休息片刻,再完成 10 分钟的另一种方式的锻炼。每种运动方式都收集了基线、运动开始 5 分钟和 10 分钟(运动结束)时的心率 (HR) 和体力消耗率 (RPE) 等主要结果。次要探索性测量包括在每次运动前后测量的数字疼痛评分量表,以及研究后的喜好度调查。 虚拟现实运动疗法与标准疗法在心率或 RPE 方面没有明显差异,100% 的参与者更喜欢虚拟现实运动疗法,而不是标准疗法。 在对患有 SCI/D 的患者进行短时间上肢锻炼时,虚拟现实外显游戏的效果并不亚于 SoC。应进一步研究为 SCI/D 患者实施 VR 对心血管健康的长期影响,并确定家庭使用的可行性和依从性。
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引用次数: 0
Student Competition (Knowledge Generation) ID 1986472 学生竞赛(知识生成) ID 1986472
IF 2.9 Q1 REHABILITATION Pub Date : 2023-09-01 DOI: 10.46292/sci23-1986472s
S. Gautam, Vivian K. Mushahwar, Mandira Baniya, K. P. Manhas, Raju Dhakal, C. Groves, Chester Ho
Spinal cord injury (SCI) results in physical impairments and psychosocial issues that generate challenges to individuals, families, and society. Understanding the acute care hospital experience after SCI is important as it may have an impact on persons with spinal cord injuries’ (PWSCI) subsequent journey to the rehabilitation center and community. This experience has not been studied in Nepal, especially from the perspective of PWSCI. To understand how PWSCI (1) are involved in decision-making for their care; (2) are educated about secondary complications and, (3) perceive overall positive and negative experiences regarding their care during their acute care hospital stay in Nepal. Qualitative study based on Van Manen’s phenomenology using purposive sampling at the Spinal Injury Rehabilitation Center, the only dedicated SCI center in Nepal. We interviewed participants (n=24) who were referred from nine different acute hospitals using a semi-structured interview guide co-developed with SCI experts and PWSCI. Using thematic analysis, we extracted the findings with Manen’s approach. We identified three preliminary themes: (1) Families, but not PWSCI, are often included in the decision-making process; (2) For education on secondary complications, only pressure injury prevention was recalled; (3) Timeliness of spinal surgery was a concern. There are opportunities to improve the acute care experience for PWSCI in Nepal. PWSCI desired to be more engaged in the decision-making process and more involved in their own care. Concerns regarding the timeliness of surgery correlated with the findings of previous Nepali studies.
脊髓损伤(SCI)会导致身体损伤和社会心理问题,给个人、家庭和社会带来挑战。了解脊髓损伤后在医院接受急性护理的经历非常重要,因为这可能会对脊髓损伤患者(PWSCI)随后前往康复中心和社区的旅程产生影响。尼泊尔尚未对这种经历进行研究,特别是从脊髓损伤患者的角度进行研究。 本研究旨在了解脊髓损伤患者(1)如何参与护理决策;(2)如何了解继发性并发症;(3)如何看待在尼泊尔急诊住院期间与护理相关的总体积极和消极体验。 基于 Van Manen 现象学的定性研究,在脊柱损伤康复中心(尼泊尔唯一一家专门的 SCI 中心)采用目的性抽样。我们使用与 SCI 专家和 PWSCI 共同制定的半结构化访谈指南,对从九家不同急症医院转诊过来的参与者(n=24)进行了访谈。通过主题分析,我们采用马南方法提取了研究结果。 我们初步确定了三个主题:(1) 决策过程中通常包括家属,但不包括残疾人社会服务机构;(2) 关于继发性并发症的教育,只回顾了预防压伤的内容;(3) 脊柱手术的及时性是一个值得关注的问题。 尼泊尔有机会改善脊柱损伤患者的急症护理体验。残疾人希望更多地参与决策过程,更多地参与自己的护理。对手术及时性的担忧与之前尼泊尔的研究结果相关。
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引用次数: 0
Poster (Health Services, Economics and Policy Change) ID 1977284 海报(医疗服务、经济学和政策变化)ID 1977284
IF 2.9 Q1 REHABILITATION Pub Date : 2023-09-01 DOI: 10.46292/sci23-1977284s
Brian Chan, Natascha Lam, Verena Rafael, Maureen Pakosh, Kristin E. Musselman
Activity-based therapies (ABT) are task specific, repetitive and intensive active movement interventions that may improve function and independence for individuals with spinal cord injury. The cost of implementing ABT is an important consideration for rehabilitation facilities interested in providing this intervention. Thus, a scoping review was conducted to evaluate the economic evidence for ABT for the rehabilitation of upper or lower limb impairment. A search of various scientific literature databases (including EMBASE, MEDLINE and CINAHL) was conducted using search terms developed in collaboration with a Medical Librarian. Studies were included if they were economic analyses of an ABT conducted for individuals with upper or lower limb mobility impairment. Titles and abstracts were initially screened by two of the authors followed by a full-text review of remaining articles. Articles included in the review were evaluated for methodological quality and presented descriptively because of the heterogeneity in study design, populations and outcomes. Of the 6,031 unique citations originally identified, 14 articles were included after full-text screening. Two-third of the studies were for stroke and half of the studies originated from the US. Robot-assisted therapies represented half of the studies and about a quarter were locomotor training programs. In the stroke and spinal cord injured population, robot-assisted therapies and body supported treadmill therapy appear to be cost-effective respectively. There is some evidence to support the cost-effectiveness of robot-assisted therapies and body supported treadmill therapy. However, the evidence is very limited and additional research is needed.
以活动为基础的疗法(ABT)是一种针对特定任务的、重复的和密集的主动运动干预措施,可以改善脊髓损伤患者的功能和独立性。对于有意提供这种干预措施的康复机构来说,实施活动疗法的成本是一个重要的考虑因素。因此,我们进行了一次范围审查,以评估 ABT 用于上肢或下肢损伤康复的经济证据。 我们使用与医学图书管理员合作开发的检索词对各种科学文献数据库(包括 EMBASE、MEDLINE 和 CINAHL)进行了检索。如果研究是针对上肢或下肢行动障碍患者进行的 ABT 经济分析,则将其纳入研究范围。标题和摘要由两位作者进行初步筛选,然后对剩余文章进行全文审阅。由于研究设计、研究人群和研究结果存在异质性,因此对纳入综述的文章进行了方法学质量评估,并以描述性的方式呈现。 在最初确定的 6031 篇文章中,有 14 篇文章经过全文筛选后被收录。其中三分之二的研究针对中风,一半的研究来自美国。机器人辅助疗法占研究的一半,约四分之一是运动训练计划。在中风和脊髓损伤人群中,机器人辅助疗法和身体支撑跑步机疗法似乎分别具有成本效益。 有一些证据支持机器人辅助疗法和身体辅助跑步机疗法具有成本效益。不过,这些证据非常有限,需要进行更多的研究。
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引用次数: 0
Poster (Clinical/Best Practice Implementation) ID 1984967 海报(临床/最佳实践实施) ID 1984967
IF 2.9 Q1 REHABILITATION Pub Date : 2023-09-01 DOI: 10.46292/sci23-1984967s
Suban Kangatharan, Mohammadreza Amiri, Louise Brisbois, Farnoosh Farahani, B. C. Craven
Assessment of physical activity (PA) prescription recall and serum screening for dyslipidemia are critical to describe and mitigate Cardiometabolic Disease (CMD) risk among adults with spinal cord injury or disease (SCI/D). To report: 1) the frequency of PA prescription recall; and, 2) the frequency of lipid profile assessment and interpretation recall among inpatients with SCI/D during rehabilitation. Adults with SCI/D completed the SCI-HIGH CMD intermediary outcome indicators. A Kinesiologist collected data via interview and chart abstraction among UHN inpatients. Survey responses were scored using Reachlite’s optical character recognition software. Descriptive statistics were used to characterize the participant’s age, sex, impairment characteristics, and report recall rates and the frequency of lipid screening/interpretation. Based on the participant’s needs, either educational materials to increase future adherence to PA guidelines and/or a Mediterranean diet were provided. Adult inpatients (n=124), mean age 59 years, 64% paraplegic, and 36% female participated. In total, 14% of participants (16/117) reported being taught the benefits of PA for their heart health; of whom 69% (11/16) recalled exercise instruction. Similarly, 15% of inpatients (17/114) recalled lipid screening during rehabilitation, although chart abstraction revealed that 30% (37/124) had completed lipid screening. Clinical interpretation of their lipid values was recalled by 30% of inpatients. There is a significant opportunity to advance PA instruction and lipid profile education and management among inpatients with SCI/D to reduce CMD risk. Inclusion of PA and lipid management instructions in patient-oriented discharge summaries may enhance patient recall/adherence.
体力活动(PA)处方召回评估和血清血脂异常筛查对于描述和降低脊髓损伤或疾病(SCI/D)成人的心脏代谢疾病(CMD)风险至关重要。 报告1)脊髓损伤或疾病(SCI/D)住院患者在康复期间回忆 PA 处方的频率;以及 2)血脂概况评估和解释回忆的频率。 患有 SCI/D 的成人完成 SCI-HIGH CMD 中间结果指标。一名运动神经学家通过访谈和病历摘录的方式收集 UHN 住院患者的数据。使用 Reachlite 光学字符识别软件对调查回答进行评分。描述性统计用于描述参与者的年龄、性别、损伤特征、报告回忆率和血脂筛查/解释频率。根据受试者的需求,提供教育材料以提高其今后对 PA 指南和/或地中海饮食的依从性。 成年住院患者(124 人),平均年龄 59 岁,64% 截瘫,36% 女性。总共有 14% 的参与者(16/117)表示曾接受过有关体育锻炼对心脏健康益处的教育;其中 69% 的参与者(11/16)回忆起运动指导。同样,15% 的住院患者(17/114)回忆起在康复期间进行过血脂筛查,但病历摘要显示 30%(37/124)的患者完成了血脂筛查。30%的住院患者回忆起对血脂值的临床解释。 在 SCI/D 住院患者中推进 PA 指导和血脂概况教育与管理以降低 CMD 风险的机会很大。在以患者为导向的出院摘要中纳入PA和血脂管理指导可提高患者的回忆率/依从性。
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引用次数: 0
Post Doc Competition (Knowledge Generation) ID 1986617 博士后竞赛(知识生成) ID 1986617
IF 2.9 Q1 REHABILITATION Pub Date : 2023-09-01 DOI: 10.46292/sci23-1986617s
Jeonghoon Oh, Michelle S. Scheffler, Catherine A. Martin, Jenny Dinh, Alexander G. Steele, D. Sayenko
Transcutaneous spinal stimulation (TSS) is emerging as a valuable tool for electrophysiological and clinical assessments. The objectives of this study were to investigate: (1) TSS above and below a spinal cord injury (SCI) lesion results in different recruitment pattern of upper limb (UL) motor pools compared to neurologically intact subjects (NIS), and (2) the relationship between recruitment pattern of UL motor pools and neurological and functional status in individuals with SCI. Methods: Eleven NIS and six participants with cervical SCI were recruited in this study. We compared spinally evoked motor potentials in UL muscles during TSS delivered to the cervical spinal cord between the spinous process of C3-C4 and C7-T1 vertebrae. As expected, TSS delivered over the cervical spinal cord in NIS can preferentially activate proximal and distal muscles along the rostrocaudal axis, as well as ipsilateral UL muscles along the mediolateral axis. However, in participants with SCI, the responses registered in UL muscles innervated by motor pools above and below the lesion demonstrated different recruitment compared to NIS, and were dependent on the level, extent, and side of SCI. The spatial map obtained from assessing evoked potentials above and below the lesion contributes to the comprehensive understanding of the viability and function of specific UL motor pools, and can be utilized to monitor changes in recruitment patterns of the UL motor pools during neurorehabilitation interventions after SCI.
经皮脊髓刺激(TSS)正在成为电生理和临床评估的重要工具。 本研究旨在探讨:(1) 与神经功能完好的受试者(NIS)相比,脊髓损伤(SCI)病灶上方和下方的经皮脊髓刺激(TSS)会导致不同的上肢(UL)运动池招募模式;(2) UL 运动池招募模式与 SCI 患者的神经和功能状态之间的关系。研究方法:本研究招募了 11 名 NIS 和 6 名颈椎 SCI 患者。我们比较了在 C3-C4 和 C7-T1 椎体棘突之间向颈脊髓输送 TSS 时 UL 肌肉的脊髓诱发运动电位。 不出所料,通过颈脊髓传递的 TSS 可优先激活 NIS 患者沿喙突轴的近端和远端肌肉,以及沿内侧轴的同侧 UL 肌肉。然而,在患有 SCI 的参与者中,由病变上方和下方的运动池所支配的 UL 肌肉所产生的反应与 NIS 相比表现出不同的招募,并且取决于 SCI 的程度、范围和侧边。 通过评估病变上方和下方的诱发电位获得的空间图有助于全面了解特定 UL 运动池的活力和功能,并可用于监测 SCI 后神经康复干预期间 UL 运动池招募模式的变化。
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引用次数: 0
Student Competition (Health Services, Economics and Policy Change) ID 1977283 学生竞赛(卫生服务、经济学和政策变化)ID 1977283
IF 2.9 Q1 REHABILITATION Pub Date : 2023-09-01 DOI: 10.46292/sci23-1977283s
Chaitali Desai, Rosalie Wang, Maureen Pakosh, Brian Chan
Assistive technologies (AT) span a large range of products from mobility aides such as canes to electronic systems that provide reminders. These technologies are important in facilitating independence, recovery and improved quality of life for individuals with spinal cord injury (SCI). However, clinical and economic outcomes for AT evaluated in the scientific literature is unclear. Thus, the aim of this study is to review the clinical and economic evidence for AT in the SCI population. Scientific literature databases including EMBASE, MEDLINE and CINAHL will be searched using terms identified in collaboration with a Medical Librarian. In the first stage, the titles and abstracts of clinical studies and economic analyses of AT focused in SCI will be screened by two reviewers. This will be followed by a second stage full-text screening for inclusion in the review by the same reviewers. The types of ATs evaluated will be identified along with the outcomes measured. Where applicable, study results will be presented using summary statistics. Work is currently underway to identify the citations. Two reviewers will then screen the titles and abstracts. It is anticipated that a large majority of the citations will be screened out with a small number of studies remaining. Most studies are also expected to be for the clinical evaluation of AT with variable outcomes. The results of this scoping review will provide valuable insight on the types of AT where clinical and economic evidence is available and identify where the current research gaps are.
辅助技术(AT)产品种类繁多,从拐杖等助行器具到提供提醒功能的电子系统,不一而足。这些技术对于促进脊髓损伤(SCI)患者的独立、康复和提高生活质量非常重要。然而,科学文献对辅助器具的临床和经济效果评估尚不明确。因此,本研究的目的是回顾脊髓损伤人群使用辅助呼吸技术的临床和经济证据。 本研究将与医学图书管理员合作,使用确定的术语对包括 EMBASE、MEDLINE 和 CINAHL 在内的科学文献数据库进行检索。在第一阶段,将由两名审稿人筛选以 SCI 为重点的 AT 临床研究和经济分析的标题和摘要。随后,同一审稿人将进行第二阶段的全文筛选,以便纳入综述。将确定所评估的 AT 类型以及所衡量的结果。在适用的情况下,研究结果将采用汇总统计的方式呈现。 目前正在开展确定引文的工作。然后,两名审稿人将对标题和摘要进行筛选。预计大部分引文将被筛选掉,剩下少量研究。此外,预计大多数研究都是针对AT的临床评估,结果不尽相同。 此次范围界定审查的结果将为我们提供关于已有临床和经济学证据的 AT 类型的宝贵见解,并确定目前的研究缺口在哪里。
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引用次数: 0
Poster (Clinical/Best Practice Implementation) ID 1978673 海报(临床/最佳实践实施)ID 1978673
IF 2.9 Q1 REHABILITATION Pub Date : 2023-09-01 DOI: 10.46292/sci23-1978673s
Jo Anne L. Savoie, Serene Qiu, Chelsea M. Crockford, Laura Kabbash
To address gaps in peer-supported services for those with a mobility disability, a virtual group was designed to have trained mentors with lived experience working alongside rehabilitation professionals to share resources and strategies that promote healthy living. Sessions offered knowledge and support in goal setting, healthy eating, physical activity, adapted recreation, emotional well-being, and social connectedness. Three rounds of the group were offered with 12 participants completing the group in its entirety. Pre- and post-measures included the Self-Efficacy to Manage Scale (Lorig, et al, 2001), the Life Satisfaction Questionnaire-11 (Fugl-Meyer, et al., 1991), and the Readiness Ruler adapted to each wellness topic (Moyers, et al., 2009). Analyses before and after group showed a slight increase (Cohen’s d = 0.3) in their subjective well-being on the life satisfaction scale and a moderately higher sense of self-efficacy (Cohen’s d = 0.6) in managing symptoms. Although perceived importance for change was similar, participants reported higher confidence in their ability to change (Cohen’s d = 0.4) and greater readiness to make changes (Cohen’s d = 0.4) after the group. The program resulted in several successes including slight increase in life satisfaction and moderately higher sense of self-efficacy in managing symptoms. Confidence in ability and readiness to make change also increased. The project had a small sample size, but the outcomes support the value of embedding a peer-support element into traditional healthcare delivery.
为了弥补针对行动不便者的同伴支持服务的不足,我们设计了一个虚拟小组,让受过培训、有生活经验的导师与康复专业人员一起工作,分享促进健康生活的资源和策略。 小组活动在目标设定、健康饮食、体育锻炼、适应性娱乐、情感健康和社会联系等方面提供知识和支持。小组共进行了三轮活动,共有 12 名参与者完成了整个小组活动。小组前后的测量包括自我管理能力量表(Lorig 等人,2001 年)、生活满意度问卷-11(Fugl-Meyer 等人,1991 年)以及根据每个健康主题调整的准备度量表(Moyers 等人,2009 年)。 分组前后的分析表明,他们在生活满意度量表上的主观幸福感略有提高(Cohen's d = 0.3),在控制症状方面的自我效能感略有提高(Cohen's d = 0.6)。虽然参与者认为改变的重要性相似,但在小组活动后,他们对自己改变的能力有了更大的信心(Cohen's d = 0.4),也更愿意做出改变(Cohen's d = 0.4)。 该计划取得了一些成功,包括生活满意度略有提高,控制症状的自我效能感略有提高。对自己能力的信心和做出改变的意愿也有所增强。该项目样本量较小,但其结果支持了在传统医疗保健服务中嵌入同伴支持元素的价值。
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引用次数: 0
Poster (Knowledge Generation) ID 1969461 海报(知识生成)ID 1969461
IF 2.9 Q1 REHABILITATION Pub Date : 2023-09-01 DOI: 10.46292/sci23-1969461s
S. Mohammadi, Victoria Bogle, Heather F. Cathcart, Sarah Park, William C. Miller
Individuals with SCI often receive care from their family members. Caregiving responsibilities lead to caregiver burden. Receiving social support may mitigate the negative impacts of caregiving. Caregivers can obtain support from people they meet in-person, such as family members and people with whom they interact through social platforms. Our objective was to investigate the moderating effect of in-person and online social supports on the association between relationship quality, caregiver competence, caregiver distress and caregiver burden. 115 caregivers who resided in Canada or the United States, understood and spoke English, and self-identified as primary family caregivers of an individual with SCI were sampled. Participants completed measures assessing relationship quality, competence, distress, burden, and in-person and online social support. Three separate moderation analyses for each outcome variable (i.e. relationship quality, competence, and distress), were conducted. In analyses, burden was the predictor, and online and in-person support were moderators. Moderation analyses showed that online support moderates the link between caregiver burden and distress. Slope analyses revealed that the positive relationship between burden and distress was weaker when caregivers reported lower levels of online support (p=0.005); this relationship was more robust when caregivers reported higher levels of online support (p <.001). Other moderation analyses were not statistically significant. Online support increases distress in family caregivers. It is likely that comparing their life with other caregivers or being exposed to other caregivers’ grief negatively affects caregivers. More research is needed to understand how online support impacts caregivers negatively.
SCI 患者通常会得到家人的照顾。护理责任导致护理负担。获得社会支持可以减轻护理的负面影响。照护者可以从亲身接触的人那里获得支持,如家庭成员和通过社交平台与他们互动的人。 我们的目的是研究亲身和在线社会支持对关系质量、照顾者能力、照顾者痛苦和照顾者负担之间关系的调节作用。 我们抽取了居住在加拿大或美国、能听懂并说英语、自我认同为 SCI 患者主要家庭照顾者的 115 名照顾者。参与者完成了对关系质量、能力、痛苦、负担以及现场和在线社会支持的评估。针对每个结果变量(即关系质量、能力和痛苦)分别进行了三项调节分析。在分析中,负担是预测因子,在线支持和亲身支持是调节因子。 调节分析表明,在线支持调节了照顾者负担与痛苦之间的联系。斜率分析表明,当照顾者报告的在线支持水平较低时,负担与痛苦之间的正相关关系较弱(p=0.005);当照顾者报告的在线支持水平较高时,这种关系更为稳固(p <.001)。其他调节分析在统计意义上并不显著。 在线支持会增加家庭照顾者的痛苦。将自己的生活与其他照顾者进行比较或接触其他照顾者的悲伤情绪很可能会对照顾者产生负面影响。要了解在线支持如何对照顾者产生负面影响,还需要进行更多的研究。
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引用次数: 0
Student Competition (Knowledge Generation) ID 1985735 学生竞赛(知识生成) ID 1985735
IF 2.9 Q1 REHABILITATION Pub Date : 2023-09-01 DOI: 10.46292/sci23-1985735s
Saina Aliabadi, Kristin E. Musselman, S. L. Hitzig, Susn Jaglal, B. C. Craven
Individuals with chronic spinal cord injury or disease (SCI/D) are at an increased risk of lower extremity fractures. Novel interventions, including nutraceuticals and pharmacotherapy, are being explored to reduce fracture-related morbidity and mortality. This retrospective cohort study aims to evaluate the effectiveness of Denosumab injections with dietary calcium and vitamin D supplements on proximaltibia bone mineral density (BMD) in adults with low bone mass and chronic SCI/D. Adult patients with SCI/D over age 18 years, with a baseline distal femur or proximal tibia Z-score <-2.0 or T-score <-2.5 exposed to at least three doses of Denosumab 60mcg/1ml vial injections will consent to chart abstraction. The cumulative Denosumab dose will be the exposure variable. Calcium intake and vitamin D serum levels will be recorded as effect modifiers. Age, sex, and BMI will be recorded as potential confounders. The primary outcome will be the change in proximal tibia BMD from baseline and secondarily the incidence of lower extremity fracture(s). Demographic and impairment characteristics of the study population will be reported using appropriate descriptive statistics. The associations between mean BMD change and Denosumab exposure will be calculated and adjusted for confounders using an appropriate univariate/multivariate model based on sample size and data distribution. This retrospective cohort study will determine the effectiveness of Denosumab injections (with calcium and vitamin D) for maintaining or increasing proximal tibia BMD among patients with chronic SCI/D. The study findings will have a significant impact on Denosumab prescribing practices.
慢性脊髓损伤或疾病(SCI/D)患者发生下肢骨折的风险增加。目前正在探索包括营养保健品和药物疗法在内的新型干预措施,以降低骨折相关的发病率和死亡率。 这项回顾性队列研究旨在评估注射地诺单抗与膳食钙和维生素 D 补充剂对低骨量和慢性 SCI/D 成人近端骨矿物质密度 (BMD) 的效果。 18岁以上患有SCI/D的成人患者,基线股骨远端或胫骨近端Z-score<-2.0或T-score<-2.5,至少接受过三次剂量的Denosumab 60mcg/1ml小瓶注射,并同意进行病历摘录。地诺单抗的累积剂量将作为暴露变量。钙摄入量和维生素 D 血清水平将被记录为效应调节因子。年龄、性别和体重指数将作为潜在混杂因素记录在案。主要结果是胫骨近端 BMD 与基线相比的变化,其次是下肢骨折的发生率。 研究对象的人口统计学特征和损伤特征将通过适当的描述性统计进行报告。将根据样本大小和数据分布情况,使用适当的单变量/多变量模型计算并调整 BMD 平均值变化与地诺单抗暴露之间的关系。 这项回顾性队列研究将确定注射地诺单抗(含钙和维生素 D)对维持或增加慢性 SCI/D 患者胫骨近端 BMD 的有效性。研究结果将对地诺单抗的处方实践产生重大影响。
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Topics in Spinal Cord Injury Rehabilitation
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