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Evidence
Acute Evidence
Cardiovascular Complications during the Acute Phase of Spinal Cord Injury
Methods
Introduction
Anatomy of the Autonomic Nervous System
Effect of Disrupted Autonomic Control on the Cardiovascular System
Cardiovascular Complications during Acute SCI
Neurogenic Shock
Orthostatic Hypotension
Autonomic Dysreflexia
Bradycardia and Arrhythmias
Interventions for Cardiovascular Complications during Acute SCI
Interventions for Neurogenic Shock
Pharmacological Interventions for Neurogenic Shock
Interventions for Treatment of Orthostatic Hypotension
Non-pharmacological Interventions for Orthostatic Hypotension
Pharmacological Interventions for Orthostatic Hypotension
Interventions for Hemodynamic Management
Interventions for Bradycardia
Pharmacological Interventions for Bradycardia
Surgical Interventions for Bradycardia
Summary
Key Points
References
Abbreviations
Neuroprotection during the Acute Phase of Spinal Cord Injury
Methods
Abbreviations
Introduction
Phases of Injury
Overview of Secondary Injuries
Pharmaceutical Agents for Neuroprotection during Acute SCI
Steroids
Naloxone
Tirilazad Mesylate
Nimodipine
Erythropoietin
GM-1 Ganglioside
Granulocyte-Colony Stimulating Factor
Thyrotropin-Releasing Hormone
Gacyclidine
Additional Phase I and Phase II Clinical Trials for Neuroprotective Pharmaceutical Agents during Acute SCI
Summary
References
Respiratory Management during the Acute Phase of Spinal Cord Injury
Methods
Introduction
Neuronal Control of Breathing
Measurements for Lung Volume and Lung Capacity
Pulmonary Complications during Acute SCI
Mechanical Ventilation
Intubation
Tracheostomy
Comparative or Combination Interventions
Timing of Mechanical Ventilation
Secretion Removal Techniques during Acute SCI
Ventilation Weaning, Extubation and Decannulation
Non-Pharmacological Interventions for Pulmonary Function Improvement during Acute SCI
Respiratory Muscle Training
Diaphragm Pacing
Intermittent Positive Pressure Breathing for Acute SCI patients
Pharmacological Interventions for Pulmonary Function Improvement during Acute SCI
Hospital Programs for Respiratory Management during Acute SCI
Summary
Key Points
References
Abbreviations
Imaging of Spinal Cord Injuries
Methods
Introduction
Radiography and Computed Tomography (CT)
Magnetic Resonance Imaging (MRI)
Spinal Cord Injury Without Radiographic Abnormality
Diffusion Tensor Imaging (DTI)
Summary
References
Abbreviations
Surgical Interventions during the Acute Phase of Spinal Cord Injury
Introduction
Surgery for Traumatic SCI
Decompression Surgery
Effect of Timing on Decompression and/or Stabilization Surgery Post SCI
Surgery for Traumatic Central Cord Syndrome
Surgical Stabilization
Prognosis Following Surgery for SCI
Surgical Management versus Other Methods
Bone Marrow Transfer
Management of Spinal Cord Compression by Metastatic Lesions
Decompression or Stabilization
Surgery in Combination with Radiotherapy
Laminoplasty and Laminectomy
Laminectomy and Fusion
Laminoplasty
Surgery for Miscellaneous Myelopathies
Cervical Spondylosis
Degenerative Compressive Myelopathy
Spinal Stenosis
Syringomyelia and Tethered Spinal Cord
Summary
References
Abbreviations
Rehabilitation Evidence
Aging
Abbreviations
Introduction
Mortality and Life Expectancy
Physiological Aging
Cardiovascular and Endocrine Systems
Immune System
Musculoskeletal System
Respiratory System
Nervous System
Skin and Subcutaneous Tissues
Genitourinary and Gastrointestinal Systems
Secondary Complications of Multiple Systems
Functional Independence
Quality of Life and Community Reintegration
Summary
References
Autonomic Dysreflexia
Introduction
Pathophysiology of AD
How to Assess – Autonomic Assessment Form
Management
Prevention Strategies
Prevention of AD during Bladder Procedures
Botulinum Toxin
Intravesical Capsaicin
Anticholinergics
Sacral Denervation
Bladder and Urethral Sphincter Surgery
Prevention of AD during Anorectal Procedures
Prevention of AD during Pregnancy and Labour
Prevention of AD during General Surgery
Prevention of AD during FES Exercise
Prevention of AD with Stoma
Prevention of AD in Acute Care
Management of Acute AD Episodes
Non-Pharmacological Management of AD
Pharmacological Management of AD
Nifedipine (Adalat, Procardia)
Nitrates (Nitroglycerine, Depo-Nit, Nitrostat, Nitrol, Nitro-Bid)
Captopril
Terazosin
Prazosin (Minipress)
Phenoxybenzamine (Dibenzyline)
Prostaglandin E2
Sildenafil (Viagra)
Other Pharmacological Agents Tested for Management of AD
Other Autonomic Dysfunctions
Bradycardia
Thermodysregulation
Thermoregulation during Exercise
Sweating
Summary
References
Abbreviations
Bladder Management
Introduction
Types of Bladder Dysfunction in SCI
Detrusor Overactivity with DSD
Detrusor Underactivity
Therapeutic Interventions for Detrusor Overactivity with Detrusor External Sphincter Dyssynergia in Spinal Cord Injury
Enhancing Bladder Volumes Pharmacologically
Anticholinergic Therapy for SCI-Related Detrusor Overactivity
Toxin Therapy for SCI-Related Detrusor Overactivity
Botulinum Toxin
Capsaicin and Resiniferotoxin
Nociception/Orphanin Phenylalanine Glutamine
Intravesical Instillations for SCI-Related Detrusor Overactivity
Other Pharmaceutical Treatments for SCI-Related Detrusor Overactivity
Enhancing Bladder Volumes Non-Pharmacologically
Electrical Stimulation to Enhance Bladder Volumes
Surgical Augmentation of the Bladder to Enhance Volume
Enhancing Bladder Emptying Pharmacologically
Alpha-adrenergic Blockers for Bladder Emptying
Botulinum Toxin for Bladder Emptying
Other Pharmaceutical Treatments for Bladder Emptying
Enhancing Bladder Emptying Non-Pharmacologically
Comparing Methods of Conservative Bladder Emptying
Intermittent Catheterization
Specific Aspects of using Intermittent Catheterization
Comparison of Intermittent Catheterization Catheter Types
Triggering-Type or Expression Voiding Methods of Bladder Management
Indwelling Catheterization (Indwelling or Suprapubic)
Condom Catheterization
Continent Catheterizable Stoma and Incontinent Urinary Diversion
Electrical Stimulation for Bladder Emptying (and Enhancing Volumes)
Sphincterotomy, Artificial Sphincters, Stents and Related Approaches for Bladder Emptying
Other Miscellaneous Treatments
Detrusor Areflexia
Urinary Tract Infections
Defining Urinary Tract Infections
Detecting and Investigating UTIs
Non-Pharmacological Methods of Preventing UTIs
Intermittent Catheterization and Prevention of UTIs
Specially Covered Intermittent Catheters for Preventing UTI
Other Issues Associated with Bladder Management and UTI Prevention
Pharmacological and Other Biological Methods of UTI Prevention
Bacterial Interference for Prevention of UTIs
Antibiotic Prophylaxis of UTIs
Antiseptic and Related Approaches for Preventing UTIs
Cranberry for Preventing UTIs
Educational Interventions for Maintaining a Healthy Bladder and Preventing UTIs
Pharmacological Treatment of UTIs
Summary
References
Bone Health
Abbreviations
Introduction
Systematic Review
Fracture Risk following SCI
Sublesional Osteoporosis (SLOP) Detection and Diagnosis
Bone Outcome Measures
Imaging Modalities
Biochemical Markers
Histomorphometry
Clinical Guide
Pharmacological Therapy: Bisphosphonates
Pharmacologic Therapy: Prevention of Bone Loss (within 12 Months of Injury)
Pharmacologic Therapy: Treatment (1 Year Post-Injury and Beyond)
Non-Pharmacologic Therapy: Rehabilitation Modalities
Non-Pharmacologic Therapy: Prevention (within 12 Months of Injury)
Non-Pharmacologic Therapy: Treatment (1 Year Post-Injury and Beyond)
Electrical Stimulation
Vibration
FES Cycle Ergometry
Standing
Physical Activity
Combination Interventions
Interventions with Bone Biomarker Outcomes
General Discussion
Summary
Key Points
References
Bowel Dysfunction and Management
Abbreviations
Introduction
Neurogenic Bowel Dysfunction and Management
General Bowel Management Systematic Review
Conservative Bowel Management
Multifaceted Programs
Dietary Fibre
Stimulation of Reflexes in the Gastrointestinal Tract
Manual Evacuation of Faeces
Abdominal Massage
Electrical and Magnetic Stimulation
Bowel Irrigation Techniques
Prokinetic Agents
Pharmacological Rectal Stimulants
Colostomy and Ileostomy
Assistive Devices
Summary
Key Points
References
Cardiovascular Health and Exercise
Introduction
The Risk for Cardiovascular Disease in Persons with SCI
Systematic Review
Exercise Rehabilitation and Cardiovascular Fitness
Treadmill Training
Upper Extremity Exercise
Functional Electrical Stimulation (FES)
Other Forms of Exercise Interventions
Glucose Homeostasis
Lipid Lipoprotein Profiles
References
Abbreviations
Economic Evaluation
Introduction
Economic Evaluations
Cost of Illness Studies
Methods
Economic Evaluation Studies
Cost of Illness Studies
Results
Economic Evaluation Studies
Intrathecal Baclofen vs. Several Conventional Treatment Options
Hydrophilic Gel Reservoir vs. Non-Coated Catheters for Intermittent Self-Catheterization
Transanal Irrigation vs. Conservative Bowel Management
Sacral Anterior Root Stimulation for Neurogenic Bladder
Duplex Ultrasound Surveillance vs. No Surveillance for Deep Venous Thrombosis
Oral vs. Non-Oral Erectile Dysfunction Treatments
Electrical Stimulation Therapy vs. Standard Wound Care
Telephone Support for Pressure Ulcer Management
Negative Pressure Wound Therapy for Pressure Injuries
Use of a Fibrin Sealant for Surgical Treatment of Pressure Injuries
Implanted Neuroprosthesis for Restoration of Effective Cough
Surgical Management in Older Individuals with SCI
Early Decompression for Individuals with Traumatic Cervical SCI
Supported Employment for US Veterans with SCI
Cost of Illness Studies
Australia
Belgium
Canada
Nigeria
Spain
United States
Discussion
Summary
References
Abbreviations
Epidemiology of Traumatic SCI
Abbreviations
Introduction
Systematic Review
Incidence and Prevalence of SCI by Continent and Country
Incidence of SCI
Prevalence of SCI
Summary – Incidence and Prevalence
Frequency of SCI by Cause
Motor Vehicle Crashes
Falls
Sports and Recreation
Violence
Self-Harm
Work-Related Incidents
Natural Disasters
Other Causes
Summary – Frequency of SCI by Cause
References
Heterotopic Ossification
Introduction
Pathophysiology of Heterotopic Ossification
Risk Factors and Clinical Presentation
Diagnosis
Treatment of Heterotopic Ossification
Non-Steroidal Anti-Inflammatory Drugs as Prophylaxis
Warfarin as Prophylaxis
Bisphosphonates
Pulse Low Intensity Electromagnetic Field Therapy
Radiation Therapy
Surgical Resection
Summary
References
Abbreviations
Housing and Attendant Care
Introduction
Housing
Attendant Care
Intervention Studies for Primary Care Attendant
Non-Intervention Attendant Care Studies
References
Abbreviations
Lower Limb
Introduction
Systematic Reviews
Sitting, Standing and Balance Training
Sitting Balance
Standing Balance
Enhancing Strength Following Locomotor Training in Incomplete SCI
Electrical Stimulation to Enhance Lower Limb Muscle Function
Neuromuscular Electrical Stimulation (NMES)
Functional Electrical Stimulation
Gait Retraining Strategies to Enhance Functional Ambulation
Overground Training for Gait Rehabilitation
Body-Weight Supported Treadmill Training (BWSTT)
BWSTT in Acute/Sub-Acute SCI
BWSTT in Chronic SCI
BWSTT Combined with Spinal Cord Stimulation
Orthoses/Braces
Ankle Foot Orthosis in SCI
Hip-Knee-Ankle-Foot Orthosis in SCI
Powered Gait Orthosis and Exoskeletons in SCI
Functional Electrical Stimulation (FES)
Functional Electrical Stimulation to Improve Locomotor Function
Functional Electrical Stimulation with Gait Training to Improve Locomotor Function
Bracing Combined with FES in SCI
Biofeedback for Gait Rehabilitation
Whole-Body Vibration and Lower Limb Motor Output
Combined Gait Training and Pharmacological Interventions
Emerging Experimental Approaches
Conditioning Reflex Protocols
Repetitive Transcranial Magnetic Stimulation
Cellular Transplantation Therapies to Augment Strength and Walking Function
Case Report: Nutrient Supplement to Augment Walking Distance
Gaps in SCI Research for Lower Limb
References
Abbreviations
Mental Health after a Spinal Cord Injury
Introduction
Depression
Prevalence of Depression Post-SCI
Interventions for Treatment of Depression following SCI
Combined Psychotherapy and Pharmacotherapy
Exercise
Other Treatments
Psychological Interventions
Cognitive Behavioural Therapy
Mindfulness for Depression following SCI
Summary
Key Points
References
Nutrition Issues Following Spinal Cord Injury
Introduction
Energy Imbalance
Dysphagia
Diagnosis of Dysphagia
Risk Factors for Dysphagia
Nutrition-Related Complications
Altered Glucose and Lipid Metabolism
Neurogenic Bowel
Neurogenic Bladder
Pressure Ulcers
Osteoporosis
Nutritional Intervention Programs for Energy Imbalance and Wellness
Diet and Exercise
Diet and Inflammatory Mediators
Health Promotion and Education
Nutritional Interventions for Dyslipidemia and Cardiovascular Disease Risk
Nutrition Counseling
Omega-3 Fatty Acid Supplementation
Nutritional Interventions for Vitamin Deficiencies and Supplementation
Vitamin D
Vitamin B12
Creatine
Cardiovascular and Hormonal Responses to Food Ingestion
Effects of Nutrient Intake on Ambulation Performance
Post-Meal Resting Energy Expenditure
Cardiovascular, Endocrine and Renal Responses to Dietary Sodium Restriction in Persons with Paraplegia and Tetraplegia
Summary
Key Points
References
Abbreviations
Orthostatic Hypotension
Introduction
Systematic Review
Pharmacological Management of OH in SCI
Non-pharmacological Management of OH in SCI
Fluid and Salt Intake for Management of OH in SCI
Blood Pooling Prevention in Management of OH in SCI
Whole-Body Vibration in Management of OH in SCI
Effect of FES on OH in SCI
Effect of Exercise on OH in SCI
Effect of Standing Training on OH in SCI
General Discussion
References
Abbreviations
Pain Management
Introduction
Incidence, Quality and Significance
Incidence of Pain Post SCI
Impact on Quality of Life
Severe Pain and SCI Location
Natural History of SCI Pain
Location and Quality of SCI Pain
Classification of SCI Pain
Musculoskeletal or Mechanical Pain
Central or Neurogenic Dysesthetic Pain
Borderzone or Segmental Pain
Psychological Factors
Catastrophizing and Pain Post SCI
Non-Pharmacological Management of Post-SCI Pain
Massage
Osteopathy
Acupuncture
Physical Activity for Post-SCI Pain
Behavioural Management of Pain Post SCI
Visual Illusion
Hypnotic Suggestions
Biofeedback
Cognitive Behavioural Therapy
Mindfulness
Transcranial Direct Stimulation Post SCI Pain
Transcranial Electrical Stimulation Post SCI Pain
Static Magnetic Field Therapy Post SCI Pain
Transcutaneous Electrical Nerve Stimulation Post SCI Pain
Transcranial Magnetic Stimulation
Neuromuscular Electrical Stimulation
Functional Electrical Stimulation
Breathing Controlled Electrical Stimulation
Diet
Pharmacological Management of Post-SCI Pain
Pharmacological Measures Overall
Anticonvulsants in SCI Pain
Tricyclic Antidepressants in Post-SCI pain
Anaesthetic Medications
Antispasticity Medications
Opioids for Post-SCI Pain
Cannabinoids in Post-SCI Pain
Clonidine for Post-SCI Pain
Topical Capsaicin
Lithium Carbonate
Transdermal Nitroglycerine
Surgical Interventions
Spinal Cord Stimulation
Dorsal Longitudinal T-Myelotomy for Pain Management Post-SCI
Dorsal Rhizotomy
Mesenchymal Stromal Cells
Sympathectomy
Lateral Spinothalamic Tractotomy
Spinal Cordotomy
Summary
References
Abbreviations
Physical Activity
Effects of Physical Activity
Effects on Muscle Morphology, Strength and Endurance
Physical Activity and Functional Improvement Including Activities of Daily Living
Physical Activity and Subjective Well-Being
Physical Activity and Secondary Conditions
Physical Activity and Cardiovascular Health
Physical Activity and Respiratory Complications
Physical Activity and Bone Health
Physical Activity and Pain
Physical Activity and Spasticity
Physical Activity and Periodic Leg Movements
Increasing Physical Activity Participation in SCI
Physical Activity Participation Levels in SCI
Barriers to Physical Activity Participation in the SCI Population
Effectiveness of Interventions to Increase Physical Activity Participation in SCI
Summary
Key Points
References
Primary Care
Abbreviations
Introduction
Access and Utilization Issues for Primary Care of Adults with SCI
Outreach Programs
Health Issues of Key Importance in Primary Care for SCI
General Discussion and Implications
Summary
Key Points
References
Rehabilitation Practices
Common Abbreviations Used In SCI Rehabilitation
What is SCI Rehabilitation
Description of SCI Rehabilitation Outcomes
Rehabilitation Length of Stay
Neurological and Functional Status
Factors for Optimal Outcomes
Effect of Intensity on Rehabilitation Outcomes
Effect of Age on Rehabilitation Outcomes
Differences in Traumatic vs Non-Traumatic SCI Rehabilitation Outcomes
Effect of Gender and Race on Rehabilitation Outcomes
Specialized vs General SCI Units (Acute Care)
Early vs Delayed Admission to Specialized SCI Units
Health Care After SCI Inpatient Rehabilitation
Outpatient and Follow-up Care
Rehospitalization and Healthcare Utilization after Initial Rehabilitation in SCI
Key Points
Summary
Appendix: Studies Describing Rehabilitation Outcomes
References
Respiratory Management
Chapter Summary
Introduction
Systematic Review
Pharmaceutical Interventions
Airway Hyperresponsiveness and Bronchodilators
Anabolic Steroids
Other Pharmaceuticals
Mechanical Ventilation
Mechanical Ventilation and Weaning Protocols
Intermittent Positive Pressure Breathing (IPPB)
Tracheostomy Placement and Decannulation
Other Surgery
Exercise Training of the Upper and Lower Limbs
Inspiratory Muscle Training
Intermittent Hypoxia
Assistive Devices and Other Treatments
Girdle/Abdominal Binder
Vibration
Immersion
Sleep Disordered Breathing in SCI
Prevalence and Risk Factors
Cough Assist and Secretion Removal
Electrical Stimulation
Phrenic Nerve and Diaphragmatic Stimulation
Abdominal Neuromuscular Electrical Stimulation
References
Abbreviations
Sexual and Reproductive Health
Introduction
Systematic Review
Sexual Health Assessment
Sexual Activity in Spinal Cord Injured Men and Women
Sexual Behaviour
Sexual Satisfaction
Sexual and Reproductive Health in Men with SCI
Male Erectile Response and Enhancement
Phosphodiesterase Type 5 Inhibitors (PDE5i) and Other Oral Agents
Intracavernosal Injections (ICI) utilizing Penile Medications
Topical Agents
Intraurethral Preparations
Mechanical Methods: Vacuum Devices and Penile Rings
Surgical Penile Implants
Intrathecal Baclofen Pump and Sacral Root Stimulation
Perineal Muscle Training
Summary: Treatment for ED
Sensation, Ejaculation and Orgasm in Men with Spinal Cord Injury
Male Fertility
Sperm Retrieval
Sperm Quality
Male Fertility and Resulting Pregnancy
Sexual and Reproductive Health in Women with SCI
Sexual Response in Women with SCI
Gynecological Health
Pregnancy and Labour
Menopause
Sexual and Reproductive Health Promotion Behaviour in Women with Spinal Cord Injury
Pregnancy, Labour and Autonomic Dysreflexia
Sexual Behaviour
Body Image and Acceptance
Sexual Satisfaction
Sexual Education and Counselling
Sexual Health Education for SCI Clinicians
Sexual Education and Counselling for SCI Patients
Clinical Focus – Multidisciplinary Approach to Sexual and Fertility Rehabilitation
Summary
Skin Integrity and Pressure Injuries
Introduction
Impact of Pressure Injuries
Incidence and Prevalence
Risk Factors
Assessment and Diagnosis
Staging
Prevention
Treatment
Prevention
Prevention Through Affecting Intrinsic Factors
Electrical Stimulation
Fat Grafting
Prevention Through Affecting Extrinsic Factors
Considerations
Differences In Interface Pressure Between SCI and Other Populations
SCI vs. Able-Bodied Participants
SCI vs. Elderly Participants
Effect of Specialized Seating Teams on Pressure Management and Prevention
Education and Prevention Programs
Using Telerehabilitation for Delivery of Prevention or Treatment Programs
Equipment and Products for Pressure Management and Prevention
Treatment
Electrical Stimulation
Laser Treatment
Ultrasound/Ultraviolet C
Non-Thermal Pulsed Electromagnetic Energy
Topical Negative Pressure
Normothermic Dressings
Alternative Pharmacological Treatments
Recombinant Human Erythropoietin
Sustained-Release Platelet-Rich Plasma Therapy in Grade IV Pressure Injuries
Anabolic Steroid Agents
Dressings
Non-Surgical Management and Debridement
Topical Oxygen
Surgical and Other Miscellaneous Topical and Physical Treatments
Alternative Organic or Herbal Treatments
Medihoney®
Cured Rot and Flat Sore Ointment
Powdered Arginine Supplement
Miscellaneous Physical Treatments
Factors Associated with Pressure Injury Treatment Success
Summary
Key Points
References
Abbreviations
Spasticity
Introduction
Definition
Pathophysiology
Impact
Determining Impact of Treatment
Outcome Measurement and Spasticity
Overview of Treatments
Non-Pharmacological Interventions for Spasticity
Passive Movement or Stretching
Interventions Based on Active Movement (Including FES-assisted Movement)
Interventions Based on Direct Muscle Electrical Stimulation
Interventions Based on Various Forms of Afferent Stimulation
Repetitive Transcranial Magnetic Stimulation
Transcranial Theta-Burst Stimulation
Neuro-Surgical Interventions for Spasticity
Cell Therapy for Spasticity
Pharmacological Treatment for Spasticity
Oral Medications
Intrathecal Baclofen for Reducing Spasticity
Effect of Medications Other Than Baclofen on Spasticity after SCI
Tizanidine
Clonidine
Fampridine (4-Aminopyridine)
Gabapentin
Other Anti-Spasmodics
Cannabinoids for Reducing Spasticity after SCI
Focal Neurolysis for Spasticity Management
Botulinum Toxin
Phenol
Summary
Key Points
References
Syringomyelia
Introduction
Epidemiology
Pathophysiology
Clinical Presentation and Natural History
Diagnosis and Monitoring
Magnetic Resonance Imaging
Myelography Enhanced Computed Tomography
Virtual Endocopy by Computer Tomography
Ultrasonography
Intraoperative Somatosensory Evoked Potentials
Management
Shunting
Untethering
Subarachnoid–Subarachnoid Bypass
Cordectomy
Neural Tissue Transplantation
Cellular Therapies
Summary
References
Abbreviations
Upper Limb
Introduction
Therapy Based Interventions
Exercise and Strengthening
Orthoses
Skills Training and Education
Motor Imagery
Action Observation
Technology Based Interventions
Virtual Reality
Robotics
Brain Computer Interfaces
EMG Biofeedback
Neuroprostheses
Sensorimotor Stimulation Interventions
Neuromuscular Electrical Stimulation
Transcutaneous Electrical Nerve Stimulation
Functional Electrical Stimulation
Muscle Vibration
Non-Invasive Brain Stimulation Interventions
Repetitive Transcranial Magnetic Stimulation
Transcranial Direct Current Stimulation
Pharmacological Interventions
Baclofen
Reconstructive Surgery and Tendon Transfers
Hand
Pinch
Pinch and Grasp (Key-Pinch and Hook Grip)
Elbow Extension
Posterior Deltoid to Triceps
Biceps to Triceps
Multiple Reconstructions
Nerve Transfers
Fundamental Principles
Advantages over Tendon Transfers
Potential Drawbacks of Nerve Transfers
Assessment and Surgical Timing
Nerve Transfer Evidence
Complementary and Alternative Medicine
Freehand System
NEC-FES System
NESS H200 (formerly HandMaster-NMS-1)
Rebersek and Vodovik (1973) Neuroprosthesis
Belgrade Grasping-Reaching System
Bionic Glove
ETHZ-ParaCare System
Stimulus Router System
Summary
Key Points
References
Abbreviations
Venous Thromboembolism
Introduction
Incidence
Diagnosis
Deep Venous Thrombosis Diagnostic Modalities
Clinical Presentation
Venous Ultrasound
Venography
D-Dimer Assay
Pulmonary Embolism
Clinical Presentation
Ventilation/Perfusion Scanning
Pulmonary Angiography
Spiral Computed Tomography Scan
DVT Prophylaxis
Pharmacological Agents
Low-Dose Unfractionated Heparin
Low-Molecular-Weight Heparin versus Low-Dose Unfractionated Heparin as Prophylaxis
Mechanical Methods
Physical Methods for Prophylaxis
Combined Physical and Pharmacological Methods
Vena Cava Filtration
Prevalence and Timing of Onset
Combined Mechanical and Pharmacological Modalities
Modalities of Thromboprophylaxis
Mechanical Modalities
Pharmacological Modalities
Inferior Vena Cava Filtration
Treatment
Summary
Key Points
Abbreviations
Wheeled Mobility and Seating Equipment
Introduction
Manual Wheelchairs
Wheelchair Propulsion
Stroke Pattern in Wheelchair Propulsion
Kinetics and Kinematics of Wheelchair Propulsion on Level Surfaces
Kinetics and Kinematics of Wheelchair Propulsion on Non-Level Surfacess on Non-Level Surfaces
Effect of Wheelchair Frame and/or Set-up on Propulsion
Axle Position of Wheelchair
Weight of Wheelchair
Wheelchair Frame and Vibration
Wheelchair Tire Pressure
Wheelchair Handrims
Pushrim-Activated Power-Assist Wheelchairs
Training
Wheelchair Propulsion Training
Physical Conditioning and Wheelchair Propulsion
Wheelchair Use
Wheelchair Usage
Falls, Accidents, Repair and Maintenance Issues with Adverse Effects Related to Wheelchair Use
Wheelchair Satisfaction
Wheelchair Skills
Power Wheelchairs
Characteristics of Power Wheelchair Use
Power Wheelchair Driving Controls
Power Positioning Device Use
Alternate Forms of Wheeled Mobility
Segway
Seating Equipment for Wheelchairs
Pressure Mapping used in SCI
Postural Implications of Wheelchairs
Impact of Equipment on Functional Tasks
Seated Surfaces
Custom Contoured Cushion
Changes in Pressure during Static Sitting versus Dynamic Movement While Sitting
Position Changes for Managing Sitting Pressure/Postural Issues, Fatigue and Discomfort
Wheelchair Provision
Summary
Key Points
References
Abbreviations
Work and Employment
Introduction
Systematic Review and Meta-Analysis
Personal Factors Associated with Employment Post-SCI
Environmental Factors Associated with Employment Post-SCI
Interventions for Enhancing Employment Post-SCI
Abbreviations
References
SCIRE Systematic Review Process: Evidence
Article Assessment
Literature Search Strategy
Quality Assessment Tool and Data Extraction
Determining Levels of Evidence and Formulating Conclusions
Appendices
Appendix 1: Specific Search Terms
Appendix 2: The PEDro Scale
Appendix 3: AMSTAR tool (Shea et al., 2007)
Rehab: From Bedside To Community
Epidemiology
Traumatic SCI
Non-traumatic SCI
Recovery
Neuroplasticity
Measures of Recovery
Outcome Measures
Browse Alphabetically
Browse by Clinical Area
Assistive Technology
Assistive Technology Device Predisposition Assessment (ATD-PA)
International Standards to Document Remaining Autonomic Function after Spinal Cord Injury (ISAFSCI)
Community Reintegration
Assessment of Life Habits Scale (LIFE-H)
Community Integration Questionnaire (CIQ)
Craig Handicap Assessment & Reporting Technique (CHART)
Impact on Participation and Autonomy Questionnaire (IPAQ)
Physical Activity Recall Assessment for People with Spinal Cord injury (PARA-SCI)
Physical Activity Scale for Individuals with Physical Disabilities (PASIPD)
Reintegration to Normal Living (RNL) Index
Spinal Cord Injury Falls Concern Scale (SCI-FCS)
Lower Limb & Walking
10 Meter Walking Test (10 MWT)
6-Minute Walk Test (6MWT)
Berg Balance Scale (BBS)
Clinical Outcome Variables Scale (COVS)
Spinal Cord Injury Functional Ambulation Inventory (SCI-FAI)
Timed Motor Test (TMT)
Timed Up and Go Test (TUG)
Walking Index for Spinal Cord Injury (WISCI) and WISCI II
Mental Health
Beck Depression Inventory (BDI)
Brief Symptom Inventory (BSI)
CAGE Questionnaire
Center for Epidemiological Studies Depression Scale (CES-D and CES-D-10)
Depression Anxiety Stress Scale-21 (DASS-21)
Fatigue Severity Scale (FSS)
Hospital Anxiety and Depression Scale (HADS)
Patient Health Questionnaire-9 (PHQ-9)
Scaled General Health Questionnaire-28 (GHQ-28)
Spinal Cord Lesion Coping Strategies Questionnaire (SCL CSQ)
Spinal Cord Lesion Emotional Wellbeing Questionnaire (SCL EWQ)
Symptom Checklist-90-Revised (SCL-90-R)
Zung Self-Rating Depression Scale (SDS / ZSDS)
Neurological Impairment and Autonomic Dysfunction
American Spinal Injury Association Impairment Scale (AIS): International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI)
5-item SCI Sacral Sparing Self-report Questionnaire
Other Affected Physiological Systems
Exercise Self-Efficacy Scale (ESES)
Moorong Self-Efficacy Scale (MSES)
Spinal Cord Ability Ruler (SCAR)
Spinal Cord Injury Secondary Conditions Scale (SCI-SCS)
Spinal Cord Lesion Coping Strategies Questionnaire (SCL CSQ)
Spinal Cord Lesion Emotional Wellbeing Questionnaire (SCL EWQ)
Wheelchair Users Shoulder Pain Index (WUSPI)
Wingate Anaerobic Testing (WAnT)
Pain
Brief Pain Inventory (BPI)
Classification System for Chronic Pain in SCI
Donovan SCI Pain Classification System
Multidimensional Pain Inventory (MPI) – SCI version
Multidimensional Pain Readiness to Change Questionnaire (MPRCQ2)
Quantitative Sensory Testing (QST)
Tunk’s Classification Scheme
Wheelchair Users Shoulder Pain Index (WUSPI)
Quality of Life and Health Status
Health Behaviour Questionnaire (HBQ)
Health Utilities Index-Mark III (HUI-Mark III)
Incontinence Quality of Life Questionnaire (I-QOL)
Life Satisfaction Questionnaire (LISAT-9, LISAT-11)
Needs Assessment Checklist (NAC)
Neurogenic Bowel Dysfunction Score (NBD)
Quality of Life Index (QLI) – SCI Version
Quality of Life Profile for Adults with Physical Disabilities (QOLP-PD)
Quality of Well Being (QWB) and Quality of Well Being– Self-Administered (QWB-SA)
Qualiveen
Satisfaction with Life Scale (SWLS, Deiner Scale)
Short Form 36 (SF-36)
Sickness Impact Profile 68 (SIP 68)
University of Washington Self-Efficacy Scale short-form (UW-SES-6)
Waist Circumference
World Health Organization Quality of Life- BREF (WHOQOL-BREF)
Self Care & Daily Living
Appraisals of DisAbility: Primary and Secondary Scale (ADAPSS)
Barthel Index (BI)
Canadian Occupational Performance Measure (COPM)
Craig Hospital Inventory of Environmental Factors (CHIEF)
Frenchay Activities Index (FAI)
Functional Independence Measure (FIM)
Functional Independence Measure Self-Report (FIM-SR)
Functional Standing Test (FST)
Lawton Instrumental Activities of Daily Living Scale (IADL)
Klein-Bell Activities of Daily Living Scale (K-B Scale)
Quadriplegia Index of Function (QIF)
Quadriplegia Index of Function Modified (QIF-Modified)
Quadriplegia Index of Function-Short Form (QIF-SF)
Rivermead Mobility Index (RMI)
Satisfaction with Life Scale (SWLS, Deiner Scale)
Self Care Assessment Tool (SCAT)
Self Reported Functional Measure (SRFM)
Sense of Well Being Inventory (SWBI)
Spinal Cord Independence Measure (SCIM)
Spinal Cord Injury Lifestyle Scale (SCILS)
Spinal Cord Injury – Person-Perceived Participation in Daily Activities Questionnaire (SCI-PDAQ)
Spinal Function Abilities Scale (S-FAS)
Sexuality and Reproduction
American Spinal Injury Association Impairment Scale (AIS): International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI)
Emotional Quality of the Relationship Scale (EQR)
Female Sexual Function Index (FSFI)
Knowledge, Comfort, Approach and Attitude towards Sexuality Scale (KCAASS)
Sexual Attitude and Information Questionnaire (SAIQ)
Sexual Behaviour Scale (SBS)
Sexual Interest, Activity and Satisfaction (SIAS) / Sexual Activity and Satisfaction (SAS) Scales
Sexual Interest and Satisfaction Scale (SIS)
Skin Health
Braden Scale
Gosnell Measure
Skin Management Needs Assessment Checklist (SMNAC)
Spinal Cord Injury Pressure Ulcer Scale – Acute (SCIPUS-A)
Spinal Cord Injury Pressure Ulcer Scale (SCIPUS) Measure
Stirling’s Pressure Ulcer Severity Scale
Waterlow Scale
Spasticity
Ashworth and Modified Ashworth Scale (MAS)
Pendulum Test (Wartenberg)
Penn Spasm Frequency Scale (PSFS)
Spinal Cord Assessment Tool for Spastic Reflexes (SCATS)
Spinal Cord Injury Spasticity Evaluation Tool (SCI-SET)
Upper Limb
Box and Block Test (BBT)
Capabilities of Upper Extremity Instrument (CUE)
Functional Standing Test (FST)
Graded Redefined Assessment of Strength, Sensibility and Prehension (GRASSP)
Grasp and Release Test (GRT)
Hand-Held Myometer
Jebsen Hand Function Test (JHFT)
Modified Functional Reach Test (mFRT)
Six-Minute Arm Test (6-MAT)
Sollerman Hand Function Test
Tetraplegia Hand Activity Questionnaire (THAQ)
Van Lieshout Test Short Version (VLT-SV)
Wheeled Mobility
4 Functional Tests for Persons who Self-Propel a Manual Wheelchair (4FTPSMW)
Timed Motor Test (TMT)
Tool for assessing mobility in wheelchair-dependent paraplegics
Wheelchair Circuit (WC)
Wheelchair Outcome Measure (WhOM)
Wheelchair Skills Test (WST)
Toolkit
Implementation Guide
SCIRE Systematic Review Process: Outcome Measures
Assessing the Outcome Measures – Methods
Inclusion criteria for Outcome Measures included in SCIRE
Why Assess Measures Used with the SCI population?
Classifying the Measures
Glossary
Abbreviations
Clinical Resources
Information Sheets and Treatment Algorithms
COVID-19
Continuing Medical Education (CME) – Coming Soon!
Clinical Practice Guidelines – Coming Soon!
Media
Videos
Newsletters
SCIRE News
10 reasons why you should visit the new SCIRE Professional Website
Cannabis: A Potential Therapeutic Treatment for People with SCI
Exercise Guidelines for adults with SCI – now available in 6 different languages!
Videos on Exercise after SCI and Neuromodulation and SCI
People in our Community – meet Bob Hoogenes
First Clinical Guidelines in Canada for Pain following SCI
SCIRE Community now offering information in French!
Publications
SCIRE Community
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