Abstract 4 metabolic and cardiovascular responses to a regimen of combined voluntary arm and electrically stimulated leg exercise in chronic spinal cord injury: a case series. Jonathan R. Strayer, MD, MS; Roger M. Glaser, MD; Stephen Page, PhD, FAHA (Univ Cincinnati Coll Med, Cincinnati, OH), e-mail: Stephen.Page@uc.edu

Abstract:Electrical stimulation-induced leg muscle contractions provide a useful model for examining the role of leg muscle neural afferents during low-intensity exercise in persons with spinal cord-injury and their able-bodied cohorts. Eight persons with paraplegia (SCI) and 8 non-disabled subjects (CONTROL) performed passive knee flexion/extension (PAS), electrical stimulation-induced knee flexion/extension (ES) and voluntary knee flexion/extension (VOL) on an isokinetic dynamometer. In CONTROLS, exercise heart rate was significantly increased during ES (94 ± 6 bpm) and VOL (85 ± 4 bpm) over PAS (69 ± 4 bpm), but no changes were observed in SCI individuals. Stroke volume was significantly augmented in SCI during ES (59 ± 5 ml) compared to PAS (46 ± 4 ml). The results of this study suggest that, in able-bodied humans, Group III and IV leg muscle afferents contribute to increased cardiac output during exercise primarily via augmented heart rate. In contrast, SCI achieve raised cardiac output during ES leg exercise via increased venous return in the absence of any change in heart rate.

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Neurological Recovery in Traumatic Spinal Cord Injury Patient with Delayed Surgical Intervention

Neurologico Spinale Medico Chirurgico ◽

10.15562/nsmc.v1i2.112 ◽

2018 ◽

Vol 1 (2) ◽

pp. 34

Author(s):

Mochamad Targib Alatas

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Surgical Intervention ◽

Case Series ◽

Spinal Cord Injury Patient ◽

Traumatic Spinal Cord Injury ◽

Best Interest ◽

Score Improvement ◽

Cord Injury ◽

Injury Patient

Early surgical treatment for traumatic spinal cord injury (SCI) patients has been proven to yield better improvement on neurological state, and widely practiced among surgeons in this field. However, it is not always affordable in every clinical setting. It is undeniable that surgery for chronic SCI has more challenges as the malunion of vertebral bones might have initiated, thus requires more complex operating techniques. In this case series, we report 7 patients with traumatic SCI whose surgical intervention is delayed due to several reasons. Initial motoric scores vary from 0 to 3, all have their interval periods supervised between outpatient clinic visits. On follow up they demonstrate significant neurological development defined by at least 2 grades motoric score improvement. Physical rehabilitation also began before surgery was conducted. These results should encourage surgeons to keep striving for the patient’s best interest, even when the injury has taken place weeks or even months before surgery is feasible because clinical improvement for these patients is not impossible.

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