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Workshop (Clinical/Best Practice Implementation) ID 2000430 讲习班(临床/最佳做法实施) ID 2000430
IF 2.9 Q2 Medicine Pub Date : 2023-09-01 DOI: 10.46292/sci23-2000430s
Julio C Furlan, Mitsue S. Aibe, M. Boulos
Sleep disorders are more common among individuals living with spinal cord injury and spinal cord disease (SCI/D) than among non-disabled people. Upon completion of this workshop, attendees will (1) understand the pathophysiology, diagnosis, classification, clinical consequences and management of the most common sleep disorders in non-disabled people; (2) recognise the current knowledge, knowledge gaps, and recently research-generated knowledge on sleep disorders in individuals living with SCI/D; and (3) appreciate the use of an educational tool to raise awareness on sleep disorders among individuals with SCI/D. This workshop will include two 20-minute lectures with illustrative cases followed by open discussion on the following topics: (i) pathophysiology, diagnosis, classification, clinical consequences and management of the most common sleep disorders in non-disabled people; and (ii) the current knowledge, knowledge gaps, and recently research-generated knowledge on sleep disorders in individuals living with SCI/D. Finally, an example of educational tool on sleep for individuals living with SCI/D will be presented. Untreated sleep disorders can have significant short-term and long-term consequences. Early diagnosis and timely treatment is key in the prevention or mitigation of consequences of sleep disorders. Proper management of sleep disorders can have psychosocial and functional impacts on the lives of individuals with SCI/D; it may also mitigate other secondary medical conditions after SCI/D. Finally, there is a pressing need to raise awareness of this issue among individuals living with SCI/D and healthcare professionals. Sleep disorders are common and understudied in the SCI/D population. Early diagnosis and proper treatment is key to improve the lives of individuals with SCI/D and, likely, reduce other secondary medical conditions from SCI/D. Raising awareness on sleep disorders among individuals with SCI/D is needed.
在脊髓损伤和脊髓疾病(SCI/D)患者中,睡眠障碍比非残疾人更常见。完成本工作坊后,与会者将:(1)了解非残障人士最常见睡眠障碍的病理生理学、诊断、分类、临床后果和处理方法;(2)认识有关脊髓损伤和脊髓疾病患者睡眠障碍的现有知识、知识差距和最新研究成果;以及(3)了解如何使用教育工具来提高脊髓损伤和脊髓疾病患者对睡眠障碍的认识。 本次研讨会将包括两场20分钟的讲座,并在讲座后就以下主题进行公开讨论:(i) 非殘疾人士最常見睡眠障礙的病理生理、診斷、分類、臨床後果及處理方法;及 (ii) 有關傷殘智障人士睡眠障礙的現有知識、知識差距及最新研究成果。最后,将介绍一个针对 SCI/D 人士的睡眠教育工具实例。 未经治疗的睡眠障碍可造成严重的短期和长期后果。早期诊断和及时治疗是预防或减轻睡眠障碍后果的关键。妥善处理睡眠障碍可对患有 SCI/D 的患者的生活产生心理和功能影响,还可减轻 SCI/D 后的其他继发性疾病。最后,迫切需要提高 SCI/D 患者和医疗保健专业人员对这一问题的认识。 睡眠障碍在 SCI/D 患者中很常见,但研究不足。早期诊断和适当治疗是改善 SCI/D 患者生活的关键,并有可能减少 SCI/D 引起的其他继发性疾病。有必要提高 SCI/D 人士对睡眠障碍的认识。
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引用次数: 0
Poster (Clinical/Best Practice Implementation) ID 1969157 海报(临床/最佳实践实施) ID 1969157
IF 2.9 Q2 Medicine Pub Date : 2023-09-01 DOI: 10.46292/sci23-1969157s
Julio C Furlan, Di Wang
This study examined the effects of concomitant TBI on injury epidemiology, management and outcomes of individuals with traumatic SCI. A propensity-score matched cohort study compared a SCI+TBI group (n=1018) with a SCI-only group (n=3687), which were matched on a 1:1 ratio by age, sex, severity and level of SCI, and Charlson Comorbidity Index. TBI was defined as a Glasgow coma score of <15 at admission. Both groups were compared regarding injury epidemiology (mechanism, ethnicity, GCS, other injuries), management (mechanical ventilation, traction, Methylprednisone, surgery, time to decompression), and post-SCI outcomes (length of stay [LOS], International Standards for Neurological Classification of SCI [ISNCSCI] motor subscore, Functional Independence Measure, discharge destination, spasticity and pain at discharge). Overall, being white (OR=5.332, p=0.0265) was associated with having TBI, while having other body injuries (OR=0.095, p=0.0065) was associated with the SCI-only group. Odds of dying in a hospital were 2.442 times larger for the TBI+SCI group. The TBI+SCI group had longer acute-care LOS. Both groups had similar rehabilitation LOS. Odds of being discharged to nursing homes/long-term care facilities were 1.949 times higher for TBI+SCI individuals. Concomitant TBI did not influence change in ISNCSCI motor subscore from initial admission to final discharge. Odds of individuals with pain was 1.52 times higher for the TBI+SCI group. Occurrence of spasticity was similar between the groups. This study highlights discrepancies between the TBI+SCI and SCI-only groups regarding injury epidemiology, survival, discharge disposition, and pain. Both groups experienced similar access to treatment services, motor recovery, and spasticity. These data were presented in the 2022 Annual Meeting of the American Neurological Association, which has a different attendance audience.
本研究探讨了并发创伤性脑损伤对创伤性 SCI 患者的损伤流行病学、管理和预后的影响。 一项倾向得分匹配队列研究比较了 SCI+TBI 组(人数=1018)和纯 SCI 组(人数=3687),这两组患者的年龄、性别、SCI 严重程度和水平以及 Charlson 合并症指数均按 1:1 的比例进行匹配。创伤性脑损伤的定义是入院时格拉斯哥昏迷评分小于 15 分。两组患者在损伤流行病学(机制、种族、GCS、其他损伤)、管理(机械通气、牵引、甲泼尼龙、手术、减压时间)和SCI后结果(住院时间、SCI神经系统分类国际标准(ISNCSCI)运动子评分、功能独立性测量、出院目的地、出院时的痉挛和疼痛)方面进行了比较。 总体而言,白人(OR=5.332,P=0.0265)与创伤性脑损伤相关,而其他身体损伤(OR=0.095,P=0.0065)与纯 SCI 组相关。创伤性脑损伤+脊髓损伤组死于医院的几率是创伤性脑损伤+脊髓损伤组的2.442倍。创伤性脑损伤+SCI组的急症护理生命周期更长。两组患者的康复生命周期相似。TBI+SCI患者出院后入住疗养院/长期护理机构的几率是TBI+SCI患者的1.949倍。从最初入院到最终出院,合并 TBI 不会影响 ISNCSCI 运动子分数的变化。TBI+SCI组患者出现疼痛的几率要高出1.52倍。两组患者出现痉挛的情况相似。 这项研究强调了TBI+SCI组和单纯SCI组在损伤流行病学、存活率、出院处置和疼痛方面的差异。两组患者在获得治疗服务、运动恢复和痉挛方面的情况相似。 这些数据已在美国神经病学协会2022年年会上公布,该年会的参会观众有所不同。
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引用次数: 0
Poster (Clinical/Best Practice Implementation) ID 1969155 海报(临床/最佳实践实施) ID 1969155
IF 2.9 Q2 Medicine Pub Date : 2023-09-01 DOI: 10.46292/sci23-1969155s
Julio C Furlan
This study examined the influence of race/ethnicity on the individuals’ survival and neurological recovery within the first year after tSCI. This retrospective cohort study included all 306 cases enrolled in the NASCIS-1, who were grouped into (a) African Americans (n=84), (b) non-Hispanic whites (n=159), and (c) other races/ethnicities that included Hispanics (n=60) and Asians (n=3). Outcome measures included survival and neurological recovery (as assessed using the NASCIS motor, and pinprick and light-touch sensory scores) within the first year post-tSCI. Data analyses of neurological recovery were adjusted for major potential confounders. There were 39 females and 267 males with a mean age of 31 years who mostly sustained cervical severe tSCI after vehicular accidents or falls. The three groups were comparable regarding sex distribution, level and severity of tSCI, level of consciousness at admission, and total received dose of methylprednisolone. However, African Americans were significantly older than non-Hispanic white individuals (P=0.0238). African Americans and individuals of other races/ethnicities had tSCI with open wounds caused by missile and water-related accidents more often than non-Hispanic white individuals (P<0.0001). However, survival rates within the first year post-tSCI were statistically comparable among the three groups (P=0.3191). Among the survivors, there was no statistically significant difference among the three groups regarding motor, and pinprick and light-touch sensory recovery (P>0.0500). The results of this study suggest that the epidemiology of tSCI might vary depending upon the individual’s race/ethnicity. Nevertheless, race/ethnicity did not influence survival rate or neurological recovery within first year post-tSCI.
本研究探讨了种族/族裔对创伤后脊髓损伤患者第一年内的存活率和神经功能恢复的影响。 这项回顾性队列研究纳入了 NASCIS-1 登记的所有 306 个病例,这些病例被分为 (a) 非洲裔美国人(n=84)、(b) 非西班牙裔白人(n=159)和 (c) 其他种族/族裔,包括西班牙裔(n=60)和亚洲裔(n=3)。结果测量包括tSCI后第一年内的存活率和神经功能恢复情况(使用NASCIS运动、针刺和轻触感觉评分进行评估)。神经功能恢复的数据分析已对主要的潜在混杂因素进行了调整。 其中有 39 名女性和 267 名男性,平均年龄为 31 岁,他们大多是在车祸或跌倒后患有颈椎重度创伤性脊髓损伤。三组患者在性别分布、颈椎重度损伤的程度和严重性、入院时的意识水平以及接受甲基强的松龙的总剂量方面具有可比性。不过,非裔美国人的年龄明显高于非西班牙裔白人(P=0.0238)。与非西班牙裔白人相比,非裔美国人和其他种族/族裔的人因导弹和与水有关的事故造成的开放性伤口而发生 tSCI 的频率更高(P0.0500)。 本研究结果表明,tSCI 的流行病学可能因个人的种族/族裔而异。尽管如此,种族/族裔并不影响创伤后脊髓损伤后第一年内的存活率或神经功能恢复情况。
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引用次数: 0
Workshop (Health Services, Economics and Policy Change) ID 2012040 工作坊(医疗服务、经济学和政策变革) ID 2012040
IF 2.9 Q2 Medicine Pub Date : 2023-09-01 DOI: 10.46292/sci23-2012040s
Christine Short, Colleen O’Connell
According to the WHO nearly one billion people worldwide live with some form of disability and one fifth of those have significant difficulty functioning as a result. Climate change is a reality and the impacts on healthcare and the care of our communities is significant. From food and water supply, housing emergency preparedness and safety to the effects on our health, climate change has a disproportionate impact on persons with disabilities. The purpose of this workshop is to provide attendees with a review of the issues that climate change has created for persons with disabilities with a focus on traumatic and non-traumatic spinal cord injury. We will then move to a group discussion on what we can do individually and as health systems to address these challenges and make sure the rights and safety of persons with disabilities are protected as we navigate our world with Climate Change. We will use powerpoint slides, polls and group discussion to explore this topic. This workshop will further educate SCI experts nationally/internationally and collect their thoughts and ideas on climate impact on persons with disabilities. Our hope is that this information will help inform a more formal position statement from the CSCIRA.
根据世界卫生组织的统计,全球有近十亿人患有某种形式的残疾,其中五分之一的人因此在工作上有很大的困难。 气候变化是一个现实,它对医疗保健和社区护理的影响是巨大的。从食物和水的供应、住房应急准备和安全到对我们健康的影响,气候变化对残疾人的影响尤为严重。 本次研讨会的目的是向与会者回顾气候变化给残疾人带来的问题,重点是创伤性和非创伤性脊髓损伤。然后,我们将进行小组讨论,探讨我们个人和医疗系统可以做些什么来应对这些挑战,并确保残疾人的权利和安全在气候变化的影响下得到保护。 我们将利用幻灯片、民意调查和小组讨论来探讨这一主题。 本次研讨会将进一步教育国内/国际 SCI 专家,收集他们关于气候对残疾人影响的想法和观点。 我们希望这些信息将有助于为 CSCIRA 更正式的立场声明提供信息。
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引用次数: 0
Workshop (Clinical/Best Practice Implementation) ID 2000428 讲习班(临床/最佳做法实施) ID 2000428
IF 2.9 Q2 Medicine Pub Date : 2023-09-01 DOI: 10.46292/sci23-2000428s
Julio C Furlan, M. G. Fehlings, James Milligan, Sukhvinder Kalsi-Ryan
This workshop aims to overview degenerative cervical myelopathy (DCM), which is the most common cause of non-traumatic spinal cord injury across the world. DCM is estimated to affect approximately 1 in 50 adults; however, < 10% receive a diagnosis, and lifelong disability remains a common outcome. Upon completion of this workshop, attendees will (1) understand the diagnostic criteria and investigations for DCM and avoid misdiagnosis in the primary care level; (2) recognise the indications and role of surgical treatment; (3) comprehend the impact of prehabilitation and rehabilitation; (4) understand the alternatives for non-operative management of DCM; and (5) appreciate the importance of raising awareness of this disease. This workshop will review the diagnostic criteria and investigations for individuals with different degrees of DCM, the current clinical practice guidelines for management of DCM with focus on the role of surgical decompression of spinal cord, the role of prehabilitation and rehabilitation, current non-operative options for patients with DCM, and some initiatives focused on raising awareness of this disease. This workshop will include lectures (10-15 minutes each) with illustrative cases followed by open discussion on the following topics: (i) diagnosis, misdiagnosis and investigations in DCM; (ii) surgical management of DCM; (iii) prehabilitation and rehabilitation in DCM; and (iv) non-operative management of DCM. Although DCM is the most common cause of non-traumatic spinal cord disease, there is a need for the development of a tailored and multi-disciplinary care framework for management of DCM, which would improve patients’ outcomes. Greater awareness of DCM among healthcare professionals is urged to avoid misdiagnosis and mitigate the long-term consequences of this disease.
本研讨会旨在概述退行性颈椎脊髓病(DCM),这是全球最常见的非外伤性脊髓损伤原因。据估计,大约每 50 个成年人中就有 1 人患有 DCM;然而,只有不到 10% 的人得到诊断,终生残疾仍然是常见的结果。完成本讲座后,与会者将:(1)了解 DCM 的诊断标准和检查方法,避免在初级保健阶段出现误诊;(2)认识手术治疗的适应症和作用;(3)理解预康复和康复的影响;(4)了解 DCM 非手术治疗的替代方法;以及(5)了解提高对该疾病认识的重要性。 本次研讨会将回顾不同程度 DCM 患者的诊断标准和检查方法、目前治疗 DCM 的临床实践指南(重点是脊髓手术减压的作用)、术前康复和康复治疗的作用、目前 DCM 患者的非手术治疗方案,以及一些旨在提高人们对该疾病认识的举措。 研讨会将包括讲座(每场 10-15 分钟)和病例说明,然后就以下主题进行公开讨论:(i) DCM 的诊断、误诊和检查;(ii) DCM 的手术治疗;(iii) DCM 的术前康复和康复治疗;以及 (iv) DCM 的非手术治疗。 虽然 DCM 是非外伤性脊髓疾病最常见的病因,但仍有必要为管理 DCM 制定一个量身定制的多学科护理框架,以改善患者的预后。我们敦促医疗保健专业人员提高对 DCM 的认识,以避免误诊并减轻该疾病的长期后果。
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引用次数: 0
Poster (Knowledge Generation) ID 1969160 海报(知识生成)ID 1969160
IF 2.9 Q2 Medicine Pub Date : 2023-09-01 DOI: 10.46292/sci23-1969160s
Julio C Furlan, E. Loh, M. Boulos
This ongoing cross-sectional study aims to examine the potential association between moderate-to-severe sleep apnea and severe cardiovascular dysfunction after spinal cord injury (SCI). This cross-sectional study included participants who were newly diagnosed with sleep apnea using a home-based/hospital unattended sleep screening test that quantifies the apnea-hypopnea index (AHI). Episodes of AD were defined as a sudden increase in systolic blood pressure (BP) of at least 20 mmHg. We exclude episodes of AD during sleep that were caused by triggers other than apnea or hypopnea. This study included English-speaking adults with subacute or chronic (≥1 month after SCI onset), cervical or high-thoracic (T6 or more cranial), complete or incomplete SCI, who reported clinical symptoms and/or signs suggestive of sleep apnea. This study included 45 individuals (14 females and 31 males; age range: 20 to 84 years, mean age: 57.0 years) with motor complete (n=22) or incomplete SCI at cervical (n=38) or high thoracic levels. Time since SCI varied from 1.5 months to 52 years. Their mean apnea-hypopnea index (AHI) was 16.0 events/hour (AHI range: 0.8 to 51.7 events/hour). Higher AHI was significantly correlated with more frequent silent episodes of AD (Rsqr=0.220, p=0.001) during sleep. The AHI was not associated with systolic BP (p=0.903), diastolic BP (p=0.639), mean arterial pressure (p=0.714), and heart rate (p=0.669) during sleep. The results of this cross-sectional study suggest that more severe sleep apnea is associated with frequent silent episodes of AD during sleep among individuals living with cervical or high-thoracic SCI.
这项正在进行的横断面研究旨在探讨中重度睡眠呼吸暂停与脊髓损伤(SCI)后严重心血管功能障碍之间的潜在关联。 这项横断面研究纳入了通过家庭/医院无人值守睡眠筛查测试新诊断出患有睡眠呼吸暂停的参与者,该测试可量化呼吸暂停-低通气指数(AHI)。AD发作的定义是收缩压(BP)突然升高至少20毫米汞柱。我们排除了睡眠中因呼吸暂停或低通气以外的诱因引起的急性呼吸暂停发作。 本研究纳入了亚急性或慢性(SCI 发病后≥1 个月)、颈椎或高胸椎(T6 或以上颅骨)、完全或不完全 SCI 的英语成年人,他们报告了提示睡眠呼吸暂停的临床症状和/或体征。 本研究共纳入 45 名患者(14 名女性和 31 名男性;年龄范围:20 至 84 岁,平均年龄:57.0 岁),他们均患有颈椎(38 名)或胸椎高位运动性完全(22 名)或不完全 SCI。SCI 后的时间从 1.5 个月到 52 年不等。他们的平均呼吸暂停-低通气指数(AHI)为 16.0 次/小时(AHI 范围:0.8 至 51.7 次/小时)。较高的 AHI 与睡眠中更频繁的无声 AD 发作有明显相关性(Rsqr=0.220,p=0.001)。AHI 与睡眠期间的收缩压(P=0.903)、舒张压(P=0.639)、平均动脉压(P=0.714)和心率(P=0.669)均无关联。 这项横断面研究的结果表明,在患有颈椎或高胸椎 SCI 的患者中,更严重的睡眠呼吸暂停与睡眠中频繁的无声 AD 发作有关。
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引用次数: 0
Student Competition (Knowledge Generation) ID 1985014 学生竞赛(知识生成) ID 1985014
IF 2.9 Q2 Medicine Pub Date : 2023-09-01 DOI: 10.46292/sci23-1985014s
Lauren Cadel, S. L. Hitzig, Lisa M McCarthy, Shoshana Hahn-Goldberg, Tanya L Packer, Chester H Ho, Aisha K Lofters, Tejal Patel, Stephanie R. Cimino, S. Guilcher
Adults with spinal cord injury/dysfunction (SCI/D) are commonly prescribed multiple medications to manage secondary complications. Significant challenges managing medications have been highlighted, with the need for more support with medication self-management. The objective of this study is to co-develop a toolkit to assist with medication self-management for persons with SCI/D. Adults with SCI/D, caregivers, and healthcare providers will participate in the three steps of concept mapping – brainstorming, sorting and rating, and mapping to identify key components of the toolkit. Participants will generate statements about what should be incorporated into a toolkit to help persons with SCI/D manage their medications. Participants will rate the final list of statements on importance and feasibility and sort the statements into thematic piles. A visual map will be developed by a subset of participants, representing the thematic piles. To date, participants have generated over 500 statements. Ideas generated around the content of the toolkit focus on information about: pharmacological and non-pharmacological options for managing secondary complications, side effects, communicating with providers, and medication access. Ideas specific to the delivery of the toolkit focus on: ensuring an individualized approach, accessibility, and the use of visuals. Statements will be synthesized for sorting and rating and mapping. Subsequent phases of this research will refine the toolkit through interviews and input from our working group. A mixed methods pilot evaluation will then be conducted to assess the feasibility, acceptability, and appropriateness of the toolkit, as well medication knowledge, self-efficacy, and quality of life.
患有脊髓损伤/功能障碍(SCI/D)的成年人通常需要服用多种药物来控制继发性并发症。药物管理方面的巨大挑战已经凸显出来,需要在药物自我管理方面提供更多支持。 本研究旨在共同开发一个工具包,以协助 SCI/D 患者进行药物自我管理。 患有 SCI/D的成年人、护理人员和医疗保健提供者将参与概念绘图的三个步骤--头脑风暴、分类和评级以及绘图,以确定工具包的关键组成部分。参与者将就工具包中应包含哪些内容以帮助 SCI/D 患者管理药物生成陈述。参与者将根据重要性和可行性对最终的陈述清单进行评分,并将陈述按主题分类。一部分参与者将绘制一张可视化地图,代表各组主题。 迄今为止,参与者已经提出了 500 多条陈述。围绕工具包内容产生的想法主要涉及以下方面的信息:控制继发性并发症的药物和非药物选择、副作用、与医疗服务提供者沟通以及药物获取。关于工具包提供方式的具体想法主要集中在:确保个性化方法、可及性和视觉效果的使用。将对陈述进行综合,以便分类、评级和制图。 本研究的后续阶段将通过访谈和工作组的意见来完善工具包。然后将进行混合方法试点评估,以评估工具包的可行性、可接受性和适宜性,以及药物知识、自我效能和生活质量。
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引用次数: 0
Student Competition (Knowledge Generation) ID 1985185 学生竞赛(知识生成) ID 1985185
IF 2.9 Q2 Medicine Pub Date : 2023-09-01 DOI: 10.46292/sci23-1985185s
Sisuri G. Hemakumara, Zahra Karamzadeh, Darren J. Mann, Trevor S. Barss, Vivian K. Mushahwar
Transcutaneous spinal cord stimulation (tSCS) facilitates spinal networks involving motor function. The purpose of this study is to compare the effect of stimulators used and amplitude of tSCS, applied at the cervical region of the spinal cord, on propriospinal modulation of lower limbs. Corticospinal and spinal reflex excitability were assessed with lower limb motor evoked potentials (MEPs), and Hoffman (H-) reflexes, respectively. Neurologically intact participants (n=6) were recruited. Two stimulators (NeoStim-5 and DS8R) were used, and different tSCS amplitudes at threshold (thresh) and maximum tolerance (max) were applied. The effect of tSCS on the amplitude of the H-reflex evoked in the soleus muscle was assessed, as well as the effect of cervical tSCS on MEPs evoked in the tibialis anterior muscle. Participants completed five conditions including: 1) Control (no stimulation) 2) DS8R Thresh 3) DS8R Max 4) NeoStim-5 Thresh 5) NeoStim-5 Max. At the same tSCS amplitude, the participants subjectively tolerated the NeoStim-5 better than the DS8R. The maximum tolerated amplitude for NeoStim-5 was higher than that of the DS8R, for all participants. Preliminary analysis suggests changes in tSCS amplitude delivered, do not appear to have an effect on the H-reflex and MEP in this small sample of participants. Preliminary findings indicate that different stimulators produce different sensations at the same tSCS amplitudes. Changes in stimulator amplitudes do not appear to have an effect on the electrophysiological outcome on propriospinal modulation. This study sets the basis for understanding mechanisms of tSCS, including cutaneous activation.
经皮脊髓刺激(tSCS)可促进涉及运动功能的脊髓网络。本研究的目的是比较应用于脊髓颈部的经皮脊髓刺激(tSCS)所使用的刺激器和振幅对下肢本体脊髓调制的影响。皮质脊髓和脊髓反射兴奋性分别通过下肢运动诱发电位(MEPs)和霍夫曼(H-)反射进行评估。 招募了神经系统完好的参与者(6 人)。他们使用了两种刺激器(NeoStim-5 和 DS8R),并在阈值(thresh)和最大耐受量(max)时使用了不同的 tSCS 振幅。评估了 tSCS 对诱发比目鱼肌 H 反射振幅的影响,以及颈部 tSCS 对诱发胫骨前肌 MEPs 的影响。参与者完成了五个条件,包括1) 对照组(无刺激) 2) DS8R Thresh 3) DS8R Max 4) NeoStim-5 Thresh 5) NeoStim-5 Max。 在相同的 tSCS 振幅下,参与者对 NeoStim-5 的主观耐受性要好于 DS8R。所有参与者对 NeoStim-5 的最大耐受振幅都高于 DS8R。初步分析表明,在这一小部分参与者中,tSCS 振幅的变化似乎不会对 H 反射和 MEP 产生影响。 初步研究结果表明,在相同的 tSCS 振幅下,不同的刺激器会产生不同的感觉。刺激器振幅的变化似乎不会对本体脊髓调制的电生理结果产生影响。这项研究为了解 tSCS 的机制(包括皮肤激活)奠定了基础。
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引用次数: 0
Student Competition (Knowledge Generation) ID 1987946 学生竞赛(知识生成) ID 1987946
IF 2.9 Q2 Medicine Pub Date : 2023-09-01 DOI: 10.46292/sci23-1987946s
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.
NX210c 是一种 12 氨基酸肽,来源于脊髓膜下器官-spondin 中保守的 thrombospondin 1 型重复序列,具有独特的多功能作用机制,可改善神经损伤后的预后。本研究旨在评估 NX210c 在颈椎创伤性脊髓损伤(SCI)模型中促进功能恢复和组织修复的功效。 成年雌性Wistar大鼠受到C6/C7夹片压迫-灌注损伤,从损伤后4小时或8小时开始,每天腹腔注射一次NX210c(8毫克/千克)或其载体,连续治疗8周(16-17只/组),同时进行神经行为测试。 较早在4小时给药NX210c可增加前肢握力(p<0.05),并改善运动的多个静态和动态方面,包括规律性指数和前肢支撑基础(CatWalk)(p<0.05)。将 NX210c 的首次给药时间延迟至 8 小时可促进体重增加,加快膀胱控制能力在伤后 14 到 9 天的恢复,并在伤后一周内改善躯干平衡(倾斜面)(p<0.05)。与 75% 的药物对照组相比,94% 的 NX210c 治疗大鼠在初始注射延迟时间点观察到体重支持。组织学研究(n=6/组)显示,与对照组相比,NX210c 在损伤后 8 小时开始治疗时,损伤中心的白质保存更完好,空腔缩小,尾部神经元体细胞数增加(p<0.05)。 NX210c针对SCI的各个方面,可改善运动功能、膀胱控制、白质保存和神经元数量,在较晚的初始注射时间点可观察到更多益处。
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引用次数: 0
Workshop (Clinical/Best Practice Implementation) ID 2002364 讲习班(临床/最佳实践实施) ID 2002364
IF 2.9 Q2 Medicine Pub Date : 2023-09-01 DOI: 10.46292/sci23-2002364s
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:
脊髓损伤(SCI)会影响患者身体机能的方方面面。因此,一个人在脊髓损伤后要想在社区中生存和发展,就需要全面有效的康复计划以及维持生命的医疗保健(即脊髓损伤专用医疗服务、设备和用品)。虽然加拿大有一个由政府资助的全民医疗保健系统,但各省在决定如何提供康复服务和定义 "基本 "医疗保健方面具有灵活性。 本次研讨会将包括两个讲座,介绍加拿大目前在急性 SCI 康复和提供维持生命的 SCI 医疗服务、设备和用品方面的护理标准,随后将对其他可比国家的标准进行初步概述,并讨论下一步如何在加拿大发展 SCI 康复和提供 SCI 相关医疗需求方面的公平性和一致性。 完成本次研讨会后,与会者将了解
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引用次数: 0
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Topics in Spinal Cord Injury Rehabilitation
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