Falls in Independent Ambulatory Patients With Spinal Cord Injury: Incidence, Associated Factors and Levels of Ability.
Falls in independent ambulatory patients with spinal cord injury: incidence, associated factors and levels of ability.
Filed under: Rehab Centers
Spinal Cord. 2012 Dec 4;
Phonthee S, Saengsuwan J, Amatachaya S
Study Design:A 6-month retrospective study.Objectives:To investigate incidence and factors associated with falls in independent ambulatory patients with spinal cord injury (SCI), and to compare levels of ability in those with and without a history of falls.Setting:A tertiary rehabilitation center and community hospitals.Methods:Seventy-seven independent ambulatory subjects with SCI were interviewed for fall data during 6 months before participation in the study. Subjects were also assessed for their functional ability using the timed up and go test (TUGT) and the 6-min walk test (6MinWT).Results:Twenty-six subjects (34%) reported falls during 6 months (range 1-6 times). After falls, two subjects required medical attention due to wrist joint fracture and back pain. Walking without a walking device significantly increased the risk of fall, whereas using a walker significantly reduced the risk of fall (P<0.05). Moreover, faller subjects showed significantly better levels of ability than the non-faller subjects (P<0.005 for the TUGT and P<0.05 for the 6MinWT).Conclusion:Approximately one-third of the independent ambulatory subjects with SCI experienced falls. Notably, faller subjects had better functional ability than the non-faller subjects. Thus, apart from emphasizing the ability to walk independently, rehabilitation professionals may need to seek strategies that improve balance and safety.Spinal Cord advance online publication, 4 December 2012; doi:10.1038/sc.2012.147. HubMed – rehab
Perilesional myeloradiculopathy with tethered cord in post-traumatic spinal cord injury.
Filed under: Rehab Centers
Spinal Cord. 2012 Dec 4;
Gross R, Hamel O, Robert R, Perrouin-Verbe B
Study design:A retrospective series of cases.Objective:To identify, among post-traumatic myelopathies, a specific entity in which clinical and radiological features are not extensive but are strictly limited to the perilesional zone.Setting:The data set of the Regional Spinal Cord Injury Department of Nantes, France.Methods:A systematic analysis of all traumatic spinal cord injury (SCI) patients who presented with a neurological aggravation delayed from initial injury, without syringomyelia or extensive myelomalacia.Results:Twelve patients presenting with this type of complication were identified (that is, four tetraplegics and eight paraplegics). The neurological worsening consisted in weakness of the muscles close to the motor level in five patients, and in isolated at-level neuropathic pain in seven patients. A tethered cord was evidenced by the magnetic resonance imaging (MRI) results in all of the patients. Roots were involved by the tethering on the MRI results in eight cases. Surgery, with untethering and expansile duraplasty, was performed in all cases. Surgery allowed motor recovery in patients who presented with a motor loss (motor score gain range=1-7 points; median=3) and decreased pain in all pain patients (decrease on the 10-point numerical rating scale: range=1-6 points; median=4).Conclusions:In traumatic SCI patients, a tethered cord could be responsible for clinical and radiological changes, which are strictly localised to the perilesional area. The term perilesional myeloradiculopathy is proposed for this complication, which requires cord release surgery.Spinal Cord advance online publication, 4 December 2012; doi:10.1038/sc.2012.154.
HubMed – rehab
Missing Attribution in: Pulmonary Rehabilitation: A Classic Tune With a New Beat, But Is Anyone Listening?
Filed under: Rehab Centers
Chest. 2012 Dec 1; 142(6): 1698
The Motor Learning Strategy Instrument: Interrater Reliability Within Usual and Virtual Reality Physical Therapy Interventions.
Filed under: Rehab Centers
Pediatr Phys Ther. 2012 Nov 30;
Levac D, Missiuna C, Wishart L, Dematteo C, Wright V
PURPOSE:: To evaluate and compare the interrater reliability of the Motor Learning Strategy Rating Instrument (MLSRI) within usual and virtual reality (VR) interventions for children with acquired brain injury. METHODS:: Two intervention sessions for each of 11 children (total, 22) were videotaped; sessions were provided by 4 physical therapists. Videotapes were divided into usual and VR components and rated by 2 observers using the MLSRI. A generalizability theory approach was used to determine interrater reliability for each intervention. RESULTS:: Interrater reliability for usual interventions was high for the MLSRI total score (g-coefficient, 0.81), whereas it was low for the VR total score (g-coefficient, 0.28); MLSRI category g-coefficients varied from 0.35 to 0.65 for usual and from 0.17 to 0.72 for VR interventions. CONCLUSION:: Adequate reliability was achieved within ratings of usual interventions; however, challenges related to MLSRI use to rate VR-based interventions require further evaluation.
HubMed – rehab
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