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":"18 1","pages":""},"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":"28 1","pages":""},"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":"38 1","pages":""},"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":"8 1","pages":""},"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":"28 1","pages":""},"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":"26 1","pages":""},"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}
Ramin Fathian, A. Khandan, Chester Ho, Hossein Rouhani
Up to 70% of individuals with spinal cord injury (SCI) experience shoulder injuries during their lifetime. Previous studies revealed a link between the risk of shoulder injury and propulsion-related kinetic and kinematic parameters that were measured using SMARTWheel or in-lab motion-capture systems. Despite their high accuracy, these systems are time and labour intensive and not commonly accessible. To develop and validate a portable and accessible method to estimate the duration of the push phase using a hand-mounted inertial measurement unit (IMU). Ten volunteers (7 males, 3 females, age: 28 ± 2 y.o.) consented to participate in the study. An IMU (3D acceleration and angular velocity, sampling frequency: 512 Hz) was attached to participant’s right hand while sitting on the instrumented wheelchair equipped with SMARTWheel (sampling frequency: 240 Hz). The SMARTWheel and IMU readouts were collected while participants were propelling the wheelchair. The peaks in the resultant acceleration and continuous wavelet transform coefficients obtained from IMU were used to identify the hand contact and release, and estimate the push phase duration. No significant differences (p-value = 0.97, 0.89, and 0.94, respectively) were observed between the parameters obtained for the hand contact and release instants and push duration estimated using IMU compared to SMARTWheel with mean errors (standard deviation) of 8.4 (15.2) ms, 3.8 (22.1) ms and −4.6 (24.6) ms, respectively. These findings support the validity of using IMU as a portable alternative to the in-lab systems to estimate the push phase duration of manual wheelchair users.
{"title":"Student Competition (Technology Innovation) ID 1986855","authors":"Ramin Fathian, A. Khandan, Chester Ho, Hossein Rouhani","doi":"10.46292/sci23-1986855s","DOIUrl":"https://doi.org/10.46292/sci23-1986855s","url":null,"abstract":"Up to 70% of individuals with spinal cord injury (SCI) experience shoulder injuries during their lifetime. Previous studies revealed a link between the risk of shoulder injury and propulsion-related kinetic and kinematic parameters that were measured using SMARTWheel or in-lab motion-capture systems. Despite their high accuracy, these systems are time and labour intensive and not commonly accessible. To develop and validate a portable and accessible method to estimate the duration of the push phase using a hand-mounted inertial measurement unit (IMU). Ten volunteers (7 males, 3 females, age: 28 ± 2 y.o.) consented to participate in the study. An IMU (3D acceleration and angular velocity, sampling frequency: 512 Hz) was attached to participant’s right hand while sitting on the instrumented wheelchair equipped with SMARTWheel (sampling frequency: 240 Hz). The SMARTWheel and IMU readouts were collected while participants were propelling the wheelchair. The peaks in the resultant acceleration and continuous wavelet transform coefficients obtained from IMU were used to identify the hand contact and release, and estimate the push phase duration. No significant differences (p-value = 0.97, 0.89, and 0.94, respectively) were observed between the parameters obtained for the hand contact and release instants and push duration estimated using IMU compared to SMARTWheel with mean errors (standard deviation) of 8.4 (15.2) ms, 3.8 (22.1) ms and −4.6 (24.6) ms, respectively. These findings support the validity of using IMU as a portable alternative to the in-lab systems to estimate the push phase duration of manual wheelchair users.","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":"139346612","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}
Thomas P. Walden, Shajaky Parameswaran, Louise Brisbois, B. C. Craven
Individuals with a neurologic level of injury (NLI) C1-T10 have an UMN bowel and propensity for external anal sphincter spasm and need chemical/mechanical stimuli to evacuate their bowels versus those with an NLI T11-S5 and LMN bowel whom have a patulous sphincter and complete manual bowel disimpaction. We describe the associations between independence in sphincter control for 5 years following discharge among individuals with traumatic SCI (tSCI). Adults with tSCI (n=113, 80 men) whom completed baseline, 1, 2, and 5-year community follow-up interviews (2014-2021) were included. Responses to the Spinal Cord Independence Measure (SCIM-III) Sphincter Control and Respiration subscores were extracted. Participants were separated into UMN and LMN groups. A linear mixed model determined longitudinal differences in SCIM subscores. NLI and follow-up time points were assigned as fixed effects, age a random effect, and sex as a covariate. Observed differences were compared to the minimal clinically importance difference (MCID) in SCIM-III subscores. The mean difference in SCIM-III subscores was 4.85 between the UMN and LMN bowel groups, with UMN group scoring lower at all-time points (p≤0.017). The mean group difference was equal to the MCID, constituting a substantial meaningful difference. No differences in SCIM subscores were noted across time (p≥0.9), regardless of NLI or bowel impairment. Self-reported sphincter control remains stable for 5 years post-injury, emphasizing the need to maximizing bowel independence before discharge. Individuals with UMN bowel have lower sphincter control scores than individuals with a LMN bowel.
{"title":"Post Doc Competition (Knowledge Generation) ID 1987817","authors":"Thomas P. Walden, Shajaky Parameswaran, Louise Brisbois, B. C. Craven","doi":"10.46292/sci23-1987817s","DOIUrl":"https://doi.org/10.46292/sci23-1987817s","url":null,"abstract":"Individuals with a neurologic level of injury (NLI) C1-T10 have an UMN bowel and propensity for external anal sphincter spasm and need chemical/mechanical stimuli to evacuate their bowels versus those with an NLI T11-S5 and LMN bowel whom have a patulous sphincter and complete manual bowel disimpaction. We describe the associations between independence in sphincter control for 5 years following discharge among individuals with traumatic SCI (tSCI). Adults with tSCI (n=113, 80 men) whom completed baseline, 1, 2, and 5-year community follow-up interviews (2014-2021) were included. Responses to the Spinal Cord Independence Measure (SCIM-III) Sphincter Control and Respiration subscores were extracted. Participants were separated into UMN and LMN groups. A linear mixed model determined longitudinal differences in SCIM subscores. NLI and follow-up time points were assigned as fixed effects, age a random effect, and sex as a covariate. Observed differences were compared to the minimal clinically importance difference (MCID) in SCIM-III subscores. The mean difference in SCIM-III subscores was 4.85 between the UMN and LMN bowel groups, with UMN group scoring lower at all-time points (p≤0.017). The mean group difference was equal to the MCID, constituting a substantial meaningful difference. No differences in SCIM subscores were noted across time (p≥0.9), regardless of NLI or bowel impairment. Self-reported sphincter control remains stable for 5 years post-injury, emphasizing the need to maximizing bowel independence before discharge. Individuals with UMN bowel have lower sphincter control scores than individuals with a LMN bowel.","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"123 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139344464","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 evaluation of hand function after spinal cord injury (SCI) is conducted in clinical settings, which may not accurately reflect hand function in the real world, thereby limiting the efficacy assessment of new treatments. Wearable cameras, also known as egocentric video, are a novel method to evaluate hand function in non-clinical environments. Nonetheless, manual processing of vast quantities of complex video data is difficult, highlighting the need for automated data analysis. The objective of this study was to automatically identify distinct hand postures in egocentric video using unsupervised machine learning. Seventeen participants with cervical SCI recorded activities of daily living in a home simulation laboratory. A hand pose estimation algorithm was applied on detected hands to determine 2D joint locations, which were lifted to 3D coordinates. The resulting hand posture information was subjected to a number of clustering techniques. Hand grasps were manually labelled into four categories for evaluation purposes: power, precision, intermediate, and non-prehensile. K-Means clustering consistently exhibited the highest Silhouette score, which reflects the presence of discrete clusters in the data. When comparing with manual annotations, Spectral Clustering applied to a feature space consisting of 2D pose estimation with confidence scores yield the best performance as quantified by maximum match (0.48), Fowlkes-Mallows score (0.46), and normalized mutual information (0.22). This is the first attempt to develop an unsupervised, data-driven hand taxonomy for individuals with SCI using wearable technology. The findings suggest that the method is capable of grouping similar hand grasps.
{"title":"Student Competition (Technology Innovation) ID 1970388","authors":"Mehdy Dousty, David J. Fleet, J. Zariffa","doi":"10.46292/sci23-1970388s","DOIUrl":"https://doi.org/10.46292/sci23-1970388s","url":null,"abstract":"The evaluation of hand function after spinal cord injury (SCI) is conducted in clinical settings, which may not accurately reflect hand function in the real world, thereby limiting the efficacy assessment of new treatments. Wearable cameras, also known as egocentric video, are a novel method to evaluate hand function in non-clinical environments. Nonetheless, manual processing of vast quantities of complex video data is difficult, highlighting the need for automated data analysis. The objective of this study was to automatically identify distinct hand postures in egocentric video using unsupervised machine learning. Seventeen participants with cervical SCI recorded activities of daily living in a home simulation laboratory. A hand pose estimation algorithm was applied on detected hands to determine 2D joint locations, which were lifted to 3D coordinates. The resulting hand posture information was subjected to a number of clustering techniques. Hand grasps were manually labelled into four categories for evaluation purposes: power, precision, intermediate, and non-prehensile. K-Means clustering consistently exhibited the highest Silhouette score, which reflects the presence of discrete clusters in the data. When comparing with manual annotations, Spectral Clustering applied to a feature space consisting of 2D pose estimation with confidence scores yield the best performance as quantified by maximum match (0.48), Fowlkes-Mallows score (0.46), and normalized mutual information (0.22). This is the first attempt to develop an unsupervised, data-driven hand taxonomy for individuals with SCI using wearable technology. The findings suggest that the method is capable of grouping similar hand grasps.","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"89 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139344699","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}
Jennifer M. Duley, Carmen D. Carmazan, Stephen J. Patton
Hamilton’s Spinal Cord Injury (SCI) Regional Rehabilitation Program in collaboration with SCI Consortium is implementing tissue integrity monitoring for pressure injury (PI) prevention. An increased prevalence of PI was found in 2021 - 2022 compared to 2020 on Hamilton’s SCI Rehabilitation Unit. To address this finding, the clinical team introduced a staff and patient education program focused on PI prevention. Upon completion of this workshop, the attendees will be aware of the CQI methodology used to implement the best practices related to tissue integrity and appreciate the education pathway for both staff and patients. Using a Continuous Quality Improvement model, a systematic approach was used to enhance the education model for staff and patients on skin assessment and appropriate interventions. A process map was created outlining steps for each discipline involved in skin assessment, intervention, and patient education. Education plan included Skin & Wound Management workshop, individual and group patient education, daily skin check calendar for patient/staff use. The workshop will be delivered in a lecture format, ending with discussion time. Preliminary data post partial implementation of the education program showed a decrease of 12% in the prevalence of PIs in the patients discharged from the program between July 2022 and March 2023 compared to January 2021 – June 2022. Preliminary results are encouraging in demonstrating that implementation of a comprehensive education plan for staff and patients using a structured framework is effective in reducing the prevalence of pressure injuries in the inpatient SCI rehab unit.
{"title":"Workshop (Clinical/Best Practice Implementation) ID 2001167","authors":"Jennifer M. Duley, Carmen D. Carmazan, Stephen J. Patton","doi":"10.46292/sci23-2001167s","DOIUrl":"https://doi.org/10.46292/sci23-2001167s","url":null,"abstract":"Hamilton’s Spinal Cord Injury (SCI) Regional Rehabilitation Program in collaboration with SCI Consortium is implementing tissue integrity monitoring for pressure injury (PI) prevention. An increased prevalence of PI was found in 2021 - 2022 compared to 2020 on Hamilton’s SCI Rehabilitation Unit. To address this finding, the clinical team introduced a staff and patient education program focused on PI prevention. Upon completion of this workshop, the attendees will be aware of the CQI methodology used to implement the best practices related to tissue integrity and appreciate the education pathway for both staff and patients. Using a Continuous Quality Improvement model, a systematic approach was used to enhance the education model for staff and patients on skin assessment and appropriate interventions. A process map was created outlining steps for each discipline involved in skin assessment, intervention, and patient education. Education plan included Skin & Wound Management workshop, individual and group patient education, daily skin check calendar for patient/staff use. The workshop will be delivered in a lecture format, ending with discussion time. Preliminary data post partial implementation of the education program showed a decrease of 12% in the prevalence of PIs in the patients discharged from the program between July 2022 and March 2023 compared to January 2021 – June 2022. Preliminary results are encouraging in demonstrating that implementation of a comprehensive education plan for staff and patients using a structured framework is effective in reducing the prevalence of pressure injuries in the inpatient SCI rehab unit.","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"38 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139345332","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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