Participation in Organized Sports Is Positively Associated With Employment in Adults With Spinal Cord Injury.

Participation in Organized Sports Is Positively Associated with Employment in Adults with Spinal Cord Injury.

Am J Phys Med Rehabil. 2013 Mar 8;
Blauwet C, Sudhakar S, Doherty AL, Garshick E, Zafonte R, Morse LR

OBJECTIVE: The aim of this study was to determine the association between participation in organized sports programs and employment in adults with chronic spinal cord injury. DESIGN: This is a cross-sectional study of 149 adults with chronic spinal cord injury. Motor level and completeness of injury were confirmed by physical examination. Information related to demographics, employment, level of education, body mass index, duration of injury, participation in individually planned exercise, and participation in organized sports was obtained using a standardized questionnaire. Multivariable logistic regression analyses were used to assess factors associated with employment. RESULTS: In univariate analyses, employment was associated with younger age (P = 0.001) and a higher level of education (P = 0.01), whereas obesity decreased the likelihood of employment (P = 0.04). Participation in organized sports approached significance (P = 0.06). In the multivariable analysis and after adjusting for age, education, and body mass index, participation in organized sports was significantly associated with employment (odds ratio, 2.4; P = 0.04). Sex, duration of injury, wheelchair use, and participation in individually planned exercise were not significantly associated with employment (P = 0.16-0.94). CONCLUSIONS: In the adults with chronic spinal cord injury, participation in organized sports was positively associated with employment. Further studies are necessary to determine the causative nature of this association and how various factors related to sports participation may contribute. HubMed – rehab


Noninvasive Arterial Studies Including Transcutaneous Oxygen Pressure Measurements with the Limbs Elevated or Dependent to Predict Healing After Partial Foot Amputation.

Am J Phys Med Rehabil. 2013 Mar 8;
Andrews KL, Dib MY, Shives TC, Hoskin TL, Liedl DA, Boon AJ

OBJECTIVE: Noninvasive arterial studies have been used to determine level of amputation. The objective of this study was to examine each component of the noninvasive arterial studies to determine optimal cut points to predict healing and to evaluate whether physiologic maneuvers could improve the utility of transcutaneous oxygen pressure (TcPO2) values to predict healing of partial foot amputation. DESIGN: The authors conducted a retrospective, observational study of 307 patients who underwent partial foot amputation and had noninvasive arterial studies in the perioperative period. RESULTS: The TcPO2 values were significantly predictive of healing. Specifically, a cut point TcPO2 value of 38 mm Hg had a sensitivity and a specificity of 71% for predicting healing or failure. The optimal cut point was mostly unaffected by patient characteristics. The addition of noninvasive arterial studies recorded in a position with the limb elevated improved prediction in the subgroup with supine TcPO2 values of 38 mm Hg or lower. CONCLUSIONS: The findings of this study validate previous reports and confirm that TcPO2 measurements are valuable to more accurately determine the correct amputation level and, in turn, obtain better outcomes. TcPO2 measurements may provide better prognostic value than do ankle-brachial indices for healing after partial foot amputation. TcPO2 measurements are useful but should not be used in isolation to make treatment decisions regarding amputation level. HubMed – rehab


Assessing the Walking Speed of Older Adults: The Influence of Walkway Length.

Am J Phys Med Rehabil. 2013 Mar 8;
Ng SS, Ng PC, Lee CY, Ng ES, Tong MH, Fong SS, Tsang WW

OBJECTIVE: The aim of this study was to investigate the effect of walkway length (5, 8, or 10 m) on measurements of comfortable and maximum walking speed in healthy older adults. DESIGN: In this cross-sectional study at a university-based rehabilitation center, 25 healthy older adults (mean age, 60.3 ± 8.3 yrs) participated in timed walking at both comfortable and maximum speeds with different walkway lengths (5-, 8-, and 10-m walkway distances) measured by a stopwatch. RESULTS: Walkway length did not affect either comfortable walking speed (P = 0.319) or maximum walking speed (P = 0.568). For all walkway lengths, comfortable speed was significantly different from maximum speed (P < 0.001). CONCLUSIONS: Different walkway lengths (5, 8, and 10 m) do not affect both comfortable and maximum walking speed and can yield consistent results in measuring gait speed clinically. A 5-m walkway with standardized 2-m acceleration and 2-m deceleration distances is recommended because it occupies less space and imposes less stress on the healthy older adults. HubMed – rehab


Standing Frame and Electrical Stimulation Therapies Partially Preserve Bone Strength in a Rodent Model of Acute Spinal Cord Injury.

Am J Phys Med Rehabil. 2013 Mar 8;
Zamarioli A, Battaglino RA, Morse LR, Sudhakar S, Maranho DA, Okubo R, Volpon JB, Shimano AC

OBJECTIVE: The aim of this study was to compare the effect of standing frame and electrical stimulation on bone quality in a rodent transection model of spinal cord injury (SCI). DESIGN: Seven-week-old male Wistar rats were divided into four groups: sham, n = 10; SCI, n = 7; SCI + standing frame, n = 7; and SCI + electrical stimulation, n = 7. Complete SCI was generated by surgical transection of the cord at the T10 level. Therapies were initiated 3 days after the surgery, 3 days/wk, 20 mins/day, for 30 days. Animals were killed on day 33 postinjury. RESULTS: No treatment preserved bone mineral density at any skeletal site tested (P = 0.08-0.99). Standing frame therapy preserved maximal load at the lumbar vertebral body (14% vs. 37% reduction, P = 0.01) and prevented SCI-induced loss of stiffness at both the femur (8% vs. 37% reduction, P = 0.03) and the tibia (35% vs. 56% reduction, P < 0.0001). Electrical stimulation therapy reduced SCI-induced loss of stiffness at the tibia only (40% vs. 56% reduction, P = 0.003). CONCLUSIONS: Standing frame and electrical stimulation may have potential as future therapeutic modalities to treat or prevent bone loss after SCI. HubMed – rehab


Dysphagia in Infants After Open Heart Procedures.

Am J Phys Med Rehabil. 2013 Mar 8;
Yi SH, Kim SJ, Huh J, Jun TG, Cheon HJ, Kwon JY

OBJECTIVE: The aims of this study were to evaluate the prevalence and the clinical predictors of dysphagia and to determine the characteristics of videofluoroscopic swallowing study findings in infants after open heart procedures. DESIGN: This study is a retrospective review of 146 infants who underwent open heart surgery. The infants with dysphagia were compared with those without dysphagia. The videofluoroscopic swallowing study findings of the infants with dysphagia were also evaluated. RESULTS: Of the 146 infants who underwent open heart surgery, 35 (24.0%) had dysphagia symptoms. The infants with dysphagia had lower body weight at operation, more malformation syndromes, longer operation times, and more complex operations than did the infants without dysphagia. In addition, the infants with dysphagia required more time to achieve full oral feeding and had longer hospital stays. Thirty-three infants underwent videofluoroscopic swallowing study: 32 (97.0%) exhibited at least one abnormal finding among the videofluoroscopic swallowing study parameters and 21 (63.6%) exhibited tracheal aspiration. CONCLUSIONS: Given the high rate of aspiration in the infants who underwent open heart procedures, monitoring and prompt recognition of the signs and the risk factors of dysphagia may substantially improve infant care with oral feeding and reduce the duration of hospital stays. HubMed – rehab