scholarly journals Examining Participation among Persons with Spinal Cord Injuries and Disorders Using Photovoice

2017 ◽  
Author(s):  
Salva Balbale ◽  
Keshonna Lones ◽  
Jennifer Hill ◽  
Sherri LaVela
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injuries ◽  
Environmental Changes ◽  
Community Dwelling ◽  
Social Aspect ◽  
Structured Interviews ◽  
Convenience Sample ◽  
Positive Effects ◽  
Cord Injury ◽  
The Mean

Participation is a significant rehabilitation outcome for individuals with spinal cord injury and/or disorder (SCI/D), yet few qualitative studies have described the social aspect of disability and community participation. We used the photovoice methodology to explore perceptions and experiences related to participation among Veterans with SCI/D. We recruited a convenience sample of individuals with SCI/D at the Hines Veterans Affairs (VA) SCI/D Unit. Participants were asked to take photographs exemplifying their experiences and activities regarding participation. Within four weeks, participants returned their photographs and completed semi-structured interviews to discuss their photographs. Interview transcripts were analyzed using an inductive coding approach to identify emerging themes. Of the 18 Veterans with SCI/D who completed the initial orientation session, 9 (50%) completed the photography phase and follow-up interviews. A majority of participants were White (67%) and the mean age was 64 years. The mean duration of injury was 21.8 years, and 75% of participants were paraplegic. Most participants (78%) were community-dwelling. All participants discussed participation as a highly relevant issue in their lives. A majority of participants (67%) described sports as an example of participation. Over half (56%) emphasized the positive effects of participation (i.e., feelings of enjoyment / accomplishment) in sports as well as engaging in faith-based activities, being outdoors, and managing business- or household-related responsibilities. Barriers to participation were mobility impairments, lack of transportation and cost. Findings from this study can be used to address environmental changes or other accommodations that influence participation, both inside and outside the health care setting.

scholarly journals Subcutaneous granulocyte colony-stimulating factor administration for subacute traumatic spinal cord injuries, report of neurological and functional outcomes: a double-blind randomized controlled clinical trial

2019 ◽  
Vol 30 (1) ◽  
pp. 19-30 ◽  
Author(s):  
Nazi Derakhshanrad ◽  
Hooshang Saberi ◽  
Mir Saeed Yekaninejad ◽  
Mohammad Taghi Joghataei
Keyword(s):  
Clinical Trial ◽  
Spinal Cord ◽  
Placebo Group ◽  
Spinal Cord Injuries ◽  
Functional Improvement ◽  
Granulocyte Colony Stimulating Factor ◽  
Double Blind ◽  
Cord Injury ◽  
The Mean ◽  
Stimulating Factor

OBJECTIVEGranulocyte-colony stimulating factor (G-CSF) is a major cytokine that has already been clinically verified for chronic traumatic spinal cord injuries (TSCIs). In this study, the authors set out to determine the safety and efficacy of G-CSF administration for neurological and functional improvement in subacute, incomplete TSCI.METHODSThis phase II/III, prospective, double-blind, placebo-controlled, parallel randomized clinical trial was performed in 60 eligible patients (30 treatment, 30 placebo). Patients with incomplete subacute TSCIs with American Spinal Injury Association Impairment Scale (AIS) grades B, C, and D were enrolled. Patients were assessed using the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) scale, Spinal Cord Independence Measure (SCIM-III) and International Association of Neurorestoratology Spinal Cord Injury Functional Rating Scale (IANR-SCIFRS), just before intervention and at 1, 3, and 6 months, after 7 daily subcutaneous administrations of 300 μg/day of G-CSF in the treatment group and placebo in the control group.RESULTSAmong 60 participants, 28 patients (93.3%) in the G-CSF group and 26 patients (86.6%) in the placebo group completed the study protocol. After 6 months of follow-up, the AIS grade remained unchanged in the placebo group, while in the G-CSF group 5 patients (45.5%) improved from AIS grade B to C, 5 (45.5%) improved from AIS grade C to grade D, and 1 patient (16.7%) improved from AIS grade D to E. The mean ± SEM change in ISNCSCI motor score in the G-CSF group was 14.9 ± 2.6 points, which was significantly greater than in the placebo group (1.4 ± 0.34 points, p < 0.001). The mean ± SEM light-touch and pinprick sensory scores improved by 8.8 ± 1.9 and 10.7 ± 2.6 points in the G-CSF group, while those in the placebo group improved by 2.5 ± 0.60 and 1.2 ± 0.40 points, (p = 0.005 and 0.002, respectively). Evaluation of functional improvement according to the IANR-SCIFRS instrument revealed significantly more functional improvement in the G-CSF group (10.3 ± 1.3 points than in the placebo group (3.0 ± 0.81 points; p < 0.001). A significant difference was also observed between the 2 groups as measured by the SCIM-III instrument (29.6 ± 4.1 vs 10.3 ± 2.2, p < 0.001).CONCLUSIONSIncomplete subacute TSCI is associated with significant motor, sensory, and functional improvement after administration of G-CSF.Clinical trial registration no.: IRCT201407177441N3 (www.irct.ir)

scholarly journals Meaning of Staring and the Starer–Staree Relationship Related to Men Living With Acquired Spinal Cord Injuries

2016 ◽  
Vol 12 (2) ◽  
pp. 283-291 ◽  
Author(s):  
Rebecca Renwick ◽  
Karen Yoshida ◽  
Elizabeth Eacrett ◽  
Natalie Rose
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injuries ◽  
Secondary Analysis ◽  
Community Dwelling ◽  
Negative Consequences ◽  
Public Places ◽  
The Public ◽  
Adult Men ◽  
Cord Injury

When in public places, many individuals with physical disabilities experience staring. Although staring is typically seen as uncomplicated and something to be “ignored,” it has consequences for the person being stared and the staree. Few studies have focused on staring experienced by men following spinal cord injury (SCI). Accordingly, this study explored how adult men with SCI give meaning to the staring from others, the consequences for them, and their responses to the staring and to the starer. Principles of modified grounded theory methods were used to conduct a secondary analysis of interview data for 30 male participants from a larger study of community-dwelling individuals with SCI. Themes revealed through analysis related to context-dependent meanings of staring, negative consequences of staring for some men, and positive opportunities for self-growth and interaction with the public. These findings contribute to a more complex understanding of staring and the relationship between the starer and staree in various social circumstances which can support people living with differences in their public interactions, and improve their quality of life.

scholarly journals The no-care of patients with spinal cord injuries in primary care: bioethical challenges for health policies

2012 ◽  
Vol 65 (2) ◽  
pp. 236-243
Author(s):  
Inácia Sátiro Xavier de França ◽  
Rosilene Santos Baptista ◽  
Fatima Maria da Silva Abrão ◽  
Alexsandro Silva Coura ◽  
Eurípedes Gil de França ◽  
...  
Keyword(s):  
Primary Care ◽  
Spinal Cord ◽  
Spinal Cord Injuries ◽  
Descriptive Study ◽  
Health Policies ◽  
Structured Interviews ◽  
Cord Injury ◽  
The Family ◽  
Basic Health Units ◽  
Analyze Data

It was aimed to investigate what actions taken in Basic Health Units of the Family-(BHUF) to meet the demands of adults with spinal cord injury (SCI) post-rehabilitation, list facilities/difficulties to meet the demands of users. Descriptive study conducted in twenty BHUF. Twenty doctors and twenty nurses, randomly selected, participated in the study. To collect and analyze data, it was used semi-structured interviews and analysis of content. The categories were based on the integrality, universality, charity and justice principles. It was found: professional disqualification to assist people with SCI, fragmented care, difficult to schedule consultations and examinations, difficulties in the reference and counter reference system, and lack of ongoing actions to take care of individuals with SCI. The BHUF not ensure the protection of all citizens, there are challenges to the construction practices of health solidarity, warm and consequently more effective and decisive for individuals with SCI.

scholarly journals The views of patients with spinal cord injuries on their rehabilitation experience

2007 ◽  
Vol 63 (3) ◽  
Author(s):  
D. J. Mothabeng ◽  
C. P. Malinga ◽  
C. Van der Merwe ◽  
P. T. Qhomane ◽  
S. N. Motjotji
Keyword(s):  
Spinal Cord ◽  
Family Involvement ◽  
Spinal Cord Injuries ◽  
Structured Interviews ◽  
Rehabilitation Outcomes ◽  
Rehabilitation Programs ◽  
Cord Injury ◽  
Emotional Issues ◽  
Rehabilitation Personnel ◽  
Patients Experience

Background and Purpose: Spinal rehabilitation programs seek toenhance the residual functional abilities of people who have an acquired disabling impairment because of SCI. Very little has been published on how patients experience rehabilitation, and what the implication of their experience is on rehabilitation outcomes. The aim of this pilot study was to explore the views of patients with SCI regarding their experience of rehabilitation while in hospital.Materials and Methods: A qualitative exploratory study using semi-structured interviews was employed. Twelve patients constituted the sample of convenience. Qualitative techniques were used to analyze the data.Results: The study revealed a variety of psycho-emotional issues related to the patients’ experience of rehabilitation. Positive issues included being treated humanly, being told the truth abouttheir condition early on, family involvement in rehabilitation and being allowed to contribute to decision making regarding their rehabilitation. Negative issues were mainly their lack of insight into their health condition.Conclusion: The study highlighted important psycho-emotional issues related to the patients’ experience of rehabilitation. Rehabilitation personnel must consider these issues when working with patients with spinal cord injury, to ensure effective rehabilitation outcomes.

Pulmonary Complications of Acute Spinal Cord Injuries

Neurosurgery ◽  
1987 ◽  
Vol 21 (2) ◽  
pp. 193-196 ◽  
Author(s):  
David H. Reines ◽  
Robert C. Harris
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Forced Vital Capacity ◽  
Vital Capacity ◽  
Spinal Cord Injuries ◽  
Pulmonary Complications ◽  
Neurological Deficits ◽  
Respiratory Problems ◽  
Cord Injury ◽  
The Mean

Abstract The records of 123 consecutive patients admitted with spinal cord injury were examined for the presence of pulmonary complications. Forty-nine had tetraplegia and 23 had paraplegia; the remainder suffered a variety of neurological deficits. Multiple injuries were encountered in 36 patients. Fifty-three pulmonary complications were noted in 44 (35.7%) patients. The most common problems were atelectasis and pneumonia. There were 22 (18%) deaths. Fourteen deaths were related to pulmonary complications. The mean age of patients who died was 52 ± 13 (SE) compared to 28 ± 12 for survivors. A mean forced vital capacity (FVC) of 1127 ± 410 cc in patients suffering respiratory difficulties compared to a FVC of 1865 ± 85 cc in patients without complications (P &lt; 0.001). Oxygenation (PaO2 90 ± 19 torr) was normal in patients without respiratory problems and was abnormal in patients developing problems (PaO2 76 ± 30 torr; P &lt; 0.05). Twenty patients were treated with a rotating bed. The complication rate of patients on the bed was only 10%. In conclusion, respiratory problems remain a significant cause of morbidity and mortality in spinal cord injury. The forced vital capacity, blood oxygen tension, and age are predictors of pulmonary complications. The use of a multidisciplinary approach and a rotating bed may minimize these problems.

scholarly journals Demographic pattern, clinical profile and outcome of traumatic spinal cord injuries at a tertiary care hospital

2015 ◽  
Vol 29 (3) ◽  
pp. 317-322 ◽  
Author(s):  
K. Aswani Kumar ◽  
B.V. Subrahmanyam ◽  
S.V. Phanidra ◽  
S. Satish Kumar ◽  
P.N. Harish ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Hospital Stay ◽  
Spinal Cord Injuries ◽  
Traumatic Spinal Cord Injury ◽  
Lumbar Region ◽  
Care Hospital ◽  
Cord Injury ◽  
The Mean ◽  
Epidemiological Characteristics

Abstract Background: Traumatic spinal cord injury (SCI) is recognized as a serious public health problem resulting in significant morbidity, mortality and permanent disability. The present study is aimed to describe the epidemiological characteristics and outcome of patients with traumatic spinal cord injury in rural tertiary referral care center form South India. Material and methods: The present study was conducted at Narayana Medical College and Hospital, Nellore. All patients admitted and managed for traumatic spinal cord injury were retrieved and data collected in a pre-designed proforma. Patient characteristics, details of etiology, mechanism of injury, level of injury, extent of neurological deficits, details of investigations, details of management and immediate outcome were recorded. Results: A total 152 patients were included in the present study. The mean age was 38.45 years and majority the patients were young adult males. The mean hospital stay was 19.12 days. 71.7% percent patients were non-agriculture workers (mainly involved in construction work) and 28.3% patients were farmers. 61.2% of the patients sustained injuries due to fall from height and 34.2% patients sustained injuries due road traffic accidents. Cervical spine injuries were most common (44.1%), followed by thoraco-lumbar region (36.8%) and dorsal spinal region (19.1%). 9 patients expired in post-injury during hospital stay and all of them had complete cervical spinal cord injury. All patients received aggressive rehabilitation care. Conclusion: In accordance with the literature our results reflect that traumatic spinal cord injuries affect young population and can leave these persons with significant functional and physical morbidity. The major limitation of the study is that it is a single institution based and may not reflect the true spectrum of traumatic spinal cord injuries in the population.

scholarly journals Novel instrumented frame for standing exercising of users with complete spinal cord injuries

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Ioannis D. Zoulias ◽  
Monica Armengol ◽  
Adrian Poulton ◽  
Brian Andrews ◽  
Robin Gibbons ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Body Weight ◽  
Spinal Cord Injuries ◽  
Weight Bearing ◽  
Ground Reaction Forces ◽  
Mineral Density ◽  
Positive Effects ◽  
Wide Range ◽  
Cord Injury ◽  
Reaction Forces

Abstract This paper describes a Functional Electrical Stimulation (FES) standing system for rehabilitation of bone mineral density (BMD) in people with Spinal Cord Injury (SCI). BMD recovery offers an increased quality of life for people with SCI by reducing their risk of fractures. The standing system developed comprises an instrumented frame equipped with force plates and load cells, a motion capture system, and a purpose built 16-channel FES unit. This system can simultaneously record and process a wide range of biomechanical data to produce muscle stimulation which enables users with SCI to safely stand and exercise. An exergame provides visual feedback to the user to assist with upper-body posture control during exercising. To validate the system an alternate weight-shift exercise was used; 3 participants with complete SCI exercised in the system for 1 hour twice-weekly for 6 months. We observed ground reaction forces over 70% of the full body-weight distributed to the supporting leg at each exercising cycle. Exercise performance improved for each participant by an increase of 13.88 percentage points of body-weight in the loading of the supporting leg during the six-month period. Importantly, the observed ground reaction forces are of higher magnitude than other studies which reported positive effects on BMD. This novel instrumentation aims to investigate weight bearing standing therapies aimed at determining the biomechanics of lower limb joint force actions and postural kinematics.

scholarly journals Comparing Activity and Participation between Acquired Brain Injury and Spinal-Cord Injury in Community-Dwelling People with Severe Disability Using WHODAS 2.0

2020 ◽  
Vol 17 (9) ◽  
pp. 3031 ◽  
Author(s):  
Seo Yeon Yoon ◽  
Ja-Ho Leigh ◽  
Jieun Lee ◽  
Wan Ho Kim
Keyword(s):  
Risk Factors ◽  
Spinal Cord ◽  
Brain Injuries ◽  
Spinal Cord Injuries ◽  
Community Dwelling ◽  
Severe Disability ◽  
World Health ◽  
Cross Sectional ◽  
Whodas 2.0 ◽  
Cord Injury

Central-nervous-system (CNS) injuries constitute a significant cause of morbidity (often resulting in long-term disability) and mortality. This cross-sectional study compared the activity and participation of community-dwelling people with severe disability from acquired brain injuries (ABI) (n = 322) and spinal-cord injuries (SCI) (n = 183) to identify risk factors related to disability. Data were collected through a questionnaire survey of community-dwelling people with severe disability attending 65 healthcare centers. The survey included the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) and sociodemographic factors. We categorized a registered grade of disability of 1 or 2 as severe disability. WHODAS 2.0 domain and summary scores were compared between the ABI and SCI groups, and risk factors associated with disability were identified through regression analysis. ABI participants had significantly higher disability in cognition and relationships, whereas patients with SCI had higher disability in mobility (p < 0.05). Onset duration was negatively correlated with cognition, relationships, participation, and summary scores in ABI participants (p < 0.05). Neither group’s socioeconomic factors were associated with WHODA 2.0 scores. Understanding the different patterns of disability between SCI and ABI in community-dwelling people with severe disability helps establish future plans for the management of health resources.

scholarly journals Cough Threshold in People With Spinal Cord Injuries

1999 ◽  
Vol 79 (11) ◽  
pp. 1026-1031 ◽  
Author(s):  
Kwan-Hwa Lin ◽  
Yih-Loong Lai ◽  
Huey-Dong Wu ◽  
Tyng-Quey Wang ◽  
Yen-Ho Wang
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Citric Acid ◽  
Spinal Cord Injuries ◽  
Acoustic Response ◽  
Sensitivity Training ◽  
Cord Injury ◽  
The Mean

Abstract Background and Purpose. The purpose of this study was to compare the cough threshold between people with and without spinal cord injury (SCI). The effect of smoking on cough threshold was also investigated. Subjects. The participants were 26 people with SCI (15 smokers, 11 nonsmokers) and 18 people without SCI (9 smokers, 9 nonsmokers). Methods. Aerosols of citric acid were delivered with incremental doubling concentration from 62.5 mmol to 2 mol. Cough threshold was defined as the first concentration of citric acid that induced at least 2 coughs, which is associated with large chest excursion and concurrently acoustic response. Results. The mean cough thresholds of smokers and nonsmokers with SCI (209 and 417 mmol, respectively) were lower than those of smokers and nonsmokers without SCI (467 and 1,072 mmol, respectively). The mean citric acid cough thresholds decreased in smokers with and without SCI when compared with nonsmokers with and without SCI. Conclusion and Discussion. The cough sensitivity increased in subjects with SCI, and smoking could also increase the cough sensitivity. Training about the frequency and technique of cough in patients with SCI should be carefully monitored.

scholarly journals Health Professionals’ Experience of Barriers in Empowering People with Spinal Cord Injury: a Qualitative Inquiry

2019 ◽  
Vol 8 (3) ◽  
pp. 143-148
Author(s):  
Maryam Shabany ◽  
Alireza Nikbakht Nasrabadi ◽  
Nooredin Mohammadi ◽  
Keyvan Davatgaran ◽  
MirSaeed Yekaninejad
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Health Professionals ◽  
Spinal Cord Injuries ◽  
Healthcare Services ◽  
Qualitative Inquiry ◽  
Structured Interviews ◽  
National Network ◽  
Cultural Aspects ◽  
Cord Injury

Introduction: Empowering an individual with spinal cord injury as far as possible is an experience with various social and cultural aspects. This study investigated health professionals' experiences of barriers in empowering individuals with spinal cord injuries. Methods: This was a qualitative inquiry with a conventional content analysis approach. A number of 11 healthcare professionals who were members of Iran Spinal Cord Injuries Research National Network or had been working in a related research center for at least three years participated in the study. A purposive sampling method was applied until reaching data saturation. The data were collected by semi-structured interviews. The collected data were managed with MAXQDA software version 10. Results: Three main themes as barriers in empowering people with spinal cord injury emerged: 1) Lack of patient-and-family-centered education, 2) Failure in providing sufficient healthcare services and 3) Inappropriate setting for using rehabilitation services. Conclusion: These finding can help policymakers to provide better social facilities and more support services for people with spinal cord injuries and their families. Further research is needed to investigate barriers to empowerment from the perspective of individuals with SCI and their families.

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