Rehospitalization During 9 Months After Inpatient Rehabilitation for Traumatic Brain Injury.

Objective: To assess the frequency of, causes for, and factors associated with acute rehospitalization during 9 months after discharge from inpatient rehabilitation for traumatic brain injury (TBI).

Design: Multicenter observational cohort.

Setting: Community.

Psychotropic Medication Use During Inpatient Rehabilitation for Traumatic Brain Injury.

Objective: To describe psychotropic medication administration patterns during inpatient rehabilitation for traumatic brain injury (TBI) and their relation to patient preinjury and injury characteristics.

Design: Prospective observational cohort.

Setting: Multiple acute inpatient rehabilitation units or hospitals.

Patient Effort in Traumatic Brain Injury Inpatient Rehabilitation: Course and Associations With Age, Brain Injury Severity, and Time Postinjury.

Objective: To describe patients' level of effort in occupational, physical, and speech therapy sessions during traumatic brain injury (TBI) inpatient rehabilitation and to evaluate how age, injury severity, cognitive impairment, and time are associated with effort.

Design: Prospective, multicenter, longitudinal cohort study.

Setting: Acute TBI rehabilitation programs.

Institutional Variation in Traumatic Brain Injury Acute Rehabilitation Practice.

Objective: To describe institutional variation in traumatic brain injury (TBI) inpatient rehabilitation program characteristics and evaluate to what extent patient factors and center effects explain how TBI inpatient rehabilitation services are delivered.

Design: Secondary analysis of a prospective, multicenter, cohort database.

Setting: TBI inpatient rehabilitation programs.

Traumatic Brain Injury-Practice Based Evidence Study: Design and Patients, Centers, Treatments, and Outcomes.

Objectives: To describe study design, patients, centers, treatments, and outcomes of a traumatic brain injury (TBI) practice-based evidence (PBE) study and to evaluate the generalizability of the findings to the U.S. TBI inpatient rehabilitation population.

The relationship between self-reported sleep disturbance and polysomnography in individuals with traumatic brain injury.

Primary Objective: To characterize sleep architecture and self-reported sleep quality, fatigue and daytime sleepiness in individuals with TBI. Possible relationships between sleep architecture and self-reported sleep quality, fatigue and daytime sleepiness were examined.

Methods: Forty-four community-dwelling adults with TBI completed the Pittsburgh Sleep Quality Index (PSQI), Multidimensional Assessment of Fatigue (MAF) and Epworth Sleepiness Scale (ESS).

Spinal Rhythm Generation by Step-Induced Feedback and Transcutaneous Posterior Root Stimulation in Complete Spinal Cord-Injured Individuals.

Background: The human lumbosacral spinal circuitry can generate rhythmic motor output in response to different types of inputs after motor-complete spinal cord injury.

Objective: To explore spinal rhythm generating mechanisms recruited by phasic step-related sensory feedback and tonic posterior root stimulation when provided alone or in combination.

Methods: We studied stepping in 4 individuals with chronic, clinically complete spinal cord injury using a robotic-driven gait orthosis with body weight support over a treadmill.

Exciting recovery: augmenting practice with stimulation to optimize outcomes after spinal cord injury.

The discovery that the nervous system is plastic even in adulthood has been a great benefit to people with spinal cord injury (SCI) and other disorders of the central nervous system. Currently, practice and training provide the best opportunities to reverse the maladaptive plasticity associated with neuropathology and to promote adaptive plasticity that is supportive of function. Evidence suggests that several noninvasive, clinically accessible forms of stimulus energy, such as electrical, magnetic, and vibration stimuli may augment the effects of training.

Discrepancy between perceived pain and cortical processing: A voxel-based morphometry and contact heat evoked potential study.

Objectives: The purpose of this study was to determine if local gray and white matter volume variations between subjects could account for variability in responses to CHEP stimulation.

Methods: Structural magnetic resonance imaging was used to perform voxel-based morphometry (VBM) of gray and white matter in 30 neurologically healthy subjects. Contact heat stimulation was performed on the dorsum of the right hand at the base of the thumb.

Safety and efficacy of medically performed tongue piercing in people with tetraplegia for use with tongue-operated assistive technology.

Background: Individuals with high-level spinal cord injuries need effective ways to perform activities.

Objectives: To develop and test a medically supervised tongue-piercing protocol and the wearing of a magnet-containing tongue barbell for use with the Tongue Drive System (TDS) in persons with tetraplegia.

Methods: Volunteers with tetraplegia underwent initial screening sessions using a magnet glued on the tongue to activate and use the TDS.

Challenges for defining minimal clinically important difference (MCID) after spinal cord injury.

Study Design: This is a review article.

Objectives: This study discusses the following: (1) concepts and constraints for the determination of minimal clinically important difference (MCID), (2) the contrasts between MCID and minimal detectable difference (MDD), (3) MCID within the different domains of International Classification of Functioning, disability and health, (4) the roles of clinical investigators and clinical participants in defining MCID and (5) the implementation of MCID in acute versus chronic spinal cord injury (SCI) studies.

Methods: The methods include narrative reviews of SCI outcomes, a 2-day meeting of the authors and statistical methods of analysis representing MDD.

Pilot study: evaluation of the effect of functional electrical stimulation cycling on muscle metabolism in nonambulatory people with multiple sclerosis.

Objective: To investigate the changes in muscle oxygen consumption (mV˙O2) using near-infrared spectroscopy (NIRS) after 4 weeks of training with functional electrical stimulation (FES) cycling in nonambulatory people with multiple sclerosis (MS).

Design: Four-week before-after trial to assess changes in mV˙O2 after an FES cycling intervention.

Setting: Rehabilitation hospital.

Practical considerations and patient selection for intrathecal drug delivery in the management of chronic pain.

Chronic pain continues to pose substantial and growing challenges for patients, caregivers, health care professionals, and health care systems. By the time a patient with severe refractory pain sees a pain specialist for evaluation and management, that patient has likely tried and failed several nonpharmacologic and pharmacologic approaches to pain treatment. Although relegated to one of the interventions of "last resort", intrathecal drug delivery can be useful for improving pain control, optimizing patient functionality, and minimizing the use of systemic pain medications in appropriately selected patients.

Improvements in hand function in adults with chronic tetraplegia following a multiday 10-Hz repetitive transcranial magnetic stimulation intervention combined with repetitive task practice.

Background And Purpose: Evidence suggests that the use of stimulation to increase corticomotor excitability improves hand function in persons with cervical spinal cord injury. We assessed effects of a multiday application of 10-Hz repetitive transcranial magnetic stimulation (rTMS) applied to the corticomotor hand area combined with repetitive task practice (RTP) in participants with tetraplegia and neurologically healthy participants.

Methods: Using a double-blind, randomized, crossover design, 11 participants with chronic tetraplegia and 10 neurologically healthy participants received 3 sessions of 10-Hz rTMS+RTP and 3 sessions of sham-rTMS+RTP to the corticomotor hand region controlling the weaker hand.

Systematic review of interventions for fatigue after traumatic brain injury: a NIDRR traumatic brain injury model systems study.

Objective: To conduct a systematic review of the evidence on interventions for posttraumatic brain injury fatigue (PTBIF).

Methods: Systematic searches of multiple databases for peer-reviewed studies published in English on interventions targeting PTBIF as a primary or secondary outcome through January 22, 2014. Reference sections were also reviewed to identify additional articles.

Comparison of cognitive behavioral therapy and supportive psychotherapy for the treatment of depression following traumatic brain injury: a randomized controlled trial.

Objective: To determine the efficacy of 2 different interventions (cognitive behavioral therapy [CBT] and supportive psychotherapy [SPT]) to treat post-traumatic brain injury (TBI) depression.

Participants: A sample of 77 community-dwelling individuals with a TBI, and a diagnosis of depression. Participants were randomized into treatment conditions either CBT or SPT and received up to 16 sessions of individual psychotherapy.

Respiratory motor function in seated and supine positions in individuals with chronic spinal cord injury.

This case-controlled clinical study was undertaken to investigate to what extent pulmonary function in individuals with chronic spinal cord injury (SCI) is affected by posture. Forced vital capacity (FVC), forced expiratory volume in one second (FEV1), maximal inspiratory pressure (PImax) and maximal expiratory pressure (PEmax) were obtained from 27 individuals with chronic motor-complete (n=13, complete group) and motor-incomplete (n=14, incomplete group) C2-T12 SCI in both seated and supine positions. Seated-to-supine changes in spirometrical (FVC and FEV1) and airway pressure (PImax and PEmax) outcome measures had different dynamics when compared in complete and incomplete groups.

Use of social media during public emergencies by people with disabilities.

Introduction: People with disabilities are generally more vulnerable during disasters and public emergencies than the general population. Physical, sensory and cognitive impairments may result in greater difficulty in receiving and understanding emergency alert information, and greater difficulty in taking appropriate action. The use of social media in the United States has grown considerably in recent years.

Activity-based therapy for recovery of walking in chronic spinal cord injury: results from a secondary analysis to determine responsiveness to therapy.

Objective: To gain insight into who is likely to benefit from activity-based therapy (ABT), as assessed by secondary analysis of data obtained from a clinical trial.

Design: Secondary analysis of results from a randomized controlled trial with delayed treatment design.

Setting: Outpatient program in a private, nonprofit rehabilitation hospital.

Activity-based therapy for recovery of walking in individuals with chronic spinal cord injury: results from a randomized clinical trial.

Objective: To examine the effects of activity-based therapy (ABT) on neurologic function, walking ability, functional independence, metabolic health, and community participation.

Design: Randomized controlled trial with delayed treatment design.

Setting: Outpatient program in a private, nonprofit rehabilitation hospital.

Variability of respiration and sleep during polysomnography in individuals with TBI.

Background: Obstructive sleep apnea (OSA) is commonly found in individuals with traumatic brain injury (TBI) and may exacerbate TBI-related symptoms. Nocturnal polysomnography (NPSG) is considered the gold standard for detecting the presence of sleep apnea. However, there is a limitation with its use known as the "first-night effect" (aberrant polysomnography findings on the first night in a sleep lab).

Brief report: Effects of exercise and self-affirmation intervention after traumatic brain injury.

Background: Physical exercise has been proven to be an effective method for improving cognition and mood, but little is known about its benefits among individuals with traumatic brain injury.

Objective: This pilot study investigated the feasibility of a combined exercise and self-affirmation intervention (IntenSati) for enhancing cognition and mood in individuals with TBI. It was hypothesized that this intervention would improve individuals' cognition and mood following the completion of the program.

Are the 10 meter and 6 minute walk tests redundant in patients with spinal cord injury?

Objective: To evaluate the relationship and redundancy between gait speeds measured by the 10 Meter Walk Test (10MWT) and 6 Minute Walk Test (6MWT) after motor incomplete spinal cord injury (iSCI). To identify gait speed thresholds supporting functional ambulation as measured with the Spinal Cord Injury Functional Ambulation Inventory (SCI-FAI).

Design: Prospective observational cohort.

Assisted movement with proprioceptive stimulation reduces impairment and restores function in incomplete spinal cord injury.

Objective: To test whether treatment with assisted movement with enhanced sensation (AMES) using vibration to the antagonist muscle would reduce impairments and restore upper limb function in people with incomplete tetraplegia.

Design: Prospective, pre-post study.

Setting: Laboratory and rehabilitation hospital.