Wheelchair Repairs: Delays, Causes, and Associated Outcomes.

Objective: To examine the length of time to complete wheelchair repairs and the relationship between negative outcomes and the factors that prevented or determined who performed the repairs.

Design: Survey, cross-sectional.

Setting: Nine spinal cord injury (SCI) Model Systems Centers.

Ultrasound in Microsurgery: Current Applications and New Frontiers.

Ultrasound has revolutionized reconstructive microsurgery, offering real-time imaging and enhanced precision allowing for preoperative flap planning, recipient vessel identification and selection, postoperative flap monitoring, and lymphatic surgery. This narrative review of the literature provides an updated evidence-based overlook on the current applications and emerging frontiers of ultrasound in microsurgery, focusing on free tissue transfer and lymphatic surgery. Color duplex ultrasound (CDU) plays a pivotal role in preoperative flap planning and design, providing real-time imaging that enables detailed perforator mapping, perforator suitability assessment, blood flow velocity measurement, and, ultimately, flap design optimization.

Blood-stage malaria vaccine candidate RH5.1/Matrix-M in healthy Tanzanian adults and children; an open-label, non-randomised, first-in-human, single-centre, phase 1b trial.

Background: A blood-stage Plasmodium falciparum malaria vaccine would provide a second line of defence to complement partially effective or waning immunity conferred by the approved pre-erythrocytic vaccines. RH5.1 is a soluble protein vaccine candidate for blood-stage P falciparum, formulated with Matrix-M adjuvant to assess safety and immunogenicity in a malaria-endemic adult and paediatric population for the first time.

Effect of Training for an Athletic Challenge on Illness Cognition in Individuals with Chronic Disability: A Prospective Cohort Study.

Illness cognitions (IC) influence how a patient adapts to a chronic disease. The aim was (1) to determine if training for a handcycling mountain time trial (HandbikeBattle) improves IC and (2) to identify factors associated with IC change scores. Persons with a chronic disability (N = 220; including N = 151 with spinal cord disorder) trained 5 months and participated in the time trial.

Pain interference, pain type, and quality of life among adults with spina bifida.

Introduction: Individuals with spina bifida (SB) experience nociceptive and neuropathic pain, and women with SB report more pain. However, the relationship between pain type and gender on pain interference and quality of life (QoL) among individuals with SB is less understood.

Objective: To assess relationships among pain interference, pain quality, participation-related QoL, and gender among adults with SB.

Cortical Mechanisms Underlying Immersive Interactive Virtual Walking Treatment for Amelioration of Neuropathic Pain after Spinal Cord Injury: Findings from a Preliminary Investigation of Thalamic Inhibitory Function.

Background: Neuropathic pain following spinal cord injury (SCI) affects approximately 60% of individuals with SCI. Effective pharmacological and non-pharmacological treatments remain elusive. We recently demonstrated that our immersive virtual reality walking intervention (VRWalk) may be effective for SCI NP.

Relationship between rolling resistance, preferred speed, and manual wheelchair propulsion mechanics in non-disabled adults.

Purpose: To characterize the relationship among rolling resistance (RR), preferred speed, and propulsion mechanics.

Methods:  = 11 non-disabled individuals (mean (SD)); Age 24 years (2), BMI 23.8 kg/m (4.

A novel approach to directly measuring wheel and caster rolling resistance accurately predicts user-wheelchair system-level rolling resistance.

Introduction: Clinical practice guidelines for preservation of upper extremity recommend minimizing wheelchair propulsion forces. Our ability to make quantitative recommendations about the effects of wheelchair configuration changes is limited by system-level tests to measure rolling resistance (RR). We developed a method that directly measures caster and propulsion wheel RR at a component-level.

Microbial perils of the tropics: A case of cutaneous leishmaniasis in an immigrant from South America.

Cutaneous leishmaniasis is an important cause of nonhealing lesions in those recently immigrated to the United States from endemic areas. The lesions can present with various characteristics such as ulcerations, macules, or papules, and may be painful or painless. Several diagnostic modalities, including polymerase chain reaction testing, should be performed to identify the causative species which is important in determining appropriate treatment.

Longitudinal Median Nerve Ultrasound Changes in Individuals With Spinal Cord Injury and an Age- and Sex-Matched Nondisabled Cohort.

Objectives: To assess the natural history for development of carpal tunnel syndrome (CTS) in persons with acute spinal cord injury (SCI) at 1 year postdischarge from initial rehabilitation and to assess baseline median nerve (MN) cross-sectional area (CSA) above/below 10 mm correlates with any longitudinal changes in quantitative ultrasound (US) of the MN.

Design: A prospective cohort study of persons with acute SCI evaluated for CTS using quantitative US and compared to a group without SCI (non-SCI).

Setting: Academic medical center.

Association between individual wheelchair skills and fitness in community-dwelling manual wheelchair users with spinal cord injuries.

Purpose: Wheelchair skills are a key component to promotion of community participation among persons with spinal cord injury (SCI). The objective of this secondary analysis was to examine the association between individual wheelchair skills from the Wheelchair Skills Test Questionnaire (WST-Q) and fitness among community-dwelling adults with SCI.

Materials And Methods: Twenty-six adults were recruited to complete the WST-Q and a standard graded aerobic wheelchair exercise test on a motorized treadmill for assessing peak power output (PO).

The Effect of External Power Output and Its Reliability on Propulsion Technique Variables in Wheelchair Users With Spinal Cord Injury.

The purpose of this study was to assess 1) how treadmill slope variance affected external power output (PO) and propulsion technique reliability; and 2) how PO is associated with propulsion technique. Eighteen individuals with spinal cord injury performed two wheelchair treadmill exercise blocks (0% and 1% treadmill slope, standardized velocity) twice on two separate days. PO, velocity, and 14 propulsion technique variables were measured.

Lifestyle physical activity in manual wheelchair users - an overlooked public health opportunity.

Public health guidelines and health promotion efforts have traditionally focused on weekly accumulation of moderate to vigorous physical activity (MVPA) via structured exercise. There has been a recent paradigm shift towards the organic incorporation of MVPA in daily leisure and non-leisure time, termed "Lifestyle Physical Activity" (LPA). However, this paradigm shift and the underlying research has neglected manual wheelchair users (MWCUs) with spinal cord injury (SCI), who could benefit from LPA.

Immersive interactive virtual walking reduces neuropathic pain in spinal cord injury: findings from a preliminary investigation of feasibility and clinical efficacy.

Chronic neuropathic pain (NP) is a common and often debilitating secondary condition for persons with spinal cord injury (SCI) and is minimally responsive to existing pharmacological and nonpharmacological treatments. The current preliminary investigation describes the feasibility and initial comparative efficacy of an interactive virtual reality walking intervention, which is a novel extension of visual feedback/illusory walking therapies shown to reduce SCI NP. Virtual reality walking intervention builds on previous research by, for the first time, allowing individuals with SCI NP to volitionally control virtual gait to interact with a fully immersive virtual environment.

Effectiveness of Group Wheelchair Maintenance Training for People with Spinal Cord Injury: A Randomized Controlled Trial.

Objective: To assess the effectiveness of group wheelchair maintenance training and investigate participant characteristics associated with responsiveness to training.

Design: Randomized controlled trial with an immediate group and a waitlist control group (WLCG) who received the intervention after a 6-month delay.

Setting: Four Spinal Cord Injury Model Systems Centers.

Sociodemographic characteristics associated with physical activity barrier perception among manual wheelchair users.

Background: Individuals with disabilities are sub-optimally active and at increased risk for chronic diseases. Limited knowledge exists about how differences among wheelchair-dependent individuals may affect their perception of physical activity barriers.

Objective: We examined whether the perception of physical activity barriers are associated with wheelchair user sociodemographic characteristics.

Efficacy of a Remote Train-the-Trainer Model for Wheelchair Skills Training Administered by Clinicians: A Cohort Study With Pre- vs Posttraining Comparisons.

Objective: To test the hypotheses that remote training improves trainer confidence and when these trainers train others the capacity and confidence of the trainees improves.

Design: Cohort study with pre- vs posttraining comparisons.

Setting: Four spinal cord injury model systems centers.

Recovery Off-Kinetics Following Exhaustive Upper Body Exercise in Spinal Cord Injury.

Background: People with spinal cord injury (SCI) present with impaired autonomic control when the lesion is above T6. This could lead to delayed cardiorespiratory recovery following vigorous physical activity.

Objectives: To characterize and compare gas exchange off-kinetics following exhaustive exercise in individuals with SCI and an apparently healthy control group.

A Primary Care Provider's Guide to Diet and Nutrition After Spinal Cord Injury.

Physiological changes that occur after spinal cord injury (SCI) are profound and affect almost every organ system in the human body. Energy balance is significantly altered due to motor paralysis, spasticity or flaccidity, neurogenic sarcopenia, neurogenic osteopenia, sympathetic nervous system disruption, and blunted anabolism. Energy expenditure is markedly reduced, whereas hypothalamic control of appetite and satiety is diminished, resulting in discordant energy intake.

Physical Activity Barriers in Danish Manual Wheelchair Users: A Cross-sectional Study.

Objective: To identify physical activity barrier prevalence and severity among manual wheelchair users (MWCUs) and test whether barrier impact is associated with self-reported physical activity level (PAL).

Design: Cross-sectional survey. The Barriers to Physical Activity Questionnaire for People with Mobility Impairments (BPAQ-MI) was translated from English to Danish and administered online.

Using remote learning to teach clinicians manual wheelchair skills: a cohort study with pre- vs post-training comparisons.

Purpose: To test the hypothesis that remote learning to teach clinicians manual wheelchair skills is efficacious.

Materials And Methods: A convenience sample of therapists (physical and occupational) and students were enrolled in pairs in a cohort study with pre- versus post-training comparisons. The intervention was a hybrid of self-study and hands-on practice paired with remote feedback for ten intermediate and advanced manual wheelchair skills.

A Primary Care Provider's Guide to Wheelchair Prescription for Persons With Spinal Cord Injury.

The wheelchair is an essential tool for individuals with spinal cord injury (SCI). When the capacity and fit of a wheelchair is matched to the needs and abilities of an individual with SCI, health, function, community participation, and quality of life are maximized. Throughout an individual's life, function and health status can decline (or improve), necessitating a new wheelchair and/or seating components (eg, cushions and backrests).

Development and deployment of an at-home strength and conditioning program to support a phase I trial in persons with chronic spinal cord injury.

Study Design: Nonrandomized clinical trial (NCT02354625).

Objectives: As a part of a Phase I clinical trial to assess the safety of autologous human Schwann cells (ahSC) in persons with chronic spinal cord injury (SCI), participants engaged in a multimodal conditioning program pre- and post-ahSC transplantation. The program included a home-based strength and endurance training program to prevent lack of fitness and posttransplantation detraining from confounding potential ahSC therapeutic effects.

Case-Control Study of Ultrasound Evaluation of Acute Median Nerve Response to Upper Extremity Circuit Training in Spinal Cord Injury.

Objective: Individuals with spinal cord injury (SCI) often present signs and symptoms of median nerve (MN) pathology. Preclinical signs identification of MN pathology might facilitate early intervention to prevent or delay carpal tunnel syndrome in SCI. We assessed if ultrasound parameters changed in response to upper extremity (UE) circuit training exercise in individuals with paraplegia and able-bodied individuals.