Minimal Clinically Important Difference of Graded Redefined Assessment of Strength, Sensibility, and Prehension Version 1 in Acute Cervical Traumatic Spinal Cord Injury.

The Graded Redefined Assessment of Strength, Sensibility, and Prehension Version 1 (GRASSP v1) is a validated measure of upper extremity impairment shown to be sensitive and responsive for traumatic cervical spinal cord injury (SCI) in both North American (NA) and European (EU) cohorts. The minimal clinically important difference (MCID) is the quantitative change in an assessment scale that patients perceive as being beneficial. Our aim was to establish the MCID of all subtests of the GRASSP v1 for cervical SCI.

Central Recruitment: A process for engaging and recruiting individuals with spinal cord injury/disease in research at Toronto Rehabilitation Institute.

Context: Insufficient recruitment is a barrier to research and limits statistical power. We describe an initiative aimed to streamline recruitment and consent processes for inpatients with spinal cord injury or disease (SCI/D) via implementation of a Central Recruitment (CR) process. The CR process adhered to ethical standards, reduced participant burden, and maximized research participation.

Effects of water immersion on gait initiation: part II of a case series after incomplete spinal cord injury.

Study Design: Case series.

Objectives: This case series describes how the aquatic environment influences gait initiation in terms of the center of pressure (COP) excursion, impulses, trunk acceleration, and perceptions of participants with incomplete spinal cord injury (iSCI).

Setting: Tertiary Rehabilitation Hospital, Ontario, Canada.

The graded redefined assessment of strength sensibility and prehension version 2 (GV2): Psychometric properties.

GRASSP Version 1 (GV1) was developed in 2010, is an upper extremity measure specifically designed to assess recovery after traumatic tetraplegia. second version was developed to reduce length of the test and refine instructions/standardization. The purpose of this analysis was to calculate psychometric properties of GRASSP Version 2 (GV2).

The relationship between pressure offloading and ischial tissue health in individuals with spinal cord injury: An exploratory study.

To compare thickness and texture measures of tissue overlying the ischial region in able-bodied (AB) individuals vs. individuals with spinal cord injury (SCI) and to determine if there is a relationship between pressure offloading of the ischial tuberosities (IT) and tissue health in individuals with SCI. Exploratory cross-sectional study.

Effects of water immersion on quasi-static standing exploring center of pressure sway and trunk acceleration: a case series after incomplete spinal cord injury.

Study Design: This work is a case series.

Objectives: We assessed the influence of the aquatic environment on quasi-static posture by measuring center of pressure (COP) sway and trunk acceleration parameters after incomplete spinal cord injury (iSCI) in water and on land.

Setting: Tertiary Rehabilitation Hospital, Ontario, Canada.

Quantitative ultrasound imaging over the ischial tuberosity: An exploratory study to inform tissue health.

Background: Characterization of ischial tissue health using a standardized diagnostic ultrasound protocol capturing thickness and gray scale analysis has not been established.

Objectives: This study evaluates inter-participant and inter-trial reliability of thickness and gray scale analysis of ultrasound images of tissues overlying the ischial tuberosity. It provides recommendations for the number of images required to minimize the standard error of measurement (SEM) and determines the number of images required for thickness, gray scale and contrast values that exceed an a-priori minimal detectable change (MDC) for repeated tissue assessment.

Assessing Heart Rate Variability As a Surrogate Measure of Cardiac Autonomic Function in Chronic Traumatic Spinal Cord Injury.

Although cardiac autonomic dysfunction is a contributing factor for cardiovascular disease development in individuals with a spinal cord injury (SCI), it remains poorly understood. Heart rate variability (HRV) analysis has the potential to non-invasively assess the cardiac autonomic nervous system. The study objectives are (a) to determine if there are differences in HRV measures across neurological level of impairment (NLI) and American Spinal Cord Injury Association Impairment Scale (AIS) subgroups, and (b) to determine if there is a relationship between HRV frequency measures (low frequency [LF] and high frequency [HF]) at rest.

Life after personalized adaptive locomotor training: a qualitative follow-up study.

Study Design: Qualitative follow-up study.

Objectives: Intensive locomotor training can improve physical and psychological functioning for individuals with spinal cord injury. Few studies have examined long-term effects of locomotor training.

The influence of the aquatic environment on the center of pressure, impulses and upper and lower trunk accelerations during gait initiation.

Gait initiation is defined as the transition from stationary standing to steady-state walking. Despite the frequent use of therapy pools for training walking in early stages of rehabilitation, none have been reported on the effects of immersion on gait initiation. We aimed to analyze the center of pressure (COP) trajectories, the vertical and anteroposterior impulses and upper and lower trunk accelerations during anticipatory (APA) and execution phases of gait initiation.

Cardiovascular Stress During Inpatient Spinal Cord Injury Rehabilitation.

Objectives: (1) To measure the amount of cardiovascular stress, self-reported physical activity, and accelerometry-measured physical activity by individuals with spinal cord injury (SCI) during physical therapy (PT) and occupational therapy (OT); and (2) to investigate the relations between these measures.

Design: Observational study.

Setting: Two inpatient SCI rehabilitation centers.

Trunk Function and Ischial Pressure Offloading in Individuals with Spinal Cord Injury.

Objective: To determine if there is a relationship between trunk function and offloading of the ischial tuberosities in individuals with Spinal Cord Injury (SCI).

Design: Prospective cross-sectional evaluation.

Setting: Sub-acute rehabilitation hospital.

Perspectives of individuals with sub-acute spinal cord injury after personalized adapted locomotor training.

Purpose: Locomotor training after incomplete spinal cord injury can improve walking function, and cardiovascular and muscle health. Participants' perspectives about locomotor training, however, have not been extensively studied. This study describes the experiences of individuals with sub-acute incomplete spinal cord injury who completed personalized adapted locomotor training; a locomotor-focused rehabilitation tailored to individual goals.

Training to Improve Walking after Pediatric Spinal Cord Injury: A Systematic Review of Parameters and Walking Outcomes.

Walking or locomotor training is often initiated following pediatric spinal cord injury (SCI). There is no synthesis of the literature on interventions targeting walking for pediatric SCI, although this would assist future clinical trials and interventions. To address this need, we completed a systematic review to summarize the who, what, when, and how of walking interventions in children with SCI.

Physical activity outside of structured therapy during inpatient spinal cord injury rehabilitation.

Background: Little information exists on the content of inpatient rehabilitation stay when individuals with spinal cord injury (SCI) are not engaged in structured rehabilitation therapy sessions. Investigation of inpatient therapy content is incomplete without the context of activities outside of this time. We sought to quantify physical activity occurring outside of physical therapy (PT) and occupational therapy (OT) sessions during inpatient SCI rehabilitation and examine how this activity changes over time from admission to discharge.

The influence of the aquatic environment on the control of postural sway.

Balance training in the aquatic environment is often used in rehabilitation practice to improve static and dynamic balance. Although aquatic therapy is widely used in clinical practice, we still lack evidence on how immersion in water actually impacts postural control. We examined how postural sway measured using centre of pressure and trunk acceleration parameters are influenced by the aquatic environment along with the effects of visual information.

Reliability and validity of daily physical activity measures during inpatient spinal cord injury rehabilitation.

Objectives: To assess the test-retest reliability and convergent validity of daily physical activity measures during inpatient spinal cord injury rehabilitation.

Design: Observational study.

Setting: Two inpatient spinal cord injury rehabilitation centres.

The Influence of the Aquatic Environment on Gait Initiation: A Pilot Study.

Aquatic therapies are used to restore step initiation in people with locomotor disabilities. However, there is lack of evidence of underlining mechanisms of gait initiation in water. We investigated center of pressure (CoP), vertical and anterior-posterior impulse forces, and kinematics of the first step performed in water in comparison with overground walking.

Responsiveness, Sensitivity, and Minimally Detectable Difference of the Graded and Redefined Assessment of Strength, Sensibility, and Prehension, Version 1.0.

As spinal cord injury (SCI) trials begin to involve subjects with acute cervical SCI, establishing the property of an upper limb outcome measure to detect change over time is critical for its usefulness in clinical trials. The objectives of this study were to define responsiveness, sensitivity, and minimally detectable difference (MDD) of the Graded Redefined Assessment of Strength, Sensibility, and Prehension (GRASSP). An observational, longitudinal study was conducted.

Trunk control impairment is responsible for postural instability during quiet sitting in individuals with cervical spinal cord injury.

Background: Individuals with cervical spinal cord injury usually sustain impairments to the trunk and upper and lower limbs, resulting in compromised sitting balance. The objectives of this study were to: 1) compare postural control of individuals with cervical spinal cord injury and able-bodied individuals; and 2) investigate the effects of foot support and trunk fluctuations on postural control during sitting balance.

Methods: Ten able-bodied individuals and six individuals with cervical spinal cord injury were asked to sit quietly during two 60s trials.

The effects of aquatic therapy on mobility of individuals with neurological diseases: a systematic review.

Objective: To summarize evidence on the effects of aquatic therapy on mobility in individuals with neurological diseases.

Data Sources: MEDLINE, EMBASE, PsycInfo, CENTRAL, CINAHL, SPORTDiscus, PEDro, PsycBITE and OT Seeker were searched from inception to 15 September 2014. Hand-searching of reference lists was performed in the selected studies.

Outcome of the upper limb in cervical spinal cord injury: Profiles of recovery and insights for clinical studies.

Background: Improved appreciation of recovery profiles of sensory and motor function as well as complex motor functions (prehension) after cervical spinal cord injury (SCI) will be essential to inform clinical studies to consider primary and secondary outcome measures for interventions and the optimization of dosing and timing of therapies in acute and chronic SCI.

Objectives: (1) To define the sensory, motor, and prehension recovery profiles of the upper limb and hand in acute cervical SCI and (2) to confirm the impact of AIS severity and conversion on upper limb sensorimotor recovery.

Methods: An observational longitudinal cohort study consisting of serial testing of 53 patients with acute cervical SCI was conducted.

Defining the role of sensation, strength, and prehension for upper limb function in cervical spinal cord injury.

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.