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101.
Tamra Keeney Mary Slavin Pamela Kisala Pengsheng Ni Allen W. Heinemann Susan Charlifue Denise C. Fyffe Ralph J. Marino Leslie R. Morse Lynn A. Worobey Denise Tate David Rosenblum Ross Zafonte David Tulsky Alan M. Jette 《Archives of physical medicine and rehabilitation》2018,99(9):1783-1788
Objective
To examine the ability of the Spinal Cord Injury-Functional Index/Assistive Technology (SCI-FI/AT) measure to detect change in persons with spinal cord injury (SCI).Design
Multisite longitudinal (12-mo follow-up) study.Setting
Nine SCI Model Systems programs.Participants
Adults (N=165) with SCI enrolled in the SCI Model Systems database.Interventions
Not applicable.Main Outcome Measures
SCI-FI/AT computerized adaptive test (CAT) (Basic Mobility, Self-Care, Fine Motor Function, Wheelchair Mobility, and/or Ambulation domains) completed at discharge from rehabilitation and 12 months after SCI. For each domain, effect size estimates and 95% confidence intervals were calculated for subgroups with paraplegia and tetraplegia.Results
The demographic characteristics of the sample were as follows: 46% (n=76) individuals with paraplegia, 76% (n=125) male participants, 57% (n=94) used a manual wheelchair, 38% (n=63) used a power wheelchair, 30% (n=50) were ambulatory. For individuals with paraplegia, the Basic Mobility, Self-Care, and Ambulation domains of the SCI-FI/AT detected a significantly large amount of change; in contrast, the Fine Motor Function and Wheelchair Mobility domains detected only a small amount of change. For those with tetraplegia, the Basic Mobility, Fine Motor Function, and Self-Care domains detected a small amount of change whereas the Ambulation item domain detected a medium amount of change. The Wheelchair Mobility domain for people with tetraplegia was the only SCI-FI/AT domain that did not detect significant change.Conclusions
SCI-FI/AT CAT item banks detected an increase in function from discharge to 12 months after SCI. The effect size estimates for the SCI-FI/AT CAT vary by domain and level of lesion. Findings support the use of the SCI-FI/AT CAT in the population with SCI and highlight the importance of multidimensional functional measures. 相似文献102.
Lynn A. Worobey Stephanie K. Rigot Nathan S. Hogaboom Chris Venus Michael L. Boninger 《Archives of physical medicine and rehabilitation》2018,99(1):9-16.e10
Objectives
To determine the efficacy of a web-based transfer training module at improving transfer technique across 3 groups: web-based training, in-person training (current standard of practice), and a waitlist control group (WLCG); and secondarily, to determine subject factors that can be used to predict improvements in transfer ability after training.Design
Randomized controlled trials.Setting
Summer and winter sporting events for disabled veterans.Participants
A convenience sample (N=71) of manual and power wheelchair users who could transfer independently.Interventions
An individualized, in-person transfer training session or a web-based transfer training module. The WLCG received the web training at their follow-up visit.Main Outcome Measure
Transfer Assessment Instrument (TAI) part 1 score was used to assess transfers at baseline, skill acquisition immediately posttraining, and skill retention after a 1- to 2-day follow-up period.Results
The in-person and web-based training groups improved their median (interquartile range) TAI scores from 7.98 (7.18–8.46) to 9.13 (8.57–9.58; P<.01), and from 7.14 (6.15–7.86) to 9.23 (8.46–9.82; P<.01), respectively, compared with the WLCG that had a median score of 7.69 for both assessments (baseline, 6.15–8.46; follow-up control, 5.83–8.46). Participants retained improvements at follow-up (P>.05). A lower initial TAI score was found to be the only significant predictor of a larger percent change in TAI score after receiving training.Conclusions
Transfer training can improve technique with changes retained within a short follow-up window, even among experienced wheelchair users. Web-based transfer training demonstrated comparable improvements to in-person training. With almost half of the United States population consulting online resources before a health care professional, web-based training may be an effective method to increase knowledge translation. 相似文献103.
Roberto Schreiber Cristiane M. Souza Layde R. Paim Guilherme de Rossi José R. Matos-Souza Anselmo de A. Costa e Silva Fernando R. Faria Eliza R. Azevedo Karina C. Alonso Andrei C. Sposito Alberto Cliquet José I. Gorla Wilson Nadruz 《Archives of physical medicine and rehabilitation》2018,99(8):1561-1567.e1
Objective
To investigate the relationship of carotid artery intima-media thickness (IMT) and cardiac structure and function with adipocytokines in sedentary (S-SCI) and physically active (PA-SCI) subjects with spinal cord injury (SCI).Design
Cross-sectional observational study.Setting
Academic medical center.Participants
Men with chronic (>1y) SCI (N=41; 16 S-SCI, 25 PA-SCI) were evaluated. S-SCI subjects did not perform labor that required physical effort, recreational physical activity, or sports, while PA-SCI subjects included competing athletes who were regularly performing adapted sports.Interventions
Not applicable.Main Outcome Measures
Clinical, laboratory, carotid ultrasonography, and echocardiography analysis. Plasma leptin, adiponectin, and plasminogen activating inhibitor-1 (PAI-1) levels were determined.Results
PA-SCI subjects had similar levels of adipocytokines, but lower carotid IMT and carotid IMT/diameter, and better left ventricular diastolic function than S-SCI participants. Bivariate analysis showed that adiponectin was inversely correlated with triglycerides (r=–.85, P<.001), low-density lipoprotein cholesterol (r=–.57, P<.05), and carotid IMT/diameter (r=–.56, P<.05) in S-SCI but not in PA-SCI participants. Additionally, the leptin-adiponectin ratio showed a direct correlation with triglycerides (r=.84, P<.001) and low-density lipoprotein cholesterol (r=.53, P<.05) in S-SCI but not in PA-SCI individuals. By contrast, the studied adipocytokines did not correlate with cardiac structure and function in PA-SCI and S-SCI participants.Conclusions
Lower adiponectin levels and higher leptin-adiponectin ratio are related to adverse vascular and/or metabolic characteristics in individuals with SCI. This relationship, however, appears to be mitigated by regular physical activity. 相似文献104.
Carolyn E. Schwartz Brian Stucky Carly S. Rivers Vanessa K. Noonan Joel A. Finkelstein 《Archives of physical medicine and rehabilitation》2018,99(8):1599-1608.e1
Objective
To investigate response shift effects in spinal cord injury (SCI) over 5 years postinjury.Design
Prospective cohort study observed at 1, 2, and 5 years post-SCI.Setting
Specialized SCI centers.Participants
Sample included 1125, 760, and 219 participants at 1, 2, and 5 years post-SCI (N = 2104). The study sample was 79% men; 39% were motor/sensory complete (mean age, 44.6±18.3y).Interventions
Not applicable.Main Outcome Measures
Patient-reported outcomes included the Medical Outcomes Study 36-Item Short-Form Health Survey version 2 and the Life Satisfaction-11 Questionnaire. Participant latent variable scores were adjusted for (1) potential attrition bias and (2) propensity scores reflecting risk of worse outcomes. The Oort structural equation modeling approach for detecting and accounting for response shift effects was used to test the hypothesis that people with SCI would undergo response shifts over follow-up.Results
The study data comprised the time after FIM scores, an objective measure of motor and cognitive function, had improved and stabilized. Three latent variables (Physical, Mental, and Symptoms) were modeled over time. The response shift model indicated uniform recalibration and reconceptualization response shift effects over time. When adjusted for these response shift effects, Physical showed small true change improvements at 2- and 5-year follow-up, despite FIM stability.Conclusions
We detected recalibration and reconceptualization response shift effects in 1- to 5-year follow-up of people with SCI. Despite stable motor and cognitive function, people with SCI are adapting to their condition. This adaptation reflects a progressive disconnection between symptoms and physical or mental health, and a real improvement in the Physical latent variable. 相似文献105.
Stephanie Rigot Lynn Worobey Michael L. Boninger 《Archives of physical medicine and rehabilitation》2018,99(8):1591-1598
Objectives
To investigate the relation of gait training (GT) during inpatient rehabilitation (IPR) to outcomes of people with traumatic spinal cord injury (SCI).Design
Prospective observational study using the SCIRehab database.Setting
Six IPR facilities.Participants
Patients with new SCI (N=1376) receiving initial rehabilitation.Interventions
Patients were divided into groups consisting of those who did and did not receive GT. Patients were further subdivided based on their primary mode of mobility as measured by the FIM.Main Outcome Measures
Pain rating scales, Patient Health Questionnaire Mood Subscale, Satisfaction With Life Scale, and Craig Handicap Assessment and Reporting Technique (CHART).Results
Nearly 58% of all patients received GT, including 33.3% of patients who were primarily using a wheelchair 1 year after discharge from IPR. Those who used a wheelchair and received GT, received significantly less transfer and wheeled mobility training (P<.001). CHART physical independence (P=.002), mobility (P=.024), and occupation (P=.003) scores were significantly worse in patients who used a wheelchair at 1 year and received GT, compared with those who used a wheelchair and did not receive GT in IPR. Older age was also a significant predictor of worse participation as measured by the CHART.Conclusions
A significant percentage of individuals who are not likely to become functional ambulators are spending portions of their IPR stays performing GT, which is associated with less time allotted for other functional interventions. GT in IPR was also associated with participation deficits at 1 year for those who used a wheelchair, implying the potential consequences of opportunity costs, pain, and psychological difficulties of receiving unsuccessful GT. Clinicians should consider these data when deciding to implement GT during initial IPR. 相似文献106.
本文以广西中医药大学图书馆近几年来建设特色资源库情况为例,分析建库内容、建库层次,指出存在的问题及应对对策,提出深化建库内容、深化层次建设是特色资源建设的发展趋势。 相似文献
107.
《中华物理医学与康复杂志》2018,(11):829-829
BACKGROUND AND OBJECTIVE As many organs,including the kidneys,are partially controlled by sympathetic innervations, some have suggested that the level of spinal cord injury (SCI)should play a role in alterations of renal funetion.This study explored the relationship between SCI level and renal funetion. 相似文献
108.
目的 通过生物信息学方法对基因表达综合(GEO)数据库中超高剂量率(FLASH)放疗的数据进行分析,寻找参与调控急性T淋巴细胞白血病FLASH放疗敏感性的枢纽(Hub)基因。方法 从GEO数据库中下载和提取接受FLASH放疗恶性肿瘤基因表达谱芯片数据,采用R软件进行差异基因的筛选,并对这些基因进行生物学功能、信号传导通路等分析。通过STRING在线软件分析差异基因的蛋白质相互作用(PPI) 网络,Cytoscape插件筛选Hub基因。最后,应用肿瘤基因组图谱(TCGA)和GTEx数据库验证Hub基因在急性T淋巴细胞白血病中的表达情况。结果 自GEO数据库中获得GSE100718芯片数据,共有12 800个基因与急性T淋巴细胞白血病放疗敏感性相关。选择表达量显著改变的61个基因进行进一步分析,这些基因参与代谢、应激反应、免疫应答等生物学过程。主要涉及氧化磷酸化、未折叠蛋白应答、脂质代谢等信号转导通路。通过PPI分析筛选出的Hub基因及后续验证表明HSPA5及SCD参与调控FLASH放疗敏感性,且在合并TRD/LMO2融合基因的急性T淋巴细胞白血病中显著高表达。结论 通过生物信息学分析可以有效筛选出调控FLASH放疗敏感性的Hub基因,基因表达谱可用于指导肿瘤患者分层以实现精准放疗。 相似文献
109.
Piero Barbanti MD PhD Luisa Fofi MD Licia Grazzi MD Fabrizio Vernieri MD Cecilia Camarda MD Paola Torelli MD Sabina Cevoli MD PhD Antonio Russo MD PhD Francesco Bono MD Cinzia Finocchi MD Renata Rao MD Stefano Messina MD Roberto De Simone MD Nicola Vanacore MD PhD Stefano Bonassi PhD ERT IRON Study Group 《Headache》2021,61(6):936-950
110.
Dilek Akakin Demir Kiran Naziye Ozkan Mehmet Erşahin Zarife Nigar Ozdemir-Kumral Berrak Yeğen Göksel Şener 《Acta histochemica》2013
Spinal cord injury (SCI) induced oxidative stress affects multiple organ systems including the kidney. We studied the possible protective effects of melatonin on SCI-induced oxidative damage in renal tissues of rats. Wistar albino rats (n = 24) were exposed to SCI and divided into vehicle- or melatonin-treated SCI groups. Melatonin was administred intraperitoneally at a dose of 10 mg/kg for seven days. Renal tissues were investigated by light and electron microscopy. Furthermore, tissue malondialdehyde (MDA) and glutathione (GSH) levels and myeloperoxidase (MPO) and superoxide dismutase (SOD) activities were also determined. In the vehicle-treated SCI group, the renal histology was disturbed compared to controls, whereas the melatonin-treated SCI group showed significantly reduced degeneration of renal tissue as seen by both light and electron microscopy. MDA levels, MPO and SOD activities were increased and GSH levels were decreased in the vehicle-treated SCI group compared to controls. On the other hand, decreased MDA levels and MPO activities and increased GSH levels were observed in the melatonin-treated SCI group compared to vehicle-treated SCI group. These results showed that experimentally induced SCI caused oxidative stress in the rat kidney, whereas melatonin treatment reduced oxidative stress, suggesting that it may be used as a complementary therapy of renal problems occurring following SCI. 相似文献