Bioelectric Medicine and Devices for the Treatment of Spinal Cord Injury

2016 ◽  
Vol 202 (1-2) ◽  
pp. 6-22 ◽  
Author(s):  
Tess Torregrosa ◽  
Ryan A. Koppes
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Spinal Column ◽  
Lower Limbs ◽  
Future Design ◽  
Recent Success ◽  
Cord Injury ◽  
Small Cohort ◽  
Based Medicine ◽  
Neuroprosthetic Devices

Recovery of motor control is paramount for patients living with paralysis following spinal cord injury (SCI). While a cure or regenerative intervention remains on the horizon for the treatment of SCI, a number of neuroprosthetic devices have been employed to treat and mitigate the symptoms of paralysis associated with injuries to the spinal column and associated comorbidities. The recent success of epidural stimulation to restore voluntary motor function in the lower limbs of a small cohort of patients has breathed new life into the promise of electric-based medicine. Recently, a number of new organic and inorganic electronic devices have been developed for brain-computer interfaces to bypass the injury, for neurorehabilitation, bladder and bowel control, and the restoration of motor or sensory control. Herein, we discuss the recent advances in neuroprosthetic devices for treating SCI and highlight future design needs for closed-loop device systems.

scholarly journals Massive Edema of the Lower Limbs in Patients after Spinal Cord Injury—One Picture, Different Diagnoses

2021 ◽  
Vol 18 (8) ◽  
pp. 4219
Author(s):  
Magdalena Mackiewicz-Milewska ◽  
Małgorzata Cisowska-Adamiak ◽  
Katarzyna Sakwińska ◽  
Iwona Szymkuć-Bukowska ◽  
Iwona Głowacka-Mrotek
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Heterotopic Ossification ◽  
Lower Limb ◽  
Bone Fractures ◽  
Lower Limbs ◽  
University Hospital ◽  
Pain Sensation ◽  
Vein Thrombosis ◽  
Cord Injury

Diagnosis of the cause of massive edema of the lower limbs in patients after spinal cord injury (SCI) can be difficult because of loss of pain sensation, commonly occurring in this group of patients. This paper reviews several different pathologies that can lead to lower-limb edema and the associated diagnostic difficulties. We present four cases of patients with massive edemas of lower limbs at different times after SCI undergoing treatment in the Department of Rehabilitation, University Hospital in Bydgoszcz, Poland. All patients had a lack of pain sensation in the lower limbs and significantly elevated levels of D-dimer. In two cases, deep vein thrombosis (DVT) and intramuscular hematomas (IHs) were diagnosed. IHs were probably a consequence of antithrombotic treatments implemented due to the occurrence of DVT. Heterotopic ossification (HO) was diagnosed in a third case, and, in another patient, who was hospitalized for the longest period after injury, we found humeral bone fractures. Heterotopic ossification, intramuscular haematomas, and bone fractures of the lower limb can mimic DVT. Careful observation of the edema evolution is recommended, as the onset of new symptoms may indicate a different cause of edema from that initially established.

scholarly journals Reliability of the radiographic variables in the International Spinal Cord Injury Spinal Column Injury Basic Data Set compared with the AO classification

Spinal Cord ◽  
2016 ◽  
Vol 54 (10) ◽  
pp. 884-888 ◽  
Author(s):  
C Lucantoni ◽  
R G Krishnan ◽  
M Gehrchen ◽  
D W Hallager ◽  
F Biering-Sørensen ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Spinal Column ◽  
Basic Data ◽  
Data Set ◽  
Ao Classification ◽  
Cord Injury

scholarly journals Bone changes in the lower limbs from participation in an FES rowing exercise program implemented within two years after traumatic spinal cord injury

2018 ◽  
Vol 43 (3) ◽  
pp. 306-314 ◽  
Author(s):  
Rebecca L. Lambach ◽  
Nicole E. Stafford ◽  
Julie A. Kolesar ◽  
B. Jenny Kiratli ◽  
Graham H. Creasey ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Exercise Program ◽  
Lower Limbs ◽  
Traumatic Spinal Cord Injury ◽  
Cord Injury ◽  
Bone Changes

The Management of Traumatic Spinal Cord Injury

2018 ◽  
pp. 97-104
Author(s):  
David M. Panczykowski ◽  
Jeremy G. Stone ◽  
David O. Okonkwo
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Spinal Column ◽  
Primary Objective ◽  
Helical Computed Tomography ◽  
Pulmonary Insufficiency ◽  
Radiographic Evaluation ◽  
Traumatic Spinal Cord Injury ◽  
Cord Injury ◽  
Important Means

The management of traumatic spinal cord injury (SCI) requires thorough neurologic assessment and injury classification to guide treatment as well as inform prognosis. Initial radiographic evaluation is aimed at efficiently determining spinal column stability and should begin with high-quality multislice helical computed tomography imaging, including coronal and sagittal reconstructions. The primary objective of clinical SCI management is to prevent or ameliorate secondary injury caused by cardiovascular instability and/or pulmonary insufficiency, in addition to other comorbid processes common to this disease. Vigilant monitoring and treatment in the critical care setting is one of the most important means of reducing morbidity and mortality following SCI.

scholarly journals Intercostal, ilioinguinal, and iliohypogastric nerve transfers for lower limb reinnervation after spinal cord injury: an anatomical feasibility and experimental study

2019 ◽  
Vol 30 (2) ◽  
pp. 268-278 ◽  
Author(s):  
Ahmed A. Toreih ◽  
Asser A. Sallam ◽  
Cherif M. Ibrahim ◽  
Ahmed I. Maaty ◽  
Mohsen M. Hassan
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Animal Studies ◽  
Femoral Nerve ◽  
Lower Limbs ◽  
Nerve Transfers ◽  
Promising Therapeutic Approach ◽  
Cord Injury ◽  
Significant Motor

OBJECTIVESpinal cord injury (SCI) has been investigated in various animal studies. One promising therapeutic approach involves the transfer of peripheral nerves originating above the level of injury into those originating below the level of injury. The purpose of the present study was to evaluate the feasibility of nerve transfers for reinnervation of lower limbs in patients suffering SCI to restore some hip and knee functions, enabling them to independently stand or even step forward with assistive devices and thus improve their quality of life.METHODSThe feasibility of transferring intercostal to gluteal nerves and the ilioinguinal and iliohypogastric nerves to femoral nerves was assessed in 5 cadavers. Then, lumbar cord hemitransection was performed below L1 in 20 dogs, followed by transfer of the 10th, 11th, and 12th intercostal and subcostal nerves to gluteal nerves and the ilioinguinal and iliohypogastric nerves to the femoral nerve in only 10 dogs (NT group). At 6 months, clinical and electrophysiological evaluations of the recipient nerves and their motor targets were performed.RESULTSThe donor nerves had sufficient length to reach the recipient nerves in a tension-free manner. At 6 months postoperatively, the mean conduction velocity of gluteal and femoral nerves, respectively, increased to 96.1% and 92.8% of the velocity in controls, and there was significant motor recovery of the quadriceps femoris and glutei.CONCLUSIONSIntercostal, ilioinguinal, and iliohypogastric nerves are suitable donors to transfer to the gluteal and femoral nerves after SCI to restore some hip and knee motor functions.

scholarly journals Development of a Rehabilitation Game for Individuals With Spinal Cord Injury Using a User-Centered Design Process

2018 ◽  
Author(s):  
Stuart R. Fairhurst ◽  
Logan C. McCool ◽  
Kristin M. Scheel ◽  
Crystal L. Stien ◽  
Charlotte M. Brenteson ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Video Game ◽  
Perceived Exertion ◽  
Interactive Video ◽  
Spinal Cord Injuries ◽  
Lower Limbs ◽  
User Centered Design ◽  
Cord Injury ◽  
Interactive Video Game

The use of video games during exercise, exergaming, has been shown to increase energy expenditure without increasing perceived exertion [1]. This suggests that exergaming may be an effective way to engage a patient during rehabilitation and increase adherence to a rehabilitation regime. Existing exergame systems are designed with able bodied users in mind and often combine hand controlled game play while using lower limbs for aerobic exertion, making current systems inaccessible to individuals with spinal cord injuries and others without lower limb function. Our earlier work on increasing exercise accessibility includes developing an ergometer for supine use for patients who have recently had a flap procedure [2]. The goal of the present project was to create an engaging, interactive video game designed for use during arm ergometry by individuals with spinal cord injury (SCI) in either the supine or seated position.

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