Defining the Role of Sensation, Strength, and Prehension for Upper Limb Function in Cervical Spinal Cord Injury.
Defining the Role of Sensation, Strength, and Prehension for Upper Limb Function in Cervical Spinal Cord Injury.
Neurorehabil Neural Repair. 2013 Jun 18;
Kalsi-Ryan S, Beaton D, Curt A, Duff S, Jiang D, Popovic MR, Rudhe C, Fehlings MG, Verrier MC
BACKGROUND: . Upper limb function plays a significant role in enhancing independence for individuals with tetraplegia. However, there is limited knowledge about the specific input of sensorimotor deficits on upper limb function. Thus the theoretical framework designed to develop the Graded Redefined Assessment of Strength Sensibility and Prehension (GRASSP) was used as a hypothetical model to analyze the impact of impairment on function. OBJECTIVE: . To define the association of impairment (sensation, strength, and prehension measured by the GRASSP) to upper limb function as defined by functional measures (Capabilities of Upper Extremity Questionnaire, Spinal Cord Independence Measure). METHODS: . A hypothetical model representing relationships by applying structural equation modeling was used to estimate the effect of the impairment domains in GRASSP on upper limb function. Data collected on 72 chronic individuals with tetraplegia was used to test the hypothetical model. RESULTS: . Structural equation modeling confirmed strong associations between sensation, strength, and prehension with upper limb function, and determined 72% of the variance in “sensorimotor upper limb function” was explained by the model. Statistics of fit showed the data did fit the hypothesized model. Sensation and strength influence upper limb function directly and indirectly with prehension as the mediator. CONCLUSIONS: . The GRASSP is a sensitive diagnostic tool in distinguishing the relative contribution of strength, sensation and prehension to function. Thus, the impact of interventions on specific domains of impairment and related contribution on clinical recovery of the upper limb can be detailed to optimize rehabilitation programs. HubMed – rehab
Otariodibacter oris and Bisgaardia Genomospecies 1 Isolated from Infections in Pinnipeds.
J Wildl Dis. 2013 Jul; 49(3): 661-5
Hansen MJ, Bertelsen MF, Delaney MA, Fravel VA, Gulland F, Bojesen AM
We document the first associations of two recently described species of Pasteurellaceae bacteria with lesions in wild pinnipeds in rehabilitation. Samples were collected from nine lesions in four California sea lions (Zalophus californianus) and two Pacific harbor seals (Phoca vitulina) during necropsy or admission examinations at a rehabilitation facility in northern California. Seven Pasteurellaceae isolates were identified using phenotypic tests and partial rpoB gene sequencing. Six strains of Otariodibacter oris were isolated from California sea lions. Otariodibacter oris was isolated in pure culture from four abscesses, an affected lymph node, and a bone lesion consistent with osteomyelitis. Otariodibacter oris was also cultured with Arcanobacterium phocae and ?-hemolytic streptococci. A pure culture of Bisgaardia genomospecies 1 was obtained from an abscess in a harbor seal. This is the first time, to our knowledge, that O. oris has been associated with infection. Isolation of these bacteria in pure culture from abscesses and osteomyelitis strongly indicates a pathogenic potential of this organism. Likewise, the isolation of Bisgaardia genomospecies 1 in pure culture from an abscess in a harbor seal implies causality. HubMed – rehab
Pilot evaluation of the short-term effect of driving simulation on novice adolescent drivers.
J Trauma Acute Care Surg. 2013 Jul; 75(1): 83-7
Ekeh AP, Herman K, Bayham D, Markert R, Pedoto M, McCarthy MC
Despite widespread application in aviation and other fields, there has been limited use of computerized simulation in driver education. We prospectively studied a group of novice drivers subjected to comprehensive virtual driving simulation modules to identify the subsequent effects on their driving records. We hypothesized that participation in a simulation program would result in fewer offences and crashes.Forty high school students who recently obtained their driver’s license were randomized into driving simulator (DS) or control groups. The DS group went through 12 modules of driver education. Upon completion, driving records for all the individuals were collected at 6 months, 12 months, and 18 months, and comparisons were made. Statistical analysis was performed using ?, Fisher’s exact tests, t tests, and Mann Whitney U-test where appropriate.Of the 20 subjects, 16 in the DS group completed all modules and were compared with 19 individuals in the control group. Sixty-nine percent in the DS group were male versus 89% in the control group. Mean age was similar in both groups. The average time to the first offense after completion in the DS group was 117 days versus 105 days in control group (p = 0.8). At 18 months, 18.8% in the DS group were involved in a driving incident compared with 47.4% in the control group (p = 0.1516). At 18 months, there were 4 incidents (0.25 incidents per person) in the DS group versus 17 incidents (0.89 incidents per person) in the control group. At 18 months, 6.2% in the DS were involved in accidents compared with 21.1% in the control group (p= 0.35). Speeding infractions occurred at 18 months in 12.5% in the DS group versus 26.3% in the control group (p = 0.4150).In this prospective pilot evaluation of computerized driving simulation, adolescents subjected to structured simulator training showed trends toward committing fewer offences and accidents. Larger studies examining the practical potential of driving simulation in novice drivers are needed.Prognostic study, level III. HubMed – rehab
Guns and states: Pediatric firearm injury.
J Trauma Acute Care Surg. 2013 Jul; 75(1): 50-3
Lee J, Moriarty KP, Tashjian DB, Patterson LA
A recent report indicates that firearm-related injuries are responsible for 30% of pediatric trauma fatality. The literature is however limited in examining pediatric firearm injuries and variations in state gun control laws. Therefore, we sought to examine the association between pediatric firearm injuries and the Stand-Your-Ground (SYG) and Child Access Protection (CAP) laws.All pediatric (age, 0-20 years) hospitalizations with firearm injuries were identified from the Kids’ Inpatient Database from 2006 and 2009. States were compared for SYG and CAP laws.A total of 19,233 firearm injury hospitalizations were identified, with 64.7% assault, 27.2% accidental, and 3.1% suicide injury. Demographics for assault injury were as follows: mean age of 17.6 years, 88.4% male, 44.4% black, 18.2% Hispanic, 70.5% from metropolitan areas, and 50.1% from the poorest median income neighborhoods. Suicide injury cases were more likely to be white (57.8% vs. 16.6%, p < 0.001) and female (15.1% vs. 9.8%, p < 0.001). States with the SYG law were associated with increased accidental injury (odds ratio [OR], 1.282; p < 0.001). There was no statistical association between CAP law and the incidence of accidental injury or suicide. Multivariate logistic regression analysis found other predictive demographic factors for firearm injury: black (OR, 6.164), urban areas (OR, 1.557), poorest median income neighborhoods (OR, 2.785), male (OR, 28.602), and 16 years or older (OR, 37.308). Total economic burden was estimated at more than $ 1 billion dollars, with a median length of stay of 3 days, 8.4% discharge to rehabilitation, and 6.2% in-hospital mortality.Pediatric firearm injuries continue to be a significant source of morbidity, mortality, and economic burden. A significant increase in accidental firearm injuries in states with the SYG law may highlight inadvertent effects of the law. Race, sex, and median income are additional contributing factors. Advocacy and focused educational efforts for specific socioeconomic and racial groups may potentially reduce firearm injuries.Prognostic study, level II. HubMed – rehab