scholarly journals Longitudinal estimation of intramuscular Tibialis Anterior coherence during subacute spinal cord injury: relationship with neurophysiological, functional and clinical outcome measures

2017 ◽  
Vol 14 (1) ◽  
Author(s):  
Elisabeth Bravo-Esteban ◽  
Julian Taylor ◽  
Manuel Aleixandre ◽  
Cristina Simón-Martínez ◽  
Diego Torricelli ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Clinical Outcome ◽  
Outcome Measures ◽  
Tibialis Anterior ◽  
Cord Injury

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.

scholarly journals Prevention, identification, and treatment of perioperative spinal cord injury

2008 ◽  
Vol 25 (5) ◽  
pp. E15 ◽  
Author(s):  
Henry Ahn ◽  
Michael G. Fehlings
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Clinical Outcome ◽  
Clinical Studies ◽  
Basic Science ◽  
Treatment Options ◽  
Arterial Blood ◽  
Secondary Damage ◽  
Increased Risk ◽  
Cord Injury

Object In this report, the authors suggest evidence-based approaches to minimize the chance of perioperative spinal cord injury (POSCI) and optimize outcome in the event of a POSCI. Methods A systematic review of the basic science and clinical literature is presented. Results Authors of clinical studies have assessed intraoperative monitoring to minimize the chance of POSCI. Furthermore, preoperative factors and intraoperative issues that place patients at increased risk of POSCI have been identified, including developmental stenosis, ankylosing spondylitis, preexisting myelopathy, and severe deformity with spinal cord compromise. However, no studies have assessed methods to optimize outcomes specifically after POSCIs. There are a number of studies focussed on the pathophysiology of SCI and the minimization of secondary damage. These basic science and clinical studies are reviewed, and treatment options outlined in this article. Conclusions There are a number of treatment options, including maintenance of mean arterial blood pressure > 80 mm Hg, starting methylprednisolone treatment preoperatively, and multimodality monitoring to help prevent POSCI occurrence, minimize secondary damage, and potentially improve the clinical outcome of after a POSCI. Further prospective cohort studies are needed to delineate incidence rate, current practice patterns for preventing injury and minimizing the clinical consequences of POSCI, factors that may increase the risk of POSCI, and determinants of clinical outcome in the event of a POSCI.

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.

scholarly journals Magnetic resonance findings and outcome in ten cats with traumatic spondylomyelopathy

2015 ◽  
Vol 84 (4) ◽  
pp. 197-204
Author(s):  
R. Tapia-Nieto ◽  
G. B. Cherubini ◽  
S. Jakovljevic ◽  
A. Caine
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Clinical Outcome ◽  
Case Series ◽  
Low Field ◽  
Muscle Trauma ◽  
Bone Injury ◽  
Cord Injury ◽  
Post Traumatic ◽  
Tissue Trauma

In this retrospective study, the MR findings of ten cats with acute post-traumatic spondylomyelopathy were described and the most useful MR sequences were determined. Spinal cord injury (SCI), bone and muscle trauma were compared with the clinical outcome (recovery or euthanasia). The extension of spinal cord injury (SCI) was measured in vertebral body length (VBL). Of the ten cats, only five fully recovered. In the recovery group, no SCI (n=1) or SCI <1 VBL (n=4) were found. In the group of euthanized dogs, SCI > 2 VBLs (n=4) or spinal cord transection (n=1) were found. Lesions were best seen on T2WSE (spinal cord injury), STIR (soft tissue trauma) and T1WSE (bone injury). Low-field MR was therefore helpful to assess feline spinal trauma and may prove helpful to predict the clinical outcome, although a larger case series is needed. The authors suggest that protocols with low-field MR should include T1WSE, T2WSE and STIR sequences.

scholarly journals Walking Ability Outcome Measures in Individuals with Spinal Cord Injury: A Systematic Review

2021 ◽  
Vol 18 (18) ◽  
pp. 9517
Author(s):  
Isabel Sinovas-Alonso ◽  
Ángel Gil-Agudo ◽  
Roberto Cano-de-la-Cuerda ◽  
Antonio J. del-Ama
Keyword(s):  
Systematic Review ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Outcome Measures ◽  
Berg Balance Scale ◽  
Walking Ability ◽  
Walk Test ◽  
Timed Up And Go ◽  
Cord Injury ◽  
Profile Score

Walking function recovery in spinal cord injury (SCI) is tackled through several therapeutic approaches in which precise evaluation is essential. A systematic review was performed to provide an updated qualitative review of walking ability outcome measures in SCI and to analyze their psychometric properties. PubMed, Cochrane, and PEDro databases were consulted until 1 April 2020. Seventeen articles written in English were included. Five of them studied the walking index for SCI, four studied the 10 meter walk test, and two studied the six-minute walk test, the timed Up and go test, and the Berg balance scale. The rest of the articles studied the following metrics: gait profile score, spinal cord injury functional ambulation profile, five times sit-to-stand test, spinal cord injury functional ambulation inventory, spinal cord independence measure (indoors and outdoors mobility items), locomotor stages in spinal cord injury, community balance and mobility scale, and activity-based balance level evaluation scale. The choice of a single or a set of metrics should be determined by the clinician. Based on the results obtained in this review, a combination of outcome measures is proposed to assess walking ability. Future work is required to integrate a more realistic environment for walking assessment.

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