Spinal cord injury providers' perspectives on managing sublesional osteoporosis.

Persons with spinal cord injuries (SCI) experience rapid sublesional bone loss following injury (1, 3). Evidence on preventing/managing osteoporosis in SCI is lacking. This project examined how providers manage bone loss in SCI.

Reasons for Initiation and Discontinuation of Pharmacological Therapies for Osteoporosis in Veterans with Spinal Cord Injury and Disorders.

Introduction: Medications for osteoporosis have not been reported to reduce fracture rates in patients with spinal cord injury and disorders (SCI/D), yet these medications are still prescribed. Clinical decision-making underscoring the initiation and discontinuation of osteoporosis medications in SCI/D remains poorly understood.

Methodology: Veterans with a SCI/D with at least one prescription for an osteoporosis medication (bisphosphonate, calcitonin, denosumab, raloxifene, and teriparatide) who received healthcare within Veterans Affairs (VA) from 2005 to 2015 were identified using VA administrative databases.

A historical study of appendicular fractures in veterans with traumatic chronic spinal cord injury: 2002-2007.

Objective: Describe the incidence and distribution of appendicular fractures in a cohort of veterans with spinal cord injury (SCI).

Design: Retrospective, observational study of fractures in veterans with a chronic traumatic SCI.

Setting: The Veterans Health Administration (VA) healthcare system.

Delayed and unmet need for medical care among publicly insured adults with disabilities.

Background: While Medicaid is an important source of insurance coverage for persons with disabilities, barriers remain to accessing care for this population.

Objectives: This study addresses 3 research questions: (1) do adults with disabilities experience greater unmet need/delayed care?; (2) do barriers related to cost, providers, or structure vary by disability status?; and (3) do barriers mediate the relationship between disability and access to care?

Research Design: Data were obtained from a 2008 stratified random sample of Minnesota Health Care Program's nonelderly adult enrollees (n=1880). The survey was administered by mail, with a telephone follow-up for nonresponders.

Life satisfaction and life values in people with spinal cord injury living in three Asian countries: a multicultural study.

Objective: To compare the differences in life satisfaction and life values among people with spinal cord injury (SCI) living in three economically similar Asian countries: India, Vietnam, and Sri Lanka.

Design: Cross-sectional and comparative investigation using the unified questionnaire.

Setting: Indian Spinal Injuries Centre in New Delhi (India), Spinal Cord Rehabilitation Department of the Bach Mai Hospital in Hanoi (Vietnam), and Foundation for the Rehabilitation of the Disabled in Colombo (Sri Lanka).

Investigation of soft-tissue stiffness alteration in denervated human tissue using an ultrasound indentation system.

Background/objective: Differences in soft-tissue stiffness may provide for a quantitative assessment and detection technique for pressure ulcers or deep-tissue injury. An ultrasound indentation system may provide a relatively convenient, simple, and noninvasive method for quantitative measurement of changes in soft-tissue stiffness in vivo.

Methods: The Tissue Ultrasound Palpation System (TUPS) was used to quantitatively measure changes in soft-tissue stiffness at different anatomical locations within and between able-bodied persons and individuals with chronic spinal cord injury (SCI).

Development and testing of a vaccination message targeted to persons with spinal cord injuries and disorders.

Background/objective: Individuals with spinal cord injuries and disorders (SCI&D) are at high-risk of complications and death after influenza and pneumonia. Respiratory vaccinations are effective in reducing infection and complications. The aim of this study was to test the feasibility and effectiveness of a multimedia educational message developed using a strong theoretical basis and targeted consumer input to modify negative perceptions, increase knowledge, and positively influence intentions and beliefs regarding respiratory vaccinations.

Epidemiology of hospital-acquired infections in veterans with spinal cord injury and disorder.

Objective: To describe the epidemiology of hospital-acquired infections (HAIs) in veterans with spinal cord injury and disorder (SCI&D).

Design: Retrospective medical record review.

Setting: Midwestern Department of Veterans Affairs spinal cord injury center.

Measuring tissue perfusion during pressure relief maneuvers: insights into preventing pressure ulcers.

Background/objective: To study the effect on tissue perfusion of relieving interface pressure using standard wheelchair pushups compared with a mechanical automated dynamic pressure relief system.

Design: Repeated measures in 2 protocols on 3 groups of subjects.

Participants: Twenty individuals with motor-complete paraplegia below T4, 20 with motor-complete tetraplegia, and 20 able-bodied subjects.

Long-term outcomes from nosocomial infections in persons with spinal cord injuries and disorders.

Background: Nosocomial infection may contribute to poor long-term consequences in persons who have spinal cord injuries and disorders (SCI&D).

Methods: This is a cohort study of individuals who had SCI&D and were hospitalized at least once during 2002. They were followed for 3 years to assess inpatient (IP) admissions, total IP length of stay (LOS), outpatient (OP) visits, and mortality.

Spinal cord injury medicine. 6. Economic and societal issues in spinal cord injury.

Unlabelled: This self-directed learning module presents a variety of social and economic issues facing people with spinal cord injury (SCI). It is part of the study guide on SCI medicine in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. This article focuses on the economic consequences of SCI, ethical issues in SCI, and the legislative efforts that have improved access and quality of life for people with disabilities.

Spinal cord injury medicine. 5. Long-term medical issues and health maintenance.

Unlabelled: This self-directed learning module highlights long-term care issues in patients with spinal cord injury (SCI). It is part of the study guide on SCI in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. The most common secondary medical complications include pressure ulcers, pneumonia, and genitourinary issues.

Spinal cord injury medicine. 4. Community reintegration after spinal cord injury.

Unlabelled: This self-directed learning module highlights community reintegration after spinal cord injury (SCI). It is part of the study guide on spinal cord injury medicine in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. This article specifically focuses on physical, social, psychologic, and environmental barriers that affect people with SCI and on how these issues affect relations with others.

Spinal cord injury medicine. 3. Rehabilitation phase after acute spinal cord injury.

Unlabelled: This self-directed learning module highlights the rehabilitation aspects of care for people with traumatic spinal cord injury (SCI). It is part of the chapter on SCI medicine in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. This article specifically focuses on the formulation of a rehabilitation plan based on functional goals by level of injury.

Spinal cord injury medicine. 2. Acute care management of traumatic and nontraumatic injury.

Unlabelled: This self-directed learning module highlights the basic acute care management of traumatic and nontraumatic spinal cord injury (SCI). It is part of the chapter on SCI medicine in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. Acute traumatic SCI is optimally managed in a level 1 trauma center.

Spinal cord injury medicine. 1. Epidemiology and classification.

Unlabelled: This self-directed learning module reviews the demographics of traumatic and nontraumatic spinal cord injuries (SCIs). It is part of the study guide on SCI medicine in the Self-Directed Physiatric Educational Program for practitioners and trainees in physical medicine and rehabilitation. This article specifically focuses on the changing demographics of traumatic SCI, the classification of SCI, the common causes of nontraumatic SCI, and the incidence and prevalence of myelomeningocele.

Impact of StatLock securing device on symptomatic catheter-related urinary tract infection: a prospective, randomized, multicenter clinical trial.

Background: The objective of this study was to assess the impact of using the StatLock securing device on symptomatic catheter-related urinary tract infection (UTI).

Methods: In this prospective, randomized, multicenter clinical trial, adult patients with spinal cord injury or dysfunction because of multiple sclerosis were randomized to have their indwelling bladder catheters secured in place by using the StatLock device (experimental group) versus preexisting methods (control group that included tape, Velcro strap, CathSecure, or none). Patients were monitored for the development of symptomatic UTI within the subsequent period of 8 weeks.

Preventable wheelchair-related thermal injury.

Background/objective: Wheelchair-related injuries are common, and with proper reporting of injuries, advanced technologic support may offer new ways to prevent those injuries.

Method: Case REPORT AND FINDINGS: A man with tetraplegia who retains only minimal use of his right hand experienced a right-sided armrest malfunction of his wheelchair resulting in his wheelchair controls being out of reach. This left him stranded in the sun for almost 2 hours in 86 degrees F weather.

Predictors of psychosocial adaptation among people with spinal cord injury or disorder.

Objective: To examine the influence of disability-related medical and psychologic variables on psychosocial adaptation to spinal cord injury or disorder (SCI/D).

Design: A structural equation modeling design linking 3 sets of predictive variables to an outcome measure of adaptation.

Setting: Two outpatient SCI clinics (1 veteran, 1 civilian) in Texas.

Analysis of sEMG during voluntary movement--Part II: Voluntary response index sensitivity.

In this paper, a method for analyzing surface electromyographic (sEMG) data recorded from the lower-limb muscles of incomplete spinal-cord injured (iSCI) subjects is evaluated. sEMG was recorded bilaterally from quadriceps, adductor, hamstring, tibialis anterior, and triceps surae muscles during voluntary ankle dorsiflexion performed in the supine position as part of a comprehensive motor control assessment protocol. Analysis of the sEMG centered on two features, the magnitude of activation and the degree of similarity [similarity index (SI)] of the sEMG distribution to that of healthy subjects performing the same maneuver (n = 10).

Predicting consistency of pain over a 10-year period in persons with spinal cord injury.

This longitudinal study was designed to test the hypothesis that persons who consistently report pain at three (women) or four (men) measurement points across 10 years (1988 to 1998) are different both physically and psychologically from those who inconsistently or never report pain. Participants were 96 persons with spinal cord injury (SCI) living in the community who participated at every measurement point. Measures included consistency of reports of pain (i.