scholarly journals Highlighting gaps in spinal cord injury research in activity-based interventions for the upper extremity: A scoping review

2021 ◽  
pp. 1-16
Author(s):  
Namrata Grampurohit ◽  
Alison Bell ◽  
Susan Duff ◽  
MJ Mulcahey ◽  
Christina Calhoun Thielen ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Upper Extremity ◽  
Scoping Review ◽  
Neurological Disorders ◽  
High Intensity ◽  
English Language ◽  
Research Work ◽  
Stroke Research ◽  
Cord Injury

BACKGROUND: Upper extremity activity-based therapy for neurologic disorders employs high-intensity, high repetition functional training to exploit neuroplasticity and improve function. Research focused on high-intensity upper extremity activity-based therapy for persons with spinal cord injury (SCI) is limited. OBJECTIVE: To summarize high-intensity activity-based interventions used in neurological disorders for their current or potential application to SCI. METHODS: The scoping review included articles from MEDLINE, CINAHL, Cochrane CENTRAL, and OTseeker with the criteria: non-invasive activity-based interventions delivered atleast three times/week for two weeks, upper extremity functional outcomes, 13 years or older, English language, and neurological disorders three months post onset/injury. RESULTS: The search yielded 172 studies. There were seven studies with SCI, all in adults. Activity-based interventions in SCI included task-specific training and gaming, with and without electrical stimulation, and a robotic exoskeleton. The other populations found in the review included studies in stroke, cerebral palsy, and multiple sclerosis. Thirty-four different interventions were reported in other populations. In comparison to the extensive stroke research, work in SCI was not found for high-intensity interventions using virtual reality, brain stimulation, rehabilitation devices, and applications to the home and telerehab settings. CONCLUSION: The results highlight critical gaps within upper extremity high-intensity activity-based research in SCI.

scholarly journals Factors Which Facilitate or Impede Interpersonal Interactions and Relationships after Spinal Cord Injury: A Scoping Review with Suggestions for Rehabilitation

2016 ◽  
Vol 2016 ◽  
pp. 1-13 ◽  
Author(s):  
Delena Amsters ◽  
Sarita Schuurs ◽  
Kiley Pershouse ◽  
Bettina Power ◽  
Yvonne Harestad ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Scoping Review ◽  
English Language ◽  
International Classification Of Functioning ◽  
Interpersonal Interactions ◽  
Self Image ◽  
Language Studies ◽  
Cord Injury ◽  
Review Question

Interpersonal interactions and relationships can influence an individual’s perceptions of health and quality of life in the presence of disability. In the case of people with spinal cord injury (SCI), positive interpersonal interactions and relationships have been shown to contribute to resilience and adaptability. Understanding factors which facilitate or impede the development and maintenance of relationships after SCI may form the basis for proactive relationship support for people with SCI. To gain a broad insight into these factors, a scoping review was undertaken. Databases were searched for English language studies published between 2000 and 2015 that informed the review question. Sixty-two (62) studies were identified. Thematic analysis was conducted on data extracted from the studies and 51 factors which may facilitate relationships and 38 factors which may impede relationships after SCI were noted. The majority of factors could be categorized as environmental or personal according to the domains of the International Classification of Functioning, Disability, and Health (ICF). The facilitating factors included partner and social support, reciprocity in relationships, and presenting oneself positively. Impeding factors included physical environmental barriers, real and perceived social biases, and poor self-image. Factors identified may inform the provision of supportive, holistic rehabilitation for people with SCI.

A critical reappraisal of corticospinal tract somatotopy and its role in traumatic cervical spinal cord syndromes

2021 ◽  
pp. 1-7
Author(s):  
Allan D. Levi ◽  
Jan M. Schwab
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Upper Extremity ◽  
Corticospinal Tract ◽  
Cervical Spinal Cord ◽  
Hand Function ◽  
Cervical Spinal Cord Injury ◽  
Pathophysiological Mechanism ◽  
Cord Injury ◽  
Central Cord Syndrome

The corticospinal tract (CST) is the preeminent voluntary motor pathway that controls human movements. Consequently, long-standing interest has focused on CST location and function in order to understand both loss and recovery of neurological function after incomplete cervical spinal cord injury, such as traumatic central cord syndrome. The hallmark clinical finding is paresis of the hands and upper-extremity function with retention of lower-extremity movements, which has been attributed to injury and the sparing of specific CST fibers. In contrast to historical concepts that proposed somatotopic (laminar) CST organization, the current narrative summarizes the accumulated evidence that 1) there is no somatotopic organization of the corticospinal tract within the spinal cord in humans and 2) the CST is critically important for hand function. The evidence includes data from 1) tract-tracing studies of the central nervous system and in vivo MRI studies of both humans and nonhuman primates, 2) selective ablative studies of the CST in primates, 3) evolutionary assessments of the CST in mammals, and 4) neuropathological examinations of patients after incomplete cervical spinal cord injury involving the CST and prominent arm and hand dysfunction. Acute traumatic central cord syndrome is characterized by prominent upper-extremity dysfunction, which has been falsely predicated on pinpoint injury to an assumed CST layer that specifically innervates the hand muscles. Given the evidence surveyed herein, the pathophysiological mechanism is most likely related to diffuse injury to the CST that plays a critically important role in hand function.

The effects of epidural stimulation on individuals living with spinal cord injury or disease: a scoping review

2021 ◽  
Vol 26 (5) ◽  
pp. 344-369
Author(s):  
Hope Jervis Rademeyer ◽  
Cindy Gauthier ◽  
Kei Masani ◽  
Maureen Pakosh ◽  
Kristin E. Musselman
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Scoping Review ◽  
Epidural Stimulation ◽  
Cord Injury

scholarly journals Efficacy of autologous bone marrow mononuclear cell transplantation in dogs with chronic spinal cord injury

2020 ◽  
Vol 10 (2) ◽  
pp. 206-215
Author(s):  
Katsutoshi Tamura ◽  
Noritaka Maeta
Keyword(s):  
Spinal Cord ◽  
Bone Marrow ◽  
Spinal Cord Injury ◽  
Cell Transplantation ◽  
Mononuclear Cell ◽  
Motor Neurons ◽  
Research Work ◽  
Autologous Bone Marrow ◽  
Bone Marrow Mononuclear Cell ◽  
Cord Injury

Background: Spinal cord injury (SCI) is relatively common in dogs and is a devastating condition involving loss of sensory neurons and motor  neurons. However, the main clinical protocol for the management of SCI is surgery to decompress and stabilize the vertebra. Cell transplantation therapy is a very promising strategy for the treatment of chronic SCI, but extensive preclinical and clinical research work remains.Aim: The aim of this study is to confirm the effect of bone marrow-derived mononuclear cell (BM-MNC) transplantation for chronic SCI in dogs.Methods: We tested the treatment efficiency of chronic SCI in 12 dogs using BM-MNC transplantation. Neurological evaluation used the Texas Spinal Cord Injury Scale (TSCIS). Concurrently, we characterized the transplanted cells by evaluation using quantitative real-time polymerase chain reaction, flow cytometry, and enzyme-linked immunosorbent assay.Result: All dogs had a pre-transplantation TSCIS score of 0. Two animals did not show any improvement in their final TSCIS scores. The remaining 10 dogs (83.4%) achieved improvement in the final TSCIS scores. Five of them (41.7%) regained ambulatory function with a TSCIS score greater than 10. We determined that canine BM-MNCs expressed hepatocyte growth factor (HGF) mRNA at higher levels than other cytokines, with significant  increases in HGF levels in cerebrospinal fluid within 48 hours after autologous BM-MNC transplantation into the subarachnoid space of the spinal dura matter in dogs.Conclusions: BM-MNC transplantation may be effective for at least some cases of chronic SCI. Keywords: Bone marrow-derived mononuclear cell, Cell therapy, Spinal cord injury.

scholarly journals A qualitative interview study on how people with incomplete spinal cord injury experience high-intensity walking exercise

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Malene Kolstad Sterling ◽  
Matthijs Ferdinand Wouda ◽  
Andreas Falck Lahelle
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
High Intensity ◽  
Inpatient Rehabilitation ◽  
Interview Study ◽  
Natural Setting ◽  
Incomplete Spinal Cord Injury ◽  
Qualitative Interview Study ◽  
Cord Injury ◽  
Walking Exercise

Abstract Study design Qualitative, in-depth research interviews. Objective To provide new insight into how people with a recent incomplete spinal cord injury (SCI) experience high-intensity walking exercise after discharge from subacute inpatient rehabilitation. Setting Informants for this interview study participated in a previous randomized controlled trial (RCT) that was conducted at Sunnaas Rehabilitation Hospital, Norway. Methods Four individual face-to-face interviews were conducted with the participants in natural setting. The interviews were analyzed through systematic text condensation and discussed in the context of experiences of bodily changes. Results Four themes emerged that described positive but also challenging bodily experiences related to performing high-intensity walking exercise: “Expectations and motivation”—reasons for participating, “Challenging bodily changes”—impacts on walking ability, “Adaptation strategies”—achieving the high-intensity target level, and “Integrating exercise into a new daily life”—combining participation, new body and new life. Conclusions This study indicates the importance of participating in a specific exercise program at discharge from subacute inpatient rehabilitation for ambulant people with SCI. However, high-intensity walking exercise may be too demanding to perform during this time period. The insights from the study provide new knowledge that can contribute to improving clinical rehabilitation practice.

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