N. Punjani, Sighild Lemarchant, Svetlana Altamentova, J. Chio, Jian Wang, Yann Godfrin, M. G. Fehlings
NX210c is a 12-amino acid peptide derived from conserved thrombospondin type 1 repeat sequences in the subcommissural organ-spondin, which has a unique multifunctional mechanism of action to ameliorate outcomes following neurological injuries. The aim of this study was to evaluate the efficacy of NX210c to promote functional recovery and tissue repair in a cervical traumatic spinal cord injury (SCI) model. Adult female Wistar rats were subjected to a C6/C7 clip compression-contusion injury and treated once daily with intraperitoneal injections of NX210c (8 mg/kg) or its vehicle for 8 weeks, beginning 4 hours (h) or 8h post-injury (n=16-17/group), with concurrent neurobehavioural tests. Earlier NX210c administration at 4h increased forelimb grip strength (p<0.05) and improved several static and dynamic aspects of locomotion including regularity index and base of support of the forelimbs (CatWalk) (p<0.05). Delaying initial administration of NX210c to 8h, promoted weight gain, accelerated bladder control recovery from 14 to 9 days post-injury, and improved trunk balance (inclined plane) as early as one-week post-injury (p<0.05). 94% of NX210c-treated rats compared to 75% of vehicle controls observed weight support at the delayed initial injection timepoint. Histology (n=6/group) demonstrated greater white matter preservation and reduced cavity size at the injury epicenter, and higher neuronal soma counts caudally, with NX210c starting 8h post-injury compared to the vehicle (p<0.05). NX210c targets various aspects of SCI, improving motor function, bladder control, white matter preservation, and neuronal counts, with more benefits observed at the later initial injection timepoint.
{"title":"Student Competition (Knowledge Generation) ID 1987946","authors":"N. Punjani, Sighild Lemarchant, Svetlana Altamentova, J. Chio, Jian Wang, Yann Godfrin, M. G. Fehlings","doi":"10.46292/sci23-1987946s","DOIUrl":"https://doi.org/10.46292/sci23-1987946s","url":null,"abstract":"NX210c is a 12-amino acid peptide derived from conserved thrombospondin type 1 repeat sequences in the subcommissural organ-spondin, which has a unique multifunctional mechanism of action to ameliorate outcomes following neurological injuries. The aim of this study was to evaluate the efficacy of NX210c to promote functional recovery and tissue repair in a cervical traumatic spinal cord injury (SCI) model. Adult female Wistar rats were subjected to a C6/C7 clip compression-contusion injury and treated once daily with intraperitoneal injections of NX210c (8 mg/kg) or its vehicle for 8 weeks, beginning 4 hours (h) or 8h post-injury (n=16-17/group), with concurrent neurobehavioural tests. Earlier NX210c administration at 4h increased forelimb grip strength (p<0.05) and improved several static and dynamic aspects of locomotion including regularity index and base of support of the forelimbs (CatWalk) (p<0.05). Delaying initial administration of NX210c to 8h, promoted weight gain, accelerated bladder control recovery from 14 to 9 days post-injury, and improved trunk balance (inclined plane) as early as one-week post-injury (p<0.05). 94% of NX210c-treated rats compared to 75% of vehicle controls observed weight support at the delayed initial injection timepoint. Histology (n=6/group) demonstrated greater white matter preservation and reduced cavity size at the injury epicenter, and higher neuronal soma counts caudally, with NX210c starting 8h post-injury compared to the vehicle (p<0.05). NX210c targets various aspects of SCI, improving motor function, bladder control, white matter preservation, and neuronal counts, with more benefits observed at the later initial injection timepoint.","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"7 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139346601","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}
Kristine Cowley, Peter Athanasopoulos, Chester Ho, Jacquie D. Ripat, Hope Jervis Rademeyer, Peter Warkentin, John Gregory
Spinal cord injury (SCI) affects every aspect of a person’s bodily functions. As such, for a person to survive and strive in the community after SCI, both a comprehensive and effective rehabilitation program, as well as life-sustaining healthcare (i.e., SCI-specific medical services, equipment, and supplies) is needed. Although Canada has a publicly funded universal healthcare system, provinces have flexibility in determining how rehabilitation is delivered and in defining ‘essential’ healthcare. This workshop will consist of two lectures on current standards of care in acute SCI rehabilitation and provision of life-sustaining SCI healthcare services, equipment, and supplies in Canada, followed by an initial overview of standards in other comparable countries and discussion of next steps for developing equity and consistency in Canada for SCI rehabilitation and provision of SCI-related healthcare needs. Upon completion of this workshop, attendees will understand:
{"title":"Workshop (Clinical/Best Practice Implementation) ID 2002364","authors":"Kristine Cowley, Peter Athanasopoulos, Chester Ho, Jacquie D. Ripat, Hope Jervis Rademeyer, Peter Warkentin, John Gregory","doi":"10.46292/sci23-2002364s","DOIUrl":"https://doi.org/10.46292/sci23-2002364s","url":null,"abstract":"Spinal cord injury (SCI) affects every aspect of a person’s bodily functions. As such, for a person to survive and strive in the community after SCI, both a comprehensive and effective rehabilitation program, as well as life-sustaining healthcare (i.e., SCI-specific medical services, equipment, and supplies) is needed. Although Canada has a publicly funded universal healthcare system, provinces have flexibility in determining how rehabilitation is delivered and in defining ‘essential’ healthcare. This workshop will consist of two lectures on current standards of care in acute SCI rehabilitation and provision of life-sustaining SCI healthcare services, equipment, and supplies in Canada, followed by an initial overview of standards in other comparable countries and discussion of next steps for developing equity and consistency in Canada for SCI rehabilitation and provision of SCI-related healthcare needs. Upon completion of this workshop, attendees will understand:","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"192 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139346660","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}
P. Eftekhar, Dr. Cathy Craven, Sukhvinder Kalsy-Ryan
It is essential that individuals with spinal cord injury set their goals prior to their peripheral nerve transfer (PNT) surgery. Goal setting is a significant factor in pre-operative planning and is one way in which we can track performance and outcomes for these patients. To describe goal types identified by patients managed in the PNT-SCI rehab program at Lyndhurst-UHN. Cite and report the COPM outcomes in the domains of Self-care and Productivity. A retrospective case series was conducted (n=14), charts were reviewed for type of goals and patient’s perception of goal attainment using COPM for a case series of three patients with tetraplegia who received PNT-SCI surgery and comprehensive rehabilitation. The changes in COPM are reported from baseline to 12 months post-surgery. Each patient identified three goals pre-surgery; their goals and the COPM were used to measure change over time. Ninety two percent of the identified goals were in the area of Self Care, and 8% were in the Productivity areas. Two of the patients who received PNT-SCI rehabilitation had an increase of 1 on the COPM, while one individual regressed by 2 points. That individual did not receive comprehensive rehabilitation. It is known that recovery after PNT-SCI surgery can take 24 or more months. We reported COPM change scores at 12 months post surgery. The MCID is two points for COPM, ideally over 24 months we will see MCID of three or higher.
{"title":"Poster (Clinical/Best Practice Implementation) ID 1998248","authors":"P. Eftekhar, Dr. Cathy Craven, Sukhvinder Kalsy-Ryan","doi":"10.46292/sci23-1998248s","DOIUrl":"https://doi.org/10.46292/sci23-1998248s","url":null,"abstract":"It is essential that individuals with spinal cord injury set their goals prior to their peripheral nerve transfer (PNT) surgery. Goal setting is a significant factor in pre-operative planning and is one way in which we can track performance and outcomes for these patients. To describe goal types identified by patients managed in the PNT-SCI rehab program at Lyndhurst-UHN. Cite and report the COPM outcomes in the domains of Self-care and Productivity. A retrospective case series was conducted (n=14), charts were reviewed for type of goals and patient’s perception of goal attainment using COPM for a case series of three patients with tetraplegia who received PNT-SCI surgery and comprehensive rehabilitation. The changes in COPM are reported from baseline to 12 months post-surgery. Each patient identified three goals pre-surgery; their goals and the COPM were used to measure change over time. Ninety two percent of the identified goals were in the area of Self Care, and 8% were in the Productivity areas. Two of the patients who received PNT-SCI rehabilitation had an increase of 1 on the COPM, while one individual regressed by 2 points. That individual did not receive comprehensive rehabilitation. It is known that recovery after PNT-SCI surgery can take 24 or more months. We reported COPM change scores at 12 months post surgery. The MCID is two points for COPM, ideally over 24 months we will see MCID of three or higher.","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"17 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139346683","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}
Philemon Tsang, Wagner H. Souza, Thomas P. Walden, M. Miyatani, Cathy Craven
Heart Disease is the leading cause of death after spinal cord injury (SCI). Individuals with paraplegia develop hypertension and elevated arterial stiffness prior to their age matched peers. Overground exoskeleton training is becoming an increasingly prevalent form of exercise. In the general population, exercise training has been shown to reduce arterial stiffness. Recent RCT failed to show changes in arterial stiffness with arm ergometry or body weight supported treadmill training. The aim of this project is to determine the effect of Exoskeleton Exercise on changing arterial stiffness. The study setting will take place at a rehabilitation facility. The study will involve 34 sessions over the span of approximately 18-20 weeks. The key intervention utilized in the investigation will be an Overground EksoNR gait and balance training program. The primary outcome measure will be carotid-femoral pulse wave velocity (cfPWV) and secondary measures will include heart rate (HR), blood pressure (BP), waist circumference (WC), and oxygen saturation (SpO2). Statistical Analysis will involve mean changes at baseline, midway, and end of study. The 34-session (2x/week for ∼18 weeks) rehabilitation protocol will focus on using the EksoNR for overground gait and balance activities. For measurement of cfPWV, two transcutaneous Doppler flowmeters will be used at the common carotid and femoral artery. To calculate cfPWV, the distance travelled by the pulse is divided by the average pulse transit time (PTT). The 18-week Exoskeleton Program would improve arterial stiffness (cfPWV) in individuals with chronic incomplete SCI/D.
{"title":"Post-Doc Competition (Knowledge Generation) ID 1985177","authors":"Philemon Tsang, Wagner H. Souza, Thomas P. Walden, M. Miyatani, Cathy Craven","doi":"10.46292/sci23-1985177s","DOIUrl":"https://doi.org/10.46292/sci23-1985177s","url":null,"abstract":"Heart Disease is the leading cause of death after spinal cord injury (SCI). Individuals with paraplegia develop hypertension and elevated arterial stiffness prior to their age matched peers. Overground exoskeleton training is becoming an increasingly prevalent form of exercise. In the general population, exercise training has been shown to reduce arterial stiffness. Recent RCT failed to show changes in arterial stiffness with arm ergometry or body weight supported treadmill training. The aim of this project is to determine the effect of Exoskeleton Exercise on changing arterial stiffness. The study setting will take place at a rehabilitation facility. The study will involve 34 sessions over the span of approximately 18-20 weeks. The key intervention utilized in the investigation will be an Overground EksoNR gait and balance training program. The primary outcome measure will be carotid-femoral pulse wave velocity (cfPWV) and secondary measures will include heart rate (HR), blood pressure (BP), waist circumference (WC), and oxygen saturation (SpO2). Statistical Analysis will involve mean changes at baseline, midway, and end of study. The 34-session (2x/week for ∼18 weeks) rehabilitation protocol will focus on using the EksoNR for overground gait and balance activities. For measurement of cfPWV, two transcutaneous Doppler flowmeters will be used at the common carotid and femoral artery. To calculate cfPWV, the distance travelled by the pulse is divided by the average pulse transit time (PTT). The 18-week Exoskeleton Program would improve arterial stiffness (cfPWV) in individuals with chronic incomplete SCI/D.","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":"139346832","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}
ISMS entails implanting micro-electrodes into the spinal cord to produce synergistic activations of the legs. To date, ISMS has produced in-place stepping in cats with complete spinal cord injury (SCI) (Saigal et al, 2004), and long distances of over ground walking in anesthetized cats (Holinski et al, 2016). The goal of this project is to develop an intervention for restoring overground walking capacity for persons experiencing paralysis due to SCI, by investigating the potential of ISMS to enable long-distance overground walking in cats with chronic SCI. Experiments will be performed in eight adult cats with chronic complete SCI. The control strategy will include timed transitions between different phases of the step cycle, which will be modified using feedback from force plates and gyroscopes. The biomechanics of walking (speed of walking, stride length, left-right symmetry, inter-joint coordination) and muscle activation patterns will be recorded and analyzed. The stride-to-stride regularity of walking, amount of weight-bearing, and level of spasticity before, during, and after ISMS will be assessed. We expect that ISMS will produce long distances of walking (>500 m) in cats with SCI. The biomechanical features of walking will be similar to those in neurologically-intact cats. This project is a critical step towards demonstrating the viability of ISMS as a means for restoring functional walking after severe SCI. If successful, ISMS and the control strategies developed may in the future change the lives of many people living with SCI, giving them the capability to walk independently.
{"title":"Student Competition (Technology Innovation) ID 1985155","authors":"Amin Arefadib, Pouria Faridi, Soroush Mirkiani, Ashley Dalrymple, Vivian K. Mushahwar","doi":"10.46292/sci23-1985155s","DOIUrl":"https://doi.org/10.46292/sci23-1985155s","url":null,"abstract":"ISMS entails implanting micro-electrodes into the spinal cord to produce synergistic activations of the legs. To date, ISMS has produced in-place stepping in cats with complete spinal cord injury (SCI) (Saigal et al, 2004), and long distances of over ground walking in anesthetized cats (Holinski et al, 2016). The goal of this project is to develop an intervention for restoring overground walking capacity for persons experiencing paralysis due to SCI, by investigating the potential of ISMS to enable long-distance overground walking in cats with chronic SCI. Experiments will be performed in eight adult cats with chronic complete SCI. The control strategy will include timed transitions between different phases of the step cycle, which will be modified using feedback from force plates and gyroscopes. The biomechanics of walking (speed of walking, stride length, left-right symmetry, inter-joint coordination) and muscle activation patterns will be recorded and analyzed. The stride-to-stride regularity of walking, amount of weight-bearing, and level of spasticity before, during, and after ISMS will be assessed. We expect that ISMS will produce long distances of walking (>500 m) in cats with SCI. The biomechanical features of walking will be similar to those in neurologically-intact cats. This project is a critical step towards demonstrating the viability of ISMS as a means for restoring functional walking after severe SCI. If successful, ISMS and the control strategies developed may in the future change the lives of many people living with SCI, giving them the capability to walk independently.","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"21 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139346891","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}
James Milligan, Joseph Lee, Allison Harrison, Kathleen MacGregor
The Centre for Family Medicine Mobility Clinic strives to provide high quality primary care to persons living with spinal cord injury or other health conditions that affect mobility. The Mobility Clinic Resource Abilities Council (MC RAC) was established to serve in an advisory capacity, making recommendations on matters that impact the experience of patients with physical disabilities and their support persons at the Mobility Clinic. MC RAC provides feedback on, and ideas for initiatives and programs that support and enhance the model of person-centred care. It also advances collaborative patient engagement and person-centred care principles and practices within primary care for persons with physical disabilities Members include individuals with lived experience with physical disability, their support persons, and Mobility Clinic staff. The council was established August 2022 and meets virtually once per month for approximately 90 minutes. MC RAC has successfully met nine times and has provided feedback on the following topics: Breast & Cervical Cancer screening Initiative for People with Physical Disabilities, Mobility Clinic website development, building pathways for advocacy with the KW4 OHT, Circulus Network webinar topics, Mobility Clinic organization and clinical flow. Feedback to be implemented into Mobility Clinic activities. Patient and support persons involvement in decision-making processes improve care experiences and contribute to better health outcomes for patients. We will continue to work and develop our patient advisory council to better support the Mobility Clinic’s patients and their support persons.
{"title":"Poster (Clinical/Best Practice Implementation) ID 2004605","authors":"James Milligan, Joseph Lee, Allison Harrison, Kathleen MacGregor","doi":"10.46292/sci23-2004605s","DOIUrl":"https://doi.org/10.46292/sci23-2004605s","url":null,"abstract":"The Centre for Family Medicine Mobility Clinic strives to provide high quality primary care to persons living with spinal cord injury or other health conditions that affect mobility. The Mobility Clinic Resource Abilities Council (MC RAC) was established to serve in an advisory capacity, making recommendations on matters that impact the experience of patients with physical disabilities and their support persons at the Mobility Clinic. MC RAC provides feedback on, and ideas for initiatives and programs that support and enhance the model of person-centred care. It also advances collaborative patient engagement and person-centred care principles and practices within primary care for persons with physical disabilities Members include individuals with lived experience with physical disability, their support persons, and Mobility Clinic staff. The council was established August 2022 and meets virtually once per month for approximately 90 minutes. MC RAC has successfully met nine times and has provided feedback on the following topics: Breast & Cervical Cancer screening Initiative for People with Physical Disabilities, Mobility Clinic website development, building pathways for advocacy with the KW4 OHT, Circulus Network webinar topics, Mobility Clinic organization and clinical flow. Feedback to be implemented into Mobility Clinic activities. Patient and support persons involvement in decision-making processes improve care experiences and contribute to better health outcomes for patients. We will continue to work and develop our patient advisory council to better support the Mobility Clinic’s patients and their support persons.","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"42 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139343405","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 Spinal Cord Injury Implementation and Evaluation Quality Care Consortium (SCI-IEQCC) is a quality improvement initiative (began in 2019) with a mission to provide optimal and equitable rehabilitation services for all Canadians regardless of where they live, and to ensure the functional recovery, health and well-being for individuals living with spinal cord injury and disease (SCI/D). To highlight the growing needs of an expanding multisite network and the importance of governance and organizational structures to support the execution of current deliverables while addressing emerging challenges. The SCI-IEQCC has a central team for network management. Administrators/leaders, clinicians with implementation science training, local site implementation teams, and individuals with lived experience comprise the SCI-IEQCC. Implementation and evaluation of indicators and best practices across 10 participating organizations requires: operational oversite; monitoring of project milestones; adherence to regulatory requirements; sustained data quality with linkage for analyses; report card dissemination; information sharing and network updates; strategic planning to map future directions; identification of priorities; and, meeting academic/funding deliverables. SCI-IEQCC has driven improvements in rehabilitation service delivery, performance, utilization of best practices, and increments in staff engagement, training, and knowledge exchange. SCI-IEQCC challenges are derived from the diversity of participating organizations, turnover in leaders, staff shortages, reducing variation in documentation and data management, and ensuring resource continuity. The growing complexity of this multisite network necessitate innovative approaches to streamline processes across sites, ensure uniform adherence to regulatory requirements, disseminate innovations in informatics, and assure dedication to its mission and vision.
{"title":"Poster (Health Services, Economics and Policy Change) ID 1985397","authors":"Farnoosh Farahani, B. C. Craven","doi":"10.46292/sci23-1985397s","DOIUrl":"https://doi.org/10.46292/sci23-1985397s","url":null,"abstract":"The Spinal Cord Injury Implementation and Evaluation Quality Care Consortium (SCI-IEQCC) is a quality improvement initiative (began in 2019) with a mission to provide optimal and equitable rehabilitation services for all Canadians regardless of where they live, and to ensure the functional recovery, health and well-being for individuals living with spinal cord injury and disease (SCI/D). To highlight the growing needs of an expanding multisite network and the importance of governance and organizational structures to support the execution of current deliverables while addressing emerging challenges. The SCI-IEQCC has a central team for network management. Administrators/leaders, clinicians with implementation science training, local site implementation teams, and individuals with lived experience comprise the SCI-IEQCC. Implementation and evaluation of indicators and best practices across 10 participating organizations requires: operational oversite; monitoring of project milestones; adherence to regulatory requirements; sustained data quality with linkage for analyses; report card dissemination; information sharing and network updates; strategic planning to map future directions; identification of priorities; and, meeting academic/funding deliverables. SCI-IEQCC has driven improvements in rehabilitation service delivery, performance, utilization of best practices, and increments in staff engagement, training, and knowledge exchange. SCI-IEQCC challenges are derived from the diversity of participating organizations, turnover in leaders, staff shortages, reducing variation in documentation and data management, and ensuring resource continuity. The growing complexity of this multisite network necessitate innovative approaches to streamline processes across sites, ensure uniform adherence to regulatory requirements, disseminate innovations in informatics, and assure dedication to its mission and vision.","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"35 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139343494","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}
Nader Fallah, H. Hong, S. Humphreys, Jessica Parsons, Kristen Walden, Vanessa K. Noonan
Multi-morbidity is common in persons with spinal cord injury (SCI). Network Analysis is a tool used to visualize and estimate complex relationships among variables. Three network models: Gaussian Graphical Model, Ising model, and Mixed Graphical Model were applied to the 2011-2012 Canadian SCI Community Survey dataset, which included individuals with traumatic and non-traumatic SCI. Data utilized included demographic and injury data as we well as 30 secondary health conditions (comorbidities and secondary complication) that are included in the Multi-Morbidity Index (MMI-30). Five health outcomes were included: healthcare utilization (HCU), health status (i.e. Short Form-12 physical and mental component summary (SF-12 PCS & MCS) score), life satisfaction, and quality of life. Using Network Analysis, we reduced the number of items in the Multi-Morbidity Index (MMI-30) by 5 items (MMI-25) and the psychometric properties were comparable. This interactive workshop will include presentations from a clinician, researcher and person with lived experience (PLEX). The goals of this workshop are to: This workshop will demonstrate the benefit of using Network Analysis, a type of Machine Learning, in SCI research. Specifically, the example of how Network Analysis identified key associations among 30 secondary health conditions and five health outcomes which resulted in the MMI-25 will be discussed as well as future opportunities for using Network Analysis and other Machine Learning methodologies in SCI research.
{"title":"Workshop (Knowledge Generation) ID 2001657","authors":"Nader Fallah, H. Hong, S. Humphreys, Jessica Parsons, Kristen Walden, Vanessa K. Noonan","doi":"10.46292/sci23-2001657s","DOIUrl":"https://doi.org/10.46292/sci23-2001657s","url":null,"abstract":"Multi-morbidity is common in persons with spinal cord injury (SCI). Network Analysis is a tool used to visualize and estimate complex relationships among variables. Three network models: Gaussian Graphical Model, Ising model, and Mixed Graphical Model were applied to the 2011-2012 Canadian SCI Community Survey dataset, which included individuals with traumatic and non-traumatic SCI. Data utilized included demographic and injury data as we well as 30 secondary health conditions (comorbidities and secondary complication) that are included in the Multi-Morbidity Index (MMI-30). Five health outcomes were included: healthcare utilization (HCU), health status (i.e. Short Form-12 physical and mental component summary (SF-12 PCS & MCS) score), life satisfaction, and quality of life. Using Network Analysis, we reduced the number of items in the Multi-Morbidity Index (MMI-30) by 5 items (MMI-25) and the psychometric properties were comparable. This interactive workshop will include presentations from a clinician, researcher and person with lived experience (PLEX). The goals of this workshop are to: This workshop will demonstrate the benefit of using Network Analysis, a type of Machine Learning, in SCI research. Specifically, the example of how Network Analysis identified key associations among 30 secondary health conditions and five health outcomes which resulted in the MMI-25 will be discussed as well as future opportunities for using Network Analysis and other Machine Learning methodologies in SCI research.","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"50 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139344545","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}
Patrik Nepomuceno, Wagner H. Souza, Kristin E. Musselman, B. C. Craven
Exoskeletons are promising tools for motor rehabilitation in spinal cord injury/disease (SCI/D); however, optimal therapeutic dose parameters are unknown. This study aimed to identify the dose and dosage of exoskeleton training for functional gait restoration in individuals with SCI/D. A systematic review (inception-03/31/2022) included CINAHL Complete Embase, Emcare Nursing, MedLine and Web of Science databases. Studies with ≥ 5 adults (≥16 years, any level/nature) who underwent exoskeleton-based overground gait rehabilitation and reporting 3 of 4 dose (e.g., session duration and number of sessions) and dosage (e.g., frequency of sessions, intervention duration) parameters, and at least one gait outcome measure were included. Of 977 studies, 964 were excluded. With 19 studies remaining, 13 included functional restoration as their therapeutic intent. Of those, 11 reported statistically significant changes and were considered for recommendation. The functional restoration ranged from 10 to 51.5 sessions, 2 to 5 sessions a week, for 3 to 12 weeks, with a duration of 45-90-minutes per session. Altogether, the data suggest that exoskeleton-based functional gait restoration would be best achieved using protocols that encompass 60-minute sessions, 3 times a week, for over 8 weeks (total of 24 sessions). Despite the high variability of dose and dosage parameters reported, significant improvements in functional performance were associated with overground exoskeleton use in most studies. The lack of therapeutic standards, however, compromises translation to clinical settings. This review provides evidence-based clinical practice recommendations for functional restoration in individuals with SCI/D to inform future functional restoration training paradigms.
{"title":"Student Competition (Clinical/Best Practice Implementation) ID 1986706","authors":"Patrik Nepomuceno, Wagner H. Souza, Kristin E. Musselman, B. C. Craven","doi":"10.46292/sci23-1986706s","DOIUrl":"https://doi.org/10.46292/sci23-1986706s","url":null,"abstract":"Exoskeletons are promising tools for motor rehabilitation in spinal cord injury/disease (SCI/D); however, optimal therapeutic dose parameters are unknown. This study aimed to identify the dose and dosage of exoskeleton training for functional gait restoration in individuals with SCI/D. A systematic review (inception-03/31/2022) included CINAHL Complete Embase, Emcare Nursing, MedLine and Web of Science databases. Studies with ≥ 5 adults (≥16 years, any level/nature) who underwent exoskeleton-based overground gait rehabilitation and reporting 3 of 4 dose (e.g., session duration and number of sessions) and dosage (e.g., frequency of sessions, intervention duration) parameters, and at least one gait outcome measure were included. Of 977 studies, 964 were excluded. With 19 studies remaining, 13 included functional restoration as their therapeutic intent. Of those, 11 reported statistically significant changes and were considered for recommendation. The functional restoration ranged from 10 to 51.5 sessions, 2 to 5 sessions a week, for 3 to 12 weeks, with a duration of 45-90-minutes per session. Altogether, the data suggest that exoskeleton-based functional gait restoration would be best achieved using protocols that encompass 60-minute sessions, 3 times a week, for over 8 weeks (total of 24 sessions). Despite the high variability of dose and dosage parameters reported, significant improvements in functional performance were associated with overground exoskeleton use in most studies. The lack of therapeutic standards, however, compromises translation to clinical settings. This review provides evidence-based clinical practice recommendations for functional restoration in individuals with SCI/D to inform future functional restoration training paradigms.","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"42 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139344860","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}
Jessica M. D’Amico, Camilo Castillo, David Rouffet, Monica Gorassini, Lalith E. Satkunam
Following a spinal cord injury, there is a significant loss of monoamines below the lesion. In the rat model, exogenous administration of the serotonin precursor, 5-hydroxytryptophan (5HTP), increases neural excitability through augmentation of spinal serotonin levels. To determine whether this compensatory mechanism can be harnessed to restore serotonergic modulation in humans after SCI, participants visited the lab on four occasions where they received i) placebo, ii) carbidopa, iii) 50mg 5HTP+carbidopa, or iv) 100mg 5HTP+carbidopa in a randomized, crossover design. Cutaneomuscular reflexes (CMR) were obtained pre-drug and 30, 60, 90 and 120-min post-drug intake. Surface electromyography was also recorded during a pedalling movement pre- and post-drug. Nine participants with chronic, complete SCI (35.3±5.5 years) and four participants with chronic, incomplete SCI (47.0±19.7years) were enrolled. Following ingestion of 100mg 5HTP only, the short polysynaptic and long-lasting reflex components of the CMR were significantly increased by ∼ 86±61% and 58±17% respectively in individuals with complete SCI. No significant changes were noted in the cohort of individuals with incomplete SCI. Integrated EMG during pedalling was increased in multiple lower extremity muscles during the extension and flexion phases of the cycle following both 50-mg (82±15% and 51±7%) and 100-mg 5HTP (140±27% and 130±16%) in individuals with more severe injuries, but not in those with incomplete injuries. Ingestion of 5HTP facilitates neural excitability and induces rhythmic muscle activity in previously inactive muscles during an assisted pedalling movement in individuals with chronic, complete SCI. This has significant clinical implications for rehabilitation after SCI.
{"title":"Poster (Knowledge Generation) ID 1985240","authors":"Jessica M. D’Amico, Camilo Castillo, David Rouffet, Monica Gorassini, Lalith E. Satkunam","doi":"10.46292/sci23-1985240s","DOIUrl":"https://doi.org/10.46292/sci23-1985240s","url":null,"abstract":"Following a spinal cord injury, there is a significant loss of monoamines below the lesion. In the rat model, exogenous administration of the serotonin precursor, 5-hydroxytryptophan (5HTP), increases neural excitability through augmentation of spinal serotonin levels. To determine whether this compensatory mechanism can be harnessed to restore serotonergic modulation in humans after SCI, participants visited the lab on four occasions where they received i) placebo, ii) carbidopa, iii) 50mg 5HTP+carbidopa, or iv) 100mg 5HTP+carbidopa in a randomized, crossover design. Cutaneomuscular reflexes (CMR) were obtained pre-drug and 30, 60, 90 and 120-min post-drug intake. Surface electromyography was also recorded during a pedalling movement pre- and post-drug. Nine participants with chronic, complete SCI (35.3±5.5 years) and four participants with chronic, incomplete SCI (47.0±19.7years) were enrolled. Following ingestion of 100mg 5HTP only, the short polysynaptic and long-lasting reflex components of the CMR were significantly increased by ∼ 86±61% and 58±17% respectively in individuals with complete SCI. No significant changes were noted in the cohort of individuals with incomplete SCI. Integrated EMG during pedalling was increased in multiple lower extremity muscles during the extension and flexion phases of the cycle following both 50-mg (82±15% and 51±7%) and 100-mg 5HTP (140±27% and 130±16%) in individuals with more severe injuries, but not in those with incomplete injuries. Ingestion of 5HTP facilitates neural excitability and induces rhythmic muscle activity in previously inactive muscles during an assisted pedalling movement in individuals with chronic, complete SCI. This has significant clinical implications for rehabilitation after SCI.","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"68 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139345341","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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