Community Needs of People Living With Spinal Cord Injury and Their Family.
Community Needs of People Living With Spinal Cord Injury and Their Family.
Top Spinal Cord Inj Rehabil. 2012; 18(2): 122-125
Beauregard L, Guindon A, Noreau L, Lefebvre H, Boucher N
31st g. Heiner sell lectureship: secondary medical consequences of spinal cord injury.
Top Spinal Cord Inj Rehabil. 2012; 18(4): 354-78
Bauman WA, Korsten MA, Radulovic M, Schilero GJ, Wecht JM, Spungen AM
Persons with spinal cord injury (SCI) have secondary medical consequences of paralysis and/or the consequences of extreme inactivity. The metabolic changes that result from reduced activity include insulin resistance with carbohydrate disorders and dyslipidemia. A higher prevalence of coronary artery calcification was found in persons with SCI than that in matched able-bodied controls. A depression in anabolic hormones, circulating testosterone and growth hormone, has been described. Adverse soft tissue body composition changes of increased adiposity and reduced skeletal muscle are appreciated. Immobilization is the cause for sublesional disuse osteoporosis with an associated increased risk of fragility fracture. Bowel dysmotility affects all segments of the gastrointestinal tract, with an interest in better defining and addressing gastroesophageal reflux disease and difficulty with evacuation. Developing and testing more effective approaches to cleanse the bowel for elective colonoscopy are being evaluated. The extent of respiratory dysfunction depends on the level and completeness of SCI. Individuals with higher spinal lesions have both restrictive and obstructive airway disease. Pharmacological approaches and expiratory muscle training are being studied as interventions to improve pulmonary function and cough strength with the objective of reducing pulmonary complications. Persons with spinal lesions above the 6th thoracic level lack both cardiac and peripheral vascular mechanisms to maintain blood pressure, and they are frequently hypotensive, with even worse hypotension with upright posture. Persistent and/or orthostatic hypotension may predispose those with SCI to cognitive impairments. The safety and efficacy of anti-hypotensive agents to normalize blood pressure in persons with higher level cord lesions is being investigated. HubMed – rehab
Effects of Nicotine on Spinal Cord Injury Pain: A Randomized, Double-Blind, Placebo Controlled Crossover Trial.
Top Spinal Cord Inj Rehabil. 2012; 18(2): 101-105
Richardson EJ, Richards JS, Stewart CC, Ness TJ
One factor affecting spinal cord injury (SCI)-related pain may be nicotine. Case reports have described a worsening of neuropathic pain from smoking and relief from abstinence. Neurobiological correlates also implicate the potential effect of nicotine on SCI-related pain.The current study employed a randomized, placebo-controlled crossover design to examine the effect of nicotine exposure on subtypes of SCI-related pain among smokers and nonsmokers.Whereas nonsmokers with SCI showed a reduction in mixed forms of pain following nicotine exposure, smokers with SCI showed a converse increase in pain with regard to both mixed and neuropathic forms of pain. The exacerbation of pain in chronic nicotine or tobacco users may not only elucidate possible pain mechanisms but may also be of use in smoking cessation counseling among those with SCI. HubMed – rehab
Planning and Structuring Spinal Cord Injury Rehabilitation: The Needs Assessment Checklist.
Top Spinal Cord Inj Rehabil. 2012; 18(2): 135-137
Kennedy P, Smithson EF, Blakey LC
The study aimed to evaluate the Needs Assessment Checklist (NAC) as a clinically appropriate assessment tool for use during spinal cord injury (SCI) rehabilitation. Data were obtained during routine clinical assessments from 193 patients admitted to the National Spinal Injuries Centre, UK, from September 2007 to November 2009. Reliability analyses yielded high internal consistency coefficients (mean ? = .889, SD .051), and the mean item internal validity correlation was .534 (SD .136). All subscales of the NAC were found to be highly significant to change between administrations (mean P <.001). Several differences were found on the NAC subscales with respect to gender, age, and mobility. Pain and psychological issues were associated with poorer rehabilitation outcomes. The NAC is demonstrated to be a clinically reliable assessment tool that can be used to structure rehabilitation progress by the generation of person-centered goals. The results highlight the importance of assessing psychological issues and pain during SCI rehabilitation. HubMed – rehab
Proposed International Spinal Cord Injury Pain (ISCIP) Classification:: Preliminary Validation Data.
Top Spinal Cord Inj Rehabil. 2012; 18(2): 143-145
Bryce TN, Ivan E, Dijkers M