Candy Tefertiller, S. Wojciehowski, Mitch Sevigny, J. Ketchum, Meghan Rozwod
To compare 1-year mobility outcomes of individuals with traumatic motor incomplete spinal cord injury (miSCI) who participated in standardized locomotor training (LT) within the first year of injury to those who did not. This retrospective case-control analysis conducted with six US rehabilitation hospitals used SCI Model Systems (SCIMS) data comparing 1-year postinjury outcomes between individuals with miSCI who participated in standardized LT to those who received usual care (UC). Participants were matched on age, gender, injury year, mode of mobility, and rehabilitation center. The primary outcome is the FIM Total Motor score. Other outcomes include the FIM Transfer Index, FIM Stairs, and self-reported independence with household mobility, community mobility, and stairs. LT participants reported significantly better FIM Total Motor (difference = 2.812, 95% confidence interval [CI] = 5.896, 17.282) and FIM Transfer Index scores (difference = 0.958, 95% CI = 0.993, 4.866). No significant between-group differences were found for FIM Stairs (difference = 0.713, 95% CI = -0.104, 1.530) or self-reported household mobility (odds ratio [OR] = 5.065, CI = 1.435, 17.884), community mobility (OR = 2.933, 95% CI = 0.868, 9.910), and stairs (OR = 5.817, 95% CI = 1.424, 23.756) after controlling for multiple comparisons. LT participants reported significantly greater improvements in primary and secondary measures of mobility and independence (FIM Total Motor score; FIM Transfer Index) compared to UC participants. Self-reported mobility outcomes were not significant between groups.
目的：比较创伤性运动性不完全性脊髓损伤（miSCI）患者在伤后第一年内参加标准化运动训练（LT）与未参加者的一年行动能力结果。 这项回顾性病例对照分析由美国六家康复医院利用 SCI 模型系统（SCIMS）数据进行，比较了参加标准化运动训练（LT）的 miSCI 患者与接受常规护理（UC）的患者在受伤后一年的疗效。参与者的年龄、性别、受伤年份、行动方式和康复中心均匹配。主要结果是 FIM 运动总分。其他结果包括 FIM 转移指数、FIM 楼梯以及自我报告的家庭行动独立性、社区行动独立性和楼梯独立性。 LT参与者的FIM运动总分（差异=2.812，95%置信区间[CI] = 5.896，17.282）和FIM转移指数得分（差异=0.958，95%置信区间[CI] = 0.993，4.866）均明显提高。在控制多重比较后，FIM 楼梯（差异 = 0.713，95% CI = -0.104，1.530）或自我报告的家庭移动能力（几率比 [OR] = 5.065，CI = 1.435，17.884）、社区移动能力（OR = 2.933，95% CI = 0.868，9.910）和楼梯（OR = 5.817，95% CI = 1.424，23.756）均未发现明显的组间差异。 与统合症参与者相比，LT参与者在活动能力和独立性的主要和次要测量指标（FIM运动总分；FIM转移指数）方面的改善幅度明显更大。自我报告的活动能力结果在组间无显著差异。
{"title":"Comparison of One-Year Postinjury Mobility Outcomes Between Locomotor Training and Usual Care After Motor Incomplete Spinal Cord Injury","authors":"Candy Tefertiller, S. Wojciehowski, Mitch Sevigny, J. Ketchum, Meghan Rozwod","doi":"10.46292/sci23-00013","DOIUrl":"https://doi.org/10.46292/sci23-00013","url":null,"abstract":"To compare 1-year mobility outcomes of individuals with traumatic motor incomplete spinal cord injury (miSCI) who participated in standardized locomotor training (LT) within the first year of injury to those who did not. This retrospective case-control analysis conducted with six US rehabilitation hospitals used SCI Model Systems (SCIMS) data comparing 1-year postinjury outcomes between individuals with miSCI who participated in standardized LT to those who received usual care (UC). Participants were matched on age, gender, injury year, mode of mobility, and rehabilitation center. The primary outcome is the FIM Total Motor score. Other outcomes include the FIM Transfer Index, FIM Stairs, and self-reported independence with household mobility, community mobility, and stairs. LT participants reported significantly better FIM Total Motor (difference = 2.812, 95% confidence interval [CI] = 5.896, 17.282) and FIM Transfer Index scores (difference = 0.958, 95% CI = 0.993, 4.866). No significant between-group differences were found for FIM Stairs (difference = 0.713, 95% CI = -0.104, 1.530) or self-reported household mobility (odds ratio [OR] = 5.065, CI = 1.435, 17.884), community mobility (OR = 2.933, 95% CI = 0.868, 9.910), and stairs (OR = 5.817, 95% CI = 1.424, 23.756) after controlling for multiple comparisons. LT participants reported significantly greater improvements in primary and secondary measures of mobility and independence (FIM Total Motor score; FIM Transfer Index) compared to UC participants. Self-reported mobility outcomes were not significant between groups.","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"30 2","pages":""},"PeriodicalIF":2.9,"publicationDate":"2023-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139268837","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}
Dannae Arnold, Jaime Gillespie, Monica Bennett, Librada Callender, Seema Sikka, Rita Hamilton, Simon Driver, Chad Swank
Background After spinal cord injury (SCI), inpatient rehabilitation begins and continues through outpatient therapy. Overground exoskeleton gait training (OEGT) has been shown to be feasible in both settings, yet its use as an intervention across the continuum has not yet been reported. Objectives This study describes OEGT for patients with SCI across the continuum and its effects on clinical outcomes. Methods Medical records of patients with SCI who completed at least one OEGT session during inpatient and outpatient rehabilitation from 2018 to 2021 were retrospectively reviewed. Demographic data, Walking Index for Spinal Cord Injury-II (WISCI-II) scores, and OEGT session details (frequency, “walk” time, “up” time, and step count) were extracted. Results Eighteen patients [male (83%), White (61%), aged 37.4 ± 15 years, with tetraplegia (50%), American Spinal Injury Association Impairment Scale A (28%), B (22%), C (39%), D (11%)] completed OEGT sessions (motor complete, 18.2 ± 10.3; motor incomplete, 16.7 ± 7.7) over approximately 18 weeks (motor complete, 15.1 ± 6.4; motor incomplete, 19.0 ± 8.2). Patients demonstrated improved OEGT session tolerance on device metrics including “walk” time (motor complete, 7:51 ± 4:42 to 24:50 ± 9:35 minutes; motor incomplete, 12:16 ± 6:01 to 20:01 ± 08:05 minutes), “up” time (motor complete, 16:03 ± 7:41 to 29:49 ± 12:44 minutes; motor incomplete, 16:38 ± 4:51 to 23:06 ± 08:50 minutes), and step count (motor complete, 340 ± 295.9 to 840.2 ± 379.4; motor incomplete, 372.3 ± 225.2 to 713.2 ± 272). Across therapy settings, patients with motor complete SCI experienced improvement in WISCI-II scores from 0 ± 0 at inpatient admission to 3 ± 4.6 by outpatient discharge, whereas the motor incomplete group demonstrated a change of 0.2 ± 0.4 to 9.0 ± 6.4. Conclusion: Patients completed OEGT across the therapy continuum. Patients with motor incomplete SCI experienced clinically meaningful improvements in walking function.
背景脊髓损伤(SCI)后，住院康复开始并通过门诊治疗继续。地面外骨骼步态训练(OEGT)已被证明在这两种情况下都是可行的，但它作为一种连续干预的使用尚未有报道。目的:本研究描述了脊髓损伤患者的连续OEGT及其对临床结果的影响。方法回顾性分析2018年至2021年住院和门诊康复期间至少完成一次OEGT治疗的脊髓损伤患者的病历。提取了人口统计数据、脊髓损伤步行指数- ii (WISCI-II)评分和OEGT会话细节(频率、“步行”时间、“起身”时间和步数)。结果18例患者[男性(83%)，白人(61%)，年龄37.4±15岁，四肢瘫痪(50%)，美国脊髓损伤协会损伤量表A (28%)， B (22%)， C (39%)， D(11%)]完成了OEGT疗程(运动完成，18.2±10.3;电机不完整，16.7±7.7)在大约18周内完成(电机完整，15.1±6.4;电机不完整，19.0±8.2)。患者在设备指标上表现出改善的OEGT会话耐受性，包括“行走”时间(运动完成，7:51±4:42至24:50±9:35分钟;电机未完成，12:16±6:01至20:01±08:05分钟)，“启动”时间(电机完成，16:03±7:41至29:49±12:44分钟;电机未完成，16:38±4:51至23:06±08:50分钟)，步数(电机完成，340±295.9至840.2±379.4;电机不完整，372.3±225.2至713.2±272)。在整个治疗设置中，运动完全性脊髓损伤患者的WISCI-II评分从住院时的0±0提高到出院时的3±4.6，而运动不完全性脊髓损伤组的评分从0.2±0.4提高到9.0±6.4。结论:患者在整个治疗过程中完成了OEGT。运动不完全性脊髓损伤患者的行走功能有临床意义的改善。
{"title":"Clinical Delivery of Overground Exoskeleton Gait Training in Persons With Spinal Cord Injury Across the Continuum of Care: A Retrospective Analysis","authors":"Dannae Arnold, Jaime Gillespie, Monica Bennett, Librada Callender, Seema Sikka, Rita Hamilton, Simon Driver, Chad Swank","doi":"10.46292/sci23-00001","DOIUrl":"https://doi.org/10.46292/sci23-00001","url":null,"abstract":"Background After spinal cord injury (SCI), inpatient rehabilitation begins and continues through outpatient therapy. Overground exoskeleton gait training (OEGT) has been shown to be feasible in both settings, yet its use as an intervention across the continuum has not yet been reported. Objectives This study describes OEGT for patients with SCI across the continuum and its effects on clinical outcomes. Methods Medical records of patients with SCI who completed at least one OEGT session during inpatient and outpatient rehabilitation from 2018 to 2021 were retrospectively reviewed. Demographic data, Walking Index for Spinal Cord Injury-II (WISCI-II) scores, and OEGT session details (frequency, “walk” time, “up” time, and step count) were extracted. Results Eighteen patients [male (83%), White (61%), aged 37.4 ± 15 years, with tetraplegia (50%), American Spinal Injury Association Impairment Scale A (28%), B (22%), C (39%), D (11%)] completed OEGT sessions (motor complete, 18.2 ± 10.3; motor incomplete, 16.7 ± 7.7) over approximately 18 weeks (motor complete, 15.1 ± 6.4; motor incomplete, 19.0 ± 8.2). Patients demonstrated improved OEGT session tolerance on device metrics including “walk” time (motor complete, 7:51 ± 4:42 to 24:50 ± 9:35 minutes; motor incomplete, 12:16 ± 6:01 to 20:01 ± 08:05 minutes), “up” time (motor complete, 16:03 ± 7:41 to 29:49 ± 12:44 minutes; motor incomplete, 16:38 ± 4:51 to 23:06 ± 08:50 minutes), and step count (motor complete, 340 ± 295.9 to 840.2 ± 379.4; motor incomplete, 372.3 ± 225.2 to 713.2 ± 272). Across therapy settings, patients with motor complete SCI experienced improvement in WISCI-II scores from 0 ± 0 at inpatient admission to 3 ± 4.6 by outpatient discharge, whereas the motor incomplete group demonstrated a change of 0.2 ± 0.4 to 9.0 ± 6.4. Conclusion: Patients completed OEGT across the therapy continuum. Patients with motor incomplete SCI experienced clinically meaningful improvements in walking function.","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"103 ","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135872449","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}
Ramtin Hakimjavadi, Shahin Basiratzadeh, Eugene K. Wai, Natalie Baddour, Stephen Kingwell, Wojtek Michalowski, Alexandra Stratton, Eve Tsai, Herna Viktor, Philippe Phan
Background Traumatic spinal cord injuries (TSCI) greatly affect the lives of patients and their families. Prognostication may improve treatment strategies, health care resource allocation, and counseling. Multivariable clinical prediction models (CPMs) for prognosis are tools that can estimate an absolute risk or probability that an outcome will occur. Objectives We sought to systematically review the existing literature on CPMs for TSCI and critically examine the predictor selection methods used. Methods We searched MEDLINE, PubMed, Embase, Scopus, and IEEE for English peer-reviewed studies and relevant references that developed multivariable CPMs to prognosticate patient-centered outcomes in adults with TSCI. Using narrative synthesis, we summarized the characteristics of the included studies and their CPMs, focusing on the predictor selection process. Results We screened 663 titles and abstracts; of these, 21 full-text studies (2009-2020) consisting of 33 distinct CPMs were included. The data analysis domain was most commonly at a high risk of bias when assessed for methodological quality. Model presentation formats were inconsistently included with published CPMs; only two studies followed established guidelines for transparent reporting of multivariable prediction models. Authors frequently cited previous literature for their initial selection of predictors, and stepwise selection was the most frequent predictor selection method during modelling. Conclusion Prediction modelling studies for TSCI serve clinicians who counsel patients, researchers aiming to risk-stratify participants for clinical trials, and patients coping with their injury. Poor methodological rigor in data analysis, inconsistent transparent reporting, and a lack of model presentation formats are vital areas for improvement in TSCI CPM research.
{"title":"Multivariable Prediction Models for Traumatic Spinal Cord Injury: A Systematic Review","authors":"Ramtin Hakimjavadi, Shahin Basiratzadeh, Eugene K. Wai, Natalie Baddour, Stephen Kingwell, Wojtek Michalowski, Alexandra Stratton, Eve Tsai, Herna Viktor, Philippe Phan","doi":"10.46292/sci23-00010","DOIUrl":"https://doi.org/10.46292/sci23-00010","url":null,"abstract":"Background Traumatic spinal cord injuries (TSCI) greatly affect the lives of patients and their families. Prognostication may improve treatment strategies, health care resource allocation, and counseling. Multivariable clinical prediction models (CPMs) for prognosis are tools that can estimate an absolute risk or probability that an outcome will occur. Objectives We sought to systematically review the existing literature on CPMs for TSCI and critically examine the predictor selection methods used. Methods We searched MEDLINE, PubMed, Embase, Scopus, and IEEE for English peer-reviewed studies and relevant references that developed multivariable CPMs to prognosticate patient-centered outcomes in adults with TSCI. Using narrative synthesis, we summarized the characteristics of the included studies and their CPMs, focusing on the predictor selection process. Results We screened 663 titles and abstracts; of these, 21 full-text studies (2009-2020) consisting of 33 distinct CPMs were included. The data analysis domain was most commonly at a high risk of bias when assessed for methodological quality. Model presentation formats were inconsistently included with published CPMs; only two studies followed established guidelines for transparent reporting of multivariable prediction models. Authors frequently cited previous literature for their initial selection of predictors, and stepwise selection was the most frequent predictor selection method during modelling. Conclusion Prediction modelling studies for TSCI serve clinicians who counsel patients, researchers aiming to risk-stratify participants for clinical trials, and patients coping with their injury. Poor methodological rigor in data analysis, inconsistent transparent reporting, and a lack of model presentation formats are vital areas for improvement in TSCI CPM research.","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135471529","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}
Lauren Cadel, Stephanie R. Cimino, Glyneva Bradley-Ridout, S. L. Hitzig, Tanya L Packer, Lisa M McCarthy, Tejal Patel, Aisha K Lofters, Shoshana Hahn-Goldberg, Chester H Ho, S. Guilcher
Persons with traumatic spinal cord injury (SCI) are often experience polypharmacy, the use of multiple medications, to manage secondary complications and concurrent conditions. Despite the prevalence of polypharmacy and challenges associated with managing medications, there are few tools to support persons with SCI with medication self-management. The purpose of this scoping review was to identify and summarize what is reported in the literature on medication self-management interventions for adults with traumatic SCI. Articles were searched on electronic databases and grey literature. For inclusion, articles were required to include an adult population with a traumatic SCI and an intervention targeting medication management. They had to incorporate a component of self-management. Articles were independently screened and data were extracted and synthesized using descriptive approaches. Three studies were included in this scoping review. Interventions included a mobile app and two education-based interventions to address self-management of SCI, medication management, and pain management. None of the identified interventions addressed medication self-management comprehensively. Learning outcomes (perceived knowledge and confidence), behavioural outcomes (management strategies, data entry), and clinical outcomes (number of medications, pain scores, functional outcomes) were evaluated. Results of the interventions varied, but some positive outcomes were noted, with improvements in perceived knowledge and confidence and a reduction in the use of multiple pain medications. Overall, there are limited interventions targeting medication self-management for persons with SCI. There is an opportunity better support this population through the co-design and implementation of an intervention that comprehensively addresses self-management.
{"title":"Student Competition (Knowledge Generation) ID 1985151","authors":"Lauren Cadel, Stephanie R. Cimino, Glyneva Bradley-Ridout, S. L. Hitzig, Tanya L Packer, Lisa M McCarthy, Tejal Patel, Aisha K Lofters, Shoshana Hahn-Goldberg, Chester H Ho, S. Guilcher","doi":"10.46292/sci23-1985151s","DOIUrl":"https://doi.org/10.46292/sci23-1985151s","url":null,"abstract":"Persons with traumatic spinal cord injury (SCI) are often experience polypharmacy, the use of multiple medications, to manage secondary complications and concurrent conditions. Despite the prevalence of polypharmacy and challenges associated with managing medications, there are few tools to support persons with SCI with medication self-management. The purpose of this scoping review was to identify and summarize what is reported in the literature on medication self-management interventions for adults with traumatic SCI. Articles were searched on electronic databases and grey literature. For inclusion, articles were required to include an adult population with a traumatic SCI and an intervention targeting medication management. They had to incorporate a component of self-management. Articles were independently screened and data were extracted and synthesized using descriptive approaches. Three studies were included in this scoping review. Interventions included a mobile app and two education-based interventions to address self-management of SCI, medication management, and pain management. None of the identified interventions addressed medication self-management comprehensively. Learning outcomes (perceived knowledge and confidence), behavioural outcomes (management strategies, data entry), and clinical outcomes (number of medications, pain scores, functional outcomes) were evaluated. Results of the interventions varied, but some positive outcomes were noted, with improvements in perceived knowledge and confidence and a reduction in the use of multiple pain medications. Overall, there are limited interventions targeting medication self-management for persons with SCI. There is an opportunity better support this population through the co-design and implementation of an intervention that comprehensively addresses self-management.","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"46 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139343742","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}
Anita Kaiser, Katherine Chan, James Sessford, S. McCullum, Peter Athanasopoulos, Chris Rice, Iona Macritchie, J. Zariffa, Kristin E. Musselman
Implementing activity-based therapy (ABT) across the continuum of care in Canada has proved challenging. The objective of this study was to understand and compare multi-group perspectives on the challenges that hinder implementation of ABT in Canada for people living with spinal cord injury or disease (SCI/D). Individuals from six key interest groups (i.e., researchers; persons living with SCI/D; administrators; physical and occupational therapists; community-based exercise trainers; and funders, advocates, and policy experts) who had knowledge of and/or experience with ABT were recruited to participate in focus group interviews that were held over web conferencing. Participants were asked about the barriers and facilitators to practicing ABT. Interview transcripts were analyzed using conventional content analysis followed by a comparative analysis across groups. Forty-eight individuals participated in interviews lasting 30-80 minutes. Six themes were identified: 1) Challenge of defining ABT and addressing gaps in knowledge/training. 2) Challenge of standardizing ABT. 3) Challenge of determining the optimal timing of ABT. 4) Challenge of defining, characterizing and achieving high dosage and intensity. 5) Challenge of funding ABT. 6) Challenge of measuring participation and performance in ABT. While all groups acknowledged these six challenges, therapists and community trainers viewed knowledge/training gaps and achieving high dosage and intensity as key challenges. Researchers and advocates emphasized funding as a key challenge. Participants highlighted the challenges that limit adoption of ABT into practice within hospital and community settings. Future research should explore avenues to address these challenges to support successful implementation of ABT in Canada.
{"title":"Student Competition (Knowledge Generation) ID 1975184","authors":"Anita Kaiser, Katherine Chan, James Sessford, S. McCullum, Peter Athanasopoulos, Chris Rice, Iona Macritchie, J. Zariffa, Kristin E. Musselman","doi":"10.46292/sci23-1975184s","DOIUrl":"https://doi.org/10.46292/sci23-1975184s","url":null,"abstract":"Implementing activity-based therapy (ABT) across the continuum of care in Canada has proved challenging. The objective of this study was to understand and compare multi-group perspectives on the challenges that hinder implementation of ABT in Canada for people living with spinal cord injury or disease (SCI/D). Individuals from six key interest groups (i.e., researchers; persons living with SCI/D; administrators; physical and occupational therapists; community-based exercise trainers; and funders, advocates, and policy experts) who had knowledge of and/or experience with ABT were recruited to participate in focus group interviews that were held over web conferencing. Participants were asked about the barriers and facilitators to practicing ABT. Interview transcripts were analyzed using conventional content analysis followed by a comparative analysis across groups. Forty-eight individuals participated in interviews lasting 30-80 minutes. Six themes were identified: 1) Challenge of defining ABT and addressing gaps in knowledge/training. 2) Challenge of standardizing ABT. 3) Challenge of determining the optimal timing of ABT. 4) Challenge of defining, characterizing and achieving high dosage and intensity. 5) Challenge of funding ABT. 6) Challenge of measuring participation and performance in ABT. While all groups acknowledged these six challenges, therapists and community trainers viewed knowledge/training gaps and achieving high dosage and intensity as key challenges. Researchers and advocates emphasized funding as a key challenge. Participants highlighted the challenges that limit adoption of ABT into practice within hospital and community settings. Future research should explore avenues to address these challenges to support successful implementation of ABT in Canada.","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"54 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139343778","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}
Giuseppe Gazzellone, Sarah Lanteigne, Kimberley Gammage, Val A. Fajardo, David S. Ditor
Previous research has shown that an anti-inflammatory diet can reduce inflammation and improve health outcomes in individuals with neurological disability; however, long term dietary adherence has proven to be challenging. Accordingly, we have designed a 2-part consultation targeted at identified barriers for adherence to an anti-inflammatory diet in this population. This study aimed to determine the effects of the consultation on self-efficacy for adhering to an anti-inflammatory diet, as well as adherence and health outcomes one month post-intervention. Eleven individuals (10 female, age 51.5±12.6 years) with neurological disability (7 multiple sclerosis, 3 spinal cord injury, 1 muscular dystrophy; 20.5±10.6 years post-injury/diagnosis) participated. The intervention group (n=7) received recipes for an anti-inflammatory diet and the 2-part consultation, while controls (n=4) received the recipes only. The consultation consisted of a home-visit that included cooking and accessible kitchen equipment demonstrations, and an accompanied trip to the grocery store. Both task and barrier self-efficacy improved immediately following the consultation and tended to stay above baseline one month post-intervention. The consultation was also associated with increased dietary adherence one month post-intervention and decreased depressive symptoms as measured by the Centre for Epidemiological Studies Depression Scale (CES-D). Changes in dietary adherence (r=-0.61; p=0.045), and barrier self-efficacy (r=-0.77; p=0.009) were negatively correlated to changes in CES-D scores. A consultation targeted at barriers related to anti-inflammatory eating can improve self-efficacy for adherence as well as actual adherence and depressive symptomology one month later. Further follow-up studies to determine the persistence of these effects are warranted.
{"title":"Student Competition (Clinical/Best Practice Implementation) ID 1983939","authors":"Giuseppe Gazzellone, Sarah Lanteigne, Kimberley Gammage, Val A. Fajardo, David S. Ditor","doi":"10.46292/sci23-1983939s","DOIUrl":"https://doi.org/10.46292/sci23-1983939s","url":null,"abstract":"Previous research has shown that an anti-inflammatory diet can reduce inflammation and improve health outcomes in individuals with neurological disability; however, long term dietary adherence has proven to be challenging. Accordingly, we have designed a 2-part consultation targeted at identified barriers for adherence to an anti-inflammatory diet in this population. This study aimed to determine the effects of the consultation on self-efficacy for adhering to an anti-inflammatory diet, as well as adherence and health outcomes one month post-intervention. Eleven individuals (10 female, age 51.5±12.6 years) with neurological disability (7 multiple sclerosis, 3 spinal cord injury, 1 muscular dystrophy; 20.5±10.6 years post-injury/diagnosis) participated. The intervention group (n=7) received recipes for an anti-inflammatory diet and the 2-part consultation, while controls (n=4) received the recipes only. The consultation consisted of a home-visit that included cooking and accessible kitchen equipment demonstrations, and an accompanied trip to the grocery store. Both task and barrier self-efficacy improved immediately following the consultation and tended to stay above baseline one month post-intervention. The consultation was also associated with increased dietary adherence one month post-intervention and decreased depressive symptoms as measured by the Centre for Epidemiological Studies Depression Scale (CES-D). Changes in dietary adherence (r=-0.61; p=0.045), and barrier self-efficacy (r=-0.77; p=0.009) were negatively correlated to changes in CES-D scores. A consultation targeted at barriers related to anti-inflammatory eating can improve self-efficacy for adherence as well as actual adherence and depressive symptomology one month later. Further follow-up studies to determine the persistence of these effects are warranted.","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"9 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139344131","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}
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.
{"title":"Student Competition (Technology Innovation) ID 1972228","authors":"Nicholas Zhao, J. Zariffa","doi":"10.46292/sci23-1972228s","DOIUrl":"https://doi.org/10.46292/sci23-1972228s","url":null,"abstract":"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.","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"15 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139344244","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}
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.
{"title":"Poster (Clinical/Best Practice Implementation) ID 1981325","authors":"Laura M. Oldford, Lauren E. Casey, Samuel Campbell, S. McCullum, Erica J. de Passillé, Colleen M. O’Connell","doi":"10.46292/sci23-1981325s","DOIUrl":"https://doi.org/10.46292/sci23-1981325s","url":null,"abstract":"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.","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"98 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139346193","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}
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.
{"title":"Student Competition (Knowledge Generation) ID 1986472","authors":"S. Gautam, Vivian K. Mushahwar, Mandira Baniya, K. P. Manhas, Raju Dhakal, C. Groves, Chester Ho","doi":"10.46292/sci23-1986472s","DOIUrl":"https://doi.org/10.46292/sci23-1986472s","url":null,"abstract":"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.","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"2014 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139346588","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}
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.
{"title":"Poster (Health Services, Economics and Policy Change) ID 1977284","authors":"Brian Chan, Natascha Lam, Verena Rafael, Maureen Pakosh, Kristin E. Musselman","doi":"10.46292/sci23-1977284s","DOIUrl":"https://doi.org/10.46292/sci23-1977284s","url":null,"abstract":"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.","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"95 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139346798","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}
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