Patterns of Changes in Wheelchair Exercise Capacity After Spinal Cord Injury.

Patterns of changes in wheelchair exercise capacity after spinal cord injury.

Arch Phys Med Rehabil. 2013 Mar 16;
van Koppenhagen CF, de Groot S, Post MW, Hoekstra T, van Asbeck FW, Bongers W, Lindeman E, van der Woude LH

OBJECTIVE: 1) to identify different patterns of changes in wheelchair exercise capacity in the period between the start of active spinal cord injury (SCI) rehabilitation and five years after discharge; 2) to examine the pattern determinants of the change in wheelchair exercise capacity. DESIGN: Prospective cohort study. Measurements at the start of active inpatient rehabilitation (start), three months after the start (3M), at discharge of inpatient rehabilitation (discharge), one year after discharge (1Y), and five years after discharge (5Y). SETTING: Eight rehabilitation centers in The Netherlands. PARTICIPANTS: The study included 130 persons with SCI, aged 18-65, who were wheelchair-dependent at least for long distances. INTERVENTIONS: Not applicable MAIN OUTCOME MEASURES: Wheelchair exercise capacity: Peak Power Output (POpeak (W)). RESULTS: We found four different patterns of the change of POpeak (means (standard deviation)): (1) HIGH-PRO (33% of total study group ): high progressive scores (Start: 49 W (15.0) – 5Y: 77 W (17.2)), (2) DETER (12%): progressive scores during inpatient rehabilitation with deteriorating scores after discharge (Start: 29 W (8.7) – Discharge: 60 W (8.4) – 5Y: 39 W (13.1), (3) LOW-PRO (52%): low progressive scores (Start: 20 W (10.1) – 5Y: 31 W (15.9)), and (4) LOW-RISE (3%): low inpatient scores with strong progressive scores after discharge (Start: 29 W (15.5) – 5Y: 82 W (10.6)). A logistic regression of factors that may distinguish between HIGH-PRO and LOW-PRO revealed that older age, female gender, tetraplegic lesion and low functional status were associated with LOW-PRO. DETER showed more neuropathic pain and lower sports participation than HIGH-PRO. CONCLUSION: For the vast majority of patients, wheelchair exercise capacity after SCI shows a positive trend and can be described in distinct patterns that are dependent on personal, lesion and functional characteristics. HubMed – rehab centers


A meaning of well-being: from the experience of paraplegic.

Asian Spine J. 2013 Mar; 7(1): 20-4
Aman H, Aslam A

Retrospective study.The goal of care for paraplegic people is the enhancement of their “well-being”. However, despite the frequent use of the term “well-being”, its definition remains unclear and there is little information in the literature concerning the paraplegic’s own perspective. The study was conducted to explore the Pakistani paraplegia’s perspective of well-being.Studies have shown that paraplegia changes not only physical and psychological, but also socioeconomic, states, which have significant impact on an individual’s “subjective well-being”, however there is no clear definition of well-being and the methods of measuring the phenomena.Fifty paraplegic adults from different rehabilitation centers of Pakistan participated in an in-depth interview using natural inquiry method. The interviews were audio-taped, transcribed, and analyzed.Three commonly used meanings of well-being and eight components were identified and included in the definition. The results indicated that the meaning of well-being is an individual’s perception, which includes both objective and subjective values and experiences.The study provides information that was used to develop specific rehabilitation program for the paraplegic Pakistani adults to enhance their well-being. HubMed – rehab centers


Impact of cancer treatments on cognitive functions: the patients’ view, their expectation and their interest in participating to cognitive rehabilitation workshops.

Bull Cancer. 2013 Mar 1; 100(3): 223-229
Le Fel J, Daireaux A, Vandenbosshe S, Heutte N, Rigal O, Rovira K, Joly F, Roy V

Cancer and chemotherapy can have adverse effects on cognitive functions and quality of life of patients. We wanted to know the patients’ view on these disorders, but also their expectations in terms of assessment and support. A survey was conducted in day care hospital among 551 patients from three cancer centers. Most of the patients were between 40 and 74 years and suffered from breast cancer. Eighty-four percent were treated with chemotherapy. Forty-one percent of patients report memory problems, 26% were affected by specific concentration disorders, and 19% of the attention. On the whole, 52% of patients report at least one of the previous cognitive impairment. Among these patients, 80% evoked that the support of these problems was essential and 70% were willing to participate in “workshops” to deal with these disorders. The cognitive impairment occurrence is a real problem for patients receiving chemotherapy and becomes a priority in the global management of their disease. Studies assessing a specific support of theses symptoms should be encouraged to help patients. HubMed – rehab centers