Realtime physical simulator for virtual reality sailing by patients with spinal cord injury: an innovative voyage.

Background: The aim of this study was to explore whether sail training using a VSail® simulator would allow people with spinal cord injuries (SCI) to learn to sail in a safe controlled environment and then sail competently on the water in wind of moderate strength (12 knots). A battery of physical tests and questionnaires was used to evaluate possible improvements in health and well-being as a consequence of participation in the trial.

Methods: Twenty participants were recruited with the assistance of their physicians from The International Center for Spinal Cord Injury, Kennedy Krieger Institute.

Exercise in the Aquatic Environment for Patients With Chronic Spinal Cord Injury and Invasive Appliances: Successful Integration and Therapeutic Interventions.

Objective: Our primary objectives of this initial "proof-of-principle" trial were to evaluate the interventions used in skilled aquatic therapy and to identify any clinical benefits for individuals with spinal cord injuries who use invasive appliances including pressure injury dressings, suprapubic catheters, indwelling catheters, colostomy bags, and tracheostomy tubes.

Design: This is a retrospective chart review of patients with chronic spinal cord injuries using invasive appliances who had also undergone skilled aquatic therapy.

Results: Forty-nine patients with traumatic spinal cord injuries demonstrated scores showing statistically significant improvement using their total mobility and self-care of the Spinal Cord Independence Measure III (P ≤ 0.

Independent sailing with high tetraplegia using sip and puff controls: integration into a community sailing center.

Background: We are continually rediscovering how adapted recreational activity complements the rehabilitation process, enriches patients' lives and positively impacts outcome measures. Although sports for people with spinal cord injuries (SCI) has achieved spectacular visibility, participation by high cervical injuries is often restricted due to poor accessibility, safety concerns, lack of adaptability, and high costs of technology.

Methods: We endeavor to demonstrate the mechanisms, adaptability, accessibility, and benefits the sport of sailing creates in the rehabilitative process.

Activity-Based Restorative Therapies after Spinal Cord Injury: Inter-institutional conceptions and perceptions.

This manuscript is a review of the theoretical and clinical concepts provided during an inter-institutional training program on Activity-Based Restorative Therapies (ABRT) and the perceptions of those in attendance. ABRT is a relatively recent high volume and intensity approach toward the restoration of neurological deficits and decreasing the risk of secondary conditions associated with paralysis after spinal cord injury (SCI). ABRT is guided by the principle of neuroplasticity and the belief that even those with chronic SCI can benefit from repeated activation of the spinal cord pathways located both above and below the level of injury.

The person with a spinal cord injury: an evolving prototype for life care planning.

The sequela of spinal cord injury (SCI) can provide a prototype for life care planning because the segmental design of the vertebrate body allows assessments to be quantitative, repeatable, and predictive of the injured person's impairments, self-care capabilities, and required assistance. Life care planning for patients with SCI uses a standard method that is comparable between planner, yet individualizes assessment and seeks resources that meet unique patient-centered needs in their communities of choice. Clinical care and rehabilitation needs organized with an SCI problem list promotes collaboration by the interdisciplinary team, caregivers, and family in efficient achievement of patient-centered goals and completion of daily care plans.

Acute spinal cord injury and infection with multidrug-resistant Acinetobacter calcoaceticus-baumannii complex among returning Operation Iraqi Freedom soldiers: Successful innovations in rehabilitation during isolation.

Concerns about drug-resistant infectious organisms are increasing in rehabilitation facilities. Resulting isolation protocols can potentially challenge the patients' access to medical care, psychological adaptation, mobility, and environmental interaction and therefore hinder the rehabilitation process. We report a systematic, retrospective case review of an active-duty Army sergeant who sustained a C5 American Spinal Cord Injury Association Impairment Scale A spinal cord injury while serving in Operation Iraqi Freedom.

Outcome measures in spinal cord injury: recent assessments and recommendations for future directions.

Study Design: Review by the spinal cord outcomes partnership endeavor (SCOPE), which is a broad-based international consortium of scientists and clinical researchers representing academic institutions, industry, government agencies, not-for-profit organizations and foundations.

Objectives: Assessment of current and evolving tools for evaluating human spinal cord injury (SCI) outcomes for both clinical diagnosis and clinical research studies.

Methods: a framework for the appraisal of evidence of metric properties was used to examine outcome tools or tests for accuracy, sensitivity, reliability and validity for human SCI.

International standards to document remaining autonomic function after spinal cord injury.

Study Design: Experts opinions consensus.

Objective: To develop a common strategy to document remaining autonomic neurologic function following spinal cord injury (SCI).

Background And Rationale: The impact of a specific SCI on a person's neurologic function is generally described through use of the International Standards for the Neurological Classification of SCI.

International bowel function basic spinal cord injury data set.

Study Design: International expert working group.

Objective: To develop an International Bowel Function Basic Spinal Cord Injury (SCI) Data Set presenting a standardized format for the collection and reporting of a minimal amount of information on bowel function in daily practice or in research.

Setting: Working group consisting of members appointed by the American Spinal Injury Association (ASIA) and the International Spinal Cord Society (ISCoS).

International bowel function extended spinal cord injury data set.

Study Design: International expert working group.

Objective: To develop an International Bowel Function Extended Spinal Cord Injury (SCI) Data Set presenting a standardized format for the collection and reporting of an extended amount of information on bowel function.

Setting: Working group consisting of members appointed by the American Spinal Injury Association (ASIA) and the International Spinal Cord Society (ISCoS).

Survey of use of the insufflator-exsufflator in patients with spinal cord injury.

Background/objective: The insufflator-exsufflator has been shown to be effective in assisting cough in individuals with spinal cord injury. However, many institutions do not use this device. The study was performed to assess use of the device and attitudes among health care providers.

The impact of spinal cord injury on sexual function: concerns of the general population.

Study Design: Secure, web-based survey.

Objectives: Obtain information from the spinal cord injured (SCI) population regarding sexual dysfunctions, with the aim of developing new basic science and clinical research and eventual therapies targeting these issues.

Setting: Worldwide web.

Spinal cord injury influences psychogenic as well as physical components of female sexual ability.

Study Design: Secure, web-based survey.

Objectives: Elicit specific information about sexual function from women with spinal cord injuries (SCI).

Setting: World-wide web.

Long-term effects of spinal cord injury on sexual function in men: implications for neuroplasticity.

Study Design: Secure, web-based survey.

Objectives: Elicit specific information about sexual function from men with spinal cord injuries (SCI).

Setting: World-wide web.

Abdominal electric stimulation facilitates penile vibratory stimulation for ejaculation after spinal cord injury: a single-subject trial.

Objective: To compare the success rate of penile vibratory stimulation (PVS) alone with PVS and abdominal electric stimulation (AES).

Design: Single-subject trials.

Setting: Outpatient.

Lifestyle physical activity for individuals with spinal cord injury: a pilot study.

Purpose: To evaluate the acceptability and feasibility of a lifestyle physical activity program for people with spinal cord injury (SCI).

Methods: Sixteen nonexercising adult volunteers with SCI participated in a single group pre-post-test of the "Be Active in Life Program" comprising stage-matched educational materials, home visit by a nurse, construction of a personal plan to increase activity, and four follow-up phone calls. Program acceptability, stage of change, barriers to health-promoting activities, abilities for health practices, health, depression, and muscle strength were rated.

Prevalence of vitamin B12 deficiency in spinal cord injury.

Objective: To assess the prevalence of vitamin B(12) deficiency in persons with spinal cord injury (SCI) or disease (SCD).

Design: Cross-sectional study with prospective blood collection and retrospective medical record review.

Setting: Regional Veterans Affairs SCI service.

Spinal cord injury medicine. 5. Preserving wellness and independence of the aging patient with spinal cord injury: a primary care approach for the rehabilitation medicine specialist.

Unlabelled: This self-directed learning module highlights consideration and treatment of individuals with long-term 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 challenges of chronic disease prevention, diagnosis, therapeutic options, and the resultant impact on the person with long-term SCI.

Spinal cord injury medicine. 4. Optimal participation in life after spinal cord injury: physical, psychosocial, and economic reintegration into the environment.

Unlabelled: This learner-directed module on spinal cord injury (SCI) presents a variety of perspectives of the process of personal and environmental adaptation for reintegration. Adaptation is unique to each person and does not predictably follow stages. Models used for understanding the process include biopsychosocial, ICIDH-2 (International Classification of Functioning, Disability and Health), and sector divisions of the environment.

Spinal cord injury medicine. 3. Rehabilitation outcomes.

Unlabelled: This self-directed learning module highlights rehabilitation outcomes in 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 focuses on the multiple concerns for functional recovery after SCI, chiefly, the potential for ambulation, upper-extremity recovery, options for functional neuromuscular stimulation (FNS), sexual activity, and optimal outcome after a metastatic lesion.

Spinal cord injury medicine. 2. Medical complications after spinal cord injury: Identification and management.

Unlabelled: This is a self-directed learning module that reviews medical complications associated with spinal cord injury (SCI). It is part of a chapter on SCI medicine in the Self-Directed Physiatric Educational Program for practitioners and trainees in physical medicine and rehabilitation. This article includes discussion of common medical complications that impact rehabilitation and long-term follow-up for individuals with SCI.

Spinal cord injury medicine. 1. Etiology, classification, and acute medical management.

Unlabelled: This self-directed learning module highlights basic management and approaches to intervention-both established and experimental. The revised American Spinal Injury Association classification (2000) of spinal cord injury (SCI) further defines the examination and classification guidelines. The incidence of traumatic SCI remains at approximately 10,000 cases per year, with 32 years the average age at injury.