Results of a Community-Based Peer Mentor Program for Spinal-Cord Injury: A Pilot Trial

OBJECTIVE: This study identified opportunities for occupational therapists serving those with a spinal cord injury needing community based dental care. METHODS: Dental professionals answered survey questions on attitudes toward treating clients with a spinal cord injury, knowledge of transfer skills, occupational therapy as a community resource, and dental clinic physical design. The data collected for this pilot study were analyzed using descriptive statistics. RESULTS: The participants revealed hesitation toward treating these clients, some knowledge of occupational therapy as a community referral source, limited knowledge for transfer skills, and questionable clinic designs for meeting accessibility guidelines. CONCLUSIONS: Findings from this pilot study should spark interest in more similar study’s and expand sample size. Based upon the initial findings, it would seem occupational therapists should search for appropriate dental offices in which to refer clients with a spinal cord injury. In addition, occupational therapists could serve as consultants to local dental clinics ensuring adequate quality of care for a variety of disabilities. Ultimately, the profession is uniquely positioned to educate clients and providers promoting utilization of community oral health care services.

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Immunomodulation for primary prevention of urinary tract infections in patients with spinal cord injury during primary rehabilitation: protocol for a randomized placebo-controlled pilot trial (UROVAXOM-pilot)

Trials ◽

10.1186/s13063-021-05630-w ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Jörg Krebs ◽

Jivko Stoyanov ◽

Jens Wöllner ◽

Ezra Valido ◽

Jürgen Pannek

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Urinary Tract ◽

Urinary Tract Infections ◽

Pilot Trial ◽

Lower Urinary Tract Dysfunction ◽

E Coli ◽

Link Type ◽

Cord Injury ◽

Tract Infections

Abstract Background Urinary tract infections (UTIs) are common in individuals with neurogenic lower urinary tract dysfunction (NLUTD) following spinal cord injury (SCI). They are not only a great burden for affected individuals, but also cause considerable health costs. Furthermore, recurrent antibiotic treatments of UTIs contribute to the growing problem of bacterial resistance to antimicrobial compounds. Even though there is a multitude of different measures to prevent UTIs in individuals with NLUTD, no clear evidence exists for any of these. Oral immunomodulation with UTI-relevant Escherichia coli lysate may be a promising preventative measure with a good safety profile in individuals with NLUTD. However, currently available data are sparse. Methods This is a randomized, quasi-blinded, placebo-controlled, mono-centric pilot trial investigating the feasibility of a main trial regarding the effects of a lyophilized lysate of E. coli strains for oral application (Uro-Vaxom®, OM Pharma SA, Meyrin, Switzerland). There will be two parallel groups of 12 participants each. Individuals with acute SCI (duration SCI ≤ 56 days) from 18 to 70 years of age admitted for primary rehabilitation will be eligible. Blood and urine samples will be taken prior to intervention start, at the end of the intervention, and 3 months after intervention termination. The trial intervention will last 90 days. The participants will not be informed regarding the treatment allocation (quasi-blinded). The nursing staff will prepare the daily dose of the allocated treatment from the original packaging. The trial personnel and the biostatistician will be blinded. Feasibility (e.g., recruitment rate, patient attrition), clinical (e.g., number of symptomatic UTIs), and laboratory parameters (e.g., urinary culture, urinary proteo- and microbiome, blood cell counts) as well as adverse events will be collected. Discussion Effective and efficient measures for the prevention of UTIs in individuals with NLUTD are urgently needed. If the conclusion of this pilot is positive regarding feasibility, the effects of oral immunomodulation with a E. coli lysate will be investigated in a larger, sufficiently powered, multi-center trial. Trial registration ClinicalTrials.govNCT04049994. Registered on 8 August 2019

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