scholarly journals Medical Treatment in Spinal Cord Injury

2021 ◽  
Author(s):  
Halil Can ◽  
Eyüp Cab Savrunlu ◽  
Serdar Kabataş
Keyword(s):  
Spinal Cord ◽  
Large Scale ◽  
Spinal Cord Injuries ◽  
Controlled Clinical Trials ◽  
Pharmacological Agents ◽  
Randomized Controlled Clinical Trials ◽  
Randomized Controlled ◽  
Secondary Damage ◽  
Cord Injury ◽  
Neurological Progression

Spinal cord injuries cause psychological in humans and require expensive care and treatments. In recent years, various pharmacological agents have been tested in acute spinal cord injuries. Prospective randomized controlled clinical trials on a large scale have failed to demonstrate significant neurological progression, in contrast to their success in the laboratory. The search for an effective neuroprotective pharmacological agent to prevent secondary damage in acute spinal cord injuries remains primary goals for basic sciences and clinicians.

scholarly journals Methylprednisolone therapy in acute spinal cord injuries

2021 ◽  
Vol 2 (4) ◽  
pp. 409-415
Author(s):  
Slaviša Zagorac
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injuries ◽  
Paper Analysis ◽  
Late Complications ◽  
Current Understanding ◽  
Neurological Deficits ◽  
Term Therapy ◽  
Pharmacological Agents ◽  
Therapeutic Benefits ◽  
Cord Injury

Spinal cord injuries represent a major challenge in terms of current concepts of treatment. This condition is frequently associated with long term therapy in addition to a greater incidence of early and late complications. The goal of treatment is to alleviate pressure on the spinal cord caused by hematomas or bone fragments, in the shortest time possible. Hence, surgical decompression of the spinal cord is the first line of treatment, in cases where this approach is indicated. Apart from invasive methods, treatment also consists of the use of various pharmacological agents, whose therapeutic goal is to decrease edema and inflammation, especially in the first several days following injury. One of the most commonly administered drugs in such cases is methylprednisolone, however, controversy with regards to the timing of its administration and proper dosing, still exists. This drug has been in use for decades in the treatment of spinal cord injuries with various protocols having been introduced and revised overtime. The aim of this article is to showcase the current understanding of the use of corticosteroids in acute spinal cord injuries. The most significant protocols in use today for the administration of methylprednisolone (National Acute Spinal Cord Injury Studies-NASCIS I, II and III), along with a brief overview of pertinent literature, are discussed in this paper. Analysis of the available data suggests that the use of methylprednisolone in spinal cord injuries is still highly controversial due to the inconclusive relationship between the therapeutic benefits and the risk of side effects. The current understanding is that the use of the drug is justified in the first eight hours following injury, especially in cases involving incomplete neurological deficits, more specifically quadriparesis and paraparesis.

Impairment Rating and Spinal Cord Injuries: Revisiting the Guides

2010 ◽  
Vol 15 (3) ◽  
pp. 1-7
Author(s):  
Richard T. Katz
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injuries ◽  
Functional Independence ◽  
Outcome Data ◽  
Multiple Organ ◽  
Loss Of Function ◽  
Sixth Edition ◽  
Organ Systems ◽  
Cord Injury ◽  
Impairment Ratings

Abstract This article addresses some criticisms of the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides) by comparing previously published outcome data from a group of complete spinal cord injury (SCI) persons with impairment ratings for a corresponding level of injury calculated using the AMA Guides, Sixth Edition. Results of the comparison show that impairment ratings using the sixth edition scale poorly with the level of impairments of activities of daily living (ADL) in SCI patients as assessed by the Functional Independence Measure (FIM) motor scale and the extended FIM motor scale. Because of the combinations of multiple impairments, the AMA Guides potentially overrates the impairment of paraplegics compared with that of quadriplegics. The use and applicability of the Combined Values formula should be further investigated, and complete loss of function of two upper extremities seems consistent with levels of quadriplegia using the SCI model. Some aspects of the AMA Guides contain inconsistencies. The concept of diminishing impairment values is not easily translated between specific losses of function per organ system and “overall” loss of ADLs involving multiple organ systems, and the notion of “catastrophic thresholds” involving multiple organ systems may support the understanding that variations in rating may exist in higher rating cases such as those that involve an SCI.

scholarly journals Dietary Supplementation for Para-Athletes: A Systematic Review

Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 2016
Author(s):  
Keely A. Shaw ◽  
Gordon A. Zello ◽  
Brian Bandy ◽  
Jongbum Ko ◽  
Leandy Bertrand ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Dietary Supplements ◽  
Sports Medicine ◽  
Spinal Cord Injuries ◽  
Sport Performance ◽  
Future Research ◽  
Inclusion Criteria ◽  
Supplement Use ◽  
Sport Supplements ◽  
Cord Injury

The use of dietary supplements is high among athletes and non-athletes alike, as well as able-bodied individuals and those with impairments. However, evidence is lacking in the use of dietary supplements for sport performance in a para-athlete population (e.g., those training for the Paralympics or similar competition). Our objective was to examine the literature regarding evidence for various sport supplements in a para-athlete population. A comprehensive literature search was conducted using PubMed, SPORTDiscus, MedLine, and Rehabilitation and Sports Medicine Source. Fifteen studies met our inclusion criteria and were included in our review. Seven varieties of supplements were investigated in the studies reviewed, including caffeine, creatine, buffering agents, fish oil, leucine, and vitamin D. The evidence for each of these supplements remains inconclusive, with varying results between studies. Limitations of research in this area include the heterogeneity of the subjects within the population regarding functionality and impairment. Very few studies included individuals with impairments other than spinal cord injury. Overall, more research is needed to strengthen the evidence for or against supplement use in para-athletes. Future research is also recommended on performance in para-athlete populations with classifiable impairments other than spinal cord injuries.

scholarly journals Housing adaptations and housing accessibility problems among older adults with long-standing spinal cord injury

2020 ◽  
pp. 030802262097951
Author(s):  
Lizette Norin ◽  
Björn Slaug ◽  
Maria Haak ◽  
Susanne Iwarsson
Keyword(s):  
Older Adults ◽  
Spinal Cord ◽  
Spinal Cord Injuries ◽  
Occupational Performance ◽  
Environmental Barriers ◽  
Cord Injury ◽  
Long Term Follow Up ◽  
Societal Level ◽  
The Individual

Introduction Adults with spinal cord injuries are living longer than previously, and a majority are living in ordinary housing in the community. Housing accessibility is important for maintaining independent occupational performance for this population, but knowledge in this area is insufficient. We investigated housing adaptations and current accessibility problems among older adults with long-standing (>10 years) spinal cord injuries. Method Data from home visits among 122 older adults with spinal cord injuries in Sweden were used. Housing adaptations and environmental barriers were descriptively analysed. Findings Kitchens, entrances, and hygiene areas were common locations for housing adaptations and environmental barriers that generated accessibility problems. The most common adaptations were ramps, wheelchair-accessible stovetops, and ceiling-lifts. Wall-mounted cupboards and high shelves (kitchen), inaccessible storage areas (outside the dwelling), and a lack of grab bars (hygiene area) generated the most accessibility problems. Conclusion Despite housing adaptations, there are considerable accessibility problems in the dwellings of older adults with long-standing spinal cord injuries in Sweden, indicating that long-term follow-up of the housing situation of this population is necessary. Focusing on accessible housing as a prerequisite for occupational performance is at the core of occupational therapy, deserving attention on the individual as well as the societal level.

scholarly journals Exoskeletons, Rehabilitation and Bodily Capacities

2021 ◽  
pp. 1357034X2110256
Author(s):  
Denisa Butnaru
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Crucial Role ◽  
Spinal Cord Injuries ◽  
Main Task ◽  
Cerebrovascular Accidents ◽  
Complex Processes ◽  
Cord Injury ◽  
Neurological Conditions

Motility impairments resulting from spinal cord injuries and cerebrovascular accidents are increasingly prevalent in society, leading to the growing development of rehabilitative robotic technologies, among them exoskeletons. This article outlines how bodies with neurological conditions such as spinal cord injury and stroke engage in processes of re-appropriation while using exoskeletons and some of the challenges they face. The main task of exoskeletons in rehabilitative environments is either to rehabilitate or ameliorate anatomic functions of impaired bodies. In these complex processes, they also play a crucial role in recasting specific corporeal phenomenologies. For the accomplishment of these forms of corporeal re-appropriation, the role of experts is crucial. This article explores how categories such as bodily resistance, techno-inter-corporeal co-production of bodies and machines, as well as body work mark the landscape of these contemporary forms of impaired corporeality. While defending corporeal extension rather than incorporation, I argue against the figure of the ‘cyborg’ and posit the idea of ‘residual subjectivity’.

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