scholarly journals Community-Associated Clostridium difficile Infection among Veterans with Spinal Cord Injury and Disorder

2014 ◽  
Vol 35 (5) ◽  
pp. 577-580 ◽  
Author(s):  
Salva N. Balbale ◽  
Stuart Johnson ◽  
Stephen P. Burns ◽  
Stephen M. Kralovic ◽  
Barry Goldstein ◽  
...  

The impact of community-associated Clostridium difficile infection (CA-CDI) on patients with spinal cord injuries and disorders (SCI/Ds) is not fully understood. We examined CA-CDI cases among veterans with SCI/D, comparing them with community-onset, healthcare facility-associated (CO-HCFA) cases. Generally, patients with CA-CDI had less comorbidity, less severe CDI, and lower likelihood of antibiotic exposure.

2019 ◽  
Vol 121 (3) ◽  
pp. 1078-1084 ◽  
Author(s):  
Amanda E. Chisholm ◽  
Taha Qaiser ◽  
Alison M. M. Williams ◽  
Gevorg Eginyan ◽  
Tania Lam

Many people with motor-incomplete spinal cord injury (m-iSCI) experience difficulty navigating obstacles, such as curbs and stairs. The ability to relearn walking skills may be limited by proprioceptive deficits. The purpose of this study was to determine the capacity of participants to acquire a precision walking skill, and to evaluate the influence of proprioceptive deficits on the skill acquisition in individuals with m-iSCI. Sixteen individuals with m-iSCI and eight controls performed a precision walking task that required matching their foot height to a target during the swing phase. Proprioceptive deficits were quantified at the hip and knee for joint position and movement detection sense. Participants completed 600 steps of training with visual feedback. Pretraining and posttraining tests were conducted without visual feedback, along with a transfer test with an ankle weight. Posttraining and transfer tests were repeated 1 day later. Participants returned to the laboratory 1 wk later to repeat the training. Performance was calculated as the vertical distance between the target and actual foot height for each step. The posttraining and transfer performances were similar between groups. However, participants with m-iSCI had a slower rate of acquisition to achieve a similar performance level compared with controls. Acquisition rate and posttraining performance of the precision walking task were related to lower limb joint position sense among SCI participants. Although they can achieve a similar level of performance in a precision walking task, proprioceptive deficits impair the rate of learning among individuals with m-iSCI compared with able-bodied controls. NEW & NOTEWORTHY People with motor-incomplete spinal cord injuries are able to achieve the same level of performance accuracy on a precision walking task as able-bodied controls; however, the rate of learning is slower, indicating that more practice is required to stabilize performance. Our findings also show a relationship between impaired sensory function and reduced accuracy when performing a precision walking task after spinal cord injury.


2009 ◽  
Vol 4 (2) ◽  
pp. 157-166 ◽  
Author(s):  
Shaun Michael Burns ◽  
Sigmund Hough ◽  
Briana L. Boyd ◽  
Justin Hill

Men constitute 82% of the approximately 250,000 people in the United States living with a spinal cord injury. Unfortunately, however, little is known about the impact of men’s adherence to gender norms on their adjustment to such injuries. The present investigation examined the utility of masculine norms in explaining variance in depression beyond that accounted for by commonly identified predictors of men’s adjustment following spinal cord injury. As hypothesized, results suggested that men’s adherence to masculine norms accounted for unique variance in their depression scores beyond that contributed by social support, environmental barriers/access, and erectile functioning. Respondents who adhered to norms stressing the primacy of men’s work demonstrated lower rates of depression, whereas those who conformed to norms for self-reliance demonstrated higher depression scores. The authors discuss future research directions and potential psychotherapeutic strategies for working with men with spinal cord injuries.


2019 ◽  
Vol 33 (9) ◽  
pp. 1503-1514 ◽  
Author(s):  
Kate Fiona Jones ◽  
Grahame Simpson ◽  
Lynne Briggs ◽  
Pat Dorsett ◽  
Malcolm Anderson

Objective: To test a model of spiritual well-being and resilience among individuals with spinal cord injuries and their family members. Design: Prospective cross-sectional observational data were analyzed by structural equation modelling. Setting: Inpatient and community services at one rehabilitation hospital. Subjects: Individual with spinal cord injury ( n = 50) and family member ( n = 50) dyads. Interventions: Standard rehabilitation, both inpatient and community. Main measure(s): Functional assessment of chronic illness therapy – spiritual well-being scale – expanded, Connor–Davidson resilience scale, positive and negative affect scale, depression anxiety and stress scale–21, satisfaction with life scale. Results: Median time post-injury was 8.95 months (IQR (interquartile range) = 14.15). Individuals with spinal cord injury and family members reported high scores for both spiritual well-being (66.06 ± 14.89; 68.42 ± 13.75) and resilience (76.68 ± 13.88; 76.64 ± 11.75), respectively. Analysis found the model had acceptable fit (e.g. chi-square goodness of fit statistic = 38.789; P = .263). For individuals with spinal cord injury, spiritual well-being was positively associated with resilience which, in turn, was associated with increasing positive affect and satisfaction with life. Among family members, spiritual well-being was positively associated with resilience. Resilience was then associated with lowered levels of depression and mediated the impact of depression on satisfaction with life. Limited evidence was found for mutual dyadic links, with the only significant pathway finding that resilience in the individual with spinal cord injury was associated with increased satisfaction with life among family members. Conclusion: Increased spirituality and resilience make a significant contribution (both independently and in combination) to positive psychological outcomes for both individuals with spinal cord injury and their family members.


2018 ◽  
Vol 7 ◽  
Author(s):  
Terry J. Ellapen ◽  
Henriëtte V. Hammill ◽  
Mariëtte Swanepoel ◽  
Gert L. Strydom

Background: Many patients with spinal cord injury (PWSCI) lead sedentary lifestyles, experiencing poor quality of life and medical challenges. PWSCI don’t like to participate in land-based-exercises because it’s tedious to perform the same exercises, decreasing their rehabilitative compliance and negatively impacting their well-being. An alternative exercise environment and exercises may alleviate boredom, enhancing compliance.Objectives: Discuss the benefits of hydrotherapy to PWSCI concerning underwater gait-kinematics, thermoregulatory and cardiovascular responses and spasticity.Methodology: A literature surveillance was conducted between 1998 and 2017, through the Crossref meta-database and Google Scholar, according to the PRISMA procedures. Key search words were water-therapy, aquatic-therapy, hydrotherapy, spinal cord injury, rehabilitation, human, kinematics, underwater gait, cardiorespiratory, thermoregulation and spasticity. The quality of each paper was evaluated using a modified Downs and Black Appraisal Scale. The participants were records pertaining to PWSCI and hydrotherapy. The outcomes of interest were: hydrotherapy interventions, the impact of hydrotherapy on gait-kinematics, thermoregulation during water submersion and cardiorespiratory function of PWSCI. Omitted records included: non-English publications from before 1998 or unrelated to hydrotherapy and PWSCI. The record screening admissibility was performed as follows: the title screen, the abstract screen and the full text screen.Results: Literature search identified 1080 records. Upon application of the exclusion criteria, 92 titles, 29 abstracts and 17 full text records were eligible. Only 15 records were selected to be included in this clinical commentary. Evidence shows a paucity of randomised control trials (RCT) conducted in this field.Conclusion: Hydrotherapy improves PWSCI underwater gait-kinematics, cardiorespiratory and thermoregulatory responses and reduces spasticity.


2021 ◽  
pp. 1357034X2110256
Author(s):  
Denisa Butnaru

Motility impairments resulting from spinal cord injuries and cerebrovascular accidents are increasingly prevalent in society, leading to the growing development of rehabilitative robotic technologies, among them exoskeletons. This article outlines how bodies with neurological conditions such as spinal cord injury and stroke engage in processes of re-appropriation while using exoskeletons and some of the challenges they face. The main task of exoskeletons in rehabilitative environments is either to rehabilitate or ameliorate anatomic functions of impaired bodies. In these complex processes, they also play a crucial role in recasting specific corporeal phenomenologies. For the accomplishment of these forms of corporeal re-appropriation, the role of experts is crucial. This article explores how categories such as bodily resistance, techno-inter-corporeal co-production of bodies and machines, as well as body work mark the landscape of these contemporary forms of impaired corporeality. While defending corporeal extension rather than incorporation, I argue against the figure of the ‘cyborg’ and posit the idea of ‘residual subjectivity’.


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