Long-Term Follow-Up of Patients With Ventilator-Dependent High Tetraplegia Managed With Diaphragmatic Pacing Systems |
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| Affiliation: | 1. Research Department, Craig Hospital, Englewood, CO;2. Department of Rehabilitation Medicine, University of Minnesota Medical School, Minneapolis, MN;3. Department of Psychology, University of Colorado, Denver, CO;4. Department of Physical Medicine and Rehabilitation, University of Colorado, Anschutz Medical School, Aurora, CO;5. Rocky Mountain Regional VA Medical Center, Aurora, CO;6. Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA;7. CNS Medical Group, Englewood CO;1. Human Engineering Research Laboratories, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA;2. Departments of Physical Medicine and Rehabilitation;3. Bioengineering;4. Physical Therapy;5. Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA;6. University of Pittsburgh Medical Center Centers for Rehab Services, Pittsburgh, PA;7. Department of Kinesiology and Community Health, College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Champaign, IL;8. Department of Human Performance and Sport Studies, Idaho State University, Pocatello, ID;1. Rehab Neural Engineering Labs, University of Pittsburgh, Pittsburgh, PA;2. Human Engineering Research Laboratories, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA;3. Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA;4. Department of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA;5. Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA;6. Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA;7. Department of Physical Therapy, University of Pittsburgh, Pittsburgh, PA;1. From the Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA;2. Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA;3. Department of Physical Therapy, University of Pittsburgh, Pittsburgh, PA;4. Human Engineering Research Laboratories, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA;5. Division of Physical Medicine and Rehabilitation, Dalhousie University, Halifax, Nova Scotia, Canada;6. Department of Physical Medicine & Rehabilitation, University of Alabama, Birmingham, AL;7. Kessler Foundation, West Orange, NJ;8. Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, Newark, NJ;9. Kessler Institute for Rehabilitation, West Orange, NJ;10. Feinberg School of Medicine, Northwestern University, Chicago, IL;11. Shirley Ryan Ability Lab, Chicago, IL;1. Biostatistics & Epidemiology Data Analytics Center, Boston University School of Public Health, Boston, MA;2. Rehabilitation Sciences, MGH Institute of Health Professions, Boston, MA;3. Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, MA;5. Department of Physical Medicine and Rehabilitation, University of Alabama at Birmingham, Birmingham, AL;6. Department of Health Law, Policy and Management, Boston University School of Public Health, Boston, MA;1. Rehab Neural Engineering Labs, University of Pittsburgh, Pittsburgh PA;2. Human Engineering Research Laboratories, Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA;3. Departments of Bioengineering;4. Physical Medicine and Rehabilitation;5. Physical Therapy, and;6. Rehabilitation Sciences and Technology, University of Pittsburgh, Pittsburgh, PA;7. Baylor College of Medicine, Houston, TX;8. MetroHealth Medical Center, Cleveland, OH;9. Shirley Ryan AbilityLab and Northwestern University Feinberg School of Medicine, Chicago, IL;1. Sociology Department, Vrije Universiteit Amsterdam, Netherlands;2. College of Health Sciences, Marquette University, Milwaukee, Wisconsin;3. Max Näder Center for Rehabilitation Technologies and Outcomes Research, Shirley Ryan AbilityLab, Chicago, Illinois;4. Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, Illinois;5. Craig Hospital, Englewood, Colorado;6. University of Colorado, Denver, Colorado;7. UT Health Science Center at Houston, Houston, Texas;8. Neurorecovery Research Center, TIRR Memorial Hermann, Houston, Texas;9. Shepherd Center, Atlanta, Georgia;10. Division of Physical Therapy, Emory University School of Medicine, Atlanta, Georgia |
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| Abstract: | ObjectiveTo explore participants’ experiences after implantation of a diaphragmatic pacing system (DPS).DesignCross-sectional, observational study using self-report questionnaires.SettingParticipants were recruited from 6 Spinal Cord Injury Model System centers across the United States (Craig Hospital, CO; Jefferson/Magee Rehabilitation Hospital, PA; Kessler Rehabilitation Center, NJ; University of Miami, FL; The Shirly Ryan Ability Lab, IL; Shepherd Center, GA).InterventionsNot applicable.ParticipantsMen and women (N=28) with tetraplegia were enrolled in the study between November 2012 and January 2015.Main Outcome MeasuresParticipants completed self-report questionnaires focused on their DPS usage and mechanical ventilation, as well as their experiences and satisfaction with the DPS.ResultsDPS is a well-tolerated and highly successful device to help individuals living with spinal cord injury who are dependent on ventilators achieve negative pressure, ventilator-free breathing. A small percentage of participants reported complications, including broken pacing wires and surgery to replace or reposition wires.ConclusionsThis study provides insight into the usage patterns of DPS and both the potential negative and positive effects that DPS can have on the life of the user. Knowledge gained from this study can provide a foundation for further discussion about the benefits and potential risks of using a DPS to inform an individual's decision to pursue a DPS implant. |
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