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- Bunketorp Käll, Lina, 1975, et al.
(author)
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Regional estimates of cortical thickness in brain areas involved in control of surgically restored limb movement in patients with tetraplegia.
- 2020
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In: The journal of spinal cord medicine. - : Informa UK Limited. - 2045-7723 .- 1079-0268. ; 43:4, s. 462-469
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Journal article (peer-reviewed)abstract
- Spinal cord injury (SCI) causes atrophy of brain regions linked to motor function. We aimed to estimate cortical thickness in brain regions that control surgically restored limb movement in individuals with tetraplegia.Cross-sectional study.Sahlgrenska University hospital, Gothenburg, Sweden.Six individuals with tetraplegia who had undergone surgical restoration of grip function by surgical transfer of one elbow flexor (brachioradialis), to the paralyzed thumb flexor (flexor pollicis longus). All subjects were males, with a SCI at the C6 or C7 level, and a mean age of 40 years (range=31-48). The average number of years elapsed since the SCI was 13 (range=6-26).We used structural magnetic resonance imaging (MRI) to estimate the thickness of selected motor cortices and compared these measurements to those of six matched control subjects. The pinch grip control area was defined in a previous functional MRI study.Compared to controls, the cortical thickness in the functionally defined pinch grip control area was not significantly reduced (P=0.591), and thickness showed a non-significant but positive correlation with years since surgery in the individuals with tetraplegia. In contrast, the anatomically defined primary motor cortex as a whole exhibited substantial atrophy (P=0.013), with a weak negative correlation with years since surgery.Individuals with tetraplegia do not seem to have reduced cortical thickness in brain regions involved in control of surgically restored limb movement. However, the studied sample is very small and further studies with larger samples are required to establish these findings.
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| 2. |
- Ertzgaard, Per, et al.
(author)
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A review and evaluation of patient-reported outcome measures for spasticity in persons with spinal cord damage: Recommendations from the Ability Network - an international initiative
- 2020
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In: Journal of Spinal Cord Medicine (JSCM). - : TAYLOR & FRANCIS LTD. - 1079-0268 .- 2045-7723. ; 43:6, s. 813-823
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Research review (peer-reviewed)abstract
- Context: Patient-reported outcome measures (PROMs) are valuable for capturing the impact of spasticity on health-related quality of life (HRQoL) in persons with spinal cord damage (SCD) and evaluating the efficacy of interventions. Objective: To provide practical guidance for measuring HRQoL in persons with spasticity following SCD. Methods: Literature reviews identified measures of HRQoL and caregiver burden, utilized in studies addressing spasticity in SCD. Identified measures were evaluated for clinical relevance and practicality for use in clinical practice and research. The PRISM, SCI-SET, EQ-5D and SF-36 instruments were mapped to the International Classification of Functioning, Disability and Health (ICF). The PRISM and SCI-SET were evaluated using the Consensus-based Standards for the Selection of Health Measurement Instruments (COSMIN) checklist. Results: Two spasticity-specific, five generic, and four preference-based measures were identified. ICF mapping and the COSMIN checklist supported the use of the PRISM and SCI-SET in SCD. The SF-36 is considered the most useful generic measure; disability-adapted versions may be more acceptable but further studies on psychometric properties are required. The SF-36 can be converted to a preference-based measure (SF-6D), or alternatively the EQ-5D can be used. While no measures specific to caregivers of people with SCD were identified, the Caregiver Burden Scale and the Zarit Burden Interview are considered suitable. Conclusion: Recommended measures include the PRISM and SCI-SET (condition-specific), SF-36 (generic), and Caregiver Burden Scale and Zarit Burden Interview (caregiver burden). Consideration should be given to using condition-specific and generic measures in combination; the PRISM or SCI-SET combined with SF-36 is recommended.
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| 3. |
- Hill, Mattias, et al.
(author)
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Functional and structural impairments of the pulmonary system in middle-aged people with cervical and upper thoracic spinal cord injuries
- 2023
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In: Journal of Spinal Cord Medicine. - : Informa UK Limited. - 2045-7723 .- 1079-0268. ; 46:5, s. 732-741
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Journal article (peer-reviewed)abstract
- OBJECTIVES: To describe functional and structural impairments of the pulmonary system in middle-aged people with cervical and upper thoracic spinal cord injuries (SCI), and compare findings to the general population. To determine if the neurological level of injury (NLI) is related to functional and structural impairments, and if age is related to structural impairments.DESIGN: Cross-sectional study with matched controls. Data from the Swedish SPinal Cord Injury Study on Cardiopulmonary and Autonomic Impairment (SPICA). Matched control data were obtained from the Swedish CArdioPulmonary bioImage Study (SCAPIS).SETTING: Outpatient SCI unit in southern Sweden.PARTICIPANTS: 25 people (20% women, mean age 58 years, mean time since injury 28 years, NLIs C2-T6, American Spinal Injury Association Impairment Scale A-C).INTERVENTIONS: Not applicable.OUTCOME MEASURES: Lung function was assessed with spirometry, diffusing capacity and impulse oscillometry. Structural assessments were performed with computed tomography.RESULTS: Pulmonary function was generally worse compared to the controls. Structural impairments were common (75% of the participants and 65% of the controls; P = 0.36, NS). NLI was significantly related to some of the functional and structural impairments.CONCLUSIONS: Middle-aged people with long-term cervical and upper thoracic SCI can have substantial pulmonary functional impairments, whereas structural impairments do not differ considerably from the general population. Further larger and longitudinal studies should focus on the clinical impact of these impairments over time.
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| 4. |
- Jörgensen, Sophie, et al.
(author)
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Global and domain-specific life satisfaction among older adults with long-term spinal cord injury
- 2021
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In: Journal of Spinal Cord Medicine. - : Informa UK Limited. - 1079-0268 .- 2045-7723. ; 44:2, s. 322-330
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Journal article (peer-reviewed)abstract
- Objective: Although life expectancy after spinal cord injury (SCI) has increased, knowledge of life satisfaction and associated factors among older adults with long-term SCI is still very limited. The objective of this study was, therefore, to assess global and domain-specific life satisfaction among older adults with long-term SCI and investigate the association with sociodemographics, injury characteristics and secondary health conditions. Design: Cross-sectional cohort study. Data from the Swedish Aging with Spinal Cord Injury Study (SASCIS). Setting: Community settings in southern Sweden. Participants: Seventy-eight individuals (32% women, injury levels C1-L3, American Spinal Injury Association Impairment Scale (AIS) A-D) mean age 68 years, mean time since injury 31 years. Interventions: Not applicable. Outcome measures: The Life Satisfaction Questionnaire (LiSat-11). Results: The participants were at least rather satisfied with most of the 11 life domains. They rated the lowest satisfaction with sexual life, activities of daily living and somatic health. Having a partner and being vocationally active was associated with greater satisfaction with life as a whole and with several other life domains. Participants with AIS D injuries were less satisfied with their somatic health than those with tetraplegia AIS A-C and paraplegia AIS A-C injuries. More secondary health conditions were negatively associated with satisfaction in five life domains. Conclusion: Life satisfaction can be affected many years after SCI. The social context, participation in meaningful activities and minimizing secondary health conditions seem to be important for maintaining life satisfaction in older adults with a long-term injury.
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| 7. |
- Salmiranta, Elin, et al.
(author)
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The voice of caregivers of children and adolescents with spinal cord injuries : A scoping review
- 2023
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In: Journal of Spinal Cord Medicine (JSCM). - : Taylor & Francis Group. - 1079-0268 .- 2045-7723. ; 47:3, s. 315-326
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Journal article (peer-reviewed)abstract
- Context:Participation in SCI research with caregivers of children and adolescents with spinal cord injury (SCI) can occur in a range of different ways. This review explores the extent to which caregivers’ participation is connected to what might be called a voice.Objectives:To explore the voice of caregivers by collating available research with the participation of caregivers of children and adolescents with SCI, and synthesizing how the research has been conducted.Methods:The databases CINAHL, ERIC, MEDLINE, PsycInfo, and Scopus were searched for articles published between January 2008 and March 2022. Descriptive and narrative information was extracted and factors describing how caregivers participated were identified using an inductive approach.Results:Twenty-nine articles were identified, of which 28 had affiliations connected to the USA, and 25 to Shriners Hospitals for Children. In most of the articles, the caregivers were invited to participate in the research to complete or develop measures. Information from the caregivers was often captured using close-structured questions and summarized quantitatively with little or no exploration of the perspectives of the caregivers.Conclusion:The voice of caregivers of children and adolescents with SCI in research is limited by representativeness, the pre-determined emphasis, a lack of involvement in the process, and the reported narrative. By reflecting on voice, caregivers can have their experiences and perspectives acted upon to a greater extent to bring change, ultimately leading to improved care and health for children and adolescents with SCI.
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