An exploratory analysis of the metabolic syndrome and cardiovascular disease risk calculations in veterans with spinal cord injury and disorders.

Objectives: (1) To describe and compare cardiovascular and cardiometabolic disease risk scores using three existing risk calculators: Framingham Risk Score (FRS), American Heart Association (AHA) and Metabolic Syndrome Severity Score (MSSS) in Veterans with spinal cord injury and disorders (SCI/D); (2) To examine level of agreement between risk scores derived from three different risk scoring systems; and (3) To investigate whether the agreement among these methods is different for Veterans with Tetraplegia versus Paraplegia.

Design: Retrospective chart review.

Methods: Electronic medical records of 194 Veterans with SCI/D who were seen at the VAPAHCS SCI/D Center between August 2004 and June 2022 were reviewed.

Adherence and perceptions of a home sports video gaming program in persons with spinal cord injuries: A pilot study.

Objective: Sports video-gaming can facilitate increased activity levels in persons with limited exercise options. Understanding how persons with spinal cord injuries (SCI) participate in home-based video-gaming and its potential impact on maintaining or enhancing physical function remains largely unexplored. The purpose of this study was to evaluate adherence, perceptions, and potential physical effects of a home sports video-game program for persons with chronic SCI.

Effect of a Home-Based Exercise Program on Indices of Physical Function and Quality of Life in Elderly Maintenance Hemodialysis Patients.

Background: Patients on maintenance hemodialysis (MHD) exhibit muscle wasting and impaired physical function which can be reversed with regular exercise, but accessibility to exercise programs for this unique population is lacking. We assessed the efficacy of a home-based exercise program on a broad range of indices of physical function, quality of life (QoL), and cognitive decline in patients with MHD.

Design And Methods: Twenty-eight MHD patients, mean age 66 ± 7 years, were randomized to a 12-week home-based, case-managed aerobic and resistance exercise program or to usual care (13 exercise and 15 usual care).

Comprehensive Lifestyle Medicine Program Improves Fitness, Function, and Blood Pressure in Poststroke Veteran Cohort: A Pilot Study.

Comprehensive lifestyle medicine programs have begun to show efficacy in patients with cerebrovascular disease. The Veterans Affairs (VA) health care system has a large poststroke population and VA rehabilitation departments have significant expertise and resources for promoting healthy lifestyles. A 12-week clinical lifestyle medicine program was therefore implemented for poststroke patients, along with an optional observational study evaluating cardiovascular fitness, function, body composition, vitals, and quality of life before and after the program.

Data acquisition process for VA and non-VA emergency department and hospital utilization by veterans with spinal cord injury and disorders in California using VA and state data.

: To identify VA and non-VA Emergency Department (ED) and hospital utilization by veterans with spinal cord injury and disorders (SCI/D) in California. Retrospective cohort study.: VA and Office of Statewide Health Planning and Development (OSHPD) in California.

Quantitative electrodiagnostic patterns of damage and recovery after spinal cord injury: a pilot study.

Study Design: Prospective observational pilot study.

Objectives: To compare quantitative electromyographic (EMG), imaging and strength data at two time points in individuals with cervical spinal cord injury (SCI).

Setting: SCI center, Veterans Affairs Health Care System, Palo Alto, California, USA.

A randomized controlled trial of exercise to prevent muscle mass and functional loss in elderly hemodialysis patients: Rationale, study design, and baseline sample.

Background: Elderly maintenance hemodialysis (MHD) patients exhibit muscle wasting and impaired physical function. This trial determines whether MHD patients benefit from a 12-week home-based exercise program, protein supplementation, or both.

Design: and Methods: This is a randomized, blinded controlled trial involving 60 elderly MHD patients with impaired exercise capacity and function.

Bone changes in the lower limbs from participation in an FES rowing exercise program implemented within two years after traumatic spinal cord injury.

: To determine the effect of a functional electrical stimulation (FES) rowing program on bone mineral density (BMD) when implemented within two years after SCI.: Prospective.: Health Care Facility.

Upper limb muscle activation during sports video gaming of persons with spinal cord injury.

Objective: Video gaming as a therapeutic tool has largely been studied within the stroke population with some benefits reported in upper limb motor performance, balance, coordination, and cardiovascular status. To date, muscle activation of upper limb muscles in persons with spinal cord injuries (SCI) has not been studied during video game play. In this paper, we provide descriptive and comparative data for muscle activation and strength during gaming for players with tetraplegia and paraplegia, as well as, compare these results with data from traditional arm exercises (ie, biceps curl and shoulder press) with light weights which are commonly prescribed for a home program.

Pixel-Based DXA-Derived Structural Properties Strongly Correlate with pQCT Measures at the One-Third Distal Femur Site.

While bone mineral density has been traditionally used to quantify fracture risk for individuals with spinal cord injuries, recent studies are including engineering measurements such as section modulus and cross sectional moment of inertia. These are almost exclusively calculated by peripheral QCT scanners which, unlike DXA scanners, are rarely found in clinical settings. Using fifty-four fresh frozen femora, we developed and validated a pixel-by-pixel method to calculate engineering properties at the distal femur using a Hologic QDR-1000 W DXA scanner and compared them against similar parameters measured using a Stratec XCT-3000 peripheral QCT scanner.

The effects of a heat acclimation protocol in persons with spinal cord injury.

Persons without spinal cord injury (SCI) physiologically acclimate between seven to fourteen consecutive days of exercise in the heat. Decreased resting and exercise core temperature, decreased heart rate, increased plasma volume and increased thermal comfort during exercise are changes consistent with heat acclimation. Autonomic dysfunction after SCI impairs heat dissipation through sweating and vasodilation.

Triceps Brachii in Incomplete Tetraplegia: EMG and Dynamometer Evaluation of Residual Motor Resources and Capacity for Strengthening.

Background: Candidates for activity-based therapy after spinal cord injury (SCI) are often selected on the basis of manual muscle test scores and the classification of the injury as complete or incomplete. However, these scores may not adequately predict which individuals have sufficient residual motor resources for the therapy to be beneficial.

Objective: We performed a preliminary study to see whether dynamometry and quantitative electromyography (EMG) can provide a more detailed assessment of residual motor resources.

Randomized controlled trial of pharmacological replacement of melatonin for sleep disruption in individuals with tetraplegia.

Objective: To determine the effectiveness of a melatonin agonist for treating sleep disturbances in individuals with tetraplegia.

Design: Placebo-controlled, double-blind, crossover, randomized control trial.

Setting: At home.

Effects of customized risk reduction program on cardiovascular risk in males with spinal cord injury.

Persons with spinal cord injury (SCI) have heightened risk for cardiovascular disease (CVD). Multidisciplinary risk reduction programs using case management models have been effective in reducing CVD risk in nondisabled persons, but little is known regarding the effects of such programs in SCI. Twenty-six persons with SCI underwent a pilot 2 yr risk intervention program including frequent telephone contact by a case manager and in-person visits by a dietitian, physical therapist, and exercise physiologist.

A modeled analysis of telehealth methods for treating pressure ulcers after spinal cord injury.

Home telehealth can improve clinical outcomes for conditions that are common among patients with spinal cord injury (SCI). However, little is known about the costs and potential savings associated with its use. We developed clinical scenarios that describe common situations in treatment or prevention of pressure ulcers.

Maintaining femoral bone density in adults: how many steps per day are enough?

Unlabelled: The amount and intensity of walking to maintain a healthy skeleton is unknown. This study examined the relationship between habitual walking activity and femoral bone mineral density (BMD) in healthy individuals using a quantitative theory for bone maintenance. Our results suggest a gender, weight, and speed sensitivity of walking interventions.

Energy cost of physical activities in persons with spinal cord injury.

Introduction: The objectives of this descriptive study were (a) to determine the energy expenditure of activities commonly performed by individuals with a spinal cord injury (SCI) and summarize this information and (b) to measure resting energy expenditure and establish the value of 1 MET for individuals with SCI.

Methods: One-hundred seventy adults with SCI were partitioned by gender, anatomical level of SCI, and American Spinal Injury Association designations for motor function. Twenty-seven physical activities, 12 recreational/sport and 15 daily living, were performed, while energy expenditure was measured continuously via a COSMED K4b portable metabolic system.

Validation of home telehealth for pressure ulcer assessment: a study in patients with spinal cord injury.

The reliability and validity of assessments and diagnoses made via home telehealth was measured in 42 patients with spinal cord injury. Two telehealth modalities were investigated: telephone-only contact and videoconferencing. The results were compared with a reference (gold-standard) method, the in-person assessment and diagnosis of skin integrity and pressure ulcers.

Reproducibility of noninvasive cardiac output during arm exercise in spinal cord injury.

The carbon dioxide (CO(2)) rebreathing method is a noninvasive technique to estimate cardiac output during exercise, but few data are available on the validity and reliability of this measure in individuals with spinal cord injury (SCI). Sixteen male subjects with SCI (mean age 45 +/- 9, seven paraplegic and nine tetraplegic) underwent three submaximal steady state arm ergometer exercise tests. We estimated cardiac output using the exponential CO(2) rebreathing technique at an individualized exercise intensity approximating 50% of peak oxygen uptake.

Regional bone mineral density in male athletes: a comparison of soccer players, runners and controls.

Objectives: To investigate the association of soccer playing and long-distance running with total and regional bone mineral density (BMD).

Design: Cross-sectional study.

Setting: Academic medical centre.

Cardiovascular disease in spinal cord injury: an overview of prevalence, risk, evaluation, and management.

Cardiovascular disease is a growing concern for the spinal cord-injured (SCI) population. For long-term SCI, morbidity and mortality from cardiovascular causes now exceeds that caused by renal and pulmonary conditions, the primary causes of mortality in previous decades. Although risk estimates commonly used for ambulatory individuals have not been established from follow-up studies in SCI, nearly all risk factors tend to be more prevalent in SCI subjects compared with ambulatory subjects.

Key characteristics of walking correlate with bone density in individuals with chronic stroke.

Several recent studies of ambulatory stroke survivors have shown decreased bone mineral density (BMD) in the lower limbs and an elevated risk of hip fracture. Because bone mass is linked to skeletal loading, weight-bearing activities of daily living such as walking are considered critically important for maintenance of femoral BMD in ambulatory individuals. Little is known about the relationships between walking characteristics, skeletal loading, and bone maintenance in individuals who have experienced a stroke.