Using telemedicine in the treatment of pressure ulcers.

Pressure ulcers are dynamic and therefore require frequent assessment and immediate treatment. For many patients who live long distances from rehabilitation hospitals, frequent assessment and immediate treatment are often unavailable. Recent advances during the last two decades have resulted in the development of telemedicine--long-distance delivery of medical education and services to patients.

Use of telerehabilitation to manage pressure ulcers in persons with spinal cord injuries.

Pressure ulcers are a common and serious secondary complication of spinal cord injury. In addition to being costly and difficult to treat, pressure ulcers may interfere with many aspects of patient and family life, including the ability to meet educational, vocational, and social goals. Treatment of pressure ulcers includes weekly assessment by a clinician, a requirement that often is impossible for clients to meet.

Employment after spinal cord injury: an analysis of cases from the Model Spinal Cord Injury Systems.

Objective: To describe the relationship of multiple biographic, injury-related, and educational factors with employment outcomes after spinal cord injury (SCI).

Design: Cross-sectional.

Setting: Data were collected through 18 model SCI systems, a nationwide network of hospitals that treat approximately 14% of all SCIs in the United States.

Health behaviors among American Indians with spinal cord injury: comparison with data from the 1996 Behavioral Risk Factor Surveillance System.

Objective: To identify patterns of health behaviors and health outcomes among a sample of American Indian men with spinal cord injury.

Design: Telephone interviews with all participants, except those who did not have telephones (they returned materials by mail).

Setting: Large rehabilitation hospital in the Western mountain region of the United States.

The ethics of using contingency management to reduce pressure ulcers: data from an exploratory study.

Although there is a widely held argument that pressure ulcers are preventable, they continue to cause major healthcare and financial problems. The blame for pressure ulcers has typically focused on the patient's self-neglect or self-destructiveness. However, more recently, there has been a call for a paradigm shift from the current "paternalistic" medical model to one that includes the patient as a participant in his or her own care.

Using telerehabilitation to support assistive technology.

Telerehabilitation--the use of telecommunications technology to provide rehabilitation and long-term support to people with disabilities--offers exciting possibilities for the delivery and support of assistive technology services. This article describes the experiences of a specialty hospital serving persons with disabilities in exploring telerehabilitation to support assistive technology use in the home. Four case studies are presented to illustrate how telerehabilitation may be used in relation to seating evaluation, evaluation of home accessibility, setup of computer access systems, and training in use of augmentative communication devices.

Dimensions of subjective well-being after spinal cord injury: an empirical analysis by gender and race/ethnicity.

Objective: The purpose of this study was twofold: (1) to identify the underlying dimensions of subjective well-being after spinal cord injury (SCI), and (2) to develop reliable scales based on measurement of these dimensions.

Design: A field study was conducted by surveying the subjective well-being of two large samples of participants with SCI. Principal axis factor analysis with varimax rotation was applied to participant responses to 50 subjective well-being items.

Employment after spinal cord injury: differences related to geographic region, gender, and race.

Objective: To compare employment outcomes after spinal cord injury (SCI) as a function of several important participant characteristics.

Design: Field study survey of the employment history of two large samples of people with SCI. Outcomes were compared as a function of multiple participant characteristics.

Aging and life adjustment after spinal cord injury.

Study Design: A field study of aging after spinal cord injury (SCI) was conducted by surveying the life adjustment of a large sample of participants with SCI.

Objectives: The purpose of the current study was to compare life adjustment scores between cohorts of participants based on chronologic age, age at injury onset, time since injury and percentage of life with SCI.

Summary Of Background Data: Existing cross-sectional research suggests that age is negatively correlated and time since injury is positively correlated with life adjustment.

Anger and blood pressure readings in children.

This study investigated the relationship of state and trait anger measured by the Jacob's Pediatric Anger Scale, patterns of anger expression measured by Jacob's Pediatric Anger Expression Scale, and blood pressure readings (BPR) in 230 third-grade children. Analysis of data revealed significant inverse relationships between anger suppression and diastolic BPR and anger reflection and control and both diastolic and systolic BPR. As anger suppression increased, diastolic BPR decreased.

Skin sores after spinal cord injury: relationship to life adjustment.

Study Design: A field study of the relationship between skin sores and life adjustment after spinal cord injury (SCI) was conducted by surveying a sample of more than 1000 participants with SCI.

Objectives: The purpose of this study was to identify the relationship between the number of skin sores and days adversely impacted by skin sores with multiple indicators of life adjustment after SCI.

Summary Of Background Data: Most existing research on skin sores after SCI has been epidemiologic in nature, with limited investigation of the relationship between problems with skin sores and psychosocial adjustment.

Neurological deterioration after posterior wiring of the cervical spine.

Posterior cervical wiring is commonly performed for patients with spinal instability, but has inherent risks. We report eight patients who had neurological deterioration after sublaminar or spinous process wiring of the cervical spine; four had complete injuries of the spinal cord, one had residual leg spasticity and three recovered after transient injuries. We found no relation between the degree of spinal canal encroachment and the severity of the spinal-cord injury, but in all cases neurological worsening appeared to have been caused by either sublaminar wiring or spinous process wiring which had been placed too far anteriorly.

Mortality after spinal cord injury: an 11-year prospective study.

Objective: To identify the relative risk of mortality after spinal cord injury (SCI) as a function of level of psychosocial, vocational, and medical adjustment.

Design: A prospective design was used: data on life adjustment was obtained at one time (1985), with subsequent survival status ascertained 11 years later (1996). Logistic regression was used to identify the relative risk of mortality given the level of adjustment on a number of predictor variables.

Adjustment after spinal cord injury: a 9-year longitudinal study.

Objective: To generate longitudinal data on the stability of life adjustment over a 9-year period among a sample of participants with spinal cord injury (SCI).

Design: A field study was conducted by surveying the adjustment of a sample of participants with SCI in 1985 and again in 1994.

Setting: Outpatient files of a large, university hospital in the Midwest.

Employment after spinal cord injury: relation to selected participant characteristics.

Objective: To investigate the relation between selected participant characteristics and employment outcomes after spinal cord injury (SCI). Previous studies produced conflicting results with widely varying employment rates due to differences in study participant characteristics.

Design: A field study of the employment history of a large stratified sample of people with SCI.

Spinal cord injury occurring in patients with ankylosing spondylitis: a multicenter study.

Treatment of spinal fractures causing paralysis in patients with ankylosing spondylitis is difficult. A multicenter concurrent study evaluated 59 patients--22 managed operatively and 37 nonoperatively. The two groups were compared for neurologic outcome, complications, mortality, and length of stay.

Biofeedback to facilitate unassisted ventilation in individuals with high-level quadriplegia. A case report.

The purpose of this case report is to discuss the effectiveness of electromyographic biofeedback in reeducating and strengthening the accessory breathing muscles in an individual with high-level (C1) complete quadriplegia. Six unassisted breathing sessions were performed with EMG biofeedback intervention. Six unassisted breathing sessions without EMG biofeedback intervention were also performed.