Rehabilitation of traumatic and non-traumatic spinal cord injuries (SCI)

Kennedy P et al. working at the National Spinal Injuries Centre, Stoke Mandeville Hospital, UK discuss whether patients with traumatic spinal cord injuries and patients with non-traumatic spinal cord injuries benefitted from the same rehabilitation programme. The research published in Spinal Cord, 05/07/2013 found that the two groups has the same rehabilitation outcome. The Needs Assessment Checklist (NAC) was used as the outcome measure. The group concluded that it is effective to admit and rehabilitate patients with injuries resulting from both traumatic and non-traumatic aetiologies in the same specialised in patient and out patient rehabilitation setting.

 

Spinal cord injury and intensive locomotor training

Evidence of improvements following a less-intensive locomotor training programme in an outpatient setting in Spinal Cord, 04/30/2013. The outcome measures looked at were Lower Extremity Motor Score (LEMS), Walking Index for Spinal Cord Injury (WISCI II), 6-min walk test (6MWT), 10-m walk test (10MWT), Timed Up and Go (TUG), and the PedsQL – Quality of Life Inventory – health-related quality of life (HRQOL). The pediatric patient was an incomplete spinal injury at T6, classified as American Spinal Injury Association (ASIA) level C. The less-intensive locomotor training programme in an outpatient setting two weekly sessions of locomotor training for a period of 6 weeks. The report was written by O’Donnell CM et al from Victorian Paediatric Rehabilitation Service, Royal Children’s Hospital, Melbourne, Victoria, Australia.

Torso stabilization and upper extremity function following Spinal Cord Injury

Following cervical spinal cord injury patients with partial spinal cord injury will benefit from exercises that result in the strengthening of the torso. Stability of the torso will positively impact spinal alignment, seated posture, pulmonary function, trunk stability, and functional reach. Outcome measures that can be assessed include spinal alignment and pelvic orientation, pulmonary function and ventilatory volumes, seated stability and resistance to externally applied disturbances, forward bimanual reaching distance.  Additionally maximal force and speed of rowing-like movements, roll in bed without assistance, the ability to independently return to an erect seated position following full forward or lateral flexion and  can be assessed.

 

Factors that contribute to SCI rehabilitation outcome

Writing in Spinal Cord, 03/06/2013 Equebal A et al. from Department of Rehabilitation, NIOH, Kolkata, India look for variables that can influence rehabilitation outcome in a similar group of spinal cord injury patients. Looking at the outcome measures of improvement in American spinal injury association (ASIA) classification, differences in length of rehabilitation stay and spinal cord independence measure (SCIM).the group found that Age and gender are not significantly related to outcomes of rehabilitation or characteristics of SCI in their sample. They suggest more research to see which factors contribute more strongly to SCI rehabilitation.

 

Spinal cord imaging following SCI

Dr Langston writing in world neurosurgery discusses how spinal imaging plays a critical role in the diagnosis, treatment, and rehabilitation of Spinal Cord Injury patients. He describes how new Imaging Techniques in Spinal Cord Injury spinal cord imaging techniques to SCI will allow for three-dimensional microstructural anatomy of the nerve fibre tracts which will yield information that will better enable predicting outcome and monitoring treatment response following spinal cord injury.

Quantitative MRI analysis now shows correlation to functional ability in MS patients

The research was done against the background that previous studies have shown no correlation in the patients functional ability and the number of lesions measured by MRI. However, in this study researchers led by Dr. Oh of Johns Hopkins University and his colleagues have shown that Spinal cord lesions imaged with quantitative MRI-based technologies correlates with clinical disability of multiple sclerosis (MS) patients.

The study was funded by the Multiple Sclerosis Society of Canada, the National Multiple Sclerosis Society, and the National Institute of Neurological Disorders and Stroke and reported in  Feb. 5 issue of Neurology

SCI Patients Improve Their Chances with the Tutor System

Image via Wikipedia

 

THE NATION featured this report by Carol Aloysius about SCI difficulties in Sri Lanka.

Spinal cord injuries are dramatically rising in Sri Lanka. Why you ask. Well because of  he increase in construction industry work, road accidents, domestic and industrial accidents as well as war injuries. Statistics show that each year around 1500 – 2400 patients are admitted to hospitals with Spinal Cord Injuries (SCI) and every four hours, someone  dies without proper treatment. In the first 3 months of 2011 175 victims of SCI admitted to the NHS. This is according to orthopedic surgeons in their media seminar held at the Health Education Bureau on Thursday.

Dr. Anil Dissanayake, Director of Youth, Elderly & Disabled said Trauma fromSCI is the leading cause for hospital admissions which affects mainly young males between 25- 45. Injuries range from minor, major or fatal and caused by occupational, home environment, war injuries, assaults and recreational activities or sports. With over 55% of the injuries being were cervical spine injuries, 15%  thoracic spine injuries and 15% lumboscaral spine injuries. Physical rehabilitation is needed as  these injuries can result in fracture, dislocation or nerve injury which may result in permanent disability and loss of function.

He aslo went on to say that Sri Lankan hospitals are still not properly equipped to handle these patients or numbers. The groups objective is to develop a regional network and set up a special ward with beds in every hospitals island wide to treat SCI patients.

The meeting was to discuss the upcoming 10th Asian Spinal cord Network ( ASCON) on total care for patients with SCI. According to the WHO over 80 million people suffer from Spinal Cord Injury worldwide.

The HandTutor, ArmTutor, LegTutor and 3DTutor are devices that are FDA and CE certified and are being used in leading U.S. and foreign hospitals. The HandTutor, ArmTutor, LegTutor and 3DTutor aid in the physical and occupational therapists treatment of

 fracture, dislocation or nerve injury and improve functional movement ability. These innovative devices implement an impairment based program with augmented feedback and encourage motor learning through intensive active exercises. These exercises are challenging and motivating and allow for repetitive training tailored to the patient’s performance. The system also includes objective quantitative evaluations that provide the therapist information to customize the most suitable rehabilitation program to the patient’s ability.

They have had success in improving movement of the hand, wrist, elbow, knee, ankle, foot and other joints of the body following Spinal Cord  and other traumatic injuries. The devices have been effective for post stroke victims as well as for those suffering from Cerebral Palsy, brain injuries, Apraxia, MS, Parkinsons and other movement disabilities. Intensive active exercise can reduce the rate of deterioration and this is what the ”Tutor” devices provide.

The system is also used in physical therapy clinics as well as the patient’s home with tele rehabilitation. The ”Tutors” are suitable for adults and children in outpatient and home care.