A. Richard-Denis, H. Hong, A. Dionne, M. Guidea, JM Mac-Thiong
Research participation for individuals with spinal cord injury (SCI) is important to develop and receive promising interventions. It has been suggested that consenting to participate may also be associated with improved long-term outcomes. The objectives of this study are twofold and consisted of 1) verifying whether consenting to participate in a national SCI registry is associated with improved outcomes, and 2) determining predictors of enrolling in the registry. This population-based retrospective cohort study was performed on 3854 individuals with acute traumatic SCI approached to participate in the Canadian patient registry (Rick Hansen SCI Registry) between 2014 and 2019. The status of consent (consent vs. declined/withdrew) consisted in the main independent variable. Outcomes included length of stay, in-hospital mortality, discharge destination, occurrence of complications. Multivariable analyses were performed to identify predictors of consenting and its association with each outcome, while accounting for important covariables (demographic-, trauma- and institution-related). 2998 individuals provided consent and 856 individuals declined/withdrew. Older age at injury and living farther away was associated with decreased likelihood for enrollment. While adjusting for covariables, declining participation was associated with increased acute length of stay, higher incidence of acute complications during acute care and decrease likelihood of being discharged home. Approximately 20% of individuals declined participation in a national registry following an acute SCI, particularly elderly individuals and those living away from the hospital. It is possible that engagement in care and/or care delivery was altered for these individuals, leading to poorer patient outcomes. Enhanced opportunities should be given to subgroups not inclined to participate in research to optimize inclusivity in care delivery, therefore improving outcomes.
{"title":"Poster (Knowledge Generation) ID 2001062","authors":"A. Richard-Denis, H. Hong, A. Dionne, M. Guidea, JM Mac-Thiong","doi":"10.46292/sci23-2001062s","DOIUrl":"https://doi.org/10.46292/sci23-2001062s","url":null,"abstract":"Research participation for individuals with spinal cord injury (SCI) is important to develop and receive promising interventions. It has been suggested that consenting to participate may also be associated with improved long-term outcomes. The objectives of this study are twofold and consisted of 1) verifying whether consenting to participate in a national SCI registry is associated with improved outcomes, and 2) determining predictors of enrolling in the registry. This population-based retrospective cohort study was performed on 3854 individuals with acute traumatic SCI approached to participate in the Canadian patient registry (Rick Hansen SCI Registry) between 2014 and 2019. The status of consent (consent vs. declined/withdrew) consisted in the main independent variable. Outcomes included length of stay, in-hospital mortality, discharge destination, occurrence of complications. Multivariable analyses were performed to identify predictors of consenting and its association with each outcome, while accounting for important covariables (demographic-, trauma- and institution-related). 2998 individuals provided consent and 856 individuals declined/withdrew. Older age at injury and living farther away was associated with decreased likelihood for enrollment. While adjusting for covariables, declining participation was associated with increased acute length of stay, higher incidence of acute complications during acute care and decrease likelihood of being discharged home. Approximately 20% of individuals declined participation in a national registry following an acute SCI, particularly elderly individuals and those living away from the hospital. It is possible that engagement in care and/or care delivery was altered for these individuals, leading to poorer patient outcomes. Enhanced opportunities should be given to subgroups not inclined to participate in research to optimize inclusivity in care delivery, therefore improving outcomes.","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"44 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139344783","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}
Guijin Li, G. Balbinot, Julio C Furlan, Sukhvinder Kalsi-Ryan, J. Zariffa
Cervical spinal cord injury (SCI) can cause significant impairment and disability with an impact on individuals’ quality of life and independence. Surface electromyography (SEMG) is a sensitive and non-invasive technique to measure muscle activity and has demonstrated great potential in capturing the impact from SCI. The mechanisms of SCI damage on SEMG signal characteristics are multi-faceted and difficult to study in vivo. Use validated computational models to characterize changes in SEMG signal after SCI and identify SEMG features that are sensitive and specific to the impact from different aspects of SCI. Starting from existing computational models for motor neuron pool organization and for motor unit action potential generation for healthy neuromuscular systems, we set up scenarios to model alterations in upper motor neurons, lower motor neurons, and the number of muscle fibers within each motor unit after SCI. After simulating SEMG signals from each scenario, we extracted time and frequency domain features and investigated the impact of SCI disruptions on SEMG features using the Pearson correlation between a feature and the extent of a given disruption. Commonly used amplitude-based SEMG features cannot differentiate between injury scenarios. A broader set of features provides greater specificity to the type of damage present. We demonstrated a novel approach to mechanistically relate SEMG features to different types of neuromuscular alterations after SCI. This work contributes to a deeper understanding and exploitation of SEMG in clinical applications, which will ultimately improve patient outcomes after SCI.
{"title":"Poster (Technology Innovation) ID 1984794","authors":"Guijin Li, G. Balbinot, Julio C Furlan, Sukhvinder Kalsi-Ryan, J. Zariffa","doi":"10.46292/sci23-1984794s","DOIUrl":"https://doi.org/10.46292/sci23-1984794s","url":null,"abstract":"Cervical spinal cord injury (SCI) can cause significant impairment and disability with an impact on individuals’ quality of life and independence. Surface electromyography (SEMG) is a sensitive and non-invasive technique to measure muscle activity and has demonstrated great potential in capturing the impact from SCI. The mechanisms of SCI damage on SEMG signal characteristics are multi-faceted and difficult to study in vivo. Use validated computational models to characterize changes in SEMG signal after SCI and identify SEMG features that are sensitive and specific to the impact from different aspects of SCI. Starting from existing computational models for motor neuron pool organization and for motor unit action potential generation for healthy neuromuscular systems, we set up scenarios to model alterations in upper motor neurons, lower motor neurons, and the number of muscle fibers within each motor unit after SCI. After simulating SEMG signals from each scenario, we extracted time and frequency domain features and investigated the impact of SCI disruptions on SEMG features using the Pearson correlation between a feature and the extent of a given disruption. Commonly used amplitude-based SEMG features cannot differentiate between injury scenarios. A broader set of features provides greater specificity to the type of damage present. We demonstrated a novel approach to mechanistically relate SEMG features to different types of neuromuscular alterations after SCI. This work contributes to a deeper understanding and exploitation of SEMG in clinical applications, which will ultimately improve patient outcomes after SCI.","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"51 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139344981","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}
B. C. Craven, Lindsie M. Blencowe, Lora M. Giangregorio, Laura Carbone, Frances M. Weaver, Susan B. Jaglal, Barry Munro, Lynn Boag, Vanessa K. Noonan, S. Humphreys, Mohammad Alavinia
To develop a lower extremity (LE) fragility fracture risk score estimation method among adults with chronic spinal cord injury (SCI). Adults (≥18) with chronic traumatic SCI (n=90, C2-T12, AIS:A-D) participated in a 2-year prospective cohort study. We used a literature search and practice expertise to identify LE fracture predictors. Reference categories (i.e., risk score = 0) were: no prior fracture, 0-9 years post-injury, AIS-CD, no parental history of osteoporosis, and no opioid use. Using logistic regression coefficients, we calculated how far each category is from the base category and computed βi (Wij-WiREF) for each risk factor. In this model, B was the increase in risk associated with each year post injury. The point value for each fracture risk category was calculated by Pointsij=βi (Wij-WiREF)/B. The total points range from 0-21, and the probability of LE fracture is calculated for each point to determine the probability of developing a LE fracture using the formula: Most participants had an AIS-A impairment (60.0%), the mean time post-injury=15.23 years (SD=9.58). For the points system (0-17), prior fracture, years post-injury, AIS, Benzodiazepine use, Opioid use, and parental osteoporosis were defined risk factors. An individual’s risk profile can estimate LE fracture risk. A score of 11 equates to 20% or high fracture risk over a 5-year time period. We describe our preliminary model to estimate LE fracture risk among those with chronic SCI. We plan to apply statistical and machine learning algorithms using Canadian RHSCIR data and US VHA data to validate the model, and increase the model’s predictability.
在慢性脊髓损伤（SCI）成人中开发一种下肢（LE）脆性骨折风险评分估算方法。 患有慢性创伤性 SCI 的成人（≥18 岁）（n=90，C2-T12，AIS:A-D）参加了一项为期 2 年的前瞻性队列研究。我们通过文献检索和实践经验来确定 LE 骨折的预测因素。参考类别（即风险评分 = 0）为：无骨折史、伤后 0-9 年、AIS-CD、父母无骨质疏松症史、未使用阿片类药物。利用逻辑回归系数，我们计算了每个类别与基础类别的距离，并计算了每个风险因素的 βi (Wij-WiREF)。在该模型中，B 是受伤后每一年相关风险的增加值。每个骨折风险类别的点值按 Pointsij=βi (Wij-WiREF)/B 计算。总点数范围为 0-21，计算出每个点的 LE 骨折概率，从而利用公式确定发生 LE 骨折的概率： 大多数参与者的损伤程度为 AIS-A（60.0%），受伤后的平均时间=15.23 年（SD=9.58）。在积分系统（0-17 分）中，既往骨折、受伤后年数、AIS、苯二氮卓类药物的使用、阿片类药物的使用以及父母骨质疏松症都被定义为风险因素。个人的风险概况可估算出 LE 骨折风险。得分 11 分相当于 5 年内有 20% 或很高的骨折风险。 我们介绍了用于估算慢性 SCI 患者 LE 骨折风险的初步模型。我们计划使用加拿大 RHSCIR 数据和美国退伍军人管理局数据应用统计和机器学习算法来验证模型，并提高模型的可预测性。
{"title":"Poster (Knowledge Generation) ID 1985362","authors":"B. C. Craven, Lindsie M. Blencowe, Lora M. Giangregorio, Laura Carbone, Frances M. Weaver, Susan B. Jaglal, Barry Munro, Lynn Boag, Vanessa K. Noonan, S. Humphreys, Mohammad Alavinia","doi":"10.46292/sci23-1985362s","DOIUrl":"https://doi.org/10.46292/sci23-1985362s","url":null,"abstract":"To develop a lower extremity (LE) fragility fracture risk score estimation method among adults with chronic spinal cord injury (SCI). Adults (≥18) with chronic traumatic SCI (n=90, C2-T12, AIS:A-D) participated in a 2-year prospective cohort study. We used a literature search and practice expertise to identify LE fracture predictors. Reference categories (i.e., risk score = 0) were: no prior fracture, 0-9 years post-injury, AIS-CD, no parental history of osteoporosis, and no opioid use. Using logistic regression coefficients, we calculated how far each category is from the base category and computed βi (Wij-WiREF) for each risk factor. In this model, B was the increase in risk associated with each year post injury. The point value for each fracture risk category was calculated by Pointsij=βi (Wij-WiREF)/B. The total points range from 0-21, and the probability of LE fracture is calculated for each point to determine the probability of developing a LE fracture using the formula: Most participants had an AIS-A impairment (60.0%), the mean time post-injury=15.23 years (SD=9.58). For the points system (0-17), prior fracture, years post-injury, AIS, Benzodiazepine use, Opioid use, and parental osteoporosis were defined risk factors. An individual’s risk profile can estimate LE fracture risk. A score of 11 equates to 20% or high fracture risk over a 5-year time period. We describe our preliminary model to estimate LE fracture risk among those with chronic SCI. We plan to apply statistical and machine learning algorithms using Canadian RHSCIR data and US VHA data to validate the model, and increase the model’s predictability.","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"59 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139345563","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}
Collaborative research with community members has been identified as “one of the best ways to support rapid application of research evidence” by focusing research to the needs of users. As funders and researchers rush to bridge the gap in healthcare delivery, there arises a need to build on integrated knowledge translation (IKT) best practices to support equitable PLEX compensation. This research will help determine the monetary value of PLEX when participating in research. An environmental scan of healthcare funders, institutions and organizations patient partners /lived experience compensation rates in Canada, United States, and select countries from 2010-2023 provided a baseline data set. A systematic scan of published literature and grey literature of this nascent field, PLEX compensation rates was synthesized from this analysis and aligned with the SPOR guidelines. A third party conducted a check of the data abstraction to ensure high data quality. Early results indicate a wide range of patient compensation rates from $40-200 a session with limited information on SCI-specific compensation. This research provides a rationale for fair and equitable compensation of PLEX, with a compensation matrix based on the level of engagement.
{"title":"Poster (Health Services, Economics and Policy Change) ID 2001712","authors":"Chris Marks","doi":"10.46292/sci23-2001712s","DOIUrl":"https://doi.org/10.46292/sci23-2001712s","url":null,"abstract":"Collaborative research with community members has been identified as “one of the best ways to support rapid application of research evidence” by focusing research to the needs of users. As funders and researchers rush to bridge the gap in healthcare delivery, there arises a need to build on integrated knowledge translation (IKT) best practices to support equitable PLEX compensation. This research will help determine the monetary value of PLEX when participating in research. An environmental scan of healthcare funders, institutions and organizations patient partners /lived experience compensation rates in Canada, United States, and select countries from 2010-2023 provided a baseline data set. A systematic scan of published literature and grey literature of this nascent field, PLEX compensation rates was synthesized from this analysis and aligned with the SPOR guidelines. A third party conducted a check of the data abstraction to ensure high data quality. Early results indicate a wide range of patient compensation rates from $40-200 a session with limited information on SCI-specific compensation. This research provides a rationale for fair and equitable compensation of PLEX, with a compensation matrix based on the level of engagement.","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"48 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139345575","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}
David S. Ditor, Alexandria Roa Agudelo, E. Loh, Sussan Askari, Chetan P. Phadke
Anti-inflammatory diets have shown effective in reducing pro-inflammatory cytokines, and neuropathic pain and depression in individuals with spinal cord injury or disease (SCI/D). However, work to date has focused on community-dwelling individuals with SCI/D, and the diet’s efficacy in an inpatient population, and the feasibility of offering it in a hospital, are unknown. The inpatient setting may be ideal for introducing an anti-inflammatory diet, as immune-related health complications peak acutely after SCI, and forming new dietary habits may be easier in an inpatient setting. Thus, it is necessary to investigate the feasibility of an anti-inflammatory diet in the inpatient SCI/D setting. Phase 1: Understand the nutritional value of the current meal plans in selected inpatient SCI/D hospitals and their compliance with our anti-inflammatory diet. Phase 2: Understand the opinions that inpatients with SCI/D have regarding their currently offered meal choices and their readiness to learn about, and adopt, an anti-inflammatory diet. Phase 3: Understand the barriers and facilitators for implementing an anti-inflammatory diet in an inpatient setting from the perspective of hospital administrators. This study will take place in the SCI inpatient settings in two Ontario hospitals. Four to five inpatients from each site will be interviewed in Phase 1 and 2, and four to five Food Services administrators from each site will be interviewed in Phase 3. Menu plans, as well as individual food logs will be analyzed for nutritional value and compliance to an anti-inflammatory diet. Interviews will be subject to thematic analysis.
{"title":"Poster (Knowledge Generation) ID 1987820","authors":"David S. Ditor, Alexandria Roa Agudelo, E. Loh, Sussan Askari, Chetan P. Phadke","doi":"10.46292/sci23-1987820s","DOIUrl":"https://doi.org/10.46292/sci23-1987820s","url":null,"abstract":"Anti-inflammatory diets have shown effective in reducing pro-inflammatory cytokines, and neuropathic pain and depression in individuals with spinal cord injury or disease (SCI/D). However, work to date has focused on community-dwelling individuals with SCI/D, and the diet’s efficacy in an inpatient population, and the feasibility of offering it in a hospital, are unknown. The inpatient setting may be ideal for introducing an anti-inflammatory diet, as immune-related health complications peak acutely after SCI, and forming new dietary habits may be easier in an inpatient setting. Thus, it is necessary to investigate the feasibility of an anti-inflammatory diet in the inpatient SCI/D setting. Phase 1: Understand the nutritional value of the current meal plans in selected inpatient SCI/D hospitals and their compliance with our anti-inflammatory diet. Phase 2: Understand the opinions that inpatients with SCI/D have regarding their currently offered meal choices and their readiness to learn about, and adopt, an anti-inflammatory diet. Phase 3: Understand the barriers and facilitators for implementing an anti-inflammatory diet in an inpatient setting from the perspective of hospital administrators. This study will take place in the SCI inpatient settings in two Ontario hospitals. Four to five inpatients from each site will be interviewed in Phase 1 and 2, and four to five Food Services administrators from each site will be interviewed in Phase 3. Menu plans, as well as individual food logs will be analyzed for nutritional value and compliance to an anti-inflammatory diet. Interviews will be subject to thematic analysis.","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":"139346454","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}
B. C. Craven, Anita Kaiser, Hope Jervis-Rademeyer, Wendy Murphy, Lynn Boag, M. Miyatani, Lindsie M. Blencowe
The Paralyzed Veterans of America inaugural Clinical Practice Guideline (CPG) for Bone Health and Osteoporosis Management for individuals with spinal cord injury or disease (SCI/D) was published for clinicians in 2022. To disseminate knowledge, we developed a series of nine podcasts and handouts, “The Bare Bones Series” (TBBS), linked with each CPG chapter. The intent was to share the CPG content with people with lived experience of SCI/D (PLEX). This workshop will: 1) introduce TBBS and intended use of the CPG framework; and 2) provide participants the opportunity to apply their learning from the podcast episodes “Get Moving and Loading” and “Snap and Crack” through discussion of two case based scenarios. The aim, content, intended use and targeted audience for TBBS will be highlighted. TBBS was developed and hosted by two PLEX, project team members, and 11 guests who were the CPG chapter authors. Podcast handouts contain infographics, key concepts and recommendations for action. Attendees including clinicians, PLEX, family and friends, will review 3 of 9 episodes. The panelists (Chair, PLEX and project team) will discuss the CPG content and actions to take to improve bone health and reduce fracture risk in PLEX with SCI/D. TBBS will be shared through social media, stakeholder and community events, and conference presentations across North America. Workshop attendance will aid participants in advocating for bone health assessments, understanding fracture risk, and promoting a dialogue with their care team about how to prevent fracture, and reduce fracture related morbidity and mortality.
{"title":"Workshop (Clinical/Best Practice Implementation) ID 1985360","authors":"B. C. Craven, Anita Kaiser, Hope Jervis-Rademeyer, Wendy Murphy, Lynn Boag, M. Miyatani, Lindsie M. Blencowe","doi":"10.46292/sci23-1985360s","DOIUrl":"https://doi.org/10.46292/sci23-1985360s","url":null,"abstract":"The Paralyzed Veterans of America inaugural Clinical Practice Guideline (CPG) for Bone Health and Osteoporosis Management for individuals with spinal cord injury or disease (SCI/D) was published for clinicians in 2022. To disseminate knowledge, we developed a series of nine podcasts and handouts, “The Bare Bones Series” (TBBS), linked with each CPG chapter. The intent was to share the CPG content with people with lived experience of SCI/D (PLEX). This workshop will: 1) introduce TBBS and intended use of the CPG framework; and 2) provide participants the opportunity to apply their learning from the podcast episodes “Get Moving and Loading” and “Snap and Crack” through discussion of two case based scenarios. The aim, content, intended use and targeted audience for TBBS will be highlighted. TBBS was developed and hosted by two PLEX, project team members, and 11 guests who were the CPG chapter authors. Podcast handouts contain infographics, key concepts and recommendations for action. Attendees including clinicians, PLEX, family and friends, will review 3 of 9 episodes. The panelists (Chair, PLEX and project team) will discuss the CPG content and actions to take to improve bone health and reduce fracture risk in PLEX with SCI/D. TBBS will be shared through social media, stakeholder and community events, and conference presentations across North America. Workshop attendance will aid participants in advocating for bone health assessments, understanding fracture risk, and promoting a dialogue with their care team about how to prevent fracture, and reduce fracture related morbidity and mortality.","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"1 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139346845","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}
Andrea Chase, Sharol E. Cordner, Jennifer M. Duley, Marty Doupe, Charlie Giurleo, Julianne W. Y. Hong, A. Kras-Dupuis, A. Ventre, Julie Watson, D. Wolfe, Nancy Xia
Persons with spinal cord injury (SCI) are at increased risk of developing pressure injuries throughout their lifetime. This significant yet preventable secondary complication can have a negative impact on one’s health and well-being. A key aspect of prevention is performing regular daily skin checks; however, a gap in knowledge is apparent among clinicians and patients on how exactly to perform them. To develop a universal and widely available skin check video resource that supports clinicians and patients. Clinicians across the SCI-IEQCC Network from Parkwood Institute, Hamilton Regional Reha-bilitation Centre, Ottawa Hospital Rehabilitation Center, Lyndhurst, Providence Care, and in partnership with SCIO, Cortree and persons with lived experiences, all contributed in an iterative manner to the development of a skin check video resource. Feedback from all relevant stakeholders was gathered after each round of edits to ensure the content would meet the educational needs of persons with lived experience and rehabilitation staff. This collaboration allowed for the development of an open-source skin check video resource for both clinicians and persons with lived experience. This video is in process of being integrated within patient skin check education of the various rehabilitation sites across Ontario. The video identifies key factors to consider when completing skin checks and demonstrates the technique on how to complete skin checks independently and with assistance. While a successful skin check video resource was created, next steps will look to its sustainable implementation and dissemination at a local and provincial level.
{"title":"Poster (Clinical/Best Practice Implementation) ID 1985182","authors":"Andrea Chase, Sharol E. Cordner, Jennifer M. Duley, Marty Doupe, Charlie Giurleo, Julianne W. Y. Hong, A. Kras-Dupuis, A. Ventre, Julie Watson, D. Wolfe, Nancy Xia","doi":"10.46292/sci23-1985182s","DOIUrl":"https://doi.org/10.46292/sci23-1985182s","url":null,"abstract":"Persons with spinal cord injury (SCI) are at increased risk of developing pressure injuries throughout their lifetime. This significant yet preventable secondary complication can have a negative impact on one’s health and well-being. A key aspect of prevention is performing regular daily skin checks; however, a gap in knowledge is apparent among clinicians and patients on how exactly to perform them. To develop a universal and widely available skin check video resource that supports clinicians and patients. Clinicians across the SCI-IEQCC Network from Parkwood Institute, Hamilton Regional Reha-bilitation Centre, Ottawa Hospital Rehabilitation Center, Lyndhurst, Providence Care, and in partnership with SCIO, Cortree and persons with lived experiences, all contributed in an iterative manner to the development of a skin check video resource. Feedback from all relevant stakeholders was gathered after each round of edits to ensure the content would meet the educational needs of persons with lived experience and rehabilitation staff. This collaboration allowed for the development of an open-source skin check video resource for both clinicians and persons with lived experience. This video is in process of being integrated within patient skin check education of the various rehabilitation sites across Ontario. The video identifies key factors to consider when completing skin checks and demonstrates the technique on how to complete skin checks independently and with assistance. While a successful skin check video resource was created, next steps will look to its sustainable implementation and dissemination at a local and provincial level.","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"51 1","pages":""},"PeriodicalIF":2.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139346941","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}
Laura Krisa, Erica Witoslawski, Linda Jones, MJ Mulcahey, Karim Fouad
Background Translating research findings from animal models of spinal cord injury (SCI) to humans is a challenging enterprise. It is likely that differences in the use of common terms contribute to this. Objectives The purpose of this study was to identify how scientists and clinicians define terms used across the research and clinical care continuum. Methods We utilized the Delphi technique to develop consensus on the opinions of experts (defined as researchers and/or clinicians working in the field of SCI) through a series of structured, iterative surveys. A focus group of stakeholders developed the terms on the initial survey. Results were used to create definitions and formulate questions for a second and third survey. Results Survey 1 yielded one definition for eight terms and multiple definitions for six terms in addition to three new terms that respondents believed should be defined. In Survey 2, definitions for eight terms reached at least 80% agreement: anatomically complete spinal cord injury, functionally complete spinal cord injury, neuromodulation, physical exercise, physical rehabilitation, plasticity, task specificity, and training intensity. Consensus was not reached for six terms. In Survey 3, definitions for seven additional terms reached at least 80% agreement: recovery, repair, compensation, regeneration, physical function, physiological function, and chronic. There were three terms that did not reach agreement after the three rounds: acute, translational research, and sprouting. Conclusion We found that different terminology contributes to the gap between preclinical and clinical research and clinical application. This suggests that increased communication among different disciplines could be a way to advance the field.
{"title":"Connecting Researchers and Clinicians Before Connecting the Injured Spinal Cord","authors":"Laura Krisa, Erica Witoslawski, Linda Jones, MJ Mulcahey, Karim Fouad","doi":"10.46292/sci22-00044","DOIUrl":"https://doi.org/10.46292/sci22-00044","url":null,"abstract":"Background Translating research findings from animal models of spinal cord injury (SCI) to humans is a challenging enterprise. It is likely that differences in the use of common terms contribute to this. Objectives The purpose of this study was to identify how scientists and clinicians define terms used across the research and clinical care continuum. Methods We utilized the Delphi technique to develop consensus on the opinions of experts (defined as researchers and/or clinicians working in the field of SCI) through a series of structured, iterative surveys. A focus group of stakeholders developed the terms on the initial survey. Results were used to create definitions and formulate questions for a second and third survey. Results Survey 1 yielded one definition for eight terms and multiple definitions for six terms in addition to three new terms that respondents believed should be defined. In Survey 2, definitions for eight terms reached at least 80% agreement: anatomically complete spinal cord injury, functionally complete spinal cord injury, neuromodulation, physical exercise, physical rehabilitation, plasticity, task specificity, and training intensity. Consensus was not reached for six terms. In Survey 3, definitions for seven additional terms reached at least 80% agreement: recovery, repair, compensation, regeneration, physical function, physiological function, and chronic. There were three terms that did not reach agreement after the three rounds: acute, translational research, and sprouting. Conclusion We found that different terminology contributes to the gap between preclinical and clinical research and clinical application. This suggests that increased communication among different disciplines could be a way to advance the field.","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"128 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135195498","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}
Objectives: To compare the effectiveness of two different interventions that promote physical activity in individuals with traumatic spinal cord injury (SCI) and determine the effect of relapse prevention. Methods: A sequential, multiple assignment, randomized trial was conducted at a universally designed community-based exercise facility. Participants were individuals with traumatic SCI, >3 months post injury, levels C5 to T12, age ≥18 years (N = 79). After randomization, Bridge Program participants completed an 8-week personalized, less intense, exercise program informed by American College of Sports Medicine (ACSM) guidelines and supported with hands-on peer mentoring, exercise of choice, and caregiver training. Structured Exercise participants completed an 8-week program in a group format based on ACSM guidelines. After intervention, participants were randomized to receive or not receive relapse prevention for 6 months. The time and intensity of physical activity and psychological change in depression, anxiety, self-efficacy, and function were assessed with self-reported measures. Results: Compared to baseline, physical activity increased post intervention for both the Bridge and Structured Exercise programs. Compared to baseline, participants in the Bridge Program recorded fewer anxiety symptoms. No significant changes were noted for either program in depressive symptoms, self-efficacy, or function. There was no difference in relapse prevention between the two groups at 6 months. Conclusions: The Bridge Program, a novel personalized exercise program with peer support, exercise of choice, and caregiver training, and a structured exercise program both improved self-reported physical activity, but the Bridge Program also reduced anxiety symptoms. This study provides important insight into the limitations of commonly used measures of physical activity and psychosocial domains in people with SCI.
{"title":"Randomized Trial of Two Exercise Programs to Increase Physical Activity and Health-Related Quality of Life for Persons With Spinal Cord Injury","authors":"J. Butzer, A. Kozlowski, Rachel Hern, Cally Gooch","doi":"10.46292/sci21-00042","DOIUrl":"https://doi.org/10.46292/sci21-00042","url":null,"abstract":"Objectives: To compare the effectiveness of two different interventions that promote physical activity in individuals with traumatic spinal cord injury (SCI) and determine the effect of relapse prevention. Methods: A sequential, multiple assignment, randomized trial was conducted at a universally designed community-based exercise facility. Participants were individuals with traumatic SCI, >3 months post injury, levels C5 to T12, age ≥18 years (N = 79). After randomization, Bridge Program participants completed an 8-week personalized, less intense, exercise program informed by American College of Sports Medicine (ACSM) guidelines and supported with hands-on peer mentoring, exercise of choice, and caregiver training. Structured Exercise participants completed an 8-week program in a group format based on ACSM guidelines. After intervention, participants were randomized to receive or not receive relapse prevention for 6 months. The time and intensity of physical activity and psychological change in depression, anxiety, self-efficacy, and function were assessed with self-reported measures. Results: Compared to baseline, physical activity increased post intervention for both the Bridge and Structured Exercise programs. Compared to baseline, participants in the Bridge Program recorded fewer anxiety symptoms. No significant changes were noted for either program in depressive symptoms, self-efficacy, or function. There was no difference in relapse prevention between the two groups at 6 months. Conclusions: The Bridge Program, a novel personalized exercise program with peer support, exercise of choice, and caregiver training, and a structured exercise program both improved self-reported physical activity, but the Bridge Program also reduced anxiety symptoms. This study provides important insight into the limitations of commonly used measures of physical activity and psychosocial domains in people with SCI.","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2023-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45183828","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}
Pub Date : 2023-01-01Epub Date: 2023-12-01DOI: 10.46292/sci23-00026
Joseph Peters, Kellie Halloran, Michael Focht, Kathryn Huang, Mariana Kersh, Ian Rice
Objectives: To compare acute cardiorespiratory responses during high intensity interval training (HIIT) and moderate intensity continuous training (MICT) on a recumbent handcycle in persons with spinal cord injury (PwSCI).
Methods: Eleven males and nine females with chronic SCI (T3 - L5), aged 23 (9) years, participated in this within-subject design. Based off peak power outputs from an incremental test to exhaustion, participants engaged in a HIIT and MICT session at matched workloads on a recumbent handcycle. Workloads (Joules), time, oxygen uptake (VO2), metabolic equivalent of task (MET), heart rate (HR), and energy expenditure (kcal) were recorded during HIIT and MICT.
Results: Total workload was similar across HIIT (87820 ± 24021 Joules) and MICT sessions (89044 ± 23696 Joules; p > .05). HIIT (20.00 [.03] minutes) was shorter in duration than MICT (23.20 [2.56]; p < .01). Average VO2 (20.96 ± 4.84 vs. 129.38 ± 19.13 mL/kg/min O2), MET (7.54 ± 2.00 vs. 6.21 ± 1.25), and HR (146.26 ± 13.80 vs. 129.38 ± 19.13 beats per minute) responses were significantly greater during HIIT than MICT (p < .01). Participants burned significantly more kilocalories during HIIT (128.08 ± 35.65) than MICT (118.93 ± 29.58; p < .01) and at a faster rate (6.40 ± 1.78 [HIIT] vs. 5.09 ± 1.14 [MICT] kcal/min; p < .01).
Conclusion: HIIT elicits greater increases in oxygen uptake and HR than MICT in PwSCI. In significantly less time, HIIT also burned more calories than MICT.
{"title":"Cardiorespiratory Responses to an Acute Bout of High Intensity Interval Training and Moderate Intensity Continuous Training on a Recumbent Handcycle in People With Spinal Cord Injury: A Within-Subject Design.","authors":"Joseph Peters, Kellie Halloran, Michael Focht, Kathryn Huang, Mariana Kersh, Ian Rice","doi":"10.46292/sci23-00026","DOIUrl":"10.46292/sci23-00026","url":null,"abstract":"<p><strong>Objectives: </strong>To compare acute cardiorespiratory responses during high intensity interval training (HIIT) and moderate intensity continuous training (MICT) on a recumbent handcycle in persons with spinal cord injury (PwSCI).</p><p><strong>Methods: </strong>Eleven males and nine females with chronic SCI (T3 - L5), aged 23 (9) years, participated in this within-subject design. Based off peak power outputs from an incremental test to exhaustion, participants engaged in a HIIT and MICT session at matched workloads on a recumbent handcycle. Workloads (Joules), time, oxygen uptake (VO<sub>2</sub>), metabolic equivalent of task (MET), heart rate (HR), and energy expenditure (kcal) were recorded during HIIT and MICT.</p><p><strong>Results: </strong>Total workload was similar across HIIT (87820 ± 24021 Joules) and MICT sessions (89044 ± 23696 Joules; <i>p</i> > .05). HIIT (20.00 [.03] minutes) was shorter in duration than MICT (23.20 [2.56]; <i>p</i> < .01). Average VO<sub>2</sub> (20.96 ± 4.84 vs. 129.38 ± 19.13 mL/kg/min O<sub>2</sub>), MET (7.54 ± 2.00 vs. 6.21 ± 1.25), and HR (146.26 ± 13.80 vs. 129.38 ± 19.13 beats per minute) responses were significantly greater during HIIT than MICT (<i>p</i> < .01). Participants burned significantly more kilocalories during HIIT (128.08 ± 35.65) than MICT (118.93 ± 29.58; <i>p</i> < .01) and at a faster rate (6.40 ± 1.78 [HIIT] vs. 5.09 ± 1.14 [MICT] kcal/min; <i>p</i> < .01).</p><p><strong>Conclusion: </strong>HIIT elicits greater increases in oxygen uptake and HR than MICT in PwSCI. In significantly less time, HIIT also burned more calories than MICT.</p>","PeriodicalId":46769,"journal":{"name":"Topics in Spinal Cord Injury Rehabilitation","volume":"29 4","pages":"16-26"},"PeriodicalIF":2.4,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10704215/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138812422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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