Establishing Objectives in Occupational Therapy Practice, Part 2

1994 ◽  
Vol 57 (2) ◽  
pp. 45-48 ◽  
Author(s):  
Karen R Whalley Hammell
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Occupational Therapy ◽  
Outcome Measures ◽  
Patient Participation ◽  
Rehabilitation Process ◽  
Rehabilitation Plan ◽  
Cord Injury ◽  
Active Patient

Part 1 of this study examined the range of objectives that must be included in a personal rehabilitation plan, in order to ensure compatibility with clients' goals, values and aspirations. In Part 2, examination is made of the importance of identifying when objectives have been reached and what characteristics these objectives should have for it to be possible to recognise that they have been achieved. This is placed in the context of accountability and the use of outcome measures. Spinal cord injury is again used for illustration. Consideration is given to the possible barriers to active patient participation in the rehabilitation process.

Establishing Objectives in Occupational Therapy Practice, Part 1

1994 ◽  
Vol 57 (1) ◽  
pp. 9-14 ◽  
Author(s):  
Karen R Whalley Hammell
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Occupational Therapy ◽  
Rehabilitation Programme ◽  
Traumatic Spinal Cord Injury ◽  
Rehabilitation Plan ◽  
Cord Injury ◽  
And Control

This article examines the range of objectives that needs to be included in a personal rehabilitation plan. It includes an analysis of what is implied by an objective and why realistic objectives should be a part of good planning in a rehabilitation programme. Part 2 will examine why it is important to be able to identify when an objective has been reached and what characteristics an objective must have in order that success in reaching it is immediately and unambiguously identifiable. The objectives are placed in the context of client and professional partnerships, implications of independence and issues surrounding choice and control. Illustration is provided with reference to traumatic spinal cord injury.

Spinal Cord Injury; Quality of Life; Occupational Therapy: Is There a Connection?

1995 ◽  
Vol 58 (4) ◽  
pp. 151-157 ◽  
Author(s):  
Karen Whalley Hammell
Keyword(s):  
Quality Of Life ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Occupational Therapy ◽  
Outcome Measures ◽  
Occupational Therapists ◽  
Cord Injury ◽  
Subjective Views ◽  
The Individual

Although occupational therapists frequently state that one of their primary goals is that of enhancing quality of life, this does not appear to be supported by either their outcome measures or their literature. Studies have shown that satisfaction with quality of life following a spinal cord injury is not predicted by either degree of impairment or disability. Handicap is negatively correlated with quality of life and this may require interventions that are focused towards the environment rather than the individual. Occupational therapists may need to adopt a more client-centred approach to practice, in which assessment, Intervention and outcome measures are sensitive to the subjective views of the individual, thus enabling therapists to understand more of what quality of life means to each client.

scholarly journals Effect of pelvic laparoscopic implantation of neuroprosthesis in spinal cord injured subjects: a 1-year prospective randomized controlled study

Spinal Cord ◽  
2021 ◽  
Author(s):  
Helge Kasch ◽  
Uffe Schou Løve ◽  
Anette Bach Jønsson ◽  
Kaare Eg Severinsen ◽  
Marc Possover ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Outcome Measures ◽  
Outcome Measure ◽  
Secondary Outcome ◽  
Controlled Study ◽  
Control Group ◽  
Walking Ability ◽  
Data Set ◽  
Cord Injury

Abstract Study design 1-year prospective RCT. Objective Examine the effect of implantable pulse generator and low-frequency stimulation of the pelvic nerves using laparoscopic implantation of neuroprosthesis (LION) compared with neuromuscular electrical stimulation (NMES) in SCI. Methods Inclusion criteria: traumatic spinal cord injury (SCI), age 18–55 years, neurological level-of-injury Th4–L1, time-since-injury >1 year, and AIS-grades A–B. Participants were randomized to (A) LION procedure or (B) control group receiving NMES. Primary outcome measure: Walking Index for Spinal Cord Injury (WISCI-II), which is a SCI specific outcome measure assessing ability to ambulate. Secondary outcome measures: Spinal Cord Independence Measure III (SCIM III), Patient Global Impression of Change (PGIC), Penn Spasm Frequency Scale (PSFS), severity of spasticity measured by Numeric Rating Scale (NRS-11); International Spinal Cord Injury data sets-Quality of Life Basic Data Set (QoLBDS), and Brief Pain Inventory (BPI). Results Seventeen SCI individuals, AIS grade A, neurological level ranging from Th4–L1, were randomized to the study. One individual was excluded prior to intervention. Eight participants (7 males) with a mean age (SD) of 35.5 (12.4) years were allocated to the LION procedure, 8 participants (7 males) with age of 38.8 (15.1) years were allocated to NMES. Significantly, 5 LION group participants gained 1 point on the WISCI II scale, (p < 0.013; Fisher´s exact test). WISCI II scale score did not change in controls. No significant changes were observed in the secondary outcome measures. Conclusion The LION procedure is a promising new treatment for individuals with SCI with significant one-year improvement in walking ability.

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

scholarly journals Effects of exercise interventions on cardiovascular health in individuals with chronic, motor complete spinal cord injury: protocol for a randomised controlled trial [Cardiovascular Health/Outcomes: Improvements Created by Exercise and education in SCI (CHOICES) Study]

BMJ Open ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. e023540 ◽  
Author(s):  
Andrei V Krassioukov ◽  
Katharine D Currie ◽  
Michèle Hubli ◽  
Tom E Nightingale ◽  
Abdullah A Alrashidi ◽  
...  
Keyword(s):  
Physical Activity ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Arterial Stiffness ◽  
Outcome Measures ◽  
Cardiovascular Health ◽  
Secondary Outcome ◽  
Exercise Interventions ◽  
Cord Injury ◽  
Randomised Controlled

IntroductionRecent studies demonstrate that cardiovascular diseases and associated complications are the leading cause of morbidity and mortality in individuals with spinal cord injury (SCI). Abnormal arterial stiffness, defined by a carotid–to-femoral pulse wave velocity (cfPWV) ≥10 m/s, is a recognised risk factor for heart disease in individuals with SCI. There is a paucity of studies assessing the efficacy of conventional training modalities on arterial stiffness and other cardiovascular outcomes in this population. Therefore, this study aims to compare the efficacy of arm cycle ergometry training (ACET) and body weight-supported treadmill training (BWSTT) on reducing arterial stiffness in individuals with chronic motor complete, high-level (above the sixth thoracic segment) SCI.Methods and analysisThis is a multicentre, randomised, controlled, clinical trial. Eligible participants will be randomly assigned (1:1) into either ACET or BWSTT groups. Sixty participants with chronic (>1 year) SCI will be recruited from three sites in Canada (Vancouver, Toronto and Hamilton). Participants in each group will exercise three times per week up to 30 min and 60 min for ACET and BWSTT, respectively, over the period of 6 months. The primary outcome measure will be change in arterial stiffness (cfPWV) from baseline. Secondary outcome measures will include comprehensive assessments of: (1) cardiovascular parameters, (2) autonomic function, (3) body composition, (4) blood haematological and metabolic profiles, (5) cardiorespiratory fitness and (6) quality of life (QOL) and physical activity outcomes. Outcome measures will be assessed at baseline, 3 months, 6 months and 12 months (only QOL and physical activity outcomes). Statistical analyses will apply linear-mixed modelling to determine the training (time), group (ACET vs BWSTT) and interaction (time × group) effects on all outcomes.Ethics and disseminationEthical approval was obtained from all three participating sites. Primary and secondary outcome data will be submitted for publication in peer-reviewed journals and widely disseminated.Trial registration numberNCT01718977; Pre-results.Trial statusRecruitment for this study began on January 2013 and the first participant was randomized on April 2013. Recruitment stopped on October 2018.

scholarly journals The Effects of Adding Transcutaneous Spinal Cord Stimulation (tSCS) to Sit-To-Stand Training in People with Spinal Cord Injury: A Pilot Study

2020 ◽  
Vol 9 (9) ◽  
pp. 2765
Author(s):  
Yazi Al’joboori ◽  
Sarah J. Massey ◽  
Sarah L. Knight ◽  
Nick de N. Donaldson ◽  
Lynsey D. Duffell
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Pilot Study ◽  
Outcome Measures ◽  
Spinal Cord Stimulation ◽  
International Standards ◽  
Sit To Stand ◽  
Cord Injury ◽  
Before And After

Spinal cord stimulation may enable recovery of volitional motor control in people with chronic Spinal Cord Injury (SCI). In this study we explored the effects of adding SCS, applied transcutaneously (tSCS) at vertebral levels T10/11, to a sit-to-stand training intervention in people with motor complete and incomplete SCI. Nine people with chronic SCI (six motor complete; three motor incomplete) participated in an 8-week intervention, incorporating three training sessions per week. Participants received either tSCS combined with sit-to-stand training (STIM) or sit-to-stand training alone (NON-STIM). Outcome measures were carried out before and after the intervention. Seven participants completed the intervention (STIM N = 5; NON-STIM N = 2). Post training, improvements in International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) motor scores were noted in three STIM participants (range 1.0–7.0), with no change in NON-STIM participants. Recovery of volitional lower limb muscle activity and/or movement (with tSCS off) was noted in three STIM participants. Unassisted standing was not achieved in any participant, although standing with minimal assistance was achieved in one STIM participant. This pilot study has shown that the recruitment of participants, intervention and outcome measures were all feasible in this study design. However, some modifications are recommended for a larger trial.

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