scholarly journals Nutritional Management Enhances the Recovery of Swallowing Ability in Older Patients with Sarcopenic Dysphagia

Nutrients ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 596
Author(s):  
Akio Shimizu ◽  
Ichiro Fujishima ◽  
Keisuke Maeda ◽  
Hidetaka Wakabayashi ◽  
Shinta Nishioka ◽  
...  
Keyword(s):  
Primary Outcome ◽  
Probability Model ◽  
Functional Independence Measure ◽  
Ideal Body Weight ◽  
Functional Independence ◽  
Secondary Outcome ◽  
Ideal Body ◽  
The Mean ◽  
Level Scale ◽  
Sarcopenic Dysphagia

This study assessed whether a high provided energy of ≥30 kcal/ideal body weight (IBW)/day (kg) for patients with sarcopenic dysphagia effectively improved swallowing ability and the activities of daily living (ADLs). Among 110 patients with sarcopenic dysphagia (mean age, 84.9 ± 7.4 years) who were admitted to a post-acute hospital, swallowing ability and the ADLs were assessed using the Food Intake LEVEL Scale (FILS) and the Functional Independence Measure (FIM), respectively. The primary outcome was the FILS at discharge, while the secondary outcome was the achievement of the FIM with a minimal clinically important difference (MCID) at discharge. We created a homogeneous probability model without statistically significant differences using the inverse probability of treatment weighting (IPTW) method with and without a mean provided energy of ≥30 kcal/IBW/day (kg) for a period of 1 week of hospitalization and compared the outcomes between groups. A mean provided energy of ≥30 kcal/IBW/day (kg) was achieved in 62.7% of patients. In the IPTW model, the FILS and the rates of achieved MCID of the FIM at discharge were significantly higher in the mean provided energy of ≥30 kcal/IBW/day (kg) group (p = 0.004 and p < 0.001, respectively). A high provided energy for patients with sarcopenic dysphagia may improve swallowing ability and produce clinically meaningful functional outcomes.

scholarly journals Predictive models for independence after stroke rehabilitation: Maugeri external validation and development of a new model

2021 ◽  
pp. 1-10
Author(s):  
Alejandro García-Rudolph ◽  
Montserrat Bernabeu ◽  
Blanca Cegarra ◽  
Joan Saurí ◽  
Vince Istvan Madai ◽  
...  
Keyword(s):  
Predictive Models ◽  
Stroke Rehabilitation ◽  
Primary Outcome ◽  
External Validation ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Secondary Outcome ◽  
Multivariable Logistic Regression Analysis ◽  
Good Discrimination ◽  
New Model

BACKGROUND: Many efforts have been devoted to identify predictors of functional outcomes after stroke rehabilitation. Though extensively recommended, there are very few external validation studies. OBJECTIVE: To externally validate two predictive models (Maugeri model 1 and model 2) and to develop a new model (model 3) that estimate the probability of achieving improvement in physical functioning (primary outcome) and a level of independence requiring no more than supervision (secondary outcome) after stroke rehabilitation. METHODS: We used multivariable logistic regression analysis for validation and development. Main outcome measures were: Functional Independence Measure (FIM) (primary outcome), Functional Independence Staging (FIS) (secondary outcome) and Minimal Clinically Important Difference (MCID). RESULTS: Patients with stroke admitted to a rehabilitation center from 2006 to 2019 were retrospectively studied (N = 710). Validation of Maugeri models confirmed very good discrimination: for model 1 AUC = 0.873 (0.833–0.915) and model 2 AUC = 0.803 (0.749–0.857). The Hosmer–Lemeshow χ 2 was 6.07(P = 0.63) and 8.91(P = 0.34) respectively. Model 3 yielded an AUC = 0.894 (0.857–0.929) (primary outcome) and an AUC = 0.769 (0.714–0.825) (MCID). CONCLUSIONS: Discriminative power of both Maugeri models was externally confirmed (in a 20 years younger population) and a new model (incorporating aphasia) was developed outperforming Maugeri models in primary outcome and MCID.

A phase III trial of intramuscular recombinant interferon beta as treatment for exacerbating-remitting multiple sclerosis: design and conduct of study and baseline characteristics of patients

1995 ◽  
Vol 1 (2) ◽  
pp. 118-135 ◽  
Author(s):  
LD Jacobs ◽  
DL Cookfair ◽  
RA Rudick ◽  
RM Herndon ◽  
J R Richert ◽  
...  
Keyword(s):  
Primary Outcome ◽  
Interferon Beta ◽  
Outcome Measure ◽  
Primary Outcome Measure ◽  
Phase Iii ◽  
Secondary Outcome ◽  
Recombinant Interferon ◽  
Study Population ◽  
The Mean ◽  
Baseline Characteristics

The design and conduct of a randomized, double-blinded, placebo-controlled, multicenter, phase III study of recombinant interferon beta-1a (IFN-β-1a) as treatment for exacerbating-remitting MS are described, as are baseline characteristics of the study population. The purpose of the study was to determine if 6.0 × 106 IU (30 μg) of IFN-β-1a, administered by weekly intramuscular (i.m.) injections, was effective in delaying the onset of sustained disability. The primary outcome measure was time to onset of treatment failure, defined as a worsening on the Kurtzke Expanded Disability Status Scale (EDSS) of greater than or equal to 1.0 point compared with baseline, persisting for at least 6 months. An intent-to-treat design was used. The primary outcome measure was analyzed using the Mantel-Cox log-rank statistic and Kaplan-Meier survival curves. Secondary outcomes included quantitative measures of upper and lower extremity function, neuropsychological test performance, functional and quality of life assessments and several measures derived from annual brain MRI studies. Entry criteria included prestudy exacerbation rates of at least 0.67 per year and EDSS scores of 1.0–3.5. A total of 301 MS patients were randomly assigned to receive weekly i.m. injections of IFN-β-1a or placebo. The average age of the study population at entry was 37 years; 92% were Caucasian and 73% were women. The mean prestudy disease duration was 6.5 years, mean prestudy exacerbation rate was 1.2 per year and the mean EDSS score was 2.3. The randomization yielded well-balanced treatment arms. Various aspects of the study are discussed, including: (1) the decision to focus study design on sustained disability; (2) the rationale for the treatment regimen; (3) measures taken to assure the reliability of the primary outcome measure; and (4) a description of the secondary outcome measures.

Abstract 133: White Matter Hyperintensity and Cardiovascular Disease Outcomes: A Secondary Analysis of the SPRINT MIND Trial

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Adam H de Havenon ◽  
Tanya Turan ◽  
Sharon Yeatts ◽  
Rebecca Gottesman ◽  
Shyam Prabhakaran ◽  
...  
Keyword(s):  
White Matter ◽  
Primary Outcome ◽  
Stroke Risk ◽  
Secondary Analysis ◽  
White Matter Hyperintensity ◽  
Secondary Outcome ◽  
Cox Models ◽  
Disease Outcomes ◽  
Hazard Ratios ◽  
The Mean

Background: The Systolic Blood Pressure Intervention Trial (SPRINT) randomized patients to a goal SBP <120 mm Hg vs. <140 mm Hg . A subset of patients enrolled in SPRINT MIND, which performed a baseline MRI and measured white matter hyperintensity volume (WMHv). We evaluated the association between WMHv and cardiovascular events. Methods: The primary outcome was a composite of stroke, MI, ACS, decompensated CHF, or CVD death. The secondary outcome was stroke. The WMHv was divided into quartiles. We fit Cox models to the outcomes and report adjusted hazard ratios for the quartiles of WMHv, and stratified by SPRINT treatment arm. Results: Among 719 included patients, the mean WMHv in the quartiles was 0.34, 1.09, 2.61, and 10.8 mL. The primary outcome occurred in 51/719 (7.1%) and the secondary outcome in 10/719 (1.4%). The WMHv was associated with both outcomes (Table 1, Figure 1). After stratifying by treatment arm, we found the association persisted in the standard, but not intensive, treatment arm (Table 2). However, the interaction term between WMHv and treatment arm was not significant. Conclusions: We observed that degree of WMH was associated with CVD and stroke risk in SPRINT MIND. The risk may be attenuated in patients randomized to intensive BP lowering. Trials are needed to determine if intensive BP lowering can prospectively reduce the high cardiovascular risk in patients with WMH.

P–328 Dienogest significantly decreases the size of the cyst and alters Anti-Müllerian Hormone concentration in patients with endometrioma

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
E Karataş ◽  
B E Temiz ◽  
S Mumusoglu ◽  
H Yarali ◽  
G Bozdag
Keyword(s):  
Primary Outcome ◽  
Statistical Significance ◽  
Mean Difference ◽  
Secondary Outcome ◽  
Control Group ◽  
Significant Drop ◽  
Mean Size ◽  
The Mean ◽  
Respective Figure

Abstract Study question Does utilization of dienogest make any impact on the size of cyst and Anti-Müllerian Hormone (AMH) concentration in patients with endometrioma throughout 12-months? Summary answer Although dienogest makes a gradual reduction in the size of endometrioma cyst throughout 12-months, a significant drop in AMH serum concentration was also noticed. What is known already According to recent studies, pre-operative serum AMH levels might be illusively increased with parallel to the size of endometrioma which will be a misleading factor while deciding to operate the patient via cystectomy. Although dienogest is one of the medical options that might be commenced in patients with endometrioma cyst, there is limited data about its effect on the size of the endometrioma and hence serum AMH concentration throughout 12 months of follow up. Study design, size, duration The current observational cohort study was conducted among patients with endometrioma those treated with dienogest from January 2017 to January 2020. The primary outcome was alteration in diameter of endometrioma cyst at 6th and 12th months of treatment. Secondary outcome was alteration in serum AMH concentration in the same period. Of 104 patients treated with dienogest, 44 patients were excluded due to being treated with any type of surgical intervention during follow up period. Participants/materials, setting, methods A total of 60 patients were recruited for the final analysis. Of them, primary symptom was dysmenorrhea, chronic pelvic pain and menstrual irregularity in 16 (26.7%), 25 (41.7%) and 8 (13.3%) patients, respectively. Eighteen patients (30%) were asymptomatic. As 21 patients had bi-lateral endometrioma, size of the leading cyst was considered to be analyzed for the primary outcome measure. Paired-t test was used for comparison of numerical values and p ≤ 0.05 was taken as statistical significance. Main results and the role of chance The mean age was 31.5±8.0 years. In the time point when dienogest was started, the mean size of the endometrioma was 46.3±17.4 mm. The mean serum AMH concentration was 3.6±2.4 ng/ml. After 6 months of treatment, the mean size of the endometrioma decreased to 38.6±14.0 mm which corresponds to a mean difference of 7.8 mm (95% CI: 3.0 to 12.6; p: 0.003). The respective figure for AMH was 3.3±2.7 ng/ml which corresponds to a mean difference of 0.3 ng/ml (95% CI: –0.2 to 0.8; p: 0.23) at 6 months. After 12 months of treatment, the mean size of the endometrioma was 37.5±15.7 mm which corresponds to a mean difference of 8.9 mm (95% CI: 2.9 to 14.9; p: 0.005) at the end of 12 months. The respective figure for AMH was 2.7±1.9 ng/ml which corresponds to a mean difference of 0.9 ng/ml (95% CI: 0.1 to 1.7; p: 0.045) at the end of 12 months. The mean diameter of endometrioma and AMH concentration did not differ throughout the time period between 6th and 12th months of the treatment. Limitations, reasons for caution Although herein we present the largest data that depicts the alteration of endometrioma cyst and AMH concentration with the application of dienogest, the lack of control group is a limitation that avoids to perform any comparison. Wider implications of the findings: A shrinkage after commencement of treatment suggest that dienogest might present improvement in patients with endometrioma with respect to radiological findings, but further studies are required whether a decline in AMH concentration after 12 months refers to a genuine decrease in ovarian reserve or resolution of misleading high pre-treatment levels. Trial registration number not available

scholarly journals FUNCTIONAL INDEPENDENCE OF PEDIATRIC PATIENTS WITH MUCOPOLYSACCHARIDOSES

2019 ◽  
Vol 27 (4) ◽  
pp. 212-215
Author(s):  
Paloma Silva Lopes ◽  
Diógenes Pires Serra Filho ◽  
Marcos Antônio Almeida Matos
Keyword(s):  
Pediatric Patients ◽  
Case Series ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Cross Sectional Study ◽  
Cognitive Domain ◽  
Level Of Evidence ◽  
Cross Sectional ◽  
Documentary Analysis ◽  
The Mean

ABSTRACT Objective: To measure the functional independence to perform activities of daily living of pediatric patients diagnosed with mucopolysaccharidoses. Methods: A descriptive cross-sectional study was carried out with the population of pediatric patients with a confirmed enzymatic diagnosis of mucopolysaccharidoses, enrolled in the Orthopedics outpatient clinic of a hospital in the State of Bahia. The data were collected between October 2016 and March 2017, based on the documentary analysis of the assessment forms used in the department. The variables of this study comprised sex, age, type of MPS and level of functional independence, measured by the Functional Independence Measure scale. Results: Twenty-six patients participated in the study. These were predominantly male (61.5%), with a mean age of 10 ± 4.5 years, affected by MPS VI (73.1%). In the motor domain, the mean score was 65 (± 19.9 points); the cognitive domain obtained a mean score equal to 28 (± 8.2 points); and the total FIM score was 93 (± 26.5). Conclusion: Impaired functional independence was observed among children and adolescents with mucopolysaccharidoses. Tasks related to dressing, toileting, bathing, problem solving and social interaction were those that required the most assistance and/or supervision. Level of Evidence IV, Case Series.

scholarly journals Epidemiological and functional profile of patients diagnosed with multiple sclerosis in Manaus, Amazonas

2018 ◽  
Vol 25 (4) ◽  
Author(s):  
Luciana Moreira de Sousa ◽  
Edinangela Silva de Oliveira ◽  
Nisi Alessandra de Carvalho Sousa ◽  
Guilherme Peixoto Tinoco Arêas ◽  
Fernando Zanela da Silva Arêas
Keyword(s):  
Multiple Sclerosis ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Functional Profile ◽  
Immune Mediated ◽  
Diagnostic Time ◽  
Subsequent Application ◽  
Reference Hospital ◽  
The Mean ◽  
Epidemiological Characteristics

Multiple sclerosis (MS) is an immune-mediated, inflammatory disease characterized by repeated episodes of demyelization. Objective: The present study aimed to trace the epidemiological and functional profile of patients with Multiple Sclerosis treated at a Reference Hospital in Manaus-AM. Method: 80 charts were selected for screening and subsequent application of the Functional Independence Measure (MIF) scale. Results: 32 patients were included in the study, 23 females (74%), whose mean age was 35 (± 12) years, with a relationship between females and males of 2.5. The mean diagnostic time for men was 7.8 years and for women of 5.3 years. The mean score on the Total MIF scale was 110.9 (± 17.5). Conclusion: Epidemiological characteristics are in line with most similar studies, but lack further studies aimed at assessing the functionality of individuals with MS.

An Audit of a New System of Self–Referral in the Management of Multiple Sclerosis

2002 ◽  
Vol 4 (1) ◽  
pp. 10-16
Author(s):  
Áine Carroll ◽  
Paul Mattison ◽  
Catherine Comiskey
Keyword(s):  
Multiple Sclerosis ◽  
Lead Time ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
The Self ◽  
Referral System ◽  
Disability Status ◽  
The Mean ◽  
Multiple Sclerosis Patients ◽  
New System

A random sample of the referral notes of 35 multiple sclerosis patients experiencing relapse and referred via the current general practitioner (GP) system was reviewed. The time between receipt of the referral and assessment/admission (lead time) was examined. The mean value was obtained and a self referral system was initiated and monitored for a period of five months. The mean referral times were compared. The patients' disability status before and after treatment was measured using the Expanded Disability Status Scale (EDSS) and Functional Independence Measure (FIM), and we invited the patients' opinions about the self-referral system. The goals of the newly implemented self-referral system were to reduce lead time to less than 6.5 days, improve patient disability, and avoid inappropriate referral; the new system was also to be “user friendly.” The new system reduced referral times by a statistically significant amount (P = 0.0016). There was a significant objective improvement in patients' disability as measured by the EDSS and FIM scores (P = 0.031 and P = 0.04, respectively). There was a subjective improvement, and patients expressed a preference for the new system. There were no inappropriate referrals. These findings suggest that the self-referral system is efficient and effective and should be further evaluated. (Int J MS Care. 2002; 4: 10–12)

Therapeutic Drug Monitoring (TDM) of IV Busulfan in Patients with Severe Obesity.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 1990-1990
Author(s):  
Donald A. Hutcherson ◽  
Jolynn K. Sessions ◽  
Ronald A. Mihelic ◽  
Katherine Sanvidge ◽  
Stephen R. Stricker ◽  
...  
Keyword(s):  
Body Weight ◽  
Severe Obesity ◽  
Package Insert ◽  
Ideal Body Weight ◽  
Obese Patients ◽  
Actual Weight ◽  
Severely Obese ◽  
Ideal Body ◽  
The Mean ◽  
Dosing Strategy

Abstract It has been previously reported that increases in relapse and graft rejection can be associated with a low busulfan area under the curve (AUC) and hepatic toxicities are associated with a high AUC. This has lead to strategies to adjust busulfan dosing to achieve a target AUC. A retrospective analysis was performed in patients with severe obesity, defined as a Body Mass Index (BMI) greater than 40, to evaluate the reliability of IV busulfan dosed using the package insert dosing strategy to reach a targeted AUC. The study included 11 females and 8 males who received IV busulfan as part of their hematopoietic progenitor cell transplant preparative regimen. There were 11 autologous and 8 allogeneic transplants for lymphoma (10) and leukemia (9). The mean and median ages were 38 and 41 years (range 19–51). The mean and median BMIs for this population were 47.8 and 46.2 (range 40.4–62.7). The mean and median weights were 139.5 kg and 142.5 kg (range 107–192.3). TDM was performed with the first dose of busulfan along with subsequent dosage adjustments to achieve a target AUC of 1150–1350 micromol X min/L. Busulfex package insert dosing recommendations are for 16 doses of 0.8 mg/kg (12.8 mg/kg) using an adjusted ideal body weight (AIBW) for obese patients. AIBW = 0.25 × (actual weight − ideal body weight) + ideal body weight. Using the AIBW dosing, the mean starting dose to actual body weight ratio was 0.48 mg/kg (range 0.40–0.55 mg/kg). Based on the AUC analysis, the predicted mean AUC using the AIBW dosing was 972 (range 702–1356). Six AUCs were below 900, 10 AUCs were above 900 but below 1150, 2 AUCs were within the target range and 1 AUC was greater than 1350. Thirteen of the patients had repeat AUC analyses following a subsequent dose to confirm that the dose adjustments achieved the targeted AUCs. Seven of these patients had further dose adjustments following the repeat AUC analysis. Five patients with a busulfan mean half-life of 235 minutes (range 218–247 minutes) had higher AUCs than the rest of the group. The mean and median AUCs for these 5 patients were 1177 and 1223 (range 997–1357). The remaining 14 patients with a mean busulfan half-life of 177 minutes (range 151–201) had mean and median AUCs of 899 and 903 (range 702–1105). The total therapy delivered ranged from 12.7 to 21.4 mg/kg based on the AIBW. When calculated on actual weight, the range was 6.9 to 11.24 mg/kg. Conclusion: The AIBW dosing strategy of IV busulfan is inadequate to achieve the targeted AUC of 1150–1350 in severely obese patients. Severely obese patients require dose increases in the majority of cases, while those with delayed clearance could be overdosed if higher doses are administered without TDM. Severely obese patients require TDM and the majority will require dosage adjustments to administer IV busulfan in the targeted therapeutic range.

Virtual Environment Training Therapy for Arm Motor Rehabilitation

2005 ◽  
Vol 14 (6) ◽  
pp. 732-740 ◽  
Author(s):  
Lamberto Piron ◽  
Paolo Tonin ◽  
Francesco Piccione ◽  
Vincenzo Iaia ◽  
Elena Trivello ◽  
...  
Keyword(s):  
Virtual Environment ◽  
Motor Impairment ◽  
Functional Independence Measure ◽  
Normal Subjects ◽  
Functional Independence ◽  
Reaching Movements ◽  
Response To Treatment ◽  
Motor Deficits ◽  
The Mean ◽  
Kinematic Measures

Enhanced feedback provided by a virtual reality system has been shown to promote motor learning in normal subjects. We evaluated whether this approach could be useful for treating patients with motor deficits following brain lesions. Fifty subjects with mild to intermediate arm impairments due to stroke were selected for the study. The patients received treatment daily for one month, consisting of an hour of virtual-environment therapy with enhanced feedback. Before and after the therapy, we assessed the degree of motor impairment and autonomy in daily living activities using the Fugl-Meyer scale for the upper extremities and Functional Independence Measure, respectively. We also analyzed the velocity, duration, and morphology of a sequence of reaching movements, finally comparing the kinematic measures with the scores obtained on the clinical scales. The rehabilitation therapy yielded significant improvements over baseline values in the mean scores on the Fugl-Meyer and Functional Independence Measure scales. The mean Fugl-Meyer score correlated significantly with the duration and velocity of reaching movements. The collated data indicate that motor recovery in post-stroke patients may be promoted by the enhanced feedback provided in a virtual environment and that kinematic analysis of their movements provides reliable measures of motor function changes in response to treatment.

Acidic fibroblast growth factor for repair of human spinal cord injury: a clinical trial

2011 ◽  
Vol 15 (3) ◽  
pp. 216-227 ◽  
Author(s):  
Jau-Ching Wu ◽  
Wen-Cheng Huang ◽  
Yu-Chun Chen ◽  
Tsung-Hsi Tu ◽  
Yun-An Tsai ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Adverse Events ◽  
Fibrin Glue ◽  
Functional Independence Measure ◽  
Functional Independence ◽  
Fibroblast Growth ◽  
Acidic Fibroblast Growth Factor ◽  
Cord Injury ◽  
The Mean

Object The study aimed to verify the safety and feasibility of applying acidic fibroblast growth factor (aFGF) with fibrin glue in combination with surgical neurolysis for nonacute spinal cord injury. Methods This open-label, prospective, uncontrolled human clinical trial recruited 60 patients with spinal cord injuries (30 cervical and 30 thoracolumbar). The mean patient age was 36.5 ± 15.33 (mean ± SD) years, and the male/female ratio was 3:1. The mean time from injury to treatment was 25.7 ± 26.58 months, and the cause of injury included motor vehicle accident (26 patients [43.3%]), fall from a height (17 patients [28.3%]), sports (4 patients [6.7%]), and other (13 patients [21.7%]). Application of aFGF with fibrin glue and duraplasty was performed via laminectomy, and an adjuvant booster of combined aFGF and fibrin glue (2 ml) was given at 3 and 6 months postsurgery via lumbar puncture. Outcome measurements included the American Spinal Injury Association (ASIA) motor scores, sensory scores, impairment scales, and neurological levels. Examination of functional independence measures, visual analog scale, MR imaging, electrophysiological and urodynamic studies, hematology and biochemistry tests, tumor markers, and serum inflammatory cytokines were all conducted. All adverse events were monitored and reported. Exclusions were based on refusal, unrelated adverse events, or failure to participate in the planned rehabilitation. Results Forty-nine patients (26 with cervical and 23 with thoracolumbar injuries) completed the 24-month trial. Compared with preoperative conditions, the 24-month postoperative ASIA motor scores improved significantly in the cervical group (from 27.6 ± 15.55 to 37.0 ± 19.93, p < 0.001) and thoracolumbar group (from 56.8 ± 9.21 to 60.7 ± 10.10, p < 0.001). The ASIA sensory scores also demonstrated significant improvement in light touch and pinprick in both groups: from 55.8 ± 24.89 to 59.8 ± 26.47 (p = 0.049) and 56.3 ± 23.36 to 62.3 ± 24.87 (p = 0.003), respectively, in the cervical group and from 75.7 ± 15.65 to 79.2 ± 15.81 (p < 0.001) and 78.2 ± 14.72 to 82.7 ± 16.60 (p < 0.001), respectively, in the thoracolumbar group. At 24-month follow-up, the ASIA impairment scale improved significantly in both groups (30% cervical [p = 0.011] and 30% thoracolumbar [p = 0.003]). There was also significant improvement in neurological level in the cervical (from 5.17 ± 1.60 to 6.27 ± 3.27, p = 0.022) and thoracolumbar (from 18.03 ± 4.19 to 18.67 ± 3.96, p = 0.001) groups. The average sum of motor items in functional independence measure also had significant improvement in both groups (p < 0.05). The walking/wheelchair locomotion subscale showed increased percentages of patients who were ambulatory (from 3.4% to 13.8% and from 17.9% to 35.7% in the cervical and thoracolumbar groups, respectively). There were no related adverse events. Conclusions The use of aFGF for spinal cord injury was safe and feasible in the present trial. There were significant improvements in ASIA motor and sensory scale scores, ASIA impairment scales, neurological levels, and functional independence measure at 24 months after treatment. Further large-scale, randomized, and controlled investigations are warranted to evaluate the efficacy and long-term results.

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