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}
William Pei, Kai Lon Fok, S. Tajali, Jae W. Lee, Sharmini Atputharaj, Kristin E. Musselman, Kei Masani
Individuals with an incomplete spinal cord injury (iSCI) have increased risk of falls during walking and standing. Our previous longitudinal pilot study demonstrated that a therapeutic system (FES+VFT system) using functional electrical stimulation (FES) and visual feedback training (VFT) improved the standing balance of individuals with iSCI. This study investigated the orthotic and acute therapeutic effects of FES in the FES+VFT system. Fifteen individuals with iSCI will be recruited for this study. To date, four participants have completed the study. The four participants completed three different sessions. In the first session, participants were evaluated for their balance, postural control and familiarized with the FES+VFT system. In the second and third sessions, the participant completed training sessions with the FES+VFT system with or without FES. Centre of pressure (COP) data were collected via force platforms. Before and after the training, the motor evoked potentials (MEP) of the soleus and tibialis anterior muscles were recorded. There was a greater increase in the total dynamic range of the COP with FES+VFT than VFT (Anterior posterior: increase of 17.5 ± 14.27mm, medial lateral: increase of 17.9 ± 19.45mm). Both the soleus and tibialis anterior muscles showed greater increases in MEP after FES+VFT than VFT (Soleus: 70.4 ± 31.1% vs 5.45 ± 29.1%; Tibialis Anterior: 115.3 ± 234.8% vs 11.0 ± 42.9%). These findings suggest that FES improves the performance of VFT (positive orthotic effect) and increases the corticospinal connection (positive acute therapeutic effect) in individuals with iSCI.
{"title":"Student Competition (Knowledge Generation) ID 1973368","authors":"William Pei, Kai Lon Fok, S. Tajali, Jae W. Lee, Sharmini Atputharaj, Kristin E. Musselman, Kei Masani","doi":"10.46292/sci23-1973368s","DOIUrl":"https://doi.org/10.46292/sci23-1973368s","url":null,"abstract":"Individuals with an incomplete spinal cord injury (iSCI) have increased risk of falls during walking and standing. Our previous longitudinal pilot study demonstrated that a therapeutic system (FES+VFT system) using functional electrical stimulation (FES) and visual feedback training (VFT) improved the standing balance of individuals with iSCI. This study investigated the orthotic and acute therapeutic effects of FES in the FES+VFT system. Fifteen individuals with iSCI will be recruited for this study. To date, four participants have completed the study. The four participants completed three different sessions. In the first session, participants were evaluated for their balance, postural control and familiarized with the FES+VFT system. In the second and third sessions, the participant completed training sessions with the FES+VFT system with or without FES. Centre of pressure (COP) data were collected via force platforms. Before and after the training, the motor evoked potentials (MEP) of the soleus and tibialis anterior muscles were recorded. There was a greater increase in the total dynamic range of the COP with FES+VFT than VFT (Anterior posterior: increase of 17.5 ± 14.27mm, medial lateral: increase of 17.9 ± 19.45mm). Both the soleus and tibialis anterior muscles showed greater increases in MEP after FES+VFT than VFT (Soleus: 70.4 ± 31.1% vs 5.45 ± 29.1%; Tibialis Anterior: 115.3 ± 234.8% vs 11.0 ± 42.9%). These findings suggest that FES improves the performance of VFT (positive orthotic effect) and increases the corticospinal connection (positive acute therapeutic effect) in individuals with iSCI.","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"66 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139345532","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}
As more research funding agencies require grant applications to include an array of stakeholder expertise, a clear and well-thought-out Engagement Plan is necessary to ensure grant reviewers understand how projects will engage relevant stakeholders. Provide a comprehensive framework for drafting Engagement Plans for grant applications that will strengthen research proposals, help to mitigate tokenism and lead to more meaningful engagement in SCI research. This presentation will describe in detail the key components you should include in your grant Engagement Plan, including tools you can utilize to select ideal project partners, develop an activity timeline, choose appropriate engagement methodologies, and prepare an accurate budget. Drawing on established best-practices in meaningful engagement, this presentation will guide delegates through the various components funding agencies expect to see in a thorough Engagement Plan. A novel framework will be shared that addresses common shortcomings in Engagement Plans and provides clear guidance on the elements to include in your grant submissions. A detailed Engagement Plan clarifies to grant reviewers the steps you intend to take to ensure meaningful engagement in your proposed work, and will help set your application apart in the highly competitive research funding market.
{"title":"Workshop (Knowledge Generation) ID 1985178","authors":"John Chernesky","doi":"10.46292/sci23-1985178s","DOIUrl":"https://doi.org/10.46292/sci23-1985178s","url":null,"abstract":"As more research funding agencies require grant applications to include an array of stakeholder expertise, a clear and well-thought-out Engagement Plan is necessary to ensure grant reviewers understand how projects will engage relevant stakeholders. Provide a comprehensive framework for drafting Engagement Plans for grant applications that will strengthen research proposals, help to mitigate tokenism and lead to more meaningful engagement in SCI research. This presentation will describe in detail the key components you should include in your grant Engagement Plan, including tools you can utilize to select ideal project partners, develop an activity timeline, choose appropriate engagement methodologies, and prepare an accurate budget. Drawing on established best-practices in meaningful engagement, this presentation will guide delegates through the various components funding agencies expect to see in a thorough Engagement Plan. A novel framework will be shared that addresses common shortcomings in Engagement Plans and provides clear guidance on the elements to include in your grant submissions. A detailed Engagement Plan clarifies to grant reviewers the steps you intend to take to ensure meaningful engagement in your proposed work, and will help set your application apart in the highly competitive research funding market.","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"22 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139345788","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}
Elina Provad, Tanha Patel, Kayla Benson, Katherine Chan, Jae W. Lee, Elizabeth L. Inness, D. Wolfe, Kei Masani, Kristin E. Musselman
Individuals with neurological injury or disease are at increased risk of experiencing falls, highlighting the need for effective balance interventions. A novel system integrating functional electrical stimulation and visual feedback balance training (FES+VFBT) is a promising balance intervention; however, this lab-based system requires a redesign to increase clinical utility. To identify possible challenges and solutions to implementing the FES+VFBT system as a balance intervention, from the perspective of end users. This qualitative study involved three semi-structured focus group meetings to explore participants’ perspectives on the feasibility and potential challenges of implementing FES+VFBT in neurorehabilitation. Two individuals with spinal cord injury (SCI), one individual with stroke, two physiotherapists and one hospital administrator participated. Interview transcripts were analyzed using a deductive-inductive content analysis. The levels of the Social Ecological Model (SEM) were used as themes for the deductive analysis. Categories and codes were detected using an inductive approach. The themes spanned the four levels of the SEM: intrapersonal, interpersonal, organizational/training environment and society/policy. Identified categories consisted of possible challenges mapped to the intrapersonal (e.g., lack of knowledge, tolerance of user) and organizational/training environment (e.g., cost, need for space and time, technical challenges) levels. Categories also reflected possible solutions mapped to all SEM levels: intrapersonal (e.g., reading and research), interpersonal (e.g., practicing together), organizational/training environment (e.g., tailoring system parameters, social support), and society/policy (e.g., create guidelines, provide cost options). The findings will be used to improve the FES+VFBT system design and facilitate implementation of the intervention in neurorehabilitation.
患有神经系统损伤或疾病的人发生跌倒的风险会增加，因此需要采取有效的平衡干预措施。集功能性电刺激和视觉反馈平衡训练（FES+VFBT）于一体的新型系统是一种很有前景的平衡干预措施；然而，这种基于实验室的系统需要重新设计，以提高临床实用性。 从最终用户的角度出发，找出实施功能性电刺激和视觉反馈平衡训练系统作为平衡干预措施可能面临的挑战和解决方案。 这项定性研究包括三次半结构化焦点小组会议，以探讨参与者对在神经康复中实施 FES+VFBT 的可行性和潜在挑战的看法。两名脊髓损伤（SCI）患者、一名中风患者、两名物理治疗师和一名医院管理人员参加了会议。访谈记录采用演绎-归纳内容分析法进行分析。社会生态模型 (SEM) 的层次被用作演绎分析的主题。使用归纳法确定类别和代码。 这些主题跨越了 SEM 的四个层次：个人、人际、组织/培训环境和社会/政策。确定的类别包括人际（如缺乏知识、用户容忍度）和组织/培训环境（如成本、空间和时间需求、技术挑战）层面可能存在的挑战。分类还反映了映射到所有 SEM 层次的可能解决方案：个人（如阅读和研究）、人际（如共同练习）、组织/培训环境（如定制系统参数、社会支持）和社会/政策（如制定指南、提供成本选择）。 研究结果将用于改进 FES+VFBT 系统设计，促进神经康复干预措施的实施。
{"title":"Student Competition (Knowledge Generation) ID 1978805","authors":"Elina Provad, Tanha Patel, Kayla Benson, Katherine Chan, Jae W. Lee, Elizabeth L. Inness, D. Wolfe, Kei Masani, Kristin E. Musselman","doi":"10.46292/sci23-1978805s","DOIUrl":"https://doi.org/10.46292/sci23-1978805s","url":null,"abstract":"Individuals with neurological injury or disease are at increased risk of experiencing falls, highlighting the need for effective balance interventions. A novel system integrating functional electrical stimulation and visual feedback balance training (FES+VFBT) is a promising balance intervention; however, this lab-based system requires a redesign to increase clinical utility. To identify possible challenges and solutions to implementing the FES+VFBT system as a balance intervention, from the perspective of end users. This qualitative study involved three semi-structured focus group meetings to explore participants’ perspectives on the feasibility and potential challenges of implementing FES+VFBT in neurorehabilitation. Two individuals with spinal cord injury (SCI), one individual with stroke, two physiotherapists and one hospital administrator participated. Interview transcripts were analyzed using a deductive-inductive content analysis. The levels of the Social Ecological Model (SEM) were used as themes for the deductive analysis. Categories and codes were detected using an inductive approach. The themes spanned the four levels of the SEM: intrapersonal, interpersonal, organizational/training environment and society/policy. Identified categories consisted of possible challenges mapped to the intrapersonal (e.g., lack of knowledge, tolerance of user) and organizational/training environment (e.g., cost, need for space and time, technical challenges) levels. Categories also reflected possible solutions mapped to all SEM levels: intrapersonal (e.g., reading and research), interpersonal (e.g., practicing together), organizational/training environment (e.g., tailoring system parameters, social support), and society/policy (e.g., create guidelines, provide cost options). The findings will be used to improve the FES+VFBT system design and facilitate implementation of the intervention in neurorehabilitation.","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"208 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139346542","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}
Participants of this workshop will be able to identify and recommend multimodal treatment options in managing challenging cases in spasticity management of lower limbs in spinal cord injury (SCI). The complexities of spasticity management will be identified through case-based presentations, including assessment and treatment directed by patient-oriented goals. Facilitated interactive discussion on these cases will engage participants for input, debate and critique. Procedural techniques for neurolysis will be discussed. Goals of spasticity management in SCI often include both proximal and distal lower limb problems. Therapies include oral medications, chemodenervation with neuromuscular junction blockade with botulinum toxin or neurolysis with phenol, intrathecal baclofen, bracing, and surgery. Many patients require multiple of these therapeutic options during their course of spasticity management. Multimodal therapy as part of the clinician toolbox is essential in tone management. Patient-oriented goals are important guideposts in spasticity management. SCI is a lifespan condition, and often patient goals and health conditions change over the years, requiring different tools to address such longitudinal needs.
{"title":"Workshop (Clinical/Best Practice Implementation) ID 1983439","authors":"K. Ethans, Colleen M. O’Connell","doi":"10.46292/sci23-1983439s","DOIUrl":"https://doi.org/10.46292/sci23-1983439s","url":null,"abstract":"Participants of this workshop will be able to identify and recommend multimodal treatment options in managing challenging cases in spasticity management of lower limbs in spinal cord injury (SCI). The complexities of spasticity management will be identified through case-based presentations, including assessment and treatment directed by patient-oriented goals. Facilitated interactive discussion on these cases will engage participants for input, debate and critique. Procedural techniques for neurolysis will be discussed. Goals of spasticity management in SCI often include both proximal and distal lower limb problems. Therapies include oral medications, chemodenervation with neuromuscular junction blockade with botulinum toxin or neurolysis with phenol, intrathecal baclofen, bracing, and surgery. Many patients require multiple of these therapeutic options during their course of spasticity management. Multimodal therapy as part of the clinician toolbox is essential in tone management. Patient-oriented goals are important guideposts in spasticity management. SCI is a lifespan condition, and often patient goals and health conditions change over the years, requiring different tools to address such longitudinal needs.","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"110 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139345464","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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