Occupational Therapy Treatment Time During Spinal Cord Injury Rehabilitation: A Retrospective Study in Riyadh

2021 ◽  
pp. 26
Author(s):  
Teif Almohimeed
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Occupational Therapy ◽  
Motor Vehicle ◽  
Treatment Plan ◽  
Inpatient Rehabilitation ◽  
Therapeutic Activity ◽  
Cord Injury ◽  
Study Population ◽  
The Mean

Introduction: Occupational therapy (OT) is a part of rehabilitation that facilitates and enables individuals with traumatic spinal cord injuries (TSCI) to engage in daily occupations independently. Little is known about the type of OT treatment plan and the amount of time spent selecting the treatment intervention during TSCI rehabilitation. This study aimed to describe the overall time spent by patients with TSCI throughout their inpatient rehabilitation stay. Methodology: A chart review was conducted of patients attending inpatient rehabilitation for TSCI at King Abdulaziz Medical City between 2016 and 2020. For each patient, an electronic medical file, the documented rehabilitation session, including the time spent and type of therapeutic activity, were extracted. Demographic, clinical data related to the type of injury and the level of spinal cord injury (SCI) involved were also collected. We estimated the time that each patient had among all sessions and examined it with clinical factors. Result: A total of 50 eligible patients were included in this analysis. The mean age of the study population was 28 (interquartile range [IQR], 22–41) years, and the majority were male patients (82%). The most common reason for the SCI was a motor vehicle accident (94%), in which 56% required ICU admission. Among the study population, 58% had paraplegia and 42% had quadriplegia. The most common specific therapeutic activity was education (100%), equipment prescription (96%), transfer training 86%, and toilet training (70%). The mean total time spent over the patients’ entire stay was 1785 min (IQR 660–3300 min), with approximately 43.7 hr (SD 52 hr) of occupational rehabilitation. After categorizing the spinal cord injury, a mean total of 33 (IQR, 20–110) hr of session was received for patients who had an SCI level between C1 and C4 over the course of rehabilitation, and this was 25 (IQR, 15–32) hr of session for patients with an SCI level between C5 and C8, 36 (IQR, 5–8) hr of session for patients with an SCI level of <T1–T6, and 29 (IQR, 5–53) hr of session for patients with an SCI level of <T6. Conclusion: Almost all patients with TSCI participated in strengthening/Range of Motion (ROM) exercises and Activities of Daily Living (ADLs) training during OT treatment; these two were the most time-consuming interventions. When examining therapy, we found that lower body dressing training was the most time-consuming ADL. Significant variation were seen in time spent among TSCI for all OT interventions when examining both the total time spent and a calculated number of minutes per session. Some of this variation could be explained by patient and injury characteristics.

scholarly journals Maximum Movement and Cumulative Movement (Travel) to Inform our Understanding of Secondary Spinal Cord Injury and its Application to Collar use in Self-extrication

2021 ◽  
Author(s):  
Tim Nutbeam ◽  
Rob Fenwick ◽  
Barbara May ◽  
Willem Stassen ◽  
Jason Smith ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Healthy Volunteers ◽  
Motor Vehicle ◽  
Cervical Collar ◽  
Spinal Movement ◽  
Cord Injury ◽  
Total Movement ◽  
The Mean ◽  
Secondary Spinal Cord Injury

Abstract Background:Motor vehicle collisions remain a common cause of spinal cord injury. Biomechanical studies of spinal movement often lack “real world” context and applicability. Additional data may enhance our understanding of the potential for secondary spinal cord injury. We propose the metric ‘travel’ (total movement) and suggest that our understanding of movement related risk of injury could be improved if travel was routinely reported. We report maximal movement and travel for collar application in vehicle and subsequent self-extrication.Methods:Biomechanical data on application of cervical collar with the volunteer sat in a vehicle were collected using Inertial Measurement Units on 6 healthy volunteers. Maximal movement and travel are reported. These data and a re-analysis of previously published work is used to demonstrate the utility of travel and maximal movement in the context of self-extrication.Results:Data from a total of 60 in-vehicle collar applications across three female and three male volunteers was successfully collected for analysis. The mean age across participants was 50.3 years (range 28–68) and the BMI was 27.7 (range 21.5–34.6). The mean maximal anterior-posterior movement associated with collar application was 2.3mm with a total AP travel of 4.9mm. Travel (total movement) for in-car application of collar and self-extrication was 9.5mm compared to 9.4mm travel for self-extrication without a collar. Conclusion:We have demonstrated the application of ‘travel’ in the context of self-extrication. Total travel is similar across self-extricating healthy volunteers with and without a collar.We suggest that where possible ‘travel’ is collected and reported in future biomechanical studies in this and related areas of research. It remains appropriate to apply a cervical collar to self-extricating casualties when the clinical target is that of movement minimisation.

Incidence and severity of acute complications after spinal cord injury

2012 ◽  
Vol 17 (Suppl1) ◽  
pp. 119-128 ◽  
Author(s):  
Robert G. Grossman ◽  
Ralph F. Frankowski ◽  
Keith D. Burau ◽  
Elizabeth G. Toups ◽  
John W. Crommett ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Clinical Trials ◽  
Motor Vehicle ◽  
Spinal Injury ◽  
Vehicle Accidents ◽  
The North ◽  
Treatment And Prevention ◽  
Cord Injury ◽  
Study Population

Object The aim of this multicenter, prospective study was to determine the spectrum, incidence, and severity of complications during the initial hospitalization of patients with spinal cord injury. Methods The study was conducted at 9 university-affiliated hospitals that comprise the clinical centers of the North American Clinical Trials Network (NACTN) for Treatment of Spinal Cord Injury. The study population comprised 315 patients admitted to NACTN clinical centers between June 25, 2005, and November 2, 2010, who had American Spinal Injury Association (ASIA) Impairment Scale grades of A–D and were 18 years of age or older. Patients were managed according to a standardized protocol. Results The study population was 79% male with a median age of 44 years. The leading causes of injury were falls (37%) and motor vehicle accidents (28%). The distribution of initial ASIA grades were A (40%), B (16%), C (15%), and D (29%). Fifty-eight percent of patients sustained 1 or more severe, moderate, or mild complications. Complications were associated with more severe ASIA grade: 84% of patients with Grade A and 25% of patients with Grade D had at least 1 complication. Seventy-eight percent of complications occurred within 14 days of injury. The most frequent types of severe and moderate complications were respiratory failure, pneumonia, pleural effusion, anemia, cardiac dysrhythmia, and severe bradycardia. The mortality rate was 3.5% and was associated with increased age and preexisting morbidity. Conclusions Knowledge of the type, frequency, time of occurrence, and severity of specific complications that occur after spinal cord injury can aid in their early detection, treatment, and prevention. The data are of importance in evaluating and selecting therapy for clinical trials.

scholarly journals Maximum movement and cumulative movement (travel) to inform our understanding of secondary spinal cord injury and its application to collar use in self-extrication

2022 ◽  
Vol 30 (1) ◽  
Author(s):  
Tim Nutbeam ◽  
Rob Fenwick ◽  
Barbara May ◽  
Willem Stassen ◽  
Jason Smith ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Healthy Volunteers ◽  
Motor Vehicle ◽  
Cervical Collar ◽  
Spinal Movement ◽  
Cord Injury ◽  
Total Movement ◽  
The Mean ◽  
Secondary Spinal Cord Injury

Abstract Background Motor vehicle collisions remain a common cause of spinal cord injury. Biomechanical studies of spinal movement often lack “real world” context and applicability. Additional data may enhance our understanding of the potential for secondary spinal cord injury. We propose the metric ‘travel’ (total movement) and suggest that our understanding of movement related risk of injury could be improved if travel was routinely reported. We report maximal movement and travel for collar application in vehicle and subsequent self-extrication. Methods Biomechanical data on application of cervical collar with the volunteer sat in a vehicle were collected using Inertial Measurement Units on 6 healthy volunteers. Maximal movement and travel are reported. These data and a re-analysis of previously published work is used to demonstrate the utility of travel and maximal movement in the context of self-extrication. Results Data from a total of 60 in-vehicle collar applications across three female and three male volunteers was successfully collected for analysis. The mean age across participants was 50.3 years (range 28–68) and the BMI was 27.7 (range 21.5–34.6). The mean maximal anterior–posterior movement associated with collar application was 2.3 mm with a total AP travel of 4.9 mm. Travel (total movement) for in-car application of collar and self-extrication was 9.5 mm compared to 9.4 mm travel for self-extrication without a collar. Conclusion We have demonstrated the application of ‘travel’ in the context of self-extrication. Total travel is similar across self-extricating healthy volunteers with and without a collar. We suggest that where possible ‘travel’ is collected and reported in future biomechanical studies in this and related areas of research. It remains appropriate to apply a cervical collar to self-extricating casualties when the clinical target is that of movement minimisation.

scholarly journals The Risk of Acute Spinal Cord Injury After Minor Trauma in Patients With Preexisting Cervical Stenosis

Neurosurgery ◽  
2015 ◽  
Vol 77 (4) ◽  
pp. 561-565 ◽  
Author(s):  
Victor Chang ◽  
Benjamin M. Ellingson ◽  
Noriko Salamon ◽  
Langston T. Holly
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Motor Vehicle ◽  
Traumatic Event ◽  
Minor Trauma ◽  
Cervical Stenosis ◽  
Canal Diameter ◽  
Cord Injury ◽  
The Mean

Abstract BACKGROUND: Cervical stenosis patients are commonly advised to undergo surgery due to the risk of spinal cord injury (SCI) after a traumatic event. However, the actual risk of SCI in this scenario is unknown. OBJECTIVE: To evaluate the risk of SCI after minor trauma in a cohort of prospectively followed cervical stenosis patients. METHODS: Clinical and radiographical analysis was performed in 55 nonoperatively treated patients evaluated between 2009 and 2014. Each patient was asked standardized questions including: 1) whether a previous physician recommended neck surgery, 2) whether a physician indicated that they would become paralyzed after a traumatic event, and 3) whether they experienced a traumatic event during the follow-up period. RESULTS: The mean age was 65, with a mean modified Japanese Orthopedic Association score of 16.6. The mean canal diameter was 6.1 mm. Nineteen patients (35%) had evidence of intramedullary T2 signal abnormality. Thirty-one patients (56%) were previously recommended for surgery. Twenty-six patients (47%) were told that they would be paralyzed after a motor vehicle accident or fall unless surgery was performed. Ten patients (18%) experienced a traumatic event during the follow-up, with none sustaining an SCI. CONCLUSION: Asymptomatic and mildly symptomatic cervical stenosis patients are commonly recommended to undergo surgery due to risk of paralysis after a traumatic event. SCI was not observed after minor trauma in our cohort of prospectively followed patients. It seems that occurrence of SCI in this patient population after minor trauma is likely smaller than many physicians surmise, yet will require future prospective study in a large cohort of patients.

scholarly journals Epidemiology of Spinal Cord Injury: Changes to Its Cause Amid Aging Population, a Single Center Study

2021 ◽  
Vol 45 (1) ◽  
pp. 7-15
Author(s):  
Ha Seong Kim ◽  
Kil-Byung Lim ◽  
Jiyong Kim ◽  
Joongmo Kang ◽  
Hojin Lee ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Motor Vehicle ◽  
Posterior Longitudinal Ligament ◽  
The Elderly ◽  
Motor Vehicle Crash ◽  
Cross Sectional ◽  
Common Cause ◽  
Cord Injury ◽  
The Mean

Objective To investigate the epidemiologic and demographic characteristics of patients with spinal cord injury (SCI) who were admitted to a department of rehabilitation of a university hospital.Methods This was a descriptive cross-sectional study. Medical records including sex, age at injury, type of disability, traumatic or non-traumatic etiology and presence of ossification of posterior longitudinal ligament (OPLL) of patients with SCI who were admitted to the department of rehabilitation between 2012 and 2018 were reviewed.Results Of the 221 cases of SCI, 161 were traumatic and 60 were non-traumatic. The mean age at injury was 52.8 years. People aged 40–49 years showed highest proportion among overall SCI patients (19.0%). The proportion of male patients was higher in traumatic SCI at 4.96:1 than in non-traumatic SCI at 1.30:1. The most common cause of traumatic SCI was falling off (37.3%), followed by motor vehicle crash (35.4%) and tripping over (19.3%). Meanwhile, the most common cause of non-traumatic SCI was neoplasm (35.0%). Tripping over was the leading cause of traumatic SCI in patients aged ≥60 years (42.6%). A high proportion of traumatic SCI patients were found to have underlying OPLL (26.1%), particularly those who were injured by tripping over (64.5%).Conclusion The mean age of SCI patients was higher than that of previous studies. Falls was the single most common cause of traumatic SCI, and tripping over was the most common cause of injury in the elderly patients. OPLL was prevalent in patients who were injured from tripping over.

Spinal Cord Tissue Bridges Validation Study: Predictive Relationships With Sensory Scores Following Cervical Spinal Cord Injury

2021 ◽  
Author(s):  
Andrew C. Smith ◽  
Denise R. O’Dell ◽  
Wesley A. Thornton ◽  
David Dungan ◽  
Eli Robinson ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
External Validation ◽  
Inpatient Rehabilitation ◽  
Spinal Cord Tissue ◽  
Light Touch ◽  
Post Injury ◽  
Data Set ◽  
Cord Injury ◽  
Predictive Relationships

Background: Using magnetic resonance imaging (MRI), widths of ventral tissue bridges demonstrated significant predictive relationships with future pinprick sensory scores, and widths of dorsal tissue bridges demonstrated significant predictive relationships with future light touch sensory scores, following spinal cord injury (SCI). These studies involved smaller participant numbers, and external validation of their findings is warranted. Objectives: The purpose of this study was to validate these previous findings using a larger independent data set. Methods: Widths of ventral and dorsal tissue bridges were quantified using MRI in persons post cervical level SCI (average 3.7 weeks post injury), and pinprick and light touch sensory scores were acquired at discharge from inpatient rehabilitation (average 14.3 weeks post injury). Pearson product-moments were calculated and linear regression models were created from these data. Results: Wider ventral tissue bridges were significantly correlated with pinprick scores (r = 0.31, p &lt; 0.001, N = 136) and wider dorsal tissue bridges were significantly correlated with light touch scores (r = 0.31, p &lt; 0.001, N = 136) at discharge from inpatient rehabilitation. Conclusion: This retrospective study’s results provide external validation of previous findings, using a larger sample size. Following SCI, ventral tissue bridges hold significant predictive relationships with future pinprick sensory scores and dorsal tissue bridges hold significant predictive relationships with future light touch sensory scores.

Poster 305: Changes in Resiliency During Inpatient Rehabilitation Following a Spinal Cord Injury

2007 ◽  
Vol 88 (9) ◽  
pp. E99-E100
Author(s):  
Ann Marie Warren ◽  
Tanisha Toaston ◽  
Brian White ◽  
Simon Driver ◽  
R. Lance Bruce
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Inpatient Rehabilitation ◽  
Cord Injury
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