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":null,"pages":null},"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":null,"pages":null},"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}
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.
{"title":"Poster (Clinical/Best Practice Implementation) ID 1984967","authors":"Suban Kangatharan, Mohammadreza Amiri, Louise Brisbois, Farnoosh Farahani, B. C. Craven","doi":"10.46292/sci23-1984967s","DOIUrl":"https://doi.org/10.46292/sci23-1984967s","url":null,"abstract":"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.","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139346848","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}
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。
{"title":"Post Doc Competition (Knowledge Generation) ID 1986617","authors":"Jeonghoon Oh, Michelle S. Scheffler, Catherine A. Martin, Jenny Dinh, Alexander G. Steele, D. Sayenko","doi":"10.46292/sci23-1986617s","DOIUrl":"https://doi.org/10.46292/sci23-1986617s","url":null,"abstract":"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.","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139347084","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}
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。
{"title":"Student Competition (Health Services, Economics and Policy Change) ID 1977283","authors":"Chaitali Desai, Rosalie Wang, Maureen Pakosh, Brian Chan","doi":"10.46292/sci23-1977283s","DOIUrl":"https://doi.org/10.46292/sci23-1977283s","url":null,"abstract":"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.","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139343638","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}
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。
{"title":"Poster (Clinical/Best Practice Implementation) ID 1978673","authors":"Jo Anne L. Savoie, Serene Qiu, Chelsea M. Crockford, Laura Kabbash","doi":"10.46292/sci23-1978673s","DOIUrl":"https://doi.org/10.46292/sci23-1978673s","url":null,"abstract":"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.","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139344076","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. 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.
{"title":"Poster (Knowledge Generation) ID 1969461","authors":"S. Mohammadi, Victoria Bogle, Heather F. Cathcart, Sarah Park, William C. Miller","doi":"10.46292/sci23-1969461s","DOIUrl":"https://doi.org/10.46292/sci23-1969461s","url":null,"abstract":"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.","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139344097","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}
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.
{"title":"Student Competition (Knowledge Generation) ID 1985735","authors":"Saina Aliabadi, Kristin E. Musselman, S. L. Hitzig, Susn Jaglal, B. C. Craven","doi":"10.46292/sci23-1985735s","DOIUrl":"https://doi.org/10.46292/sci23-1985735s","url":null,"abstract":"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.","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139344853","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}
The foremost reported unmet health need for Canadians with chronic neurological conditions is linked to physical maintenance. One way to address this issue is through activity programing offered through public institutions, where rehabilitation can be integrated into secondary health care settings. Parkwood Institute in London, Ontario has developed several programs, including virtual exercise classes, day programs, and a community fitness center. People who have participated in these initiatives can provide insights that could be used to create more robust person-centered rehabilitation physical activity programing. To explore the lived experiences of individuals participating in activity programs offered through Parkwood Institute to develop recommendations for future program development. Using purposive sampling of individuals with a chronic neurological health condition who have participated in a physical activity program offered through Parkwood, we will use a grounded theory methodology to explore individual perspectives. Data will be collected using semi-structured interviews to gather critical perspectives and data will be analyzed using constant comparative analysis. Data collection and analysis will be an iterative process, meaning codes and categories will be developed from initial interviews, with subsequent data being continuously compared to identify similarities and differences. The findings of this research will, once completed, describe the impact of various physical activity programs, including benefits, challenges, and recommendations for future development. The theoretical interpretations of the findings will be presented as a list of recommendations for activity programs offered through rehabilitation centers to assist researchers, clinicians, and policy makers in decision-making.
{"title":"Student Competition (Clinical/Best Practice Implementation) ID 1984705","authors":"Joshua Stoikos, Janelle Unger","doi":"10.46292/sci23-1984705s","DOIUrl":"https://doi.org/10.46292/sci23-1984705s","url":null,"abstract":"The foremost reported unmet health need for Canadians with chronic neurological conditions is linked to physical maintenance. One way to address this issue is through activity programing offered through public institutions, where rehabilitation can be integrated into secondary health care settings. Parkwood Institute in London, Ontario has developed several programs, including virtual exercise classes, day programs, and a community fitness center. People who have participated in these initiatives can provide insights that could be used to create more robust person-centered rehabilitation physical activity programing. To explore the lived experiences of individuals participating in activity programs offered through Parkwood Institute to develop recommendations for future program development. Using purposive sampling of individuals with a chronic neurological health condition who have participated in a physical activity program offered through Parkwood, we will use a grounded theory methodology to explore individual perspectives. Data will be collected using semi-structured interviews to gather critical perspectives and data will be analyzed using constant comparative analysis. Data collection and analysis will be an iterative process, meaning codes and categories will be developed from initial interviews, with subsequent data being continuously compared to identify similarities and differences. The findings of this research will, once completed, describe the impact of various physical activity programs, including benefits, challenges, and recommendations for future development. The theoretical interpretations of the findings will be presented as a list of recommendations for activity programs offered through rehabilitation centers to assist researchers, clinicians, and policy makers in decision-making.","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139346278","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. Mehta, M. Nugent, K. Prasad, R. Upper, E. Loh, R. Teasell, K. Sequeira, D. Wolfe, N. Titov, B. Dear, H. Hadjistavropoulos
Guided internet-delivered CBT (ICBT) offers an alternative approach for mental health service delivery in the community for those with spinal cord injury (SCI). However, there is a lack of evidence to support its use through large, controlled trials. The primary aim of the current study is to explore the efficacy of ICBT in reducing symptoms of depression and anxiety among persons with SCI compared to an online SCI Rehabilitation Education program. Upon completing this workshop, attendees will: 1) understand the state of mental health among those post SCI; 2) explain the evidence behind guided ICBT among those post SCI; 3) apply cognitive behaviour therapy skills. The presenters of this workshop will engage in lecture to provide current state of evidence for ICBT among those post SCI, conduct small-group discussions to apply CBT skills and examine barriers and facilitators of implementing the program. Participants (n=122) endorsing symptoms of depression and/or anxiety related to SCI were randomized to an 8-week transdiagnostic ICBT program for those with SCI or an online SCI Rehabilitation Education program. Participants completed measures on depression, anxiety, self-efficacy, quality of life, and pain at pre-, post-, 3-months, and 6-months post-intervention. Significantly greater improvements in depression, anxiety, self-efficacy, quality of life, and pain interference were seen in the ICBT group compared to the Education group at post treatment and follow-up. Completion rates (∼90%) and satisfaction (>90%) were high in both groups. The findings provide evidence for the superiority of ICBT over education in improving well-being among those with SCI.
{"title":"Workshop (Knowledge Generation) ID 2001810","authors":"S. Mehta, M. Nugent, K. Prasad, R. Upper, E. Loh, R. Teasell, K. Sequeira, D. Wolfe, N. Titov, B. Dear, H. Hadjistavropoulos","doi":"10.46292/sci23-2001810s","DOIUrl":"https://doi.org/10.46292/sci23-2001810s","url":null,"abstract":"Guided internet-delivered CBT (ICBT) offers an alternative approach for mental health service delivery in the community for those with spinal cord injury (SCI). However, there is a lack of evidence to support its use through large, controlled trials. The primary aim of the current study is to explore the efficacy of ICBT in reducing symptoms of depression and anxiety among persons with SCI compared to an online SCI Rehabilitation Education program. Upon completing this workshop, attendees will: 1) understand the state of mental health among those post SCI; 2) explain the evidence behind guided ICBT among those post SCI; 3) apply cognitive behaviour therapy skills. The presenters of this workshop will engage in lecture to provide current state of evidence for ICBT among those post SCI, conduct small-group discussions to apply CBT skills and examine barriers and facilitators of implementing the program. Participants (n=122) endorsing symptoms of depression and/or anxiety related to SCI were randomized to an 8-week transdiagnostic ICBT program for those with SCI or an online SCI Rehabilitation Education program. Participants completed measures on depression, anxiety, self-efficacy, quality of life, and pain at pre-, post-, 3-months, and 6-months post-intervention. Significantly greater improvements in depression, anxiety, self-efficacy, quality of life, and pain interference were seen in the ICBT group compared to the Education group at post treatment and follow-up. Completion rates (∼90%) and satisfaction (>90%) were high in both groups. The findings provide evidence for the superiority of ICBT over education in improving well-being among those with SCI.","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":null,"pages":null},"PeriodicalIF":2.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139346519","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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