scholarly journals Exploring the causes and impacts of falls among ambulators with spinal cord injury using photovoice: a mixed-methods study

BMJ Open ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. e039763 ◽  
Author(s):  
Hardeep Singh ◽  
Arielle Shibi Rosen ◽  
Geoff Bostick ◽  
Anita Kaiser ◽  
Kristin E Musselman
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Mixed Methods ◽  
Focus Group ◽  
Fall Prevention ◽  
Fall Risk ◽  
Phase 1 ◽  
Phase 2 ◽  
Prevention Strategies ◽  
Cord Injury

ObjectivesThis study explored: (1) fall circumstances experienced by ambulators with spinal cord injury (SCI) over a 6-month period, (2) the impacts of falls-related injuries and fall risk and (3) their preferences/recommendations for fall prevention.DesignA sequential explanatory mixed-methods design with two phases.SettingA Canadian SCI rehabilitation hospital and community setting.ParticipantsThirty-three ambulators with SCI participated in phase 1 and eight participants that fell in phase 1 participated in phase 2.MethodsIn phase 1, fall circumstances were tracked using a survey that was completed each time a participant fell during the 6-month tracking period. Phase 2 involved photovoice; participants took photographs of factors that influenced their fall risk and how their fall risk impacted their work/recreational activities. Participants discussed the photographs and topics related to fall prevention in an individual interview and a focus group.ResultsOf the 33 participants, 21 fell in 6 months. Falls commonly occurred in the home while participants were changing positions or walking. Most falls occurred in the morning or afternoon. In phase 2, interviews and focus group discussion revealed three themes: (1) falls are caused by bodily impairments (eg, impaired reactive response during slips and trips and weakness and altered sensation in legs/feet), (2) impacts of fall-related injuries and fall risk (eg, psychosocial effects of fall-related injuries, limiting community participation due to the risk of falling and activity-dependent concern of falling) and (3) approaches to fall prevention (eg, fall prevention strategies used, components of fall prevention and utility of professional fall prevention strategies/interventions).ConclusionsFall prevention interventions/strategies should focus on minimising a person’s fall risk within their home as most falls occurred in the home environment. Ambulators with SCI would benefit from education and awareness about common fall circumstances that they may encounter in their daily lives.

Understanding the Perspectives of Ambulators with Spinal Cord Injury on Fall Circumstances, Fall Risk and Fall Prevention Using Mixed Methods

2020 ◽  
Vol 101 (11) ◽  
pp. e24
Author(s):  
Hardeep Singh ◽  
Arielle Shibi Rosen ◽  
Geoff Bostick ◽  
Anita Kaiser ◽  
B Catharine Craven ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Mixed Methods ◽  
Fall Prevention ◽  
Fall Risk ◽  
Cord Injury

scholarly journals Perspectives of wheelchair users with spinal cord injury on fall circumstances and fall prevention: A mixed methods approach using photovoice

PLoS ONE ◽  
2020 ◽  
Vol 15 (8) ◽  
pp. e0238116 ◽  
Author(s):  
Hardeep Singh ◽  
Carol Y. Scovil ◽  
Geoff Bostick ◽  
Anita Kaiser ◽  
B. Catharine Craven ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Mixed Methods ◽  
Fall Prevention ◽  
Wheelchair Users ◽  
Mixed Methods Approach ◽  
Cord Injury

scholarly journals Pain and its impact on functioning and disability in manual wheelchair users with spinal cord injury: a protocol for a mixed-methods study

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e044152
Author(s):  
Mokgadi Kholofelo Mashola ◽  
Elzette Korkie ◽  
Diphale Joyce Mothabeng
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
South African ◽  
Phase 1 ◽  
Pain Medication ◽  
Self Management ◽  
Medication Misuse ◽  
Wheelchair Users ◽  
Manual Wheelchair ◽  
Cord Injury

IntroductionApproximately 80% of people with spinal cord injury experience clinically significant chronic pain. Pain (whether musculoskeletal or neuropathic) is consistently rated as one of the most difficult problems to manage and negatively affects the individual’s physical, psychological and social functioning and increases the risk of pain medication misuse and poor mental health. The aim of this study is to therefore determine the presence of pain and its impact on functioning and disability as well as to develop a framework for self-management of pain for South African manual wheelchair users with spinal cord injury.Methods and analysisCommunity-dwelling participants with spinal cord injury will be invited to participate in this three-phase study. Phase 1 will use a quantitative, correlational design to determine factors related to pain such as pectoralis minor length, scapular dyskinesis, wheelchair functioning, physical quality of life, community reintegration and pain medication misuse. Demographic determinants of pain such as age, gender, type of occupation, completeness of injury and neurological level of injury will also be investigated. Participants with pain identified in phase 1 will be invited to partake in a qualitative descriptive and contextually designed phase 2 to explore their lived experience of pain through in-depth interviews. The results of phases 1 and 2 will then be used with the assistance from experts to develop a framework for self-management of pain using a modified Delphi study. Data analysis will include descriptive and inferential statistics (quantitative data) and thematic content analysis (qualitative data).Ethics and disseminationApproval for this study is granted by the Faculty of Health Sciences Research Ethics Committee of the University of the Pretoria (approval number 125/2018). This study is registered with the South African National Health Research Database (reference GP201806005). This study’s findings will be shared in academic conferences and published in scientific peer-reviewed journals.

scholarly journals Outcome Measures for Acute/Subacute Cervical Sensorimotor Complete (AIS-A) Spinal Cord Injury During a Phase 2 Clinical Trial

2012 ◽  
Vol 18 (1) ◽  
pp. 1-14 ◽  
Author(s):  
John Steeves ◽  
Daniel Lammertse ◽  
John Kramer ◽  
Naomi Kleitman,* ◽  
Sukhvinder Kalsi-Ryan ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Outcome Measures ◽  
Phase 2 ◽  
Cord Injury ◽  
Phase 2 Clinical Trial

Development and feasibility testing of an online virtual reality platform for delivering therapeutic group singing interventions for people living with spinal cord injury

2019 ◽  
Vol 26 (6) ◽  
pp. 365-375 ◽  
Author(s):  
Jeanette Tamplin ◽  
Ben Loveridge ◽  
Ken Clarke ◽  
Yunhan Li ◽  
David J Berlowitz
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Virtual Reality ◽  
Music Therapy ◽  
Phase 1 ◽  
User Evaluation ◽  
Face To Face ◽  
System Usability Scale ◽  
Cord Injury ◽  
Therapy Sessions

People with quadriplegia have a high risk for respiratory illness, social isolation and depression. Previous research has demonstrated that therapeutic singing interventions can not only improve breathing function and speech loudness, but also improve mood and social connectedness for people with quadriplegia. Face-to-face group attendance is difficult for this population due to difficulties with distance and travel. Online environments offer an accessible and cost-effective solution for people to connect with others without leaving their home. In a two-phase iterative design, we explored and tested different approaches for delivering online music therapy sessions with 12 patients from an inpatient spinal cord injury rehabilitation service. Six participants in Phase 1 trialled different virtual reality headsets and completed a short interview about their experience of the equipment and online singing trials. Outcomes from Phase 1 testing led to the development of a custom-built virtual reality application for online group music therapy sessions with low-latency audio. We tested the acceptability and feasibility of this platform in comparison to face-to-face and teleconference options for music therapy with six different patients. These participants completed three validated questionnaires: System Usability Scale, Quebec User Evaluation of Satisfaction with assistive Technology, and Psychosocial Impact of Assistive Devices Scale, and an interview about their experience. Questionnaire scores were good with mean ratings of 4.4 for Quebec User Evaluation of Satisfaction with assistive Technology, 53 for System Usability Scale and positive mean Psychosocial Impact of Assistive Devices Scale scores of 1.5 for competence, 2 for adaptability and 1.5 for self-esteem. Thematic analysis of post-session qualitative interviews revealed five themes: virtual reality was a positive experience, virtual reality was immersive and transportative, virtual reality reduced inhibitions about singing in front of others, virtual reality may reduce social cues, and the virtual reality equipment was comfortable, accessible and easy to use. Telehealth options, including a custom-designed virtual reality program, with low-latency audio are an acceptable and feasible mode of delivery for therapeutic singing interventions for people with spinal cord injury. Future non-inferiority research is needed to test online delivery modes for music therapy in comparison to face-to-face treatment.

778 Phase 1 Trial of Oscillating Electrical Field Stimulation in Human Complete Spinal Cord Injury

Neurosurgery ◽  
2004 ◽  
pp. 479
Author(s):  
Scott A. Shapiro ◽  
Richard Borgens ◽  
Robert Pascuzzi ◽  
Michael Groff ◽  
Thomas Altstadt ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Phase 1 ◽  
Electrical Field Stimulation ◽  
Field Stimulation ◽  
Electrical Field ◽  
Phase 1 Trial ◽  
Cord Injury ◽  
Complete Spinal Cord Injury

Oscillating field stimulation for complete spinal cord injury in humans: a Phase 1 trial

2005 ◽  
Vol 2 (1) ◽  
pp. 3-10 ◽  
Author(s):  
Scott Shapiro ◽  
Richard Borgens ◽  
Robert Pascuzzi ◽  
Karen Roos ◽  
Michael Groff ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Upper Extremity ◽  
Phase 1 ◽  
Wilcoxon Test ◽  
Content Type ◽  
Cord Injury ◽  
Asia Score ◽  
The Mean ◽  
Fine Print

Object. An electrical field cathode (negative pole) has trophic and tropic effects on injured spinal cord axons in in vitro and in vivo models of sea lamprey, rodent, and canine spinal cord injury (SCI) and it improves functional outcome. A human oscillating field stimulator (OFS) was built, a Food and Drug Administration (FDA) exemption number was obtained, and institutional review board approval was given for a Phase 1 trial to study 10 humans with complete motor and sensory SCI. Methods. Entry criteria were complete SCI between C-5 and T-10 in patients 18 to 65 years of age and no transection demonstrated on magnetic resonance imaging. All participants received the National Acute Spinal Cord Injury Study (NASCIS) III methylprednisilone protocol. Cord compression and/or vertebral instability was treated before study entry. After treatment complete SCI (according to the American Spinal Injury Association [ASIA] score) remained in all patients with no somatosensory evoked potentials (SSEPs) below the injury level after surgery or for 48 hours. All patients underwent implantation of the OFS within 18 days. Patients underwent evaluation every 2 weeks postimplantation; the OFS was explanted at 15 weeks. Independent neurological status was assessed based on the ASIA score, visual analog scale (VAS) pain score, and SSEPs at 6 weeks, 6 months, and 1 year. Statistical analyses were performed using the two-tailed Wilcoxon test and analysis of variance (ANOVA). There were no complications at insertion of the OFS; there was one case of wound infection after explantation (5% infection rate). One patient was lost to follow up after 6 months. In all 10 patients the mean VAS pain score was 8 at implantation, 2 at 6 months, and in the nine attending follow up for 1 year it remained 2. At 1 year, the mean improvement in light touch was 25.5 points (ANOVA p < 0.001, Wilcoxon test p = 0.02), the mean improvement in pinprick sensation was 20.4 points (ANOVA p < 0.001, Wilcoxon test p = 0.02), and the mean improvement in motor status was 6.3 points (ANOVA p < 0.01, Wilcoxon test p = 0.02). Of five cases involving cervical cord injuries, bilateral upper-extremity SSEPs were normal in one, unilateral upper-extremity SSEPs were recovered in four, bilateral upper-extremity SSEPs were recovered in one, and abnormal lower-extremity SSEPs resolved in one case. In one of the five cases involving thoracic injuries an abnormal lower-extremity SSEP resolved. Conclusions. The use of OFS treatment in patients with SCI is safe, reliable, and easy. Compared with the outcomes obtained in compliant NASCIS III plegic patients, the results of the present study indicate efficacy, and the FDA has given permission for enrollment of 10 additional patients.

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