| 1. |
- Bach Baunsgaard, Carsten, et al.
(författare)
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Gait training after spinal cord injury: safety, feasibility and gait function following 8 weeks of training with the exoskeletons from Ekso Bionics.
- 2018
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Ingår i: Spinal cord. - : Springer Science and Business Media LLC. - 1476-5624 .- 1362-4393. ; 56, s. 106-116
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Tidskriftsartikel (refereegranskat)abstract
- Prospective quasi-experimental study, pre- and post-design.Assess safety, feasibility, training characteristics and changes in gait function for persons with spinal cord injury (SCI) using the robotic exoskeletons from Ekso Bionics.Nine European rehabilitation centres.Robotic exoskeleton gait training, three times weekly over 8 weeks. Time upright, time walking and steps in the device (training characteristics) were recorded longitudinally. Gait and neurological function were measured by 10 Metre Walk Test (10 MWT), Timed Up and Go (TUG), Berg Balance Scale (BBS), Walking Index for Spinal Cord Injury (WISCI) II and Lower Extremity Motor Score (LEMS).Fifty-two participants completed the training protocol. Median age: 35.8 years (IQR 27.5-52.5), men/women: N=36/16, neurological level of injury: C1-L2 and severity: AIS A-D (American Spinal Injury Association Impairment Scale). Time since injury (TSI)<1 year, N=25;>1 year, N=27. No serious adverse events occurred. Three participants dropped out following ankle swelling (overuse injury). Four participants sustained a Category II pressure ulcer at contact points with the device but completed the study and skin normalized. Training characteristics increased significantly for all subgroups. The number of participants with TSI<1 year and gait function increased from 20 to 56% (P=0.004) and 10MWT, TUG, BBS and LEMS results improved (P<0.05). The number of participants with TSI>1 year and gait function, increased from 41 to 44% and TUG and BBS results improved (P<0.05).Exoskeleton training was generally safe and feasible in a heterogeneous sample of persons with SCI. Results indicate potential benefits on gait function and balance.
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| 2. |
- Bersch, Ines, et al.
(författare)
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Electrical stimulation-a mapping system for hand dysfunction in tetraplegia
- 2018
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Ingår i: Spinal Cord. - : Springer Science and Business Media LLC. - 1362-4393 .- 1476-5624. ; 56:5, s. 516-522
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Tidskriftsartikel (refereegranskat)abstract
- Study design Retrospective data analysis Objectives To define the distribution of the motor points and excitability of the key wrist and finger actuators in order to detect upper (UMN) and lower motor neuron (LMN) lesions potentially influencing the development of a tenodesis grasp. Setting A rehabilitation centre for spinal cord injuries, Nottwil, Switzerland. Methods Forearm muscles of 32 patients with tetraplegia (AIS A-D) were tested bilaterally with electrical stimulation (ES) to differentiate whether UMN or LMN was present. For testing, a standardised mapping was developed. All patients underwent the same positioning schedule. Results Sixteen hands developed a tenodesis grasps, 24 hands showed neither shortening nor tightening of the finger flexors. Two patients developed unilateral tenodesis grasp and showed no tightening of the finger flexors on the contralateral hand. Seven patients developed tenodesis grasps symmetrically and bilaterally, whereas one maintained an essentially open hand without tightening of the finger flexors. All hands that developed a tenodesis grasp showed a LMN lesion of the M. extensor digitorum communis (EDC). The frequency of the tenodesis grasp differed significantly between the groups with and without intact reflex arc (p < 0.0001). Conclusion Surface ES may serve as a diagnostic tool to detect an UMN or LMN lesion of the key actuator muscles affecting the tenodesis grasp. These findings provide information that is essential for the choice of treatment to optimise function of the tetraplegic hand.
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| 3. |
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| 4. |
- Bjerkefors, Anna, et al.
(författare)
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Diagnostic accuracy of common clinical tests for assessing abdominal muscle function after motor-complete spinal cord injury above T6.
- 2015
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Ingår i: Spinal Cord. - : Springer Science and Business Media LLC. - 1362-4393 .- 1476-5624. ; 53, s. 114-119
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Tidskriftsartikel (refereegranskat)abstract
- Study design:Diagnostic study.Objectives:The objective of this study was to compare patterns of electromyography (EMG) recordings of abdominal muscle function in persons with motor-complete spinal cord injury (SCI) above T6 and in able-bodied controls, and to determine whether manual examination or ultrasound measures of muscle activation can be accurate alternatives to EMG.Setting:Research center focused on SCI and University laboratory, Vancouver, Canada.Methods:Thirteen people with SCI (11 with American Spinal Injury Association Impairment Scale (AIS) A and 2 AIS B; C4-T5), and 13 matched able-bodied participants volunteered for the study. Participants completed trunk tasks during manual examination of the abdominal muscles and then performed maximal voluntary isometric contractions, while EMG activity and muscle thickness changes were recorded. The frequency of muscle responses detected by manual examination and ultrasound were compared with detection by EMG (sensitivity and specificity).Results:All individuals with SCI were able to elicit EMG activity above resting levels in at least one abdominal muscle during one task. In general, the activation pattern was task specific, confirming voluntary control of the muscles. Ultrasound, when compared with EMG, showed low sensitivity but was highly specific in its ability to detect preserved abdominal muscle function in persons with SCI. Conversely, manual examination was more sensitive than ultrasound but showed lower specificity.Conclusion:The results from this study confirm preserved voluntary abdominal muscle function in individuals classified with motor-complete SCI above T6 and highlight the need for further research in developing more accurate clinical measures to diagnose the level of trunk muscle preservation in individuals with SCI.Spinal Cord advance online publication, 25 November 2014; doi:10.1038/sc.2014.202.
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| 5. |
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| 6. |
- Bunketorp Käll, Lina, 1975, et al.
(författare)
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Essential gains and health after upper-limb tetraplegia surgery identified by the International classification of functioning, disability and health (ICF)
- 2017
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Ingår i: Spinal Cord. - : Springer Science and Business Media LLC. - 1362-4393 .- 1476-5624. ; 55:9, s. 857-863
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Tidskriftsartikel (refereegranskat)abstract
- Study Design: A questionnaire-based survey. Objectives: To describe functional gains and health following upper-limb tetraplegia surgery using the International Classification of Functioning, Disability and Health (ICF) as a reference and to explore interconnections across different dimensions of functioning and health. Setting: A specialized center for advanced reconstruction of extremities at Sahlgrenska University Hospital, Gothenburg, Sweden. Methods: Fifty-seven individuals who participated in a satisfaction survey were included in the present study. Besides questions concerned with the respondents' satisfaction with different aspects of surgery, the measures included perceived overall health status (EQ-VAS) and achieved grip strength. Univariate analyses were used to explore interconnections between measures. Results: The gains could be subcategorized and linked to the ICF domains 'mobility', 'self-care', 'communication', 'domestic life', and 'community, social and civic life', with 'handling objects' and 'maneuvering a wheelchair' as the most frequently reported gains. The mean EQ-VAS score was 67 +/- 22. No significant correlation was shown between grip strength and activity gains, nor between grip strength and perceived overall health. The degree of satisfaction was, however, associated with self-reported overall health among participants. Conclusion: The functional gains achieved after tetraplegia surgery could be applied to the ICF constructs' body functions/structures and activity with possible implications on participation. The overall health perception was relatively high and could be linked to the degree of satisfaction among participants. Muscle strength is not necessarily transferable to activity performance. This emphasizes the importance of addressing factors other than strength in the post-surgical rehabilitation and assessments.
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| 7. |
- Bunketorp Käll, Lina, 1975, et al.
(författare)
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Satisfaction with upper limb reconstructive surgery in individuals with tetraplegia: the development and reliability of a Swedish self-reported satisfaction questionnaire.
- 2017
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Ingår i: Spinal cord. - : Springer Science and Business Media LLC. - 1476-5624 .- 1362-4393. ; 55, s. 664-671
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Tidskriftsartikel (refereegranskat)abstract
- A questionnaire-based survey.To assess satisfaction after upper limb reconstructive surgery in individuals with tetraplegia and to determine the reliability of a Swedish satisfaction questionnaire.A center for advanced reconstruction of extremities, Gothenburg, Sweden.Seventy-eight individuals with tetraplegia were invited to participate in the survey assessing satisfaction with the result of surgery across various domains. Measures of reliability included stability and internal consistency of domains consisting questions regarding global satisfaction, activities and occupation/schooling.Fifty-eight individuals (76%) participated, among whom 47 (82%) completed the questionnaire twice for repeatability assessment. The responses in the domains relating to global satisfaction, activities and occupation/schooling were positive in 83%, 72% and 31% of participants, respectively. Ninety-five percent felt they had benefited from the surgery, and 86% felt that the surgery had made a positive impact on their life. The psychometric testing indicated that the questionnaire yields scores that are reliable by both test-retest and internal consistency, with the exception of the domain occupation/schooling that had a high prevalence of missing and neutral responses and seemingly represents separate and distinct entities.Surgical rehabilitation of the upper limb in tetraplegia is highly beneficial and rewarding from a patient perspective, leading to satisfactory gains in activities of daily living as well as enhanced quality of life. The questionnaire is a reliable instrument for measuring satisfaction after surgery. However, occupationally and educationally related aspects of the surgical outcome should constitute separate domains, and further modifications of the questionnaire are thus recommended.Spinal Cord advance online publication, 21 February 2017; doi:10.1038/sc.2017.12.
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| 8. |
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| 9. |
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| 10. |
- Divanoglou, Anestis, et al.
(författare)
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Active Rehabilitation for persons with spinal cord injury in Botswana – effects of a community peer-based programme
- 2019
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Ingår i: Spinal Cord. - : Springer Science and Business Media LLC. - 1362-4393 .- 1476-5624.
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Tidskriftsartikel (refereegranskat)abstract
- Study design:: Prospective cohort study with a repeated measures analysis. Objectives:: To measure the effects of the Active Rehabilitation (AR) training programme for community-dwelling individuals with spinal cord injury (SCI) in Botswana on physical independence, wheelchair mobility, self-efficacy, life satisfaction, level of physical activity and community participation. Setting:: The inaugural AR training programme in Botswana, a community peer-based programme for people with SCI. The 10-day residential programme in Botswana was led by an international team of peer mentors and health professionals. Methods:: Participants with SCI (on average 4 years after injury) completed a survey comprising a battery of standardised outcome measures at three timepoints: at the start, on completion and at 5 months after the programme (n = 14). Participants also completed a practical wheelchair skills test at start and completion of the programme (n = 17). Results:: Participants improved in the mobility subscale of the Spinal Cord Independence Measure Self Report on completion (p = 0.011, d = 0.85) and at 5-month follow-up (p = 0.005, d = 0.93) as compared to baseline. They also achieved moderate improvement in self-efficacy to manage their condition (physical function domain of Moorong Self-Efficacy Scale) and large improvements in wheelchair mobility as assessed through the Queensland Evaluation of Wheelchair Skills test and the Wheelchair Skills Test Questionnaire. All positive results were retained at 5-month follow-up. Conclusions:: Findings indicate that the peer-based programme AR can play an important role in promoting physical independence, wheelchair mobility and injury-management self-efficacy in community-dwelling individuals with SCI in Botswana.
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| 11. |
- Divanoglou, Anestis, et al.
(författare)
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Perceived effectiveness and mechanisms of community peer-based programmes for Spinal Cord Injuries- a systematic review of qualitative findings
- 2017
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Ingår i: Spinal Cord. - : Springer Science and Business Media LLC. - 1362-4393 .- 1476-5624. ; 55:3, s. 225-234
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Forskningsöversikt (refereegranskat)abstract
- Study design: Systematic review and meta-synthesis of qualitative findings.Objectives: To establish the perceived effectiveness and mechanisms of community peer-based programmes based on narratives of consumers with spinal cord injury (SCI).Methods: Scopus, Academic Search Complete, CINAHL, Health Source, Medline, PsycARTICLES, PsychINFO, SPORTSDiscus and ProQuest were searched for articles published in English between January 1990 and December 2015. Qualitative studies referring to community peer-based interventions were included if most cases had a SCI. The results section of included studies was extracted and entered in NVivo. Data were inductively coded and analysed according to the three phases of Thematic Synthesis.Results: The search yielded 1402 unique records, out of which 126 were scrutinised in full. Four studies were appraised based on eight criteria and were finally included in the analysis. Three analytical themes emerged: (1) a unique learning environment created by the right mixture of learning resources, learning processes and a can-do attitude; (2) peer mentors—a unique learning resource with high level of relatedness that eases and empowers participants; and (3) an intervention that responds to important unmet needs and unrealised potential.Conclusions: Community peer-based programmes for people with SCI provide individualised training in important life areas, using a variety of learning resources and a plethora of learning processes. The high level of perceived effectiveness suggests that this type of intervention is an important tool of health systems post discharge from initial rehabilitation. Community organisations should be supported with evaluating their programmes through quality research.
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| 12. |
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| 13. |
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| 14. |
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| 15. |
- Halvorsen, A., et al.
(författare)
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Epidemiology of traumatic spinal cord injury in Norway in 2012-2016: a registry-based cross-sectional study
- 2019
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Ingår i: Spinal Cord. - : Springer Science and Business Media LLC. - 1362-4393 .- 1476-5624. ; 57:4, s. 331-338
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Tidskriftsartikel (refereegranskat)abstract
- Study design A registry-based cross-sectional study. Objectives To analyse the epidemiological and demographic characteristics of persons with traumatic spinal cord injury (TSCI) in Norway. Setting TSCI patients admitted for primary rehabilitation to one of the three specialised spinal cord injury (SCI) departments (located in Bergen, Trondheim, and Oslo) and consented to the Norwegian Spinal Cord Injury Registry (NorSCIR). Methods Analysis of data from NorSCIR during a 5-year period (2012-2016) was performed. Data were collected by using the International SCI Core Data Set as recommended by the International Spinal Cord Society (ISCoS). Results The lowest incidence of TSCI was 11.4/million (2012), and the highest incidence was 15.9/million (2014). In the study period, 349 individuals were registered with TSCI. In total, 76% were male, and the mean age was 47 (SD +/- 19) years. We observed dominance in the 60-74 years age group. The distribution between tetraplegia and paraplegia was 48%/42%. For those initially classified as American Spinal Cord Injury Association Impairment Scale (AIS) grade A (complete injury), 77% remained grade A at discharge. Considerable changes during primary rehabilitation after incomplete lesions were observed. Most patients (68%) were discharged home after primary rehabilitation. Falls were the main cause of TSCI (47%) and occurred more often during the weekend. Conclusion Through a National Medical Quality Registry based on internationally provided data sets, we are able to present systematic and updated data from Norway.
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| 16. |
- Halvorsen, A., et al.
(författare)
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Non-traumatic spinal cord injury in Norway 2012-2016: analysis from a national registry and comparison with traumatic spinal cord injury
- 2019
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Ingår i: Spinal Cord. - : Springer Science and Business Media LLC. - 1362-4393 .- 1476-5624. ; 57:4, s. 324-330
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Tidskriftsartikel (refereegranskat)abstract
- Study design Registry-based cross-sectional study. Objectives To describe and analyze epidemiological and demographic characteristics of non-traumatic spinal cord injury (NTSCI) and to compare persons with NTSCI and traumatic spinal cord injury (TSCI). Setting A total of 225 non-traumatic and 349 traumatic SCI patients were admitted for primary rehabilitation at one of the three specialized SCI departments in Norway (located in Bergen, Trondheim, and Oslo) from 2012 to 2016. Patients who consented to registration in the Norwegian Spinal Cord Injury Registry (NorSCIR) were included. Methods Data were collected using the International SCI Core Data Set, as recommended by the International Spinal Cord Society (ISCoS). Demographics and injury characteristics were analyzed descriptively. The NTSCI and TSCI groups were compared using a Mann-Whitney U test and chi-square test. Results The mean age of the NTSCI patients was 55 years, and 59% were male. The incidence of NTSCI was 7.7-10.4 per million person-years, which is lower than the incidence of TSCI. NTSCI individuals were older, less severely injured, and their length of stay at the hospital was shorter than the TSCI individuals. The results may be influenced by the inclusion criterion in the registry. This makes the analyzed sample for NTSCI less complete. However, the majority of patients with non-progressive NTSCI are included in the NorSCIR. Conclusion For the first time, we are able to provide the national epidemiological status on NTSCI based on available data from the national registry. Further studies are required to improve the capture of NTSCI for future incidence studies.
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| 17. |
- Hilton, G., et al.
(författare)
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Longitudinal employment outcomes of an early intervention vocational rehabilitation service for people admitted to rehabilitation with a traumatic spinal cord injury
- 2017
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Ingår i: Spinal Cord. - : Nature Publishing Group. - 1362-4393 .- 1476-5624. ; 55:8, s. 743-752
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Tidskriftsartikel (refereegranskat)abstract
- Study design: Longitudinal cohort design.Objectives: First, to explore the longitudinal outcomes for people who received early intervention vocational rehabilitation (EIVR); second, to examine the nature and extent of relationships between contextual factors and employment outcomes over time.Setting: Both inpatient and community-based clients of a Spinal Community Integration Service (SCIS).Methods: People of workforce age undergoing inpatient rehabilitation for traumatic spinal cord injury were invited to participate in EIVR as part of SCIS. Data were collected at the following three time points: Discharge and at 1 year and 2+ years post discharge. Measures included the spinal cord independence measure, hospital anxiety and depression scale, impact on participation and autonomy scale, numerical pain-rating scale and personal wellbeing index. A range of chi square, correlation and regression tests were undertaken to look for relationships between employment outcomes and demographic, emotional and physical characteristics.Results: Ninety-seven participants were recruited and 60 were available at the final time point where 33% (95% confidence interval (CI): 24-42%) had achieved an employment outcome. Greater social participation was strongly correlated with wellbeing (Ï =0.692), and reduced anxiety (Ï =â '0.522), depression (Ï =â '0.643) and pain (Ï =â '0.427) at the final time point. In a generalised linear mixed effect model, education status, relationship status and subjective wellbeing increased significantly the odds of being employed at the final time point. Tertiary education prior to injury was associated with eight times increased odds of being in employment at the final time point; being in a relationship at the time of injury was associated with increased odds of being in employment of more than 3.5; subjective wellbeing, while being the least powerful predictor was still associated with increased odds (1.8 times) of being employed at the final time point.Conclusions: EIVR shows promise in delivering similar return-to-work rates as those traditionally reported, but sooner. The dynamics around relationships, subjective wellbeing, social participation and employment outcomes require further exploration.
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| 18. |
- Holmlund, Tobias, et al.
(författare)
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Energy expenditure after spinal cord injury in people with motor-complete tetraplegia or motor-complete paraplegia.
- 2018
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Ingår i: Spinal Cord. - : Springer Science and Business Media LLC. - 1362-4393 .- 1476-5624. ; 56:3, s. 274-283
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Tidskriftsartikel (refereegranskat)abstract
- STUDY DESIGN: Cross-sectional.OBJECTIVES: This study aimed to describe and compare VO2 and energy expenditure at rest (REE) and during standardized sedentary, non-exercise physical activity, and exercise activities, in people with motor-complete tetraplegia (C5-C8). Further, REE and energy expenditure (EE) for the different activities were compared to data from a reference group of people with motor-complete paraplegia (T7-T12).SETTING: Sweden.METHODS: The sample of people with motor-complete tetraplegia consisted of 26 adults (seven women) with SCI, C5-C8 AIS A-B. REE and EE for the different activities were measured with indirect calorimetry. The results were further compared to people with motor-complete paraplegia.RESULTS: Resting VO2 was 2.57 ml O2 kg-1 min-1, 2.54 for men and 2.60 for women. The VO2 or activity energy expenditure related to body weight increased three to four times during non-exercise physical activity compared to sedentary activities for the people with motor-complete tetraplegia, and up to six times during exercise activity. No significant differences were seen in resting or sedentary activity VO2 between the people with motor-complete tetraplegia and those with motor-complete paraplegia. Activities of daily life revealed no or small differences in VO2, except for setting a table, while the people with tetraplegia had ∼50% lower VO2 during exercise activities.CONCLUSIONS: Non-exercise physical activities of daily life may be significant for increasing total daily EE in people with motor-complete tetraplegia. This might act to motivate the individual, and might be clinically important when designing adapted lifestyle intervention programs for the target group.
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| 19. |
- Holmlund, Tobias, et al.
(författare)
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Energy expenditure in people with motor-complete paraplegia.
- 2017
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Ingår i: Spinal Cord. - : Springer Science and Business Media LLC. - 1362-4393 .- 1476-5624. ; 55:8, s. 774-781
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Tidskriftsartikel (refereegranskat)abstract
- STUDY DESIGN: The present descriptive clinical and laboratory study is cross-sectional in design.OBJECTIVES: The primary aim is to describe and compare resting energy expenditure (REE) and energy expenditure (EE) during different standardized sedentary, non-exercise and exercise activities in people with motor-complete paraplegia (Th7 to Th12.). A secondary aim was to compare men and women.METHODS: Thirty-eight adults (10 women) with SCI, T7-T12 AIS A-B, were recruited. All the data were collected through indirect calorimetry. REE was measured in supine for 30 min after 8 h of overnight fasting. Activity energy expenditure (AEE) for activities was measured for seven minutes during sedentary, non-exercise physical activity (NEPA) and exercise activities.RESULTS: AEE increased four to eight times when engaging in NEPA compared to that in sedentary activities. Men had significantly higher resting oxygen uptake compared to women, 0.19 vs 0.15 l min(-1) (P=0.005), REE per 24 h, 1286 vs 1030 kcal (P=0.003) and EE during weight-bearing activities. However, these became nonsignificant after adjustment for body weight and speed of movement, with a mean resting oxygen uptake of 2.47 ml O2 per kg min(-1) for the whole group (women 2.43 and men 2.57 ml O2 kg(-1) min(-1), P=0.49).CONCLUSIONS: NEPA increases AEE up to eight times compared to sedentary activities. Gender differences in oxygen uptake during both rest and weight-bearing activities were diminished after adjustment for body weight. The mean resting oxygen uptake for the whole group was 2.47 ml O2 kg(-1) min(-1). These results highlight the importance, especially of NEPA, for increasing total daily EE in the target population.
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| 20. |
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| 21. |
- Holmström, Ulrika, et al.
(författare)
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Neurosurgical untethering with or without syrinx drainage results in high patient satisfaction and favorable clinical outcome in post-traumatic myelopathy patients
- 2018
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Ingår i: Spinal Cord. - : NATURE PUBLISHING GROUP. - 1362-4393 .- 1476-5624. ; 56:9, s. 873-882
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Tidskriftsartikel (refereegranskat)abstract
- Study design: Retrospective data collection and patient-reported outcome measures.Objectives: To investigate surgical outcome, complications, and patient satisfaction in patients with chronic SCI and symptomatic post-traumatic progressive myelopathy (PPM) who underwent neurosurgical untethering and/or spinal cord cyst drainage with the aim of preventing further neurological deterioration.Setting: Single-center study at an academic neurosurgery department.Methods: All SCI patients who underwent neurosurgery between 1996 and 2013 were retrospectively included. All medical charts and the treating surgeon's operative reports were reviewed to identify surgical indications, surgical technique, and post-operative complications. A questionnaire and an EQ-5D-instrument were used to assess patient's self-described health status and satisfaction at long-term follow-up.Results: Fifty-two patients (43 men, 9 women) were identified, of whom five were dead and one was lost to follow-up. Main indications for surgery were pain (54%), motor (37%), or sensory (8%) impairment, and spasticity (2.0%). Overall complications were rare (8%). At follow-up, the subjectively perceived outcome was improved in 24 and remained unchanged in 21 patients. Thus, the surgical aim was met in 87% of patients. Of the 46 eligible patients, 38 responded to the questionnaire of whom 65% were satisfied with the surgical results. Patients with cervical lesions were more satisfied with the surgical treatment than patients with thoracic/thoracolumbar lesions (p = 0.05).Conclusions: Neurosurgical untethering and/or cyst drainage in chronic SCI patients and PPM resulted in a high degree of patient satisfaction, particularly in cervical SCI patients with minimal complications.
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| 22. |
- Irgens, I., et al.
(författare)
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Telehealth for people with spinal cord injury: a narrative review
- 2018
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Ingår i: Spinal Cord. - : Springer Science and Business Media LLC. - 1362-4393 .- 1476-5624. ; 56:7, s. 643-655
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Tidskriftsartikel (refereegranskat)abstract
- Study design Narrative review. Objectives To find and discuss what has been published about the use of telehealth, on people with spinal cord injury (teleSCI). Method Cochrane Library, Ovid Medline, EMBASE and CINAHL, from 1996 till June 2017 have been searched. Searches in PsycINFO, from 1996 till September 2017, were included afterwards. Extracted data include studies in English language, containing information about spinal cord injury and disorders, and telehealth. Literature reviews, systematic reviews, and studies containing other types of neurological disorders, were excluded. Studies were grouped based on how and to whom telehealth was offered. Results Twenty nine studies were included in the review. They were categorized according to the way teleSCI was provided, and to what modality was used. Some studies utilized more than one modality. TeleSCI seems to be favorable concerning treatment and follow-up, as well as favorable socioeconomically and environmentally. The studies spanned across several aims and outcomes. There was also heterogeneity in number of participants, the differences in modalities, and in the level of evidence. Thus it was challenging to compare studies and make future recommendations. Conclusions TeleSCI can be used for examination and guiding purposes. Further research is warranted to evaluate optimal utilization, methodology and efficacy.
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| 23. |
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| 24. |
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| 25. |
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| 26. |
- Jörgensen, Sophie, et al.
(författare)
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Associations between leisure time physical activity and cardiovascular risk factors among older adults with long-term spinal cord injury
- 2019
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Ingår i: Spinal Cord. - : NATURE PUBLISHING GROUP. - 1362-4393 .- 1476-5624. ; 57:5, s. 427-433
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Tidskriftsartikel (refereegranskat)abstract
- Study Design: This is a cross-sectional study.Objectives: To describe the association between cardiovascular risk factors (body mass index (BMI), waist circumference (WC), blood pressure, blood glucose and lipids) and leisure time physical activity (LTPA) in older adults with long-term spinal cord injury (SCI).Setting: Community settings, southern Sweden.Methods: Data from the baseline data collection of the Swedish Aging with Spinal Cord Injury Study (SASCIS) (n = 123, 71% men, injury levels C1-L5, American Spinal Injury Association Impairment Scale A-D, mean age 63 years, mean time since injury 24 years). Data were collected through home interviews, assessments and blood samples. The Physical Activity Recall Assessment for People with SCI was used to assess LTPA. Associations were investigated using multivariable linear regression analyses adjusted for age, gender, level and severity of injury, cause of injury, time since injury and tobacco use.Results: More minutes per day of moderate-to-heavy LTPA were significantly associated with a lower BMI (Beta = -0.31; p = 0.001) and a lower WC (Beta = -0.24; p = 0.009). More minutes per day of total LTPA (mild intensity or greater) were associated with a higher systolic blood pressure (Beta = 0.27; p = 0.041) among participants with tetraplegia. No other significant associations between the cardiovascular risk factors and total LTPA were found.Conclusion: Participation in daily LTPA is associated with better cardiovascular health with regard to BMI and WC in older adults with long-term SCI. Further studies are needed to establish the specific amount of activity needed to obtain positive health effects in this group and the directional causality of the associations.
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| 27. |
- Jörgensen, S., et al.
(författare)
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Leisure time physical activity among older adults with long-term spinal cord injury
- 2017
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Ingår i: Spinal Cord. - : Nature Publishing Group. - 1362-4393 .- 1476-5624. ; 55:9, s. 848-856
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Tidskriftsartikel (refereegranskat)abstract
- STUDY DESIGN:Cross-sectional.OBJECTIVES:To describe participation in leisure time physical activity (LTPA) (amount, intensity and type) among older adults with long-term spinal cord injury (SCI), and to investigate the associations with sociodemographics, injury characteristics and secondary health conditions (SHCs).SETTING:Home settings in southern Sweden.METHODS:Data from the Swedish Aging with Spinal Cord Injury Study (SASCIS). The physical activity recall assessment for people with SCI was used to assess LTPA among 84 men and 35 women (mean age 63.5 years, mean time since injury 24 years, injury levels C1-L5, American Spinal Injury Association Impairment Scale A-D). Associations were analyzed statistically using hierarchical multivariable regression.RESULTS:Twenty-nine percent reported no LTPA, whereas 53% performed moderate-to-heavy intensity LTPA. The mean minutes per day of total LTPA was 34.7 (±41.5, median 15, range 0-171.7) and of moderate-to-heavy LTPA 22.5 (±35.1, median 5.0, range 0-140.0). The most frequently performed activities were walking and wheeling. Sociodemographics, injury characteristics and SHCs (bowel-related and bladder-related problems, spasticity and pain) explained 10.6% and 13.4%, respectively, of the variance in total and moderate-to-heavy LTPA. Age and wheelchair use were significantly, negatively associated with total LTPA. Women, wheelchair users and employed participants performed significantly less moderate-to-heavy LTPA than men, those using walking devices/no mobility device and unemployed participants.CONCLUSION:Many older adults with long-term SCI do not reach the amount or intensity of LTPA needed to achieve fitness benefits. Research is needed on how to increase LTPA and to identify modifiable factors that could enhance their participation.Spinal Cord advance
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| 28. |
- Kader, Manzur, et al.
(författare)
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Socio-demographic and injury-related factors contributing to activity limitations and participation restrictions in people with spinal cord injury in Bangladesh
- 2018
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Ingår i: Spinal Cord. - : Springer Science and Business Media LLC. - 1362-4393 .- 1476-5624. ; 56:3, s. 239-246
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Tidskriftsartikel (refereegranskat)abstract
- Study design: Cross-sectional study. Objectives: To identify socio-demographic and injury-related factors that contribute to activity limitations and participation restrictions in people with spinal cord injury (SCI) in Bangladesh. Setting: Centre for the Rehabilitation of the Paralysed (CRP), Savar, Dhaka, Bangladesh. Methods: This study involved 120 (83% men) participants with SCI; their median (interquartile range) age and injury duration were 34 (25–43) years and 5 (2–10) years, respectively. Data were collected from the follow-up records kept by the Community Based Rehabilitation (CBR) unit of CRP and a subsequent home visit that included interview-administered questions, questionnaires, and a neurological examination. The dependent variables were activity limitations and participation restrictions, assessed with the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0, scored 0–100; a high score indicates greater activity limitations and participation restrictions). Independent variables included socio-demographic factors (i.e., age, sex, marital status, educational level, monthly household income, employment status, and place of residence) and injury-related factors (i.e., injury duration, cause of injury, injury severity, and type of paralysis). Multivariable linear regression analyses were performed to identify the factors that independently contributed to activity limitations and participation restrictions. Results: Three significant independent variables explained 20.7% of the variance in activity limitations and participation restrictions (WHODAS 2.0 score), in which tetraplegia was the strongest significant contributing factor, followed by rural residence and complete injury. Conclusions: This study would indicate that tetraplegia, complete injury, and residing in a rural area are the major contributions in limiting the activity and participation following SCI in Bangladesh.
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| 33. |
- Lundström, Ulrica, et al.
(författare)
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Participation in activities and secondary health complications among persons aging with traumatic spinal cord injury
- 2017
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Ingår i: Spinal Cord. - : Nature Publishing Group. - 1362-4393 .- 1476-5624. ; 55:4, s. 367-372
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Tidskriftsartikel (refereegranskat)abstract
- STUDY DESIGN:Cross-sectional study.OBJECTIVES:To describe participation in activities and explore the relationship with secondary complications among persons aging with a traumatic spinal cord injury (SCI).SETTING:A regional SCI outpatient center in Sweden.METHODS:Data were collected through a phone survey, which included 10 activities from the instrument PARTS/M-v3 (PARTicipation Survey/Mobility version-3) together with data from the participants' medical records. Cross-tabulation and χ2 were used for data analysis.RESULTS:In this study, 121 persons matched the inclusion criteria and the final study sample comprised 73 participants (60% response rate): 55 men and 18 women. Mean age was 63.7±9.4 years, and mean time since injury was 36.3±9.2 years. Regardless of duration of SCI, all 73 participated in dressing, bathing and leisure activities. Women reported better health than men. Particularly for those who lived 36-55 years after injury; increasing pain, fatigue, spasticity and decreased muscle strength were negatively affecting participation in activities, especially exercise and active recreation. Additionally, a need to save strength/energy was also a reason for not participating in the activities. Perceived future support and concerns in relation to personal assistance, assistive devices and rehabilitation was also reported.CONCLUSION:Increasing secondary health complications and a need to save strength/energy influenced participation in activities. Laws and/or governmental policies regarding personal assistance and assistive devices did not always support participation in activities. Interventions should aim to create a balance among activities in everyday life
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| 34. |
- Martin Ginis, Kathleen A., et al.
(författare)
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Evidence-based scientific exercise guidelines for adults with spinal cord injury : an update and a new guideline
- 2018
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Ingår i: Spinal Cord. - : Springer Science and Business Media LLC. - 1362-4393 .- 1476-5624. ; 56, s. 308-321
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To describe the process and outcomes of using a new evidence base to develop scientific guidelines that specify the type and minimum dose of exercise necessary to improve fitness and cardiometabolic health in adults with spinal cord injury (SCI). Setting: International. Methods: Using Appraisal of Guidelines, Research and Evaluation (AGREE) II reporting criteria, steps included (a) determining the guidelines’ scope; (b) conducting a systematic review of relevant literature; (c) holding three consensus panel meetings (European, Canadian and International) to formulate the guidelines; (d) obtaining stakeholder feedback; and (e) process evaluation by an AGREE II consultant. Stakeholders were actively involved in steps (c) and (d). Results: For cardiorespiratory fitness and muscle strength benefits, adults with a SCI should engage in at least 20 min of moderate to vigorous intensity aerobic exercise 2 times per week AND 3 sets of strength exercises for each major functioning muscle group, at a moderate to vigorous intensity, 2 times per week (strong recommendation). For cardiometabolic health benefits, adults with a SCI are suggested to engage in at least 30 min of moderate to vigorous intensity aerobic exercise 3 times per week (conditional recommendation). Conclusions: Through a systematic, rigorous, and participatory process involving international scientists and stakeholders, a new exercise guideline was formulated for cardiometabolic health benefits. A previously published SCI guideline was endorsed for achieving fitness benefits. These guidelines represent an important step toward international harmonization of exercise guidelines for adults with SCI, and a foundation for developing exercise policies and programs for people with SCI around the world.
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- Mehmedagic, Irma, et al.
(författare)
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Mid-term follow-up of patients with permanent sequel due to spinal cord ischemia after advanced endovascular therapy for extensive aortic disease.
- 2015
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Ingår i: Spinal Cord. - : Springer Science and Business Media LLC. - 1476-5624 .- 1362-4393. ; 53:3, s. 232-237
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Tidskriftsartikel (refereegranskat)abstract
- Study design:Observational study.Objectives:Thoraco-abdominal endovascular aortic aneurysm repair (TAEVAR) can be used to treat patients with extensive and complex aortic disease, however, at the risk of spinal cord ischemia (SCI). The aim of this follow-up study was to evaluate the life satisfaction in patients with SCI after TAEVAR.Setting:Among 83 patients undergoing TAEVAR between 2009 and 2012 at the Vascular Centre, Malmö, Sweden, 29 developed SCI in-hospital and at follow-up (median 26 months), eight had died and three had no complaints.Methods:Patients diagnosed with permanent (n=10) and transient (n=8) SCI were interviewed at home. The Life Satisfaction Questionnaire (LiSat-11) and the Satisfaction With Life Scale (SWLS) were compared with reference samples.Results:Mid-term mortality in patients with permanent SCI (7/17) was higher than those with transient SCI (1/12) (P=0.035). Ten patients had permanent T1-S5 SCI, two were classified as ASIA Impairment Scale (AIS) A, one as AIS B and seven as AIS D at hospital discharge. Patients diagnosed with transient SCI had residual neurological deficits in the legs (n=8), urge incontinence (n=3) and fecal leakage (n=2) at follow-up. Patients with SCI had lower self-rated life satisfaction in terms of 'life as a whole', 'sexual life', 'somatic health' and 'psychological health' but better in the 'economy' domain.Conclusion:Assessment of life satisfaction at mid-term follow-up suggests that all patients with SCI in-hospital, whether permanent or transient, should have a multi-disciplinary follow-up regime. Most patients diagnosed with transient neurological deficits had an overlooked permanent, less severe, SCI.Spinal Cord advance online publication, 23 September 2014; doi:10.1038/sc.2014.163.
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| 37. |
- Melin, Jeanette, et al.
(författare)
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Patient participation from the perspective of staff members working in spinal cord injury rehabilitation
- 2018
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Ingår i: Spinal Cord. - : Springer Science and Business Media LLC. - 1362-4393 .- 1476-5624. ; 56:6, s. 614-620
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Tidskriftsartikel (refereegranskat)abstract
- Study design Qualitative method, semi-structured interviews. Objectives The aims of this study were to explore the meaning of patient participation from the perspective of staff members working with spinal cord injury (SCI) rehabilitation, and what they saw as requisites for and constraints to patient participation. Methods Interviews with 13 staff members at a spinal unit were conducted individually and analyzed by means of content analysis. Results One category describing patient participation emerged from the interviews: Patient - a team member. Four categories were extracted as requisites: Communication; information and knowledge; routines; respecting the patient as a unique person; and an open climate. Three categories of constraints were identified: Understaffing and new staff members; patients' inability to grasp information; and structures and fragmented responsibilities. Conclusions The informants were unanimous in stating that the patient is an integral and natural member of the rehabilitation team. Recognizing the person with SCI as a team member acknowledges and endorses the patient as a person with capabilities to participate in his or her rehabilitation. The patient as a person also means that he or she has unique needs and preferences, which the staff members must accommodate. This is also fundamental in a person-centered approach. Therefore, the viewpoints of the informants may be useful for other settings to enhance person centeredness and patient participation.
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| 38. |
- Mirzaeva, L., et al.
(författare)
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Incidence of adult traumatic spinal cord injury in Saint Petersburg, Russia
- 2019
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Ingår i: Spinal Cord. - : Springer Science and Business Media LLC. - 1362-4393 .- 1476-5624. ; 57:8, s. 692-699
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Tidskriftsartikel (refereegranskat)abstract
- Study design Retrospective population-based cohort study. Objectives To characterise the epidemiology of traumatic spinal cord injury (TSCI) among the inhabitants of Saint Petersburg, Russia. Methods Charts for all individuals admitted to city hospitals from 1st January 1 2012 to 31st December 2016 with acute TSCI were reviewed. Incidence rates were calculated for the whole period and for each year separately. Gender-specific and age-specific incidence rates were calculated, and epidemiological characteristics and possible risk factors were analysed. Results A total of 361 people were identified. The average annual incidence rate was 17.6 per million, varying from 21.2 (2013) to 13.6 (2016), and 70.9% were men. Mean age at injury was 42.1 years. Injuries from falls represented 49.8% of cases, and motor vehicle accidents 18.9%. The male:female ratio in the low-falls group was 1.2:1, and among the elderly patients, it was 0.5:1. Lesions at the cervical level were involved in 49.3%, thoracic in 24.7%, and lumbar/sacral in 23.5%. TSCI was complete in 16.9%. Concomitant injuries occurred in 47.2% of cases, and traumatic brain injuries in 37.7%. Conclusion TSCI incidence decreased during the observation period and was 2.4 times more common among men than women. In half of the cases, injuries involved the cervical level, and a fall was the most frequent injury cause. Elderly women more often had falls from a low height than men. Multiple injuries-most frequently traumatic brain injuries-were common.
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| 39. |
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| 40. |
- Nooijen, Carla F., et al.
(författare)
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Fatigue in persons with subacute spinal cord injury who are dependent on a manual wheelchair
- 2015
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Ingår i: Spinal Cord. - : Springer Science and Business Media LLC. - 1362-4393 .- 1476-5624. ; 53:10, s. 758-62
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Tidskriftsartikel (refereegranskat)abstract
- STUDY DESIGN: Cross-sectional. OBJECTIVES: To determine the prevalence and severity of fatigue in persons with subacute spinal cord injury (SCI), assess whether demographic and lesion characteristics are related to fatigue and determine the relationship with physical fitness and physical behavior. SETTING: Measurements were performed 2 months before discharge from inpatient rehabilitation. METHODS: Thirty-six persons with subacute SCI, dependent on a manual wheelchair, mean age 43+/-15 and 83% men, completed the Fatigue Severity Scale (FSS). FSS scores >4 indicated fatigue. We recorded age and lesion characteristics, measured body mass index, measured peak power output and peak oxygen uptake during a maximal handcycling test and determined physical behavior using an accelerometer-based activity monitor. T-tests were used to test for differences in fatigue between subgroups based on age and lesion characteristics, and regression analyses to assess the relationship with physical fitness and physical behavior. RESULTS: Mean FSS was 3.3+/-1.3. Fatigue, including severe fatigue, was prevalent in 31% (95% confidence interval: 16-46) of participants compared with 18% in the general population. Furthermore, mean fatigue was significantly higher in persons with incomplete compared with complete lesions (t=2.22, P=0.03). Mean scores between other subgroups did not differ significantly. Of the physical fitness and physical behavior measures, only peak oxygen uptake tended to be related to more fatigue (B=-1.47, P=0.05). CONCLUSION: Fatigue was prevalent and is of concern in persons with subacute SCI. Those with incomplete lesions seem to be at higher risk. Because fatigue is known to persist among persons with SCI, interventions to reduce fatigue seem necessary.
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| 41. |
- Wangdell, Johanna, 1971, et al.
(författare)
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Outcomes of reconstructive hand surgery in patients with tetraplegia and neuropathic pain.
- 2018
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Ingår i: Spinal cord. - : Springer Science and Business Media LLC. - 1476-5624 .- 1362-4393. ; 56, s. 1194-1198
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Tidskriftsartikel (refereegranskat)abstract
- Retrospective cohort study OBJECTIVES: To evaluate the impact of preoperative neuropathic pain on outcome and postoperative compliance after grip reconstructive surgery in people with tetraplegia.Specialized tetraplegia upper-limb surgery center in Sweden.All patients who underwent grip reconstructive surgery and attended a 6 month follow up during January 2012 and May 2015 were included. Participants were divided into two groups, pain group and no pain group, based on preoperative rating of experienced pain on a visual analog scale. The main outcome measures were grip strength, grasp ability (Grasp and Release Test) and prioritized activity outcome (Canadian Occupational Performance Measure) together with compliance to the rehabilitation plan.The study include 37 patients (86% of the cohort). Seventeen patients experienced preoperative pain (46%). There were no differences in outcome between the pain- and the no pain group regarding grip strength (5 vs. 4.6kg), grip ability or activity performance and satisfaction (COPM improvement of 3.1 vs. 3.0 for performance and 3.6 for both groups in satisfaction). Both groups experienced improvements in all aspects and there were no differences in the ability to fulfill postoperative treatment.Individuals with tetraplegia and preoperative neuropathic pain in the arm/hand improve after grip reconstructions in a similar way to those without pain. Patients with neuropathic pain therefore should be considered as surgery candidates to the same extent as those without pain.
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