Toward non-clinical validation of fractional flow reserve simulation software: A generic coronary artery geometry.

Medical image-based diagnostic techniques have become increasingly common in the clinic. Estimating fractional flow reserve in coronary stenoses from medical image data is among the most prominent examples. The modeling techniques used in these clinical tools require rigorous experimental validation yet there is currently no standardized, public toolset to help assess model credibility.

Trabecular Bone Score in Individuals with Chronic Spinal Cord Injury: A Cross-Sectional Study.

Objectives: To describe lumbar spine (LS) trabecular bone score (TBS) values after SCI, and to explore the differences in fractures risk assessment between FRAX® and TBS-adjusted FRAX® in individuals living with chronic SCI.

Methods: Baseline dual-energy x-ray absorptiometry (DXA) scans from an established cohort were acquired using a Hologic Discovery QDR 4500. TBS measurements were performed using the TBS iNsight software version 2.

Urban-Rural Disparities in Community Participation after Spinal Cord Injury in Ontario.

Background: Personal, social, and environmental factors may influence self-efficacy and social reintegration among people living with spinal cord injury or disease (SCI/D) in urban and rural areas. Novel data collection methods have the potential to characterize community participation (CP) in diverse settings.

Objectives: The objectives were (1) to describe and compare self-reported community participation (Reintegration to Normal Living Index (RNLI) and Moorong Self-Efficacy Scale (MSES)) levels of individuals with SCI/D living in urban or rural Ontario, Canada; and (2) to determine the accuracy of an artificial intelligence (AI) optical mark recognition tool for extracting data from CP surveys conducted among participants after transitioning from inpatient rehabilitation to home and residing in the community.

COVID-19 and Mortality in the Spinal Cord Injury Population: Examining the Impact of Sex, Mental Health, and Injury Etiology.

Background/objective: The purpose of this study was to investigate the impact of the COVID-19 pandemic on mortality rates in a community-dwelling spinal cord injury (SCI) population in Ontario.

Methods: Using health administrative databases, monthly mortality rates were evaluated pre-pandemic, during the pandemic, and post-pandemic from March 2014 to May 2024. Data were stratified by sex, injury etiology, and mental health status.

COVID-19 Vaccine Uptake among People with Spinal Cord Injury and Dysfunction in Ontario, Canada: A Population-Based Retrospective Cohort Study.

Persons with disabilities experience numerous barriers to healthcare access including vaccine accessibility. The purpose of this study was to determine COVID-19 vaccine uptake in the spinal cord injury and disease (SCI/D) population of Ontario and identify potential factors influencing C OVID-19 vaccine uptake. This was a retrospective closed-cohort study using administrative health data on individuals with SCI/D of traumatic and non-traumatic causes to examine the monthly number of COVID-19 vaccine doses received between December 2020 and December 2023.

Parkwood's VIP4SCI platform: A virtual e-health self-management solution for persons with spinal cord injury across the care continuum.

Objective: Parkwood VIP4SCI platform is a virtual e-health solution adapted from a version created for Spinal Cord Injury Ontario (SCIO) that focused on self-management skill development for persons with spinal cord injury (SCI) transitioning between stages of care, in partnership with caregivers and clinicians. This evaluation of the platform informs the usability and feasibility of a model to facilitate service care aims postrehabilitation.

Design: Inpatients and outpatients admitted to the SCI Rehabilitation Program (n = 31), and a mix of interdisciplinary clinicians on the Rehabilitation Team (n = 20).

Credibility assessment of in silico clinical trials for medical devices.

In silico clinical trials (ISCTs) are an emerging method in modeling and simulation where medical interventions are evaluated using computational models of patients. ISCTs have the potential to provide cost-effective, time-efficient, and ethically favorable alternatives for evaluating the safety and effectiveness of medical devices. However, ensuring the credibility of ISCT results is a significant challenge.

The Changing Prevalence of Pressure Injury among Ontarians with SCI/D at Rehabilitation Admission: Opportunities for Improvement.

Background: Despite preventability, 20-50% of patients with acute spinal cord injury/disease (SCI/D) develop hospital-acquired pressure injuries (PIs). The Spinal Cord Injury Implementation and Evaluation Quality Care Consortium (SCI IEQCC) aimed to mitigate PI risk through patient-reported daily skin checks alongside usual care.

Methods: This quality improvement initiative utilized an interrupted time series design, encompassing adults ≥ 18 years admitted for inpatient rehabilitation across five Ontario sites from 2020 to 2023.

Examining the impact of the COVID-19 pandemic on homecare services among individuals with traumatic and non-traumatic spinal cord injuries.

Study Design: Descriptive repeated-cross sectional retrospective longitudinal cohort study.

Objective: To investigate the impact of the COVID-19 pandemic on homecare services in individuals with traumatic or non-traumatic Spinal Cord Injury (SCI).

Setting: Health administrative database in Ontario, Canada.

Exoskeleton-based exercises for overground gait and balance rehabilitation in spinal cord injury: a systematic review of dose and dosage parameters.

Background: Exoskeletons are increasingly applied during overground gait and balance rehabilitation following neurological impairment, although optimal parameters for specific indications are yet to be established.

Objective: This systematic review aimed to identify dose and dosage of exoskeleton-based therapy protocols for overground locomotor training in spinal cord injury/disease.

Methods: A systematic review was conducted in accordance with the Preferred Reporting Items Systematic Reviews and Meta-Analyses guidelines.

The impact of the COVID-19 virus and pandemic on healthcare utilization, access, delivery, experiences, and outcomes in the spinal cord injuries/dysfunction population: A scoping review study.

Background: Individuals with spinal cord injuries or disease (SCI/D) require frequent healthcare services. The COVID-19 pandemic may have impacted healthcare. Furthermore, due to secondary health conditions and comorbidities persons with SCI/D are at increased risk of experiencing severe symptoms or outcomes if infected with the COVID-19 virus.

Convergent validity and responsiveness of The Standing and Walking Assessment Tool (SWAT) among individuals with non-traumatic spinal cord injury.

Aim: This study aimed to (1) describe the use of the Standing and Walking Assessment Tool (SWAT) among individuals with non-traumatic spinal cord injury or disease (NT-SCI/D); (2) evaluate the convergent validity of SWAT for use among inpatients with NT-SCI/D; (3) describe SWAT responsiveness; and (4) explore the relationship between hours of walking therapy and SWAT change.

Methods: A quality improvement project was conducted at the University Health Network between 2019 and 2022. Participants' demographics and impairments data, rehabilitation length of stay, and FIM scores were obtained from the National Rehabilitation Reporting System.

Identifying prescribers of antibiotics in a primary care spinal cord injury cohort.

Study Design: A retrospective cross-sectional study.

Objective: To identify who prescribes outpatient antibiotics among a primary care spinal cord injury (SCI) cohort.

Setting: ICES databases in Ontario, Canada.

Developing and Evaluating Data Infrastructure and Implementation Tools to Support Cardiometabolic Disease Indicator Data Collection.

Background: Assessment of aerobic exercise (AE) and lipid profiles among individuals with spinal cord injury or disease (SCI/D) is critical for cardiometabolic disease (CMD) risk estimation.

Objectives: To utilize an artificial intelligence (AI) tool for extracting indicator data and education tools to enable routine CMD indicator data collection in inpatient/outpatient settings, and to describe and evaluate the recall of AE levels and lipid profile assessment completion rates across care settings among adults with subacute and chronic SCI/D.

Methods: A cross-sectional convenience sample of patients affiliated with University Health Network's SCI/D rehabilitation program and outpatients affiliated with SCI Ontario participated.

Identifying Patterns of Primary Care Antibiotic Prescribing for a Spinal Cord Injury (SCI) Cohort Using an Electronic Medical Records (EMR) Database.

Background: Individuals with a spinal cord injury (SCI) are considered higher users of antibiotics. However, to date there have been no detailed studies investigating outpatient antibiotic use in this population.

Objectives: (1) To describe primary care antibiotic prescribing patterns in adults with SCI rostered to a primary care physician (PCP), and (2) to identify patient or PCP factors associated with number of antibiotics prescribed and antibiotic prescription duration.

Using Risk Scores to Estimate Lower Extremity Fragility Fracture Risk among Individuals with Chronic Spinal Cord Injury: A Preliminary Model.

Objectives: To develop SCI-FX, a risk score to estimate 5-year lower extremity fragility fracture risk among patients living with chronic spinal cord injury (cSCI).

Methods: Adults with traumatic cSCI ( = 90) participated in a 2-year prospective longitudinal cohort study describing bone mineral density (BMD) change and fracture incidence conducted at the Lyndhurst Centre (University Health Network), University of Waterloo, and Physical Disability Rehabilitation Institute of Québec City. Prior publication and clinical intuition were used to identify fragility fracture risk factors including prior fragility fracture, years post-injury, motor complete injury (AIS A/B), benzodiazepine use, opioid use, and parental osteoporosis.

Reducing endocrine metabolic disease risk in adults with chronic spinal cord injury: strategic activities conducted by the Ontario-Quebec RIISC team.

Purpose: The ehabilitation nterventions for ndividuals with a pinal Cord Injury in the ommunity (RIISC) team aimed to develop and evaluate innovative rehabilitation interventions to identify endocrine metabolic disease (EMD) risk, intending to reduce the frequency and severity of EMD related morbidity and mortality among adults living with chronic spinal cord injury or disease (SCI/D).

Materials And Methods: An interprovincial team from Ontario and Quebec reviewed available EMD literature and evidence syntheses and completed an inventory of health services, policies and practices in SCI/D care. The review outcomes were combined with expert opinion to create an EMD risk model to inform health service transformation.