scholarly journals Blood Alcohol Concentration Is Associated With Improved AIS Motor Score After Spinal Cord Injury

2020 ◽  
Vol 26 (4) ◽  
pp. 261-267
Author(s):  
Josephine Volovetz ◽  
Mary Joan Roach ◽  
Argyrios Stampas ◽  
Gregory Nemunaitis ◽  
Michael L. Kelly
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Blood Alcohol Concentration ◽  
Alcohol Concentration ◽  
Blood Alcohol ◽  
Motor Score ◽  
Neurologic Recovery ◽  
Cord Injury ◽  
Score Gain ◽  
The Relationship

Objective: To investigate the relationship between blood alcohol concentration (BAC) and neurologic recovery after traumatic spinal cord injury (TSCI) using standardized outcome measures from the International Standards for the Neurological Classification of Spinal Cord Injury (ISNCSCI) examination. Method: This is a retrospective review of merged, prospectively collected, multicenter data from the Spinal Cord Injury Model Systems Database and institutional trauma databases from five academic medical centers across the United States. Patients with SCI and a documented BAC were analyzed for American Spinal Injury Association Impairment Scale (AIS) motor score, FIM, sensory light touch score, and sensory proprioception score upon admission and discharge from rehabilitation. Linear regression was used for the analysis. Results: The study identified 210 patients. Mean age at injury was 47 ± 20.5 years, 73% were male, 31% had an AIS grade A injury, 56% had ≥1 comorbidity, mean BAC was 0.42 ± 0.9 g/dL, and the mean Glasgow Coma Score upon arrival was 13.27 ± 4.0. ISNCSCI motor score gain positively correlated with higher BAC (4.80; confidence interval [CI], 2.39–7.22; p < .0001). FIM motor gain showed a trend toward correlation with higher BAC, although it did not reach statistical significance (3.27; CI, −0.07 to 6.61; p = .055). ISNCSCI sensory light touch score gain and sensory proprioception score gain showed no correlation with BAC (p = .44, p = .09, respectively). Conclusion: The study showed a positive association between higher BAC and neurologic recovery in patients with SCI as measured by ISNCSCI motor score gain during rehabilitation. This finding has not been previously reported in the literature and warrants further study to better understand possible protective physiological mechanisms underlying the relationship between BAC and SCI.

scholarly journals The relationship between pressure offloading and ischial tissue health in individuals with spinal cord injury: An exploratory study

2019 ◽  
Vol 42 (sup1) ◽  
pp. 186-195 ◽  
Author(s):  
Sharon Gabison ◽  
Sunita Mathur ◽  
Ethne L. Nussbaum ◽  
Milos R. Popovic ◽  
Mary C. Verrier
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Exploratory Study ◽  
Cord Injury ◽  
The Relationship

Correlating the Blood Alcohol Concentration with Outcome after Traumatic Brain Injury: Too Much Is Not a Bad Thing

2011 ◽  
Vol 77 (10) ◽  
pp. 1416-1419 ◽  
Author(s):  
Cherisse Berry ◽  
Eric J. Ley ◽  
Daniel R. Margulies ◽  
James Mirocha ◽  
Marko Bukur ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Los Angeles ◽  
Linear Trend ◽  
Blood Alcohol Concentration ◽  
Alcohol Concentration ◽  
Multivariable Logistic Regression Analysis ◽  
Blood Alcohol ◽  
Severe Tbi ◽  
The Relationship

Although recent evidence suggests a beneficial effect of alcohol for patients with traumatic brain injury (TBI), the level of alcohol that confers the protective effect is unknown. Our objective was to investigate the relationship between admission blood alcohol concentration (BAC) and outcomes in patients with isolated moderate to severe TBI. From 2005 to 2009, the Los Angeles County Trauma Database was queried for all patients ≥14 years of age with isolated moderate to severe TBI and admission serum alcohol levels. Patients were then stratified into four levels based on admission BAC: None (0 mg/dL), low (0-100 mg/dL), moderate (100-230 mg/dL), and high (≥230 mg/dL). Demographics, patient characteristics, and outcomes were compared across levels. In evaluating 3794 patients, the mortality rate decreased with increasing BAC levels (linear trend P < 0.0001). In determining the relationship between BAC and mortality, multivariable logistic regression analysis demonstrated a high BAC level was significantly protective (adjusted odds ratio 0.55; 95% confidence interval: 0.38-0.8; P = 0.002). In the largest study to date, a high (≥230 mg/dL) admission BAC was independently associated with improved survival in patients with isolated moderate to severe TBI. Additional research is warranted to investigate the potential therapeutic implications.

scholarly journals The effects of FES cycling combined with virtual reality racing biofeedback on voluntary function after incomplete SCI: a pilot study

2019 ◽  
Vol 16 (1) ◽  
Author(s):  
Lynsey D. Duffell ◽  
Sue Paddison ◽  
Ahmad F. Alahmary ◽  
Nick Donaldson ◽  
Jane Burridge
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Virtual Reality ◽  
Electrical Stimulation ◽  
Pilot Study ◽  
Controlled Trial ◽  
Training Programme ◽  
International Standards ◽  
Motor Score ◽  
Cord Injury

Abstract Background Functional Electrical Stimulation (FES) cycling can benefit health and may lead to neuroplastic changes following incomplete spinal cord injury (SCI). Our theory is that greater neurological recovery occurs when electrical stimulation of peripheral nerves is combined with voluntary effort. In this pilot study, we investigated the effects of a one-month training programme using a novel device, the iCycle, in which voluntary effort is encouraged by virtual reality biofeedback during FES cycling. Methods Eleven participants (C1-T12) with incomplete SCI (5 sub-acute; 6 chronic) were recruited and completed 12-sessions of iCycle training. Function was assessed before and after training using the bilateral International Standards for Neurological Classification of SCI (ISNC-SCI) motor score, Oxford power grading, Modified Ashworth Score, Spinal Cord Independence Measure, the Walking Index for Spinal Cord Injury and 10 m-walk test. Power output (PO) was measured during all training sessions. Results Two of the 6 participants with chronic injuries, and 4 of the 5 participants with sub-acute injuries, showed improvements in ISNC-SCI motor score > 8 points. Median (IQR) improvements were 3.5 (6.8) points for participants with a chronic SCI, and 8.0 (6.0) points for those with sub-acute SCI. Improvements were unrelated to other measured variables (age, time since injury, baseline ISNC-SCI motor score, baseline voluntary PO, time spent training and stimulation amplitude; p > 0.05 for all variables). Five out of 11 participants showed moderate improvements in voluntary cycling PO, which did not correlate with changes in ISNC-SCI motor score. Improvement in PO during cycling was positively correlated with baseline voluntary PO (R2 = 0.50; p < 0.05), but was unrelated to all other variables (p > 0.05). The iCycle was not suitable for participants who were too weak to generate a detectable voluntary torque or whose effort resulted in a negative torque. Conclusions Improved ISNC-SCI motor scores in chronic participants may be attributable to the iCycle training. In sub-acute participants, early spontaneous recovery and changes due to iCycle training could not be distinguished. The iCycle is an innovative progression from existing FES cycling systems, and positive results should be verified in an adequately powered controlled trial. Trial registration ClinicalTrials.gov, NCT03834324. Registered 06 February 2019 - Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT03834324. Protocol V03, dated 06.08.2015.

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