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1.
Anne Riordan Erin H. Kelly Sara J. Klaas Lawrence C. Vogel 《The journal of spinal cord medicine》2015,38(1):76-83
Objective
Examine psychosocial outcomes of youth with spinal cord injury (SCI) as a function of neurological level (paraplegia/tetraplegia) and severity (American Spinal Injury Association (ASIA) Impairment Scale (AIS)).Design
Survey research.Setting
Three pediatric SCI specialty centers in the USA.Participants
Youth with SCI ages 5–18 with neurological impairment classifications of: tetraplegia AIS ABC (tetraplegia ABC), paraplegia AIS ABC (paraplegia ABC), or AIS D.Outcome Measures
Children''s Assessment of Participation and Enjoyment, Pediatric Quality of Life Inventory, Revised Children''s Manifest Anxiety Scale, and Children''s Depression Inventory.Results
Three hundred and forty youth participated; 57% were male; 60% were Caucasian, 21% Hispanic, 7% African-American, 2% Native American, and 3% reported “other”. Their mean age was 8.15 years (standard deviation (SD) = 5.84) at injury and 13.18 years (SD = 3.87) at interview. Ninety-six youth (28%) had tetraplegia ABC injuries, 191 (56%) paraplegia ABC injuries, and 53 (16%) AIS D injuries. Neurological impairment was significantly related to participation and quality of life (QOL). Specifically, youth with paraplegia ABC and AIS D injuries participated in more activities than youth with tetraplegia ABC (P = 0.002; P = 0.018, respectively) and youth with paraplegia ABC participated more often than youth with tetraplegia ABC (P = 0.006). Youth with paraplegia ABC reported higher social QOL than youth with tetraplegia ABC (P = 0.001) and AIS D injuries (P = 0.002). Groups did not differ regarding mental health.Conclusion
Interventions should target youth with tetraplegia ABC, as they may need support in terms of participation, and both youth with tetraplegia ABC and AIS D injuries in terms of social integration. 相似文献2.
Charlesnika T. Evans Jennifer N. Hill Marylou Guihan Amy Chin Barry Goldstein Michael S. A. Richardson Vicki Anderson Kathleen Risa Susan Kellie Kenzie A. Cameron 《The journal of spinal cord medicine》2014,37(2):152-161
Objectives
To assess the feasibility and effect of a nurse-administered patient educational intervention about Methicillin-resistant Staphylococcus aureus (MRSA) prevention on knowledge and behavior of Veterans with spinal cord injuries and disorders (SCI/D).Design
Blinded, block-randomized controlled pilot trial.Setting
Two Department of Veterans Affairs (VA) SCI Centers.Participants
Veterans were recruited March–September 2010 through referral by a healthcare provider from inpatient, outpatient, and residential care settings.Intervention
Thirty participants were randomized to the nurse-administered intervention and 31 to the usual care group. The intervention included a brochure and tools to assist nurses in conducting the education.Outcome measures
Pre- and post-intervention measurement of knowledge and behaviors related to MRSA and prevention strategies and feasibility measures related to implementation.Results
Participants were primarily male (95.1%), white (63.9%), with tetraplegia (63.9%) and mean age and duration of injury of 64.3 and 20.5 years, respectively. The intervention groups mean knowledge score significantly increased between pre- and post-test (mean change score = 1.70, 95% confidence interval, CI 0.25–3.15) while the usual care groups score did not significantly change (mean change score = 1.45, 95% CI −0.08–2.98). However, the mean knowledge change between intervention and usual care groups was not significantly different (P = 0.81). Overall behavior scores did not significantly differ between treatment groups; however, the intervention group was more likely to report intentions to clean hands (90.0% vs. 64.5%, P = 0.03) and asking providers about MRSA status (46.7% vs. 16.1%, P = 0.01). Nurse educators reported that the quality of the intervention was high and could be implemented in clinical care.Conclusions
A targeted educational strategy is feasible to implement in SCI/D clinical practices and may improve some participants’ knowledge about MRSA and increase intentions to improve hand hygiene and engagement with providers about their MRSA status. 相似文献3.
Julio T. Chong Adam P. Klausner Albert Petrossian Michael D. Byrne Jewel R. Moore Lance L. Goetz David R. Gater B. Mayer Grob 《The journal of spinal cord medicine》2015,38(2):187-192
Objective
The objective of this study was to compare the safety, efficacy, quality-of-life impact, and costs of a single dose or a longer course of pre-procedural antibiotics prior to elective endoscopic urological procedures in individuals with spinal cord injury and disorders (SCI/D) and asymptomatic bacteriuria.Design
A prospective observational study.Setting
Hunter Holmes McGuire Veterans Affairs Medical Center, Richmond, Virginia, USA.Participants
Sixty persons with SCI/D and asymptomatic bacteriuria scheduled to undergo elective endoscopic urological procedures.Interventions
A single pre-procedural dose of antibiotics vs. a 3–5-day course of pre-procedural antibiotics.Outcome measures
Objective and subjective measures of health, costs, and quality of life.Results
There were no significant differences in vital signs, leukocytosis, adverse events, and overall satisfaction in individuals who received short-course vs. long-course antibiotics. There was a significant decrease in antibiotic cost (33.1 ± 47.6 vs. 3.6 ± 6.1 US$, P = 0.01) for individuals in the short-course group. In addition, there was greater pre-procedural anxiety (18 vs. 0%, P < 0.05) for individuals who received long-course antibiotics.Conclusion
SCI/D individuals with asymptomatic bacteriuria may be able to safely undergo most endoscopic urological procedures with a single dose of pre-procedural antibiotics. However, further research is required and even appropriate pre-procedural antibiotics may not prevent severe infections. 相似文献4.
Lisa M. Lombardo Stephanie N. Bailey Kevin M. Foglyano Michael E. Miller Gilles Pinault Ronald J. Triolo 《The journal of spinal cord medicine》2015,38(1):115-122
Objective
Explore whether electromyography (EMG) control of electrical stimulation for walking after incomplete spinal cord injury (SCI) can affect ability to modulate speed and alter gait spatial-temporal parameters compared to cyclic repetition of pre-programmed stimulation.Design
Single case study with subject acting as own concurrent control.Setting
Hospital-based biomechanics laboratory.Participants
Single subject with C6 AIS D SCI using an implanted neuroprosthesis for walking.Interventions
Lower extremity muscle activation via an implanted system with two different control methods: (1) pre-programmed pattern of stimulation, and (2) EMG-controlled stimulation based on signals from the gastrocnemius and quadriceps.Outcome measures
Gait speed, distance, and subjective rating of difficulty during 2-minute walks. Range of walking speeds and associated cadences, stride lengths, stride times, and double support times during quantitative gait analysis.Results
EMG control resulted in statistically significant increases in both walking speed and distance (P < 0.001) over cyclic stimulation during 2-minute walks. Maximum walking speed with EMG control (0.48 m/second) was significantly (P < 0.001) faster than the fastest automatic pattern (0.39 m/second), with increased cadence and decreased stride and double support times (P < 0.000) but no change in stride length (z = −0.085; P = 0.932). The slowest walking with EMG control (0.25 m/second) was virtually indistinguishable from the slowest with automatic cycling (z = −0.239; P = 0.811).Conclusion
EMG control can increase the ability to modulate comfortable walking speed over pre-programmed cyclic stimulation. While control methods did not differ at the lowest speed, EMG-triggered stimulation allowed significantly faster walking than cyclic stimulation. The expanded range of available walking speeds could permit users to better avoid obstacles and naturally adapt to various environments. Further research is required to definitively determine the robustness, generalizability, and functional implications of these results. 相似文献5.
Heather L. Gainforth Amy E. Latimer-Cheung Connie Davis Sheila Casemore Kathleen A. Martin Ginis 《The journal of spinal cord medicine》2015,38(4):515-525
Objective
The present study tested the feasibility of training peers with spinal cord injury (SCI) to learn brief action planning (BAP), an application of motivational interviewing principles, to promote physical activity to mentees with SCI.Method
Thirteen peers with SCI attended a half-day BAP workshop. Using a one-arm, pre-, post-test design, feasibility to learn BAP was assessed in terms of peers'' (1) BAP and motivational interviewing spirit competence; (2) training satisfaction; and (3) motivations to use BAP as assessed by measures of the theory of planned behavior constructs. Measures were taken at baseline, immediately post-training, and 1 month follow up.Results
Following the training, participants'' BAP and motivational interviewing competence significantly increased (P''s < 0.05, d''s > 2.27). Training satisfaction was very positive with all means falling above the scale midpoint. Participants'' perceived behavioral control to use BAP increased from baseline to post (P < 0.05, d = 0.91) but was not maintained at follow up (P > 0.05).Conclusion
Training peers with a SCI to learn to use BAP is feasible.Practical implications
BAP is a tool that can be feasibly learned by peers to promote physical activity to their mentees. 相似文献6.
Casper Floris van Koppenhagen Marcel Post Sonja de Groot Christel van Leeuwen Floris van Asbeck Janneke Stolwijk-Swüste Lucas van der Woude Eline Lindeman 《The journal of spinal cord medicine》2014,37(3):328-337
Objective
To examine the relationship between wheelchair exercise capacity and life satisfaction in persons with spinal cord injury from the start of active inpatient rehabilitation up to 5 years after discharge.Design
Prospective cohort study.Subjects
Persons with spinal cord injury, aged 18–65 years, and wheelchair dependent at least for long distances.Method
Measurements at the start of active rehabilitation, after 3 months, at discharge from inpatient rehabilitation, and 1 and 5 years after discharge. A peak wheelchair exercise test was performed to record peak oxygen uptake (VO2peak) and peak power output (POpeak). Life satisfaction was measured as current life satisfaction and change of life satisfaction in comparison with life after spinal cord injury. Relationships between (changes in) exercise capacity and (changes in) life satisfaction were analyzed random coefficient analysis, corrected for possible confounders (age, gender, level of lesion, functional status, secondary impairments, pain, and sports activity) if necessary.Results
Of 225 persons included, 130 attended two or more peak exercise tests, who were include in the analyses. Mean age at start was 39 years, 75% were male, 73% had paraplegia, and 76% had a traumatic lesion. Mean POpeak increased during the study from 32.9 to 55.9 Watts, mean VO2peak from 1.02 to 1.38 l/minute, and mean life satisfaction from 5.7 to 7.8. An increase of POpeak with 10 W was associated with a 0.3-point increase of life satisfaction (P = 0.01). An increase of VO2peak with 0.1 l/minute was associated with a 0.1-point increase of life satisfaction (P = 0.049).Conclusion
High(er) wheelchair exercise capacity is related to high(er) life satisfaction in spinal cord injury patients. 相似文献7.
Jamie M. Zeitzer Ban Ku Doug Ota B. Jenny Kiratli 《The journal of spinal cord medicine》2014,37(1):46-53
Objective
To determine the effectiveness of a melatonin agonist for treating sleep disturbances in individuals with tetraplegia.Design
Placebo-controlled, double-blind, crossover, randomized control trial.Setting
At home.Participants
Eight individuals with tetraplegia, having an absence of endogenous melatonin production and the presence of a sleep disorder.Interventions
Three weeks of 8 mg of ramelteon (melatonin agonist) and 3 weeks of placebo (crossover, randomized order) with 2 weeks of baseline prior to and 2 weeks of washout between active conditions.Outcome
Change in objective and subjective sleep.Measures
Wrist actigraphy, post-sleep questionnaire, Stanford sleepiness scale, SF-36.Results
We observed no consistent changes in either subjective or objective measures of sleep, including subjective sleep latency (P = 0.55, Friedman test), number of awakenings (P = 0.17, Friedman test), subjective total sleep time (P = 0.45, Friedman test), subjective morning alertness (P = 0.35, Friedman test), objective wake after sleep onset (P = 0.70, Friedman test), or objective sleep efficiency (P = 0.78, Friedman test). There were significant increases in both objective total sleep time (P < 0.05, Friedman test), subjective time in bed (P < 0.05, Friedman test), and subjective sleep quality (P < 0.05, Friedman test), although these occurred in both arms. There were no significant changes in any of the nine SF-36 subscale scores (Friedman test, Ps >Bonferroni adjusted α of 0.005).Conclusion
In this pilot study, we were unable to show effectiveness of pharmacological replacement of melatonin for the treatment of self-reported sleep problems in individuals with tetraplegia.Trial Registration
ClinicalTrials.gov # . NCT00507546相似文献8.
Sherri L. LaVela Kelsie Landers Bella Etingen Vytas P. Karalius Scott Miskevics 《The journal of spinal cord medicine》2015,38(4):505-514
Context/objective
To compare outcomes among caregivers of adults with spinal cord injuries (SCIs) to caregivers of adults with other neurological conditions, and determine if caregiving for SCI is associated with poor health status and chronic conditions.Design
Secondary data analysis of 2009/2010 Behavioral Risk Factor Surveillance System survey.Participants
Informal caregivers of adults with neurological conditions.Outcome measures
Sociodemographics, caregiving factors (e.g. role, emotional support, life satisfaction), lifestyle behaviors, chronic conditions, and health status.Results
Demographics and lifestyle behaviors did not differ in caregivers of adults with SCI vs. caregivers of adults with other neurological conditions (except younger age of SCI caregivers). Greater proportions of caregivers of adults with SCI had coronary heart disease (CHD) (12% vs. 6%, P = 0.06) and were obese (43% vs. 28%, P = 0.03). Frequent physical distress was reported by 20% of caregivers of persons with SCI (vs. 12% of other caregivers, P = 0.09), but mental health did not differ between caregiver groups. A greater proportion of caregivers of adults with SCI experienced insufficient sleep (47% vs. 30%, P = 0.008) and more days without enough sleep (13 vs. 9 days, P = 0.008). Odds of being younger, caregiver of a spouse, having CHD, and being obese were associated with being a caregiver of an adult with SCI.Conclusion
Caregivers of adults with SCI report similar mental health status, but more poor sleep, and have increased odds of CHD and obesity. Interventions to address physical distress, improve sleep, and address CHD and obesity are needed in this cohort. 相似文献9.
Cathy Lysack Stewart Neufeld Heather Dillaway 《The journal of spinal cord medicine》2014,37(2):193-201
Objective
To describe how men and women with spinal cord injury (SCI) rate the risks posed by a set of everyday activities measured using the Risk Inventory for persons with Spinal Cord Injury (RISCI), and to examine whether sex differences are related to community integration and participation.Design
Cohort study.Setting
Metropolitan Detroit.Participants
One hundred and forty community-dwelling white and African-American men and women with SCI.Outcome measures
RISCI scores, community integration, and level of and satisfaction with community participation.Results
Study participants were just over age 40 years, and had been living with SCI for 10.8 years. One-third were women and 40% were African-American. Results showed women with SCI had higher RISCI scores (perceived more dangers) on every item on the RISCI Scale (P < 0.001). The items perceived to hold greatest risk were revealing personal information to others, going on a blind date, and going for a roll (“walk”) alone after dark. Women with higher RISCI scores reported lower community integration (P < 0.05) and lower levels of and lower satisfaction with community participation (P < 0.01). For men, however, RISCI scores were mainly unrelated (except for community integration) to participation measures.Conclusion
More research is needed to determine whether the levels of risk perceived by women are warranted and whether a sense of vulnerability for women with SCI is unnecessarily limiting their chances at “a good life” after injury. 相似文献10.
Padmaja Kankipati Michael L. Boninger Dany Gagnon Rory A. Cooper Alicia M. Koontz 《The journal of spinal cord medicine》2015,38(4):485-497
Study design
Repeated measures design.Objective
This study compared the upper extremity (UE) joint kinetics between three transfer techniques.Setting
Research laboratory.Methods
Twenty individuals with spinal cord injury performed three transfer techniques from their wheelchair to a level tub bench. Two of the techniques involved a head–hips method with leading hand position close (HH-I) and far (HH-A) from the body, and the third technique with the trunk upright (TU) and hand far from body. Motion analysis equipment recorded upper body movements and force sensors recorded their hand and feet reaction forces during the transfers.Results
Several significant differences were found between HH-A and HH-I and TU and HH-I transfers indicating that hand placement was a key factor influencing the UE joint kinetics. Peak resultant hand, elbow, and shoulder joint forces were significantly higher for the HH-A and TU techniques at the trailing arm (P < 0.036) and lower at the leading arm (P < 0.021), compared to the HH-I technique.Conclusion
Always trailing with the same arm if using HH-A or TU could predispose that arm to overuse related pain and injuries. Technique training should focus on initial hand placement close to the body followed by the amount of trunk flexion needed to facilitate movement. 相似文献11.
Leslie R. M. Hausmann Larissa Myaskovsky Christian Niyonkuru Michelle L. Oyster Galen E. Switzer Kelly H. Burkitt Michael J. Fine Shasha Gao Michael L. Boninger 《The journal of spinal cord medicine》2015,38(1):102-110
Context
Despite evidence that healthcare providers have implicit biases that can impact clinical interactions and decisions, implicit bias among physicians caring for individuals with spinal cord injury (SCI) has not been examined.Objective
Conduct a pilot study to examine implicit racial bias of SCI physicians and its association with functioning and wellbeing for individuals with SCI.Design
Combined data from cross-sectional surveys of individuals with SCI and their SCI physicians.Setting
Four national SCI Model Systems sites.Participants
Individuals with SCI (N = 162) and their SCI physicians (N = 14).Outcome measures
SCI physicians completed online surveys measuring implicit racial (pro-white/anti-black) bias. Individuals with SCI completed questionnaires assessing mobility, physical independence, occupational functioning, social integration, self-reported health, depression, and life satisfaction. We used multilevel regression analyses to examine the associations of physician bias and outcomes of individuals with SCI.Results
Physicians had a mean bias score of 0.62 (SD = 0.35), indicating a strong pro-white/anti-black bias. Greater physician bias was associated with disability among individuals with SCI in the domain of social integration (odds ratio = 4.80, 95% confidence interval (CI) = 1.44, 16.04), as well as higher depression (B = 3.24, 95% CI = 1.06, 5.41) and lower life satisfaction (B = −4.54, 95% CI= −8.79, −0.28).Conclusion
This pilot study indicates that SCI providers are susceptible to implicit racial bias and provides preliminary evidence that greater implicit racial bias of physicians is associated with poorer psychosocial health outcomes for individuals with SCI. It demonstrates the feasibility of studying implicit bias among SCI providers and provides guidance for future research on physician bias and patient outcomes. 相似文献12.
Jia-Chi Wang Rai-Chi Chan Yun-An Tsai Wen-Cheng Huang Henrich Cheng Han-Lin Wu Shih-Fong Huang 《The journal of spinal cord medicine》2015,38(5):587-592
Objective
To assess whether functional activity, perceived health, and depressive symptoms differ between individuals with traumatic paraplegia with and without shoulder pain.Design
Cross sectional and comparative investigation using the unified questionnaire.Setting
Neural Regeneration and Repair Division unit of Taipei Veterans General Hospital in Taiwan.Participants
Seventy-six patients with paraplegia (23 with and 53 without shoulder pain) who had experienced spinal cord injury at American Spinal Injury Association Impairment Scale T2 to T12 neurologic level (at least 6 months previously).Outcome measures
Spinal Cord Independence Measure (SCIM), a single item from the Medical Outcomes Study 36-Item Short-Form Health Survey, and Patient Health Questionnaire-9 (PHQ-9) depression scale.Results
Shoulder pain was prevalent in 30% patients. Patients with shoulder pain had significantly worse perceived health and greater depressive symptoms than those without. No significant difference was found in functional ability between groups. Greater shoulder pain intensity was related to higher depressive scores (r = 0.278, P = 0.017) and lower self-perceived health scores (r = −0.433, P < 0.001) but not SCIM scores (P = 0.342).Conclusion
Although shoulder pain was unrelated to functional limitation, it was associated with lower perceived health and higher depressive mood levels. 相似文献13.
Inge E. Eriks-Hoogland Trynke Hoekstra Sonja de Groot Gerold Stucki Marcel W. Post Lucas H. van der Woude 《The journal of spinal cord medicine》2014,37(3):288-298
Objective/Background
Although shoulder pain is a problem in up to 86% of persons with a spinal cord injury (SCI), so far, no studies have empirically identified longitudinal patterns (trajectories) of musculoskeletal shoulder pain after SCI. The objective of this study was: (1) to identify distinct trajectories of musculoskeletal shoulder pain in persons with SCI, and (2) to determine possible predictors of these trajectories.Design/Methods
Multicenter, prospective cohort study in 225 newly injured persons with SCI.Outcome Measure
Shoulder pain was assessed on five occasions up to 5 years after discharge. Latent class growth mixture modeling was used to identify the distinct shoulder pain trajectories.Results
Three distinct shoulder pain trajectories were identified: (1) a “No or Low pain” trajectory (64%), (2) a “High pain” (30%) trajectory, and (3) a trajectory with a “Decrease of pain” (6%). Compared with the “No or Low pain” pain trajectory, the “High pain” trajectory consisted of more persons with tetraplegia, shoulder pain before injury, limited shoulder range of motion (ROM), lower manual muscle test scores, or more spasticity at t1. Multiple logistic regression analysis showed two significant predictors for the “High pain” trajectory (as compared with the “No or Low pain” trajectory): having a tetraplegia (odds ratio (OR) = 3.2; P = 0.002) and having limited shoulder ROM (OR = 2.8; P = 0.007).Conclusion
Shoulder pain in people with SCI follows distinct trajectories. At risk for belonging to the “High pain” trajectory are persons with tetraplegia and those with a limited shoulder ROM at start of active rehabilitation. 相似文献14.
Abbas Norouzi Javidan Hadis Sabour Sahar Latifi Farzad Shidfar Mohammad Reza Vafa Ramin Heshmat Hasan Emami Razavi Bagher Larijani Hamidreza Aghaei Meybodi 《The journal of spinal cord medicine》2014,37(6):744-750
Objectives
We described the associations between demographic and injury-related factors on bone mineral density (BMD) of the spine and the hip among adult patients with chronic spinal cord injury (SCI).Design
BMD in spinal and femoral bone sites were assessed. Multivariate analysis was performed to evaluate the relationship between anthropometric and injury-related factors with BMD. Serum level and amount of dietary intake of calcium, phosphor, and 25-hydroxy vitamin D were measured.Setting
A referral tertiary rehabilitation center in Iran.Participants
Patients with SCI who had no previous history of endocrine disorders and were not on specific medications entered the investigation. Those with non-traumatic SCI, pregnant, or with substance dependency were excluded as well.Interventions
No interventions were applied.Main study outcome measures
Dual X-ray absorptiometry was performed to estimate BMD. Body mass index was positively associated with higher femoral (P < 0.01, r = 0.56) and hip (P < 0.0001, r = 0.82) BMD only in female participants. The high prevalence of vitamin D deficiency (60%) was noticeable.Results
Older male patients revealed lower BMD only in spinal vertebrae (P < 0.02, r = −0.21). A significant higher BMD loss in lumbar vertebras in male patients with complete spinal cord lesion (P < 0.009) was detected. Spinal reduction of BMD was more severe when the level of injury was above T6 (P < 0.02).Conclusion
Along with the clarification of age, gender, post injury duration, and the other factors'' effect on the BMD in the SCI patients, here we have also shown the noticeable prevalence of the 25-hydoxy vitamin D deficiency in these patients which needs attention. 相似文献15.
Todd A. Astorino Eric T. Harness Kara A. Witzke 《The journal of spinal cord medicine》2015,38(5):615-625
Spinal cord injury (SCI) induces dramatic changes in body composition including reductions in fat-free mass (FFM) and increases in fat mass (FM).
Objective
To examine changes in body composition in response to chronic activity-based therapy (ABT) in persons with SCI.Design
Longitudinal exercise intervention.Methods
Seventeen men and women with SCI (mean age = 36.1 ± 11.5 years) completed 6 months of supervised ABT consisting of load bearing, resistance training, locomotor training, and functional electrical stimulation. At baseline and after 3 and 6 months of ABT, body weight, body fat, and FFM were assessed using dual-energy X-ray absorptiometry, and fasting blood samples were obtained to assess changes in insulin-like growth factor-I (IGF-I), adiponectin, and myostatin.Results
Across all subjects, there was no change (P > 0.05) in body weight, percent body fat, or FFM of the leg, arm, or trunk, whereas whole-body FFM declined (P = 0.02, 50.4 ± 8.4 to 49.2 ± 7.4 kg). No changes (P = 0.21–0.41) were demonstrated in IGF-I, adiponectin, or myostatin during the study.Conclusions
Chronic ABT focusing on the lower extremity does not slow muscle atrophy or alter body fat, body mass, or regional depots of FFM in persons with SCI. Further, it does not induce beneficial changes in adiponectin, myostatin, or IGF-I. Alternative exercise-based therapies are needed in SCI to reverse muscle atrophy and minimize the onset of related health risks. 相似文献16.
Ralph J. Marino Stephen B. Kern Benjamin Leiby Mary Schmidt-Read M. J. Mulcahey 《The journal of spinal cord medicine》2015,38(4):498-504
Objective
To determine the reliability and validity of the capabilities of upper extremity test (CUE-T), a measure of functional limitations, in patients with chronic tetraplegia.Design
Repeated measures.Setting
Outpatient rehabilitation center.Participants
Fifty subjects (36 male/14 female) with spinal cord injury (SCI) of ≥1-year duration participated. Subjects were 17–81 years old (mean 48.1 ± 18.2); neurological levels ranged from C2 through T6, American Spinal Injury Association Impairment Scale grades A–D.Interventions
Not applicable.Outcome measures
Intraclass correlation coefficients (ICC), weighted kappa and repeatability values for CUE-T; Spearman correlations of CUE-T with upper extremity motor scores (UEMS), and self-care and mobility portions of the Spinal Cord Independence Measure, vIII (SCIM III).Results
Score ranges for UEMS were 8–50, CUE-T 7–135, self-care SCIM 0–20, and mobility SCIM 0–40. The ICC values for total, right, and left side scores were excellent (0.97–0.98; 95% confidence interval 0.96–0.99). Item weighted kappa values were ≥0.60 for all but five items, four of which were right and left pronation and supination. Repeatability of total score was 10.8 points, right and left sides 6.3 and 6.1 points. Spearman correlations of the total CUE-T with the UEMS and SCIM self-care and mobility scores were 0.83, 0.70, and 0.55 respectively.Conclusions
The CUE-T displays excellent test–retest reliability, and good–excellent correlation with impairment and capacity measures in persons with chronic SCI. After revising pronation and supination test procedures, the sensitivity to change should be determined. 相似文献17.
Mahmoud Joghtaei Amir Massoud Arab Hamed Hashemi-Nasl Mohammad Taghi Joghataei Mohammad Osman Tokhi 《The journal of spinal cord medicine》2015,38(2):170-177
Objective
Stiffness and viscosity represent passive resistances to joint motion related with the structural properties of the joint tissue and of the musculotendinous complex. Both parameters can be affected in patients with spinal cord injury (SCI). The purpose of this study was to measure passive knee stiffness and viscosity in patients with SCI with paraplegia and healthy subjects using Wartenberg pendulum test.Design
Non-experimental, cross-sectional, case–control design.Setting
An outpatient physical therapy clinic, University of social welfare and Rehabilitation Science, Iran.Patients
A sample of convenience sample of 30 subjects participated in the study. Subjects were categorized into two groups: individuals with paraplegic SCI (n = 15, age: 34.60 ± 9.18 years) and 15 able-bodied individuals as control group (n = 15, age: 30.66 ± 11.13 years).Interventions
Not applicable.Main measures
Passive pendulum test of Wartenberg was used to measure passive viscous-elastic parameters of the knee (stiffness, viscosity) in all subjects.Results
Statistical analysis (independent t-test) revealed significant difference in the joint stiffness between healthy subjects and those with paraplegic SCI (P = 0.01). However, no significant difference was found in the viscosity between two groups (P = 0.17). Except for first peak flexion angle, all other displacement kinematic parameters exhibited no statistically significant difference between normal subjects and subjects with SCI.Conclusions
Patients with SCI have significantly greater joint stiffness compared to able-bodied subjects. 相似文献18.
19.
Objective
Characterization of a non-invasive method of quantifying subepidermal moisture (SEM) surrounding stages III and IV pressure ulcers (PrUs) in spinal cord injury (SCI).Design
Prospective, single-visit, single-rater, observational study, using repeated-measures analysis.Method
Setting-inpatient units of one VA SCI Center.Participants
Convenience sample of 16 subjects with SCI with stage III or IV PrUs over sacrum or ischium.Interventions
Measurement with the MoistureMeter-D, a hand-held device using 300 MHz electromagnetic waves.Outcome measures
Dielectric constant, a dimensionless number which increases with the moisture content. Each subject had a PrU site and a control site. Measurements were made at each site, on intact skin, at four points spaced angularly around the site, in triplicate.Results
(1) Short-term, single-rater relative error was 2.5%. (2) Order effect: first readings were higher than second readings in 55 of 64 measurement sets. Order effect was significant for control sites (P < 0.0001) but not for PrU sites. (3) Angular effect: SEM varied by angle at the PrU sites (P < 0.01); 12 o''clock position the highest and 6 o''clock the lowest. (4) Ability to differentiate PrUs from intact skin: SEM at PrU sites was greater by 9.0% than control sites (P < 0.05). (5) Site effect: SEM was higher at sacral locations than ischial at control sites by 20% (P < 0.005).Conclusions
SEM differentiates PrUs from intact skin. Future study designs must take into account order, angular, and site effects on this measure. This information will inform designers of future studies of SEM in healing of PrUs. 相似文献20.
Wilairat Saensook Puttipong Poncumhak Jiamjit Saengsuwan Lugkana Mato Worawan Kamruecha Sugalya Amatachaya 《The journal of spinal cord medicine》2014,37(2):212-217