Annals of Rehabilitation Medicine

"Spinal cord injuries"

Review Articles

Spinal cord injury

Effects of Botulinum Toxin-A for Spasticity and Nociceptive Pain in Individuals with Spinal Cord Injury: A Systematic Review and Meta-Analysis: Dewan Md. Sumsuzzman, Zeeshan Ahmad Khan, Irin Sultana Nila, Vanina Myuriel Villagra Moran, Madhuvilakku Rajesh, Won Jong Yang, Yonggeun Hong; Ann Rehabil Med 2024;48(3):192-202. Published online June 28, 2024; DOI: https://doi.org/10.5535/arm.240034

We conducted a systematic review and meta-analysis to examine the protective effects of botulinum toxin-A (Botox-A) on spasticity and nociceptive pain in individuals with spinal cord injuries (SCIs). PubMed, Embase, and Cochrane Library databases were searched from inception to July 2023. The primary outcome of interest was spasticity and nociceptive pain. We pooled the available data using the generic inverse variance method, and we used a fixed-effect/random-effects model. We then calculated standardized mean difference (SMD) and 95% confidence intervals (95% CIs) to estimate the effect size. A total of fourteen studies meeting the inclusion criteria comprised two randomized controlled trials, five pre-post studies, and seven case reports. Across the various study designs, the majority of trials were assessed to have fair to high quality. The meta-analysis shows that Botox-A significantly decreased spasticity (SMD, -1.73; 95% CI, -2.51 to -0.95; p<0.0001, I2=48%) and nociceptive pain (SMD, -1.79; 95% CI, -2.67 to -0.91; p<0.0001, I2=0%) in SCI patients. Furthermore, Botox-A intervention improved motor function, activities of daily living (ADL), and quality of life. Our study suggests that Botox-A may alleviate spasticity and nociceptive pain in SCI patients. Moreover, the observed improvements in motor function, ADL, and overall quality of life following Botox-A intervention underscore its pivotal role in enhancing patient outcomes.

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Spinal cord injury

Robot-Assisted Gait Training in Individuals With Spinal Cord Injury: A Systematic Review and Meta-Analysis of Randomized Controlled Trials: Jong Mi Park, Yong Wook Kim, Su Ji Lee, Ji Cheol Shin; Ann Rehabil Med 2024;48(3):171-191. Published online June 28, 2024; DOI: https://doi.org/10.5535/arm.230039

Spinal cord injury (SCI) rehabilitation emphasizes locomotion. Robotic-assisted gait training (RAGT) is widely used in clinical settings because of its benefits; however, its efficacy remains controversial. We conducted a systematic review and meta-analysis to investigate the efficacy of RAGT in patients with SCI. We searched international and domestic databases for articles published until April 18, 2024. The meta-analysis employed a random effects model to determine the effect size as either mean difference (MD) or standardized MD (SMD). Evidence quality was evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. Twenty-three studies with a total of 690 participants were included in the final analysis. The overall pooled effect size for improvement in activities of daily living was 0.24, with SMD (95% confidence interval [95% CI], 0.04–0.43; GRADE: high) favoring RAGT over conventional rehabilitation. Muscular strength (MD, 0.23; 95% CI, 0.02–0.44; GRADE: high), walking index for SCI (MD, 0.31; 95% CI, 0.07–0.55; GRADE: moderate) and 6 min walk test distance (MD, 0.38; 95% CI, 0.14–0.63; GRADE: moderate) showed significant improvement in the robot group. Subgroup analysis revealed that subacute patients and intervention periods >2 months were more effective. This meta-analysis revealed that RAGT significantly improved activities of daily living, muscular strength, and walking abilities. Additional studies are needed to identify the optimal treatment protocol and specific patient groups for which the protocol is most effective.

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Effects of Unpredictable Perturbation Training on a Split-Belt Treadmill on Physical Performance in Older Adults: A Randomized Controlled Trial
Kap-Soo Han, Myoung-Hwan Ko
Geriatrics.2025; 10(1): 23. CrossRef
Advances and New Therapies in Traumatic Spinal Cord Injury
Antonio Montoto-Marqués, Jesús Benito-Penalva, María Elena Ferreiro-Velasco, Mark Andrew Wright, Sebastian Salvador-De la Barrera, Hatice Kumru, Nelson Gaitán-Pérez, Agustin Hernández-Navarro, Antonio Rodríguez-Sotillo, Fernando Martins Braga, Angela Pale
Journal of Clinical Medicine.2025; 14(7): 2203. CrossRef
Factors influencing on functional independence outcomes after hospitalization and rehabilitation in children with spinal cord injury
Hong-Bo Zhao, Xiang-Jiang Rong, Qi Zhang, Ting-Ting Ma, He Yan, Tian-Tian Zhou, Yan-Qing Zhang
BMC Pediatrics.2025;[Epub] CrossRef

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Original Articles

Spinal cord injury

Epidemiology of Traumatic Spinal Cord Injury in the Himalayan Range and Sub-Himalayan region: A Retrospective Hospital Data-Based Study: Osama Neyaz, Vinay Kanaujia, Raj Kumar Yadav, Bhaskar Sarkar, Md. Quamar Azam, Pankaj Kandwal; Ann Rehabil Med 2024;48(1):86-93. Published online December 26, 2023; DOI: https://doi.org/10.5535/arm.23107

Objective
To compile epidemiological characteristics of traumatic spinal cord injury (TSCI) in the Northern Indian Himalayan regions and Sub-Himalayan planes.
Methods
The present study is a retrospective, cross-sectional descriptive analysis based on hospital data conducted at the Department of Physical Medicine and Rehabilitation and Spine Unit of Trauma Centre in a tertiary care hospital in Uttarakhand, India. People hospitalized at the tertiary care center between August 2018 and November 2021 are included in the study sample. A prestructured proforma was employed for the evaluation, including demographic and epidemiological characteristics.
Results
TSCI was found in 167 out of 3,120 trauma patients. The mean age of people with TSCI was 33.5±13.3, with a male-to-female ratio of 2.4:1. Eighty-three participants (49.7%) were from the plains, while the hilly region accounts for 50.3%. People from the plains had a 2.9:1 rural-to-urban ratio, whereas the hilly region had a 6:1 ratio. The overall most prevalent cause was Falls (59.3%), followed by road traffic accidents (RTAs) (35.9%). RTAs (57.2%) were the most common cause of TSCI in the plains’ urban regions, while Falls (58.1%) were more common in rural plains. In both urban (66.6%) and rural (65.3%) parts of the hilly region, falls were the most common cause.
Conclusion
TSCI is more common in young males, especially in rural hilly areas. Falls rather than RTAs are the major cause.

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Spinal cord injury

Risk Factors for Suicidality in Individuals With Spinal Cord Injury: A Focus on Physical and Functional Characteristics: Sora Han, Wooyeung Kim, Onyoo Kim; Ann Rehabil Med 2023;47(5):377-384. Published online October 4, 2023; DOI: https://doi.org/10.5535/arm.23110

Objective
To demonstrate the association between the physical and functional characteristics of individuals with spinal cord injury (SCI) and suicidality, an area of research that is less understood than the association with demographic, social, and psychological characteristics.
Methods
A retrospective cross-sectional study was conducted with 259 patients with SCI admitted for rehabilitation at the National Rehabilitation Center, Seoul, between January 2019 and December 2021. Demographic, SCI-related, physical, and functional data were collected from their medical records. Suicide risk was assessed using the Mini International Neuropsychiatric Interview.
Results
The 259 participants had an average age of 49.1 years, and 75.7% were male. The analysis revealed a statistically significant negative correlation between age and suicidality. No significant differences were found for sex, education, occupation, or SCI-related factors. Lower upper extremity motor score (UEMS) was significantly associated with higher suicide risk. Regarding functional factors, the inability to perform independent rolling, come to sit, wheelchair propelling, and self-driving were associated with increased suicidality. In the multiple linear regression analysis, lower UEMS, limited shoulder joint motion, upper extremity spasticity, and dependent wheelchair propulsion were predictors of higher suicide risk.
Conclusion
This study highlights the associations among physical status, functional dependency, and suicide risk in individuals with SCI. These findings emphasize the need to address psychological aspects and physical and functional factors in the management of individuals with SCI who are at a high risk of suicide.

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A Case Report of a Patient with Suicidal Trauma, Abdominal Surgery, and Short Bowel Syndrome
Ghasem Zarei, Iman Nariman, Hosein Ghaderi-Zefrhi, Mohamad Sadegh Aboutalebi
Journal of Surgery and Trauma.2024; 12(4): 160. CrossRef

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Spinal cord injury

Characteristics of Pediatric Spinal Cord Injury in South Korea: A Single-Centered Study: Wooyeung Kim, Bum-Suk Lee, Onyoo Kim, Hyeyeung Yun, So-Ra Han; Ann Rehabil Med 2022;46(5):248-255. Published online October 31, 2022; DOI: https://doi.org/10.5535/arm.22062

Abstract
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Objective
To determine the characteristics of pediatric spinal cord injury (SCI) in South Korea from 1990 to 2019.
Methods
This single-centered retrospective study included pediatric SCIs. Individuals were divided into the following five groups according to onset age: ≤5, 6–12, 13–14, 15–17, and 18–19 years. The severity of complete injury was graded according to the American Spinal Injury Association impairment scale A (AIS A). Incomplete injury was graded according to AIS B, C, and D. Pearson chi-square test was used for statistical analysis.
Results
Of the 267 individuals included, 216 (80.9%) had traumatic SCIs (male-to-female ratio of 3.2:1), and 51 (19.1%) had non-traumatic SCIs (male-to-female ratio of 0.7:1). In the traumatic SCI group, 192 (88.9%) individuals were ≥15 years at the time of injury (males, 78.6%). The most common etiologies of traumatic SCIs, ranging from most to least common, were accidents related to motorcycles, falls, cars, and diving. In the non-traumatic SCI group, inflammatory (33.3%) and neoplastic (25.5%) etiologies were found to be the most common ones.
Conclusion
We found that traumatic SCIs incidence in the pediatric population was high, particularly in male individuals aged 15–19 years. The non-traumatic SCIs mostly cause paraplegia and incomplete injury. Therefore, it can be used as a basic data for the evaluation, treatment and prevention strategy of pediatric patients with SCI.

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Do we know the normal anterior-posterior diameters of the spinal cord and canal in newborns?
Öner ÖZBEY, Fatma Zeynep ARSLAN, Muslu Kazım KÖREZ, Müge PAYASLI
Journal of Health Sciences and Medicine.2023; 6(2): 456. CrossRef
A systematic review and meta-analysis of the global epidemiology of pediatric traumatic spinal cord injuries
Seyed Behnam Jazayeri, Samuel Berchi Kankam, Ali Golestani, Parnian Shobeiri, Morteza Gholami, Mohammad Amin Dabbagh Ohadi, Seyed Farzad Maroufi, Mohammad Reza Fattahi, Hamid Malekzadeh, Seyed Behzad Jazayeri, Zahra Ghodsi, Seyed Mohammad Ghodsi, Vafa Rah
European Journal of Pediatrics.2023; 182(12): 5245. CrossRef

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Spinal cord injury

Quantitative Analysis in Cervical Spinal Cord Injury Patients Using Diffusion Tensor Imaging and Tractography: Geun Seok Park, Tae Uk Kim, Seong Jae Lee, Jung Keun Hyun, Seo Young Kim; Ann Rehabil Med 2022;46(4):172-184. Published online August 31, 2022; DOI: https://doi.org/10.5535/arm.22053

Abstract
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Objective
To investigate the clinical usefulness of diffusion tensor imaging (DTI) and tractography in the prediction of outcomes after traumatic cervical spinal cord injury (SCI) and to assess whether the predictability is different between DTI and tractography administered before and after surgery.
Methods
Sixty-one subjects with traumatic cervical SCI were randomly assigned to preop or postop groups and received DTI accordingly. Among the patients who had DTI before surgery, we assigned 10 patients who had received repeated DTI examinations at 8 weeks after injury to the follow-up group. Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values were obtained from DTI, and imaginary fiber and crossing fiber numbers were calculated from the tractography. Neurological status and functional status were assessed at 4 and 8 weeks after SCI.
Results
The neurologic and functional statuses of both groups improved after 4 weeks. Out of the initial 61 patients who were enrolled in the study, the failure rate of DTI image analysis was significantly higher in the postop group (n=17, 41.5%) than in the preop group (n=6, 20%). The FA values and fiber numbers in the preop group tended to be higher than those in the postop group, whereas ADC values were lower in the preop group. When comparing the tractographic findings in the follow-up group, imaginary fiber numbers at the C6 and C7 levels and crossing fiber numbers from the C3 to C6 levels were significantly decreased after surgery. Several DTI and tractographic parameters (especially the ADC value at the C4 level and imaginary fiber numbers at the C6 level) showed significant correlations with neurologic and functional statuses in both the preop and postop groups. These findings were most prominent when DTI and physical examination were simultaneously performed.
Conclusion
Preoperative DTI and tractography demonstrated better FA and ADC values with lower interpretation failure rates than those obtained after surgery, whereas postoperative data significantly reflected the patient’s clinical state at the time of evaluation. Therefore, DTI and tractography could be useful in predicting clinical outcomes after traumatic cervical SCI and should be interpreted separately before and after spine surgery.

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Quantitative Magnetic Resonance Identifies Recovery from Spinal Cord Injury after Bioactive Implants
DIANA OSORIO-LONDOÑO, AXAYÁCATL MORALES-GUADARRAMA, ROBERTO OLAYO-GONZÁLEZ, ERNESTO ROLDAN-VALADEZ
Archives of Medical Research.2024; 55(5): 103012. CrossRef

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Spinal cord injury

Effects of Resistance Circuit Training on Health-Related Physical Fitness in People With Paraplegia: A Pilot Randomized Controlled Trial: Minkyoung Son, Hyejin Lee, Bum-Suk Lee, EunYoung Kim, Hyeyeong Yun, Seck Jin Kim, JaeHak Kim, Seung-Mo Jin, Seon-Deok Eun; Ann Rehabil Med 2022;46(2):87-96. Published online April 30, 2022; DOI: https://doi.org/10.5535/arm.22012; Correction in: Ann Rehabil Med 2022;46(4):219

Objective
To evaluate the efficacy and safety of 8 weeks of resistance circuit training in people with paraplegia due to spinal cord injury.
Methods
Participants were randomized into experimental and control groups. Although the intensity and sequence of movements of the exercise programs were identical in both groups, the resting time between sets was limited to 1 minute in the experimental group. In the control group, the participants were allowed to rest until they were comfortable. Both groups received 8 weeks of training twice per week. Before and after the program, muscle mass, body fat percentage, fat mass, blood pressure, heart rate, muscle strength and muscular endurance were evaluated, and 6-minute propulsion test was conducted. Additionally, the safety of the program was assessed.
Results
Twenty-two individuals with paraplegia were enrolled (11 in each group). After the training program, the experimental group showed a significant decrease in the resting blood pressure and improvement in the upper extremity muscle mass, strength, and endurance (p<0.05). Each variable showed significant inter-group differences (p<0.05). Furthermore, none of the participants showed autonomic adverse events, musculoskeletal side effects, or discomfort.
Conclusion
The results show that resistance circuit training programs with short resting intervals are superior to the usual resistance exercise programs in improving the blood pressure and physical strength and are safe for people with upper thoracic level injuries at T6 or higher.

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Effectiveness of a Community-Based Exercise Program for Ambulatory Individuals With Spinal Cord Injury: A Randomized Controlled Trial
Sungchul Huh, Yuna Kim, Hyun-Yoon Ko, Mi Sook Yun, Yong Il Shin, Jung Lim Lee, Sung-Hwa Ko
Archives of Physical Medicine and Rehabilitation.2025; 106(4): 481. CrossRef
A three-arm randomized controlled trial of aerobic and resistance training in women with spinal cord injuries: Effects on physical fitness and pulmonary function
Amir Hossein Haghighi, Atefeh Ahmadi, Roya Askari, Hadi Shahrabadi, Jeremy A. Moody, Joshua M. Miller, Filipe Clemente, Paulo Gentil
Heliyon.2024; 10(13): e32538. CrossRef
Effectiveness of Circuit and Fartlek Exercises to Increase Aerobic Endurance in Adolescent Futsal Players
M Haris Satria, Juhanis Juhanis, Mohamad Da'i, Lalu Moh Yudha Isnaini, Khaerul Anam, Karlina Dwijayanti
International Journal of Disabilities Sports and Health Sciences.2024; 7(4): 782. CrossRef
Multicomponent Training in Progressive Phases Improves Functional Capacity, Physical Capacity, Quality of Life, and Exercise Motivation in Community-Dwelling Older Adults: A Randomized Clinical Trial
Emilio Jofré-Saldía, Álvaro Villalobos-Gorigoitía, Cristián Cofré-Bolados, Gerson Ferrari, Gemma María Gea-García
International Journal of Environmental Research and Public Health.2023; 20(3): 2755. CrossRef
Evaluation of a Physical-Psychological Integrative (PPI) intervention for community-dwelling spinal cord injury survivors: Study protocol of a preliminary randomized controlled trial
Yan Li, Arnold Wong, Wai Man Chung, Mengqi Li, Alex Molasiotis, Daniel Bressington, Christina Zong-Hao Ma, Patrick Pui Kin Kor, Wing Fai Yeung, Victor Afamefuna Egwuonwu
PLOS ONE.2023; 18(3): e0282846. CrossRef

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Spinal cord injury

Factors Affecting Metabolic Syndrome in Individuals With Chronic Spinal Cord Injury: Ji Won Shin, Tayeon Kim, Bum-Suk Lee, Onyoo Kim; Ann Rehabil Med 2022;46(1):24-32. Published online February 28, 2022; DOI: https://doi.org/10.5535/arm.21144; Correction in: Ann Rehabil Med 2022;46(2):109

Objective
To assess the validity of different anthropometric measures (waist circumference [WC], body mass index [BMI], and percentage body fat) in diagnosing metabolic syndrome (MetS) among individuals with SCI and provides preliminary data for future studies in setting obesity cutoff values for this population.
Methods
This was a single-center retrospective cohort study. Sample information, anthropometric measures, and MetS variables of 157 individuals with chronic SCI were collected from an electronic medical records database.
Results
Increasing age (odds ratio [OR]=1.040, p=0.016) and lower neurological level of injury (OR=1.059, p=0.046) were risk factors for MetS. Male BMI (r=0.380, p<0.001) and male WC (r=0.346, p<0.001) were positively correlated with the number of MetS subfactors. Individuals with non-obese WC, excluding central obesity, were associated with having no MetS subfactors (p=0.005), and individuals with obese WC were associated with one or more subfactors (p=0.005). BMI was associated with MetS diagnosis (area under the curve=0.765, p<0.001), with the calculated cutoff value for BMI being 22.8 kg/m².
Conclusion
This study calls for a stricter BMI cutoff for individuals with SCI in diagnosing MetS and warrants a large population-based study to define central obesity according to sex and ethnicity.

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Physical and emotional consequences of excess weight as experienced by individuals with spinal cord injuries
Sherri L. LaVela, Justina Wu, Alex H.S. Harris, Susan M. Frayne, Andrea L. Nevedal, Katherine D. Arnow, Nicolas B. Barreto, Kristen Davis, Dan Eisenberg
The Journal of Spinal Cord Medicine.2024; 47(3): 412. CrossRef
Correlates of metabolic syndrome in people with chronic spinal cord injury
F. Di Giulio, C. Castellini, S. Palazzi, D. Tienforti, F. Antolini, G. Felzani, M. Giorgio Baroni, A. Barbonetti
Journal of Endocrinological Investigation.2024; 47(8): 2097. CrossRef
Increased Risk of Myocardial Infarction, Heart Failure, and Atrial Fibrillation After Spinal Cord Injury
Jung Eun Yoo, Miso Kim, Bongseong Kim, Heesun Lee, Won Hyuk Chang, Jeehyun Yoo, Kyungdo Han, Dong Wook Shin
Journal of the American College of Cardiology.2024; 83(7): 741. CrossRef
The Clinical Management of Electrical Stimulation Therapies in the Rehabilitation of Individuals with Spinal Cord Injuries
David R. Dolbow, Ines Bersch, Ashraf S. Gorgey, Glen M. Davis
Journal of Clinical Medicine.2024; 13(10): 2995. CrossRef
Racial differences in serological markers across the first year of injury in spinal cord injury: a retrospective analysis of a multi-center interventional study
Jia Li, Matthew Farrow, Kerollos Ibrahim, Dana M. McTigue, John Kramer, Bobo Tong, Catherine Jutzeler, Linda Jones, Ceren Yarar-Fisher
Spinal Cord.2024; 62(8): 486. CrossRef
Effect of Detraining on Muscle Strength, Functional Capacity, Mental Health, and Body Composition in Individuals with Spinal Cord Injury
Lucas Almada, Lucas Santos, Karla Freitas, Joel Rodrigues, Elizângela Diniz, Mauro Mazini-Filho, Luís Leitão, Eveline Pereira, Cláudia Oliveira, Osvaldo Moreira
International Journal of Environmental Research and Public Health.2024; 21(7): 900. CrossRef
Impaired Glucose Tolerance and Visceral Adipose Tissue Thickness among Lean and Non-Lean People with and without Spinal Cord Injury
Amy L. Kimball, Michael A. Petrie, Patrick M. McCue, Kristin A. Johnson, Richard K. Shields
Journal of Functional Morphology and Kinesiology.2023; 8(3): 123. CrossRef
The Diagnosis and Management of Cardiometabolic Risk and Cardiometabolic Syndrome after Spinal Cord Injury
Gary J. Farkas, Adam M. Burton, David W. McMillan, Alicia Sneij, David R. Gater
Journal of Personalized Medicine.2022; 12(7): 1088. CrossRef

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Physical Therapy

Effects of Paraplegia Fitness Integrated Training on Physical Function and Exercise Self-Efficacy and Adherence Among Individuals With Spinal Cord Injury: Hafifi Hisham, Maria Justine, Nazirah Hasnan, Haidzir Manaf; Ann Rehabil Med 2022;46(1):33-44. Published online February 28, 2022; DOI: https://doi.org/10.5535/arm.21127

Abstract
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Objective
To determine the effects of the Paraplegia Fitness Integrated Training (PARAFiT) program, which is an integrated graded physical exercise and health education program for individuals with spinal cord injury (SCI).
Methods
This nonrandomized single-blind study included 44 participants, who were assigned to either an intervention (PARAFiT) group or an active control (conventional physiotherapy) group. The intervention group underwent the PARAFiT program (8 weeks), which consisted of circuit-based interval training, progressive upper limb resistance training, and health education sessions. During the unsupervised period, the intervention group continuously underwent health education program once a month for 2 months (8 weeks). Repeated-measures analysis of variance was used for the analysis.
Results
The intervention group presented with a higher level of physical activity than did the control group; however, the difference was not significant (p=0.36). Additionally, the intervention group presented with better exercise self-efficacy and cardiorespiratory fitness and stronger bilateral shoulder muscle and handgrip than did the control group (all p<0.05). Exercise adherence was higher in the intervention group than in the control group during both the supervised (80% vs. 75%) and unsupervised (40% vs. 20%) periods.
Conclusion
The PARAFiT program enhanced the level of physical activity, exercise self-efficacy, physical fitness, and exercise adherence among the patients with SCI. Future studies should incorporate guidelines for home-based exercises and regular monitoring to promote long-term adherence to exercise and physical activity among individuals with SCI.

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Reliability and Validity of the Japanese Version of the Exercise Self‐Efficacy Scale in Older People Undergoing Lower Extremity Arthroplasty
Mina Matsumura, Kimie Fujita, Yuriko Matsunaga‐Myoji, Goro Motomura, Satoshi Hamai, Yasuharu Nakashima
Nursing & Health Sciences.2025;[Epub] CrossRef
The Relationship Between Physical Activity and Mental Health Among Individuals With Spinal Cord Injury: Protocol for a Scoping Review
Winslet Ong, Noor Arfa Omar, Asfarina Zanudin, Muhamad Faiz Alias, Lim Hui Wen, Angel Thang Xue Ee, Nor Azlin Mohd Nordin, Haidzir Manaf, Basri Husin, Mahadir Ahmad, Hafifi Hisham
JMIR Research Protocols.2024; 13: e56081. CrossRef
Effects of behaviour change interventions on physical activity in people with spinal cord injury: A systematic review and meta-analysis
Paul K. Watson, Aitthanatt C. Eitivipart, Glen M. Davis, Mohit Arora, James W. Middleton, Camila Quel De Oliveira
Psychology of Sport and Exercise.2023; 67: 102408. CrossRef
Feasibility, Usability, and Safety of ParaGym, an Intelligent Mobile Exercise App for Individuals With Paraplegia: Protocol for a Pilot Block-Randomized Controlled Trial
Janika Bolz, Adrian Löscher, Rainer Muhl, Andreas Badke, Hans-Georg Predel, Claudio Perret
JMIR Research Protocols.2023; 12: e45652. CrossRef
Risk Factors for Suicidality in Individuals With Spinal Cord Injury: A Focus on Physical and Functional Characteristics
Sora Han, Wooyeung Kim, Onyoo Kim
Annals of Rehabilitation Medicine.2023; 47(5): 377. CrossRef

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Spinal cord injury

Utilizing Pulmonary Function Parameters to Predict Dysphagia in Individuals With Cervical Spinal Cord Injuries: So Jung Lee, Sungchul Huh, Sung-Hwa Ko, Ji Hong Min, Hyun-Yoon Ko; Ann Rehabil Med 2021;45(6):450-458. Published online December 31, 2021; DOI: https://doi.org/10.5535/arm.21161

Abstract
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Objective
To utilize pulmonary function parameters as predictive factors for dysphagia in individuals with cervical spinal cord injuries (CSCIs).
Methods
Medical records of 78 individuals with CSCIs were retrospectively reviewed. The pulmonary function was evaluated using spirometry and peak flow meter, whereas the swallowing function was assessed using a videofluoroscopic swallowing study. Participants were divided into the non-penetration-aspiration group (score 1 on the Penetration-Aspiration Scale [PAS]) and penetration-aspiration group (scores 2–8 on the PAS). Individuals with pharyngeal residue grade scores >1 were included in the pharyngeal residue group.
Results
The mean age was significantly higher in the penetration-aspiration and pharyngeal residue groups. In this study, individuals with clinical features, such as advanced age, history of tracheostomy, anterior surgical approach, and higher neurological level of injury, had significantly more penetration-aspiration or pharyngeal residue. Individuals in the penetration-aspiration group had significantly lower peak cough flow (PCF) levels. Individuals in the pharyngeal residue group had a significantly lower forced expiratory volume in 1 second (FEV1). According to the receiver operating characteristic curve analysis of PCF and FEV1 on the PAS, the cutoff value was 140 L/min and 37.5% of the predicted value, respectively.
Conclusion
Low PCF and FEV1 values may predict the risk of dysphagia in individuals with CSCIs. In these individuals, active evaluation of swallowing is recommended to confirm dysphagia.

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Methods of diagnosis and rehabilitation of dysphagia in patients with spinal cord injury: a systematic review
Roberta ZUPO, Beatrice POGGI, Nicole CAGGIANO, Giulio VARRONE, Fabio CASTELLANA, Silvia NATOLI, Rodolfo SARDONE, Antonio NARDONE, Chiara PAVESE
European Journal of Physical and Rehabilitation Medicine.2025;[Epub] CrossRef
Pulmonary function and sarcopenia as predictors of dysphagia in cervical spinal cord injury
Su Ji Lee, Ji Cheol Shin
Spinal Cord.2024; 62(1): 42. CrossRef
Evaluation of clinical factors predicting dysphagia in patients with traumatic and non-traumatic cervical spinal cord injury: a retrospective study
Jin-Woo Choi, Dae Yeong Kim, Sun Young Joo, Donghwi Park, Min Cheol Chang
Frontiers in Neurology.2024;[Epub] CrossRef
Coordination Between Respiration and Swallowing in Patients With Dysphagia After Cervical Spinal Cord Injury: An Observational Case–Control Study
Xuluan Xu, Qingsu Zhang, Yongqi Xie, Degang Yang, Feng Gao, Yongxue Yuan, Yu Zhang, Jianjun Li
American Journal of Speech-Language Pathology.2024; 33(5): 2572. CrossRef
Flujo máximo de tos y evaluación de la deglución: Una revisión de literatura
Amalia Nanjarí R , María del Carmen Campos
Revista Científica Signos Fónicos.2024; 10(1): 7. CrossRef
Voluntary Cough Testing as a Clinical Indicator of Airway Protection in Cervical Spinal Cord Injury
Laura Pitts, Valerie K. Hamilton, Erin A. Walaszek, Stephanie Watts, Leora R. Cherney
The Laryngoscope.2023; 133(6): 1434. CrossRef
Association between Anterior Surgical Approach and Dysphagia Severity in Patients with Cervical Spinal Cord Injury
Min Cheol Chang, Dae Yeong Kim, Jin-Woo Choi, Ho Yong Choi, Jin-Sung Park, Donghwi Park
Journal of Clinical Medicine.2023; 12(9): 3227. CrossRef
Successful Continuation of Oral Intake in a Dysphagic and Tetraplegic Patient With Alternate Right and Left Complete Lateral Decubitus Positions in Rehabilitation
Yoshinori Maki, Mayumi Takagawa, Akio Goda, Junichi Katsura, Ken Yanagibashi
Cureus.2023;[Epub] CrossRef
Laryngeal and swallow dysregulation following acute cervical spinal cord injury
Teresa Pitts, Kimberly E. Iceman, Alyssa Huff, M. Nicholas Musselwhite, Michael L. Frazure, Kellyanna C. Young, Clinton L. Greene, Dena R. Howland
Journal of Neurophysiology.2022; 128(2): 405. CrossRef

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Spinal cord injury

Development and Evaluation of the Korean Version of Hospital-Based Transitional Rehabilitation Program Using Daily Living Home for Spinal Cord Injury: Chang-Won Moon, Il-Young Jung, Ju Young Kim, Ha Neul Jang, Kang Hee Cho; Ann Rehabil Med 2021;45(5):379-392. Published online October 31, 2021; DOI: https://doi.org/10.5535/arm.21119

Abstract
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Objective
To develop and evaluate the Korean version of a hospital-based transitional rehabilitation program (TRP), using daily living home for spinal cord injury (SCI) patients.
Methods
In this study, we developed the Korean version of a hospital-based TRP through domestic and overseas surveys and focus group meetings. By applying this to chronic SCI patients, we observed the functional and quality of life (QOL) changes and evaluated the degree of achievement of the core goals set for each patient during hospital-based TRP.
Results
Hospital-based TRP, for 21.8±3.9 days on average, was applied to four chronic SCI patients (two patients with long-term hospital stays and two homebound disabled individuals) with an average injury period of 736.8±185.4 days. The Korean version of the Spinal Cord Independence Measure (49.3±6.9 vs. 62.5±6.0; p<0.05) showed functional improvement at the end of TRP, when compared to that before the TRP. The Korean version of the World Health Organization’s QOL scale, abbreviated version (159.8±36.6 vs. 239.8±36.1; p<0.05), showed improvement in QOL. Goal attainment scaling showed a significant degree of achievement for the core goals through TRP (33.6±4.4 vs. 70.0±2.8; p<0.05). These results confirmed that the effect was maintained 1 month after the end of TRP. Additionally, two patients were successfully discharged after TRP completion, and the other two could start social activities.
Conclusion
The Korean version of the hospital-based TRP, applied to chronic SCI patients, showed the potential to improve the patients’ functioning and QOL and appeared to be effective in successful discharge and social participation.

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Interventional Programs for Community Reintegration after Spinal Cord Injury: A Scoping Review
Surajo Kamilu Sulaiman, Bashir Kaka, Bashir Bello, Ashiru Hamza Mohammed, Dauda Salihu, Umar Muhammad Bello, Muhammad Chutiyami, Francis Fatoye
Critical Reviews in Physical and Rehabilitation Medicine.2023; 35(3): 19. CrossRef

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Spinal cord injury

Should We Delay Urodynamic Study When Patients With Spinal Cord Injury Have Asymptomatic Pyuria?: EunYoung Kim, Hye Jin Lee, Onyoo Kim, In Suk Park, Bum-Suk Lee; Ann Rehabil Med 2021;45(3):178-185. Published online June 14, 2021; DOI: https://doi.org/10.5535/arm.20241

Objective
To assess the incidence of urinary tract infection (UTI) with post-urodynamic study (post-UDS) in patients with spinal cord injury (SCI) and study its relationship with pre-UDS pyuria.
Methods
Patients with SCI who were hospitalized and underwent UDS during a 4-year period were reviewed. Patients with pre-test lower urinary tract symptoms were excluded. Urinalysis and urine culture were performed before and 24 hours after UDS. Prophylactic antibiotics were administered for 5 days starting from the morning of the UDS. UTI was defined as bacteriuria with accompanying symptoms.
Results
Of 399 patients reviewed, 209 (52.4%) had pyuria in pre-UDS urinalysis, and 257 (64.4%) had bacteriuria in pre-UDS culture. Post-UDS UTI occurred in 6 (1.5%) individuals who all complained of fever: 5 (2.4%) of the post-UDS UTI cases occurred in patients with pre-UDS pyuria, and 1 (0.5%) in a person without. The differences between groups were not statistically significant (p=0.218). Of 221 patients with bacteriuria (gram-negative isolates) on pre-UDS culture, resistance to ciprofloxacin, cephalosporin, and trimethoprim/sulfamethoxazole (TMP/SMT) was noted in 52.9% (117 cases), 57.0% (126 cases), and 38.9% (86 cases), respectively.
Conclusion
No difference was found in the prevalence of post-UDS UTI based on the presence of pyuria in pre-UDS urinalysis. UDS may be performed even in SCI cases of pre-UDS pyuria without increasing the prevalence of post-UDS UTI if prophylactic antibiotics are administered. TMP/SMT could be used as a first-line antibiotic for the prevention of post-UDS UTI in Korea.

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Spinal cord injury

Correlation Between Duration From Injury and Bone Mineral Density in Individuals With Spinal Cord Injury: Hyehoon Choi, So-youn Chang, Jaewan Yoo, Seong Hoon Lim, Bo Young Hong, Joon Sung Kim; Ann Rehabil Med 2021;45(1):1-6. Published online February 9, 2021; DOI: https://doi.org/10.5535/arm.20169

Abstract
PDF

Objective
To investigate the correlation between bone mineral density (BMD) and duration of injury in individuals with spinal cord injury (SCI).
Methods
Patients with SCI who visited the outpatient department between January 2009 and January 2019 were enrolled. Patients’ most recent dual energy X-ray absorptiometry images were reviewed. According to the 2007 International Society for Clinical Densitometry guidelines, vertebrae with a local structural change were excluded when deriving spine BMD. If one or no vertebra is suitable for evaluation, spine BMD was judged as “improper for assessment”. Correlation analysis was performed between duration from injury and BMD Z-scores of the hip and spine.
Results
Among 83 individuals with SCI, the spines of 44 were judged as improper for assessment. The correlation analysis showed a significant negative relationship between the duration from injury and femur neck BMD (r=-0.40, p<0.01) and total proximal femur BMD (r=-0.39, p<0.01). However, no significant correlation was found between the duration from injury and spine BMD Z-score.
Conclusion
The duration of SCI correlated with hip BMD, but not with spine BMD. Further, more than half of the individuals with SCI could not undergo spinal assessment due to local structural changes. Therefore, spine BMD measurement is not an appropriate method for predicting future fracture risk in those with SCI.

Citations

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“I think it was helpful but not as helpful as it could have been” - a qualitative study of the experiences and perspectives of using fitness apps among manual wheelchair users with spinal cord injury
Claire Hickey, Éimear Smith, Sara Hayes
Disability and Rehabilitation.2025; 47(3): 633. CrossRef
Bone Mineral Density Post a Spinal Cord Injury: A Review of the Current Literature Guidelines
Georgia Antoniou, Ioannis S Benetos, John Vlamis, Spyros G Pneumaticos
Cureus.2022;[Epub] CrossRef

5,333 View
203 Download
2 Web of Science
2 Crossref

Spinal cord injury

Epidemiology of Spinal Cord Injury: Changes to Its Cause Amid Aging Population, a Single Center Study: Ha Seong Kim, Kil-Byung Lim, Jiyong Kim, Joongmo Kang, Hojin Lee, Sang Wan Lee, Jeehyun Yoo; Ann Rehabil Med 2021;45(1):7-15. Published online February 9, 2021; DOI: https://doi.org/10.5535/arm.20148

Abstract
PDF

Objective
To investigate the epidemiologic and demographic characteristics of patients with spinal cord injury (SCI) who were admitted to a department of rehabilitation of a university hospital.
Methods
This was a descriptive cross-sectional study. Medical records including sex, age at injury, type of disability, traumatic or non-traumatic etiology and presence of ossification of posterior longitudinal ligament (OPLL) of patients with SCI who were admitted to the department of rehabilitation between 2012 and 2018 were reviewed.
Results
Of the 221 cases of SCI, 161 were traumatic and 60 were non-traumatic. The mean age at injury was 52.8 years. People aged 40–49 years showed highest proportion among overall SCI patients (19.0%). The proportion of male patients was higher in traumatic SCI at 4.96:1 than in non-traumatic SCI at 1.30:1. The most common cause of traumatic SCI was falling off (37.3%), followed by motor vehicle crash (35.4%) and tripping over (19.3%). Meanwhile, the most common cause of non-traumatic SCI was neoplasm (35.0%). Tripping over was the leading cause of traumatic SCI in patients aged ≥60 years (42.6%). A high proportion of traumatic SCI patients were found to have underlying OPLL (26.1%), particularly those who were injured by tripping over (64.5%).
Conclusion
The mean age of SCI patients was higher than that of previous studies. Falls was the single most common cause of traumatic SCI, and tripping over was the most common cause of injury in the elderly patients. OPLL was prevalent in patients who were injured from tripping over.

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Samantha J. Borg, Cate M. Cameron, Karen Luetsch, Adam Rolley, Timothy Geraghty, Steven McPhail, Victoria McCreanor
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Danielle Hildegard Bass, Pardis Ghamasaee, Gregory E. Bigford, Mandeville Wakefield, Lunthita M. Duthely, Daniel Samano
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Beverley Catharine Craven, Emma A. Bateman, Heather Flett, Farnoosh Farahani, Dalton L. Wolfe, Sussan Askari, Maryam Omidvar, Mohammad Alavinia
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Timothy Aghoghko Ehwarieme, Uzezi Josiah, Auwuli Emina
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Maricela Dragomir, Claudiu Mereuță, Carmen Gheorghe
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Hamish Patel, Daniel Blackburn, Ram Hariharan, Krishnan Padmakumari Sivaraman Nair, Simon M. Bell
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Marta Mascanzoni, Alessia Luciani, Federica Tamburella, Marco Iosa, Emanuela Lena, Sergio Di Fonzo, Valerio Pisani, Maria Carmela Di Lucente, Vincenzo Caretti, Lucia Sideli, Gaia Cuzzocrea, Giorgio Scivoletto
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Yoonjeong Choi, Ja-Ho Leigh, Jooeun Jeon, Goo Joo Lee, Hyung-Ik Shin, Moon Suk Bang
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Gabriel S. Gonzales-Portillo, Mauricio J. Avila, Omar Rizvi, Travis M. Dumont
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Prevalence and Characteristics of Neuropathic Pain in Patients With Spinal Cord Injury Referred to a Rehabilitation Center: Hae Young Kim, Hye Jin Lee, Tae-lim Kim, EunYoung Kim, Daehoon Ham, Jaejoon Lee, Tayeun Kim, Ji Won Shin, Minkyoung Son, Jun Hun Sung, Zee-A Han; Ann Rehabil Med 2020;44(6):438-449. Published online December 31, 2020; DOI: https://doi.org/10.5535/arm.20081

Abstract
PDF

Objective
To identify the prevalence and characteristics of neuropathic pain (NP) in patients with spinal cord injury (SCI) and to investigate associations between NP and demographic or disease-related variables.
Methods
We retrospectively reviewed medical records of patients with SCI whose pain was classified according to the International Spinal Cord Injury Pain classifications at a single hospital. Multiple statistical analyses were employed. Patients aged <19 years, and patients with other neurological disorders and congenital conditions were excluded.
Results
Of 366 patients, 253 patients (69.1%) with SCI had NP. Patients who were married or had traumatic injury or depressive mood had a higher prevalence rate. When other variables were controlled, marital status and depressive mood were found to be predictors of NP. There was no association between the prevalence of NP and other demographic or clinical variables. The mean Numeric Rating Scale (NRS) of NP was 4.52, and patients mainly described pain as tingling, squeezing, and painful cold. Females and those with below-level NP reported more intense pain. An NRS cut-off value of 4.5 was determined as the most appropriate value to discriminate between patients taking pain medication and those who did not.
Conclusion
In total, 69.1% of patients with SCI complained of NP, indicating that NP was a major complication. Treatment planning for patients with SCI and NP should consider that marital status, mood, sex, and pain subtype may affect NP, which should be actively managed in patients with an NRS ≥4.5.

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Mechanisms and Therapeutic Prospects of Microglia-Astrocyte Interactions in Neuropathic Pain Following Spinal Cord Injury
Yinuo Liu, Xintong Cai, Bowen Shi, Yajie Mo, Jianmin Zhang, Wenting Luo, Bodong Yu, Xi Li
Molecular Neurobiology.2025; 62(4): 4654. CrossRef
Comparative outcomes of microsurgical dorsal root entry zone lesioning (DREZotomy) for intractable neuropathic pain in spinal cord and cauda equina injuries
Bunpot Sitthinamsuwan, Tanawat Ounahachok, Sawanee Pumseenil, Sarun Nunta-aree
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Efficacy of neuromodulation and rehabilitation approaches on pain relief in patients with spinal cord injury: a systematic review and meta-analysis
Simona Portaro, Angelo Alito, Giulia Leonardi, Nicola Marotta, Adriana Tisano, Daniele Bruschetta, Umile Giuseppe Longo, Antonio Ammendolia, Demetrio Milardi, Alessandro de Sire
Neurological Sciences.2025;[Epub] CrossRef
Correlation of Severity of Neuropathic Pain in Traumatic Spinal Cord Injury Patients with Sociodemographic and Clinical Characteristics Including Depression and Quality of Life: A Cross-sectional Study
Arun Yadav, Mrinal Joshi, Shivangi Yadav
Indian Journal of Physical Medicine and Rehabilitation.2025; 35(2): 128. CrossRef
Curcumin reduces pain after spinal cord injury in rats by decreasing oxidative stress and increasing GABAA receptor and GAD65 levels
Maryam Hadadi, Mohammad Mojtaba Farazi, Mehrnaz Mehrabani, Mahsa Tashakori-Miyanroudi, Zahra Behroozi
Scientific Reports.2025;[Epub] CrossRef
Clinical Characteristics of Adults Living with a Spinal Cord Injury Across the Continuum of Care: A Population-Based Cross-Sectional Study
Matteo Ponzano, Anja Declercq, Melissa Ziraldo, John P. Hirdes
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Occurrence of neuropathic pain and its characteristics in patients with traumatic spinal cord injury
Arun Yadav, Mrinal Joshi
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A Fully Immersive Virtual Reality Method for Upper Limb Rehabilitation in Spinal Cord Injury: Da Young Lim, Dong Min Hwang, Kang Hee Cho, Chang Won Moon, So Young Ahn; Ann Rehabil Med 2020;44(4):311-319. Published online July 28, 2020; DOI: https://doi.org/10.5535/arm.19181; Correction in: Ann Rehabil Med 2025;49(1):60

Abstract
PDF

Objective
To determine whether a fully immersive virtual reality (VR) intervention combined with conventional rehabilitation (CR) can improve upper limb function more than CR alone in patients with spinal cord injury (SCI), we conducted a prospective, randomized, controlled clinical trial.
Methods
Participants were randomly assigned to either the control group (CG; n=10) or experimental group (EG; n=10). The participants in the CG received 60 minutes of conventional therapy per day, 4 days per week for 4 weeks, whereas those in the EG received 30 minutes of VR training and 30 minutes of conventional therapy per day, 4 days per week for 4 weeks. The clinical outcome measures included Medical Research Council grade, the American Spinal Injury Association upper extremity motor score (ASIA-UEMS), and scores in the Hand Strength Test, Box and Block Test, Nine-Hole Peg Test, Action Research Arm Test, and Korean version of the Spinal Cord Independence Measure (K-SCIM). The assessments were performed at the beginning (T0) and end of the intervention (T1).
Results
Grip power and K-SCIM score significantly improved in the EG after the intervention. When comparing differences between the groups, elbow extensor, wrist extensor, ASIA-UEMS, grip power, lateral pinch power, and palmar pinch power were all significantly improved.
Conclusion
VR training of upper limb function after SCI can provide an acceptable adjunctive rehabilitation method without significant adverse effects.

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Creating adapted environments: enhancing accessibility in virtual reality for upper limb rehabilitation through automated element adjustment
V. Herrera, J. Albusac, J. J. Castro-Schez, C. González-Morcillo, D. N. Monekosso, S. Pacheco, R. Perales, A. de los Reyes-Guzmán
Virtual Reality.2025;[Epub] CrossRef
Immersive Virtual Reality in Stroke Rehabilitation: A Systematic Review and Meta-Analysis of Its Efficacy in Upper Limb Recovery
Chala Diriba Kenea, Teklu Gemechu Abessa, Dheeraj Lamba, Bruno Bonnechère
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Claudia Vinciguerra, Antonio Federico
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Xiaolei Chu, Shuaiyi Liu, Xiaoxuan Zhao, Tao Liu, Zheng Xing, Qingwen Li, Qi Li
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Jacek Polechoński, Alan Langer, Anna Akbaş, Anna Zwierzchowska
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Chala Diriba Kenea, Teklu Gemechu Abessa, Dheeraj Lamba, Bruno Bonnechère
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Tianci Wang, Zaixin Song, Hao Wen, Chunhua Liu
IEEE Open Journal of the Industrial Electronics Society.2024; 5: 575. CrossRef
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Xupeng Ai, Victor Santamaria, Sunil K. Agrawal
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Matteo Scalise, Tevfik Serhan Bora, Chiara Zancanella, Adrian Safa, Roberto Stefini, Delia Cannizzaro
Journal of Clinical Medicine.2024; 13(18): 5429. CrossRef
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Xupeng Ai, Sunil K. Agrawal
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Likun Wang, Hong Zhang, Haibo Ai, Yuxi Liu
Journal of NeuroEngineering and Rehabilitation.2024;[Epub] CrossRef
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Antonio Rodríguez-Fernández, Alex van den Berg, Salvatore Luca Cucinella, Joan Lobo-Prat, Josep M. Font-Llagunes, Laura Marchal-Crespo
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Armin Paravlic, Luka Šlosar, Ensar Abazovic, Uros Marusic
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Sophie Dewil, Shterna Kuptchik, Mingxiao Liu, Sean Sanford, Troy Bradbury, Elena Davis, Amanda Clemente, Raviraj Nataraj
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Farhah Amaliya Zaharuddin, Nazrita Ibrahim, Azmi Mohd Yusof
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Changes in the Trend in Bladder Emptying Methods in Patients With Spinal Cord Injury: A 20-Year Single-Center Retrospective Study: Sang-Wook Oh, Joo Hwan Jung, In Kyoung Cho, Hye Jin Lee, Seung Hyun Kwon, Bum Suk Lee; Ann Rehabil Med 2020;44(3):228-237. Published online June 30, 2020; DOI: https://doi.org/10.5535/arm.19107

Abstract
PDF

Objective
To review trends in bladder emptying methods over a 20-year period in patients with spinal cord injury (SCI) by severity according to the American Spinal Injury Association impairment scale (AIS).
Methods
Medical records of patients with SCI from 1994 to 1998 (group 1) and from 2012 to 2016 (group 2) were retrospectively reviewed. We classified bladder emptying methods according to the International Spinal Cord dataset. We grouped patients with normal voiding, bladder reflex triggering, and bladder expression as those using voiding without catheter.
Results
A total of 667 patients were included in the analysis. The proportion of patients using voiding without catheter and intermittent catheterization decreased from 67.0% to 30.0% and increased from 26.8% to 54.8%, respectively. In patients with AIS-A and AIS-B, the proportion of patients with intermittent catheterization increased from 32.8% to 73.3%. In patients with AIS-D, the proportion of patients using voiding without catheter and intermittent catheterization decreased from 88.5% to 68.9% and increased from 11.5% to 26.8%, respectively. In group 2, among 111 patients with AIS-D using voiding without catheter at admission, 8 (7.2%) switched to intermittent catheterization at discharge due to decreased bladder volume, increased post-voiding residual urine, or incontinence.
Conclusion
Over the past 20 years, trends in bladder emptying methods in patients with SCI changed from voiding without catheter to intermittent catheterization in Korea. This was especially prominent in patients with AIS-A, AIS-B, and AIS-C. Even in patients with AIS-D, the use of intermittent catheterization at hospital discharge increased.

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Changes in bladder emptying during inpatient rehabilitation after spinal cord injury and predicting factors: data from the Dutch Spinal Cord Injury Database
Claire G. Poublon, Eline W. M. Scholten, Michel I. A. Wyndaele, Marcel W. M. Post, Janneke M. Stolwijk-Swüste
Spinal Cord.2023; 61(11): 624. CrossRef
Should We Delay Urodynamic Study When Patients With Spinal Cord Injury Have Asymptomatic Pyuria?
EunYoung Kim, Hye Jin Lee, Onyoo Kim, In Suk Park, Bum-Suk Lee
Annals of Rehabilitation Medicine.2021; 45(3): 178. CrossRef

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Energy Efficiency and Patient Satisfaction of Gait With Knee-Ankle-Foot Orthosis and Robot (ReWalk)-Assisted Gait in Patients With Spinal Cord Injury: Seung Hyun Kwon, Bum Suk Lee, Hye Jin Lee, Eun Joo Kim, Jung Ah Lee, Sung Phil Yang, Tae Young Kim, Han Ram Pak, Hyun Ki Kim, Hae Young Kim, Joo Hwan Jung, Sang Wook Oh; Ann Rehabil Med 2020;44(2):131-141. Published online April 29, 2020; DOI: https://doi.org/10.5535/arm.2020.44.2.131

Abstract
PDF

Objective
To compare the energy efficiency of gait with knee-ankle-foot orthosis (KAFO) and robot-assisted gait and to develop a usability questionnaire to evaluate the satisfaction of walking devices in paraplegic patients with spinal cord injuries.
Methods
Thirteen patients with complete paraplegia participated and 10 completed the evaluation. They were trained to walk with KAFO (KAFO-gait) or a ReWalk robot (ReWalk-gait) for 4 weeks (20 sessions). After a 2-week wash-out period, they switched walking devices and underwent 4 additional weeks of training. Two evaluations were performed (after 2 and 4 weeks) following the training periods for each walking device, using the 6-minute walking test (6MWT) and 30-minute walking test (30MWT). The spatiotemporal variables (walking distance, velocity, and cadence) and energy expenditure (heart rate, maximal heart rate, the physiologic cost index, oxygen consumption, metabolic equivalents, and energy efficiency) were evaluated duringthe 6MWT and 30MWT. A usability evaluation questionnaire for walking devices was developed based on the International Organization for Standardization/International Electrotechnical Commission guidelines through expert consultation.
Results
The ReWalk-gait presented significant advantages in energy efficiency compared to KAFO-gait in the 6MWT and 30MWT; however, there were no differences in walking distance or speed in the 30MWT between ReWalk-gait and KAFOgait. The usability test demonstrated that ReWalk-gait was not superior to KAFO-gait in terms of safety, efficacy, efficiency, or patient satisfaction.
Conclusion
The robot (ReWalk) enabled patients with paraplegia to walk with lower energy consumption compared to KAFO, but the ReWalk-gait was not superior to KAFO-gaitin terms of patient satisfaction.

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Intrathecal Baclofen Dosage for Long-Term Treatment of Patients With Spasticity Due to Traumatic Spinal Cord Injuries or Multiple Sclerosis: Bengt Skoog, Björn Hedman; Ann Rehabil Med 2019;43(5):555-561. Published online October 31, 2019; DOI: https://doi.org/10.5535/arm.2019.43.5.555

Abstract
PDF

Objective
To investigate dosage changes in intrathecal baclofen during long-term treatment of patients with severe leg spasticity.
Methods
We performed a retrospective chart review of 49 patients treated with an intrathecal baclofen pump (ITB) because of severe leg spasticity, for a minimum of 7 years. Eight patients were excluded due to catheter/pump failure or factors aggravating spasticity. Of the remaining 41 patients, 19 had spinal cord injury (SCI) and 22 were diagnosed with multiple sclerosis (MS). Among the SCI patients, 15 had cervical and 4 thoracic SCI, with 7 patients showing the American Spinal Injury Association impairment scale (AIS) A and 12 patients with AIS B–D. The dose was regulated by discussion among the patients and their physicians, usually 4–10 times annually, to reduce leg spasticity and also avoid leg/trunk weakness.
Results
After 1 year patients on ITB needed a median dose of 168 mg/24 hr (range, 30–725 mg) for an optimal effect. After 7 to 10 years the dosage needed to reduce leg spasticity in the MS patients was significantly increased compared with the initial dose (mean 157%, n=22 and mean 194%, n=18). In contrast, the SCI patients needed only a modest increase (mean 113% and 121%). The difference between MS and SCI patients was significant (t-test p=0.006 and p=0.004).
Conclusion
The increased dosage in MS patients compared with patients diagnosed with SCI probably reflects the progressive disease course. The need for a large dosage increase in patients with SCI suggests possible pump failure, triggering factors for spasticity or progressive spinal disease.

Citations

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Quality of life of individuals with intrathecal baclofen pump therapy
Abdulaziz Al Mosallam, Ahmad Zaheer Qureshi, Anas J. AlSaleh
The Journal of the International Society of Physical and Rehabilitation Medicine.2025;[Epub] CrossRef
Scar Tissue Catheter Tip Occlusion From an Intrathecal Baclofen Delivery: A Case Report and Review of the Literature
James W Leiphart, Thaddeus J Leiphart
Cureus.2024;[Epub] CrossRef
Spasticity Management after Spinal Cord Injury: The Here and Now
Zackery J. Billington, Austin M. Henke, David R. Gater
Journal of Personalized Medicine.2022; 12(5): 808. CrossRef
Results of Intrathecal Baclofen Treatment in Sixteen Spasticity Patients According to Four Different Measurement Scales: A Retrospective Analysis
Hasan Burak Gündüz
Cureus.2022;[Epub] CrossRef

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Effects of Combined Upper Limb Robotic Therapy in Patients With Tetraplegic Spinal Cord Injury: Joo Hwan Jung, Hye Jin Lee, Duk Youn Cho, Jung-Eun Lim, Bum Suk Lee, Seung Hyun Kwon, Hae Young Kim, Su Jeong Lee; Ann Rehabil Med 2019;43(4):445-457. Published online August 31, 2019; DOI: https://doi.org/10.5535/arm.2019.43.4.445

Objective
To confirm the effects of combined upper limb robotic therapy (RT) as compared to conventional occupational therapy (OT) in tetraplegic spinal cord injury (SCI) patients and to suggest the optimized treatment guidelines of combined upper limb RT.
Methods
After subject recruitment and screening for eligibility, the baseline evaluation for outcome measures were performed. We evaluated the Graded and Redefined Assessment of Strength, Sensibility, and Prehension (GRASSP), the American Spinal Injury Association upper extremity motor score, grip and pinch strength, and the Spinal Cord Independence Measurement III (SCIM-III). In this study, the pre-tested participants were divided randomly into the RT and OT group. The utilized interventions included combined upper limb RT using ArmeoPower and Amadeo (RT group), or conventional OT (OT group) in addition to daily inpatient rehabilitation program. The participants underwent 40 minutes×3 sessions×5 weeks of interventions.
Results
A total of 30 tetraplegic SCI patients completed entire study program. After 5 weeks of intervention, both groups demonstrated increases in GRASSP-strength and SCIM-III. The manual muscle test scores of elbow flexion, elbow extension, 2-5th metacarpophalangeal extension, and SCIM-III subscores of bathing-upper, dressing-upper, and grooming as well as the GRASSP-qualitative prehension score were noted to have been significantly increased in the RT group as evaluated. The OT group showed improvements in the GRASSP-quantitative prehension score and some items in grip and pinch strength. There was no significant difference between the two groups in almost all measurements except for the SCIM-III bathing-upper subscore.
Conclusion
Combined upper limb RT demonstrated beneficial effects on the upper limb motor function in patients with tetraplegic SCI, which were comparable with conventional OT.

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Anxiety and Depression in Pediatric-Onset Traumatic Spinal Cord Injury: A Systematic Review
Mohammad Mofatteh, Mohammad Sadegh Mashayekhi, Saman Arfaie, Yimin Chen, Armaan K. Malhotra, Georgios P. Skandalakis, Mohammed Ali Alvi, Fardad T. Afshari, Shakila Meshkat, Famu Lin, Ebtesam Abdulla, Ayush Anand, Xuxing Liao, Roger S. McIntyre, Carlo Sant
World Neurosurgery.2024; 184: 267. CrossRef
Technology-Assisted Upper Limb Therapy (TAULT): Evaluation of Clinical Practice at a Specialised Centre for Spinal Cord Injury in Switzerland
Daniela B. Kuchen, Beatrice Hubacher, Andris Ladner, Inge-Marie Velstra, Mario Widmer
Healthcare.2023; 11(23): 3055. CrossRef
Reliability Validity and Responsiveness of the Spinal Cord Independence Measure 4th Version in a Multicultural Setup
Amiram Catz, Malka Itzkovich, Keren Elkayam, Dianne Michaeli, Ilana Gelernter, Yoav Benjamini, Harvinder Singh Chhabra, Luigi Tesio, Einat Engel-Haber, Emiliana Bizzarini, Claudio Pilati, Giulio Del Popolo, Ilaria Baroncini, Nan Liu, Paulo Margalho, Thaba
Archives of Physical Medicine and Rehabilitation.2022; 103(3): 430. CrossRef
Donor activation focused rehabilitation approach to hand closing nerve transfer surgery in individuals with cervical level spinal cord injury
Lorna C. Kahn, Adam G. Evans, Elspeth J. R. Hill, Ida K. Fox
Spinal Cord Series and Cases.2022;[Epub] CrossRef
The Impact of Robotic Therapy on the Self-Perception of Upper Limb Function in Cervical Spinal Cord Injury: A Pilot Randomized Controlled Trial
V. Lozano-Berrio, M. Alcobendas-Maestro, B. Polonio-López, A. Gil-Agudo, A. de la Peña-González, A. de los Reyes-Guzmán
International Journal of Environmental Research and Public Health.2022; 19(10): 6321. CrossRef
The Outcomes of Robotic Rehabilitation Assisted Devices Following Spinal Cord Injury and the Prevention of Secondary Associated Complications
Carmen Delia Nistor-Cseppento, Anamaria Gherle, Nicoleta Negrut, Simona Gabriela Bungau, Anca Maria Sabau, Andrei-Flavius Radu, Alexa Florina Bungau, Delia Mirela Tit, Bogdan Uivaraseanu, Timea Claudia Ghitea, Diana Uivarosan
Medicina.2022; 58(10): 1447. CrossRef
LncRNA Airsci increases the inflammatory response after spinal cord injury in rats through the nuclear factor kappa B signaling pathway
Tao Zhang, Kang Li, Zi-Lu Zhang, Kai Gao, Chao-Liang Lv
Neural Regeneration Research.2021; 16(4): 772. CrossRef
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Lisa A. Harvey, Joanne V. Glinsky, Jackie Chu
Spinal Cord.2021; 59(7): 705. CrossRef
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Muhammad Ahsan Gull, Shaoping Bai, Jakob Udby Blicher, Tobias Glaston Staermose
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Upper Limb Robotic Rehabilitation for Patients with Cervical Spinal Cord Injury: A Comprehensive Review
Giovanni Morone, Alessandro de Sire, Alex Martino Cinnera, Matteo Paci, Luca Perrero, Marco Invernizzi, Lorenzo Lippi, Michela Agostini, Irene Aprile, Emanuela Casanova, Dario Marino, Giuseppe La Rosa, Federica Bressi, Silvia Sterzi, Daniele Giansanti, Al
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Drug Metabolism and Personalized Therapy.2020;[Epub] CrossRef

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The Value of MicroRNAs as an Indicator of the Severity and the Acute Phase of Spinal Cord Injury: Junyoung Park, Dongsoo Yi, Jiyoon Jang, Jiseon Hong; Ann Rehabil Med 2019;43(3):328-334. Published online June 28, 2019; DOI: https://doi.org/10.5535/arm.2019.43.3.328

Abstract
PDF

Objective
To assess the role of miRNA-21 and miRNA-223 in a balloon-compression model of spinal cord injury (SCI).
Methods
A total of 50 male Wistar rats (n=50) were divided into the three groups: the group A (n=15, insertion of the unflated Fogarty balloon catheter), the group B (n=15, insertion of the Fogarty balloon catheter at a volume of 20 μL) and the group C (n=15, insertion of the Fogarty balloon catheter at a volume of 50 μL). After the behavioral test, RNA isolation, microRNA expression profiling using microarrays and quantitative polymerase chain reaction, measurements were compared between the three groups.
Results
Despite a lack of significant differences in time-dependent changes in miRNA-21 expression levels between the three groups at 4 hours, there were significant differences in them at 1, 3, and 7 days (p<0.05). Moreover, there were significant differences in time-dependent changes in miRNA-223 expression levels between the three groups at 4 hours and 1, 3, and 7 days (p<0.05). Furthermore, miRNA-223 expression levels reached the highest at 1 day but were decreased with time thereafter in all the three groups.
Conclusion
Expression levels of miRNA-21 and miRNA-223 might be associated with the severity and acute phase of SCI, respectively. It is mandatory, however, to analyze changes in levels of inflammatory markers and the relevant biological pathways.

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Spinal Cord Injury: From MicroRNAs to Exosomal MicroRNAs
Xiangyang Xu, Ruyin Liu, Yunpeng Li, Cheng Zhang, Chuanghao Guo, Jiong Zhu, Jiaan Dong, Liyun Ouyang, Mohammad Reza Momeni
Molecular Neurobiology.2024; 61(8): 5974. CrossRef
Long non-coding RNA-small nucleolar RNA host gene 7 regulates inflammatory responses following spinal cord injury by regulating the microRNA-449a/TNF-α-induced protein 3-interacting protein 2 axis
Chunlei He, Jianhua Xiao, Yongjun Ye, Shiqiao Huang, Yanchun Zhong, Lulin Liu, Wuyang Liu, Sheng Liu
Bioengineered.2022; 13(4): 10215. CrossRef
Improving Diagnostic Workup Following Traumatic Spinal Cord Injury: Advances in Biomarkers
Simon Schading, Tim M. Emmenegger, Patrick Freund
Current Neurology and Neuroscience Reports.2021;[Epub] CrossRef
Serum exosomal microRNA transcriptome profiling in subacute spinal cord injured rats
Shu-Qin Ding, Yu-Qing Chen, Jing Chen, Sai-Nan Wang, Fei-Xiang Duan, Yu-Jiao Shi, Jian-Guo Hu, He-Zuo Lü
Genomics.2020; 112(2): 2092. CrossRef
Serum exosomal microRNA transcriptome profiling in subacute spinal cord injured rats
Shu-Qin Ding, Yu-Qing Chen, Jing Chen, Sai-Nan Wang, Fei-Xiang Duan, Yu-Jiao Shi, Jian-Guo Hu, He-Zuo Lü
Genomics.2020; 112(6): 5086. CrossRef

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Repetitive Transcranial Magnetic Stimulation Enhances Recovery in Central Cord Syndrome Patients: Hana Choi, Kyung Cheon Seo, Tae Uk Kim, Seong Jae Lee, Jung Keun Hyun; Ann Rehabil Med 2019;43(1):62-73. Published online February 28, 2019; DOI: https://doi.org/10.5535/arm.2019.43.1.62

Abstract
PDF

Objective
To investigate the effect of repetitive transcranial magnetic stimulation (rTMS) on neurological and functional recovery in patients with central cord syndrome (CCS) involving the upper extremities between the treated and non-treated sides of the treated group and whether the outcomes are comparable to that of the untreated control group.
Methods
Nineteen CCS patients were treated with high-frequency (20 Hz) rTMS over the motor cortex for 5 days. The stimulation side was randomly selected, and all the subjects received conventional occupational therapy during the rTMS-treatment period. Twenty CCS patients who did not receive rTMS were considered as controls. Clinical assessments, including those by the International Standard for Neurological Classification of Spinal Cord Injury, the Jebsen-Taylor Hand Function Test, and the O'Connor Finger Dexterity Test were performed initially and followed up for 1 month after rTMS treatment or 5 weeks after initial assessments.
Results
The motor scores for upper extremities were increased and the number of improved cases was greater for the treated side in rTMS-treated patients than for the non-treated side in rTMS-treated patients or controls. The improved cases for writing time and score measured on the Jebsen-Taylor Hand Function Test were also significantly greater in number on the rTMS-treated side compared with the non-treated side and controls. There were no adverse effects during rTMS therapy or the follow-up period.
Conclusion
The results of the application of high-frequency rTMS treatment to CCS patients suggest that rTMS can enhance the motor recovery and functional fine motor task performance of the upper extremities in such individuals.

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De-mei Jia, Xuan Li, Bin-cang Zhang, Bing-ran Zhang, Qiu-juan Zhang, Ming-wei Liu, Lin-ming Zhang
BMC Neurology.2025;[Epub] CrossRef
Stimulation Parameters Used During Repetitive Transcranial Magnetic Stimulation for Motor Recovery and Corticospinal Excitability Modulation in SCI: A Scoping Review
Nabila Brihmat, Didier Allexandre, Soha Saleh, Jian Zhong, Guang H. Yue, Gail F. Forrest
Frontiers in Human Neuroscience.2022;[Epub] CrossRef
rTMS induces analgesia and modulates neuroinflammation and neuroplasticity in neuropathic pain model rats
Roberta Ströher Toledo, Dirson João Stein, Paulo Roberto Stefani Sanches, Lisiane Santos da Silva, Helouise Richardt Medeiros, Felipe Fregni, Wolnei Caumo, Iraci L.S. Torres
Brain Research.2021; 1762: 147427. CrossRef
Research on Assisting Clinicians to Operate rTMS Precisely Based on the Coil Magnetic Field Spatial Distribution With Magnetic Resonance Imaging Navigation
Shijun Li, Yi Wang, ShengJie Li, Yanwei Lv, Lei Zhang, Jun Zou, Lin Ma
Frontiers in Neuroscience.2019;[Epub] CrossRef
Effects of Combined Upper Limb Robotic Therapy in Patients With Tetraplegic Spinal Cord Injury
Joo Hwan Jung, Hye Jin Lee, Duk Youn Cho, Jung-Eun Lim, Bum Suk Lee, Seung Hyun Kwon, Hae Young Kim, Su Jeong Lee
Annals of Rehabilitation Medicine.2019; 43(4): 445. CrossRef

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Long-Term Efficacy of Mirabegron Add-On Therapy to Antimuscarinic Agents in Patients With Spinal Cord Injury: Seok-Hee Han, In Kyoung Cho, Joo Hwan Jung, Seong Ho Jang, Bum-Suk Lee; Ann Rehabil Med 2019;43(1):54-61. Published online February 28, 2019; DOI: https://doi.org/10.5535/arm.2019.43.1.54

Abstract
PDF

Objective
To evaluate the long-term efficacy of mirabegron add-on therapy in patients with spinal cord injury (SCI) based on an urodynamic study.
Methods
This retrospective study involved a chart audit of individuals with SCI who underwent two consecutive urodynamic studies between April 1, 2015 and April 1, 2018. After adding 50 mg of mirabegron once a day to the pre-existing antimuscarinic therapy for a period of, at least 6 months, the following variables were analyzed: change in cystometric capacity, change in bladder compliance, change in maximal detrusor pressure, change in reflex volume, and presence of significant leakage during filling cystometry.
Results
A total of 31 participants with a mean age of 41±15 years were included in the analysis. A significant increase in cystometric capacity (mean, 362 to 424 mL; p=0.03), reflex volume (mean, 251 to 329 mL; p=0.02), and bladder compliance (median, 12 to 18 mL/cmH2O; p=0.04) was observed. The presence of leakage during filling cystometry was significantly reduced (29% to 10%; p=0.03). Likewise, a non-significant decrease in the change in maximal detrusor pressure was observed (mean, 31 to 27 cmH2O; p=0.39).
Conclusion
Adding mirabegron to conventional antimuscarinics further improved urodynamic parameters in patients with chronic SCI, and sustained efficacy was observed in long-term use.

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Mirabegron in the treatment of neurogenic detrusor overactivity: pharmacological and clinical aspects
Igor V. Kuzmin
Urology reports (St. - Petersburg).2025; 15(1): 51. CrossRef
Drug Repurposing for Spinal Cord Injury: Progress Towards Therapeutic Intervention for Primary Factors and Secondary Complications
Lahanya Guha, Hemant Kumar
Pharmaceutical Medicine.2023; 37(6): 463. CrossRef
Management of the Devastated Female Urethra
Anne Shirley Hoselton, Paige Kuhlmann, Ramy Goueli
Current Bladder Dysfunction Reports.2023; 18(4): 293. CrossRef
Bowel and Bladder Care in Patients With Spinal Cord Injury
Eren O. Kuris, Daniel Alsoof, Camilo Osorio, Alan H. Daniels
Journal of the American Academy of Orthopaedic Surgeons.2022; 30(6): 263. CrossRef
Urological Care After Spinal Cord Injury
Gamal Ghoniem, Dena Moskowitz, Catherine Nguyen
Current Physical Medicine and Rehabilitation Reports.2022; 10(2): 89. CrossRef
Efficacy and safety of mirabegron for treatment of neurogenic detrusor overactivity in adults with spinal cord injury or multiple sclerosis: a systematic review
Yesim Akkoc
Spinal Cord.2022; 60(10): 854. CrossRef
Urogenital dysfunction following neurotrauma
Udit Saraf, Anand Kumar A, Jalesh N. Panicker
Current Opinion in Neurology.2022; 35(6): 753. CrossRef

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The Nutritional Status and the Clinical Outcomes of Patients With a Spinal Cord Injury Using Nutritional Screening Tools: Ji Cheol Shin, Shin Hye Chang, Sang Won Hwang, Jae Joong Lee; Ann Rehabil Med 2018;42(4):591-600. Published online August 31, 2018; DOI: https://doi.org/10.5535/arm.2018.42.4.591

Abstract
PDF

Objective
To assess the nutritional status of Korean patients with spinal cord injury (SCI), identify the predictors of undernutrition, and investigate the relationship between undernutrition and clinical outcomes.
Methods
A retrospective study design was used to determine the nutritional status of 130 patients over 19 years old admitted to the rehabilitation hospital of Yonsei University Health System between June 2015 and February 2017. The nutritional status was assessed using the malnutrition universal screening tool (MUST) and the spinal nutrition screening tool (SNST). The relationship between undernutrition and clinical outcomes was examined by comparing a low-risk group with an at-risk group using a t-test.
Results
Among the SCI patients, 70 (50.8%) were confirmed with undernutrition based on the MUST scores, while 60 (46.2%) had undernutrition based on the SNST scores. It was found that undernutrition has an effect on functional outcomes.
Conclusion
We assessed the undernutrition risk in Korean SCI patients, and found that approximately 50% of the patients were at risk of undernutrition. We also found that undernutrition can affect functional recovery.

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Multifaceted Pathophysiology and Secondary Complications of Chronic Spinal Cord Injury: Focus on Pressure Injury
Mario Martínez-Torija, Pedro F. Esteban, Angela Santos-De-La-Mata, Matilde Castillo-Hermoso, Eduardo Molina-Holgado, Rafael Moreno-Luna
Journal of Clinical Medicine.2025; 14(5): 1556. CrossRef
Defining malnutrition in persons with spinal cord injury – does the Global Criteria for Malnutrition work?
Hanne Bjørg Slettahjell, Maria Bastakis, Fin Biering-Sørensen, Vegard Strøm, Christine Henriksen
Food & Nutrition Research.2024;[Epub] CrossRef
Significance of physical factors on activities of daily living in patients with tetraplegia after spinal cord injury: a retrospective study
Kimin Yun, Jin-cheol Lim, Onyoo Kim
BMC Sports Science, Medicine and Rehabilitation.2024;[Epub] CrossRef
The risk of malnutrition in patients with spinal cord injury during inpatient rehabilitation–A longitudinal cohort study
Irene Flury, Gabi Mueller, Claudio Perret
Frontiers in Nutrition.2023;[Epub] CrossRef
Predictive validity of the Mini Nutritional Assessment Short‐Form for rehabilitation patients: A retrospective analysis of the Japan Rehabilitation Nutrition Database
Shinta Nishioka, Hidetaka Wakabayashi, Jun Kayashita, Yutaka Taketani, Ryo Momosaki
Journal of Human Nutrition and Dietetics.2021; 34(5): 881. CrossRef

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Motor and Sensory Function as a Predictor of Respiratory Function Associated With Ventilator Weaning After High Cervical Cord Injury: Tae Wan Kim, Jung Hyun Yang, Sung Chul Huh, Bon Il Koo, Jin A Yoon, Je Sang Lee, Hyun-Yoon Ko, Yong Beom Shin; Ann Rehabil Med 2018;42(3):457-464. Published online June 27, 2018; DOI: https://doi.org/10.5535/arm.2018.42.3.457

Abstract
PDF

Objective
To analyze the respiratory function of high cervical cord injury according to ventilator dependence and to examine the correlations between diaphragm movement found on fluoroscopy and sensory and motor functions.
Methods
A total of 67 patients with high cervical spinal cord injury (SCI), admitted to our hospital were enrolled in the study. One rehabilitation physician performed sensory and motor examinations on all patients while each patient was in the supine position on the American Spinal Injury Association (ASIA) standard. In addition, fluoroscopic diaphragm movement studies and bedside spirometry were performed.
Results
Bedside spirometry and diaphragm fluoroscopic tests were analyzed according to ventilator dependence. Forced vital capacity and maximal inspiratory pressure were significantly higher in the ventilator weaned group. Natural breathing during the fluoroscopic diaphragm examinations and ventilator weaning showed statistical significance with the movement on the right, while deep breathing showed statistical significance with the movement on both sides. Deep breathing movement has correlation with the C5 key muscle. Diaphragm movement has correlation with right C3 and bilateral C4 sensory functions.
Conclusion
The present expansion study showed that, through simple bedside physical examinations, rehabilitation physicians could relatively easily predict diaphragm movement and respiratory function recovery, which showed significance with ventilator weaning in patients with high cervical SCI.

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Predicting extubation in patients with traumatic cervical spinal cord injury using the diaphragm electrical activity during a single maximal maneuver
Rui Zhang, Xiaoting Xu, Hui Chen, Jennifer Beck, Christer Sinderby, Haibo Qiu, Yi Yang, Ling Liu
Annals of Intensive Care.2023;[Epub] CrossRef
Respiratory Complications and Weaning Considerations for Patients with Spinal Cord Injuries: A Narrative Review
Kristopher A. Hendershot, Kristine H. O’Phelan
Journal of Personalized Medicine.2022; 13(1): 97. CrossRef
Separation from mechanical ventilation and survival after spinal cord injury: a systematic review and meta-analysis
Annia F. Schreiber, Jacopo Garlasco, Fernando Vieira, Yie Hui Lau, Dekel Stavi, David Lightfoot, Andrea Rigamonti, Karen Burns, Jan O. Friedrich, Jeffrey M. Singh, Laurent J. Brochard
Annals of Intensive Care.2021;[Epub] CrossRef

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Pressure Relieving Effect of Adding a Pelvic Well Pad to a Wheelchair Cushion in Individuals With Spinal Cord Injury: Hyunsoo Shin, Junsik Kim, Jin-Ju Kim, Hye-Ri Kim, Hye-Jin Lee, Bum-Suk Lee, Zee-A Han; Ann Rehabil Med 2018;42(2):270-276. Published online April 30, 2018; DOI: https://doi.org/10.5535/arm.2018.42.2.270

Abstract
PDF

Objective

To identify the pressure relieving effect of adding a pelvic well pad, a firm pad that is cut in the ischial area, to a wheelchair cushion on the ischium.

Methods

Medical records of 77 individuals with SCI, who underwent interface pressure mapping of the buttock-thigh area, were retrospectively reviewed. The pelvic well pad is a 2.5-cm thick firm pad and has a cut in the ischial area. Expecting additional pressure relief, it can be inserted under a wheelchair cushion. Subjects underwent interface pressure mapping in the subject's wheelchair utilizing the subject's pre-existing pressure relieving cushion and subsequently on a combination of a pelvic well pad and the cushion. The average pressure, peak pressure, and contact area of the buttock-thigh were evaluated.

Results

Adding a pelvic well pad, under the pressure relieving cushion, resulted in a decrease in the average and peak pressures and increase in the contact area of the buttock-thigh area when compared with applying only pressure relieving cushions (p<0.05). The mean of the average pressure decreased from 46.10±10.26 to 44.09±9.92 mmHg and peak pressure decreased from 155.03±48.02 to 131.42±45.86 mmHg when adding a pelvic well pad. The mean of the contact area increased from 1,136.44±262.46 to 1,216.99±255.29 cm².

Conclusion

When a pelvic well pad was applied, in addition to a pre-existing pressure relieving cushion, the average and peak pressures of the buttock-thigh area decreased and the contact area increased. These results suggest that adding a pelvic well pad to wheelchair cushion may be effective in preventing a pressure ulcer of the buttock area.

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Stability of ischial pressure with 3D thermoplastic elastomer cushion and the characteristics of four types of cushions in pressure redistribution
Yoshiyuki Yoshikawa, Kyoko Nagayoshi, Noriaki Maeshige, Atomu Yamaguchi, Yuki Aoyama, Shuto Takita, Teppei Wada, Masayuki Tanaka, Hiroto Terashi, Yuma Sonoda
Drug Discoveries & Therapeutics.2024; 18(3): 188. CrossRef
Padding the seat of a wheelchair reduces ischial pressure and improves sitting comfort
Yoshiyuki Yoshikawa, Kiyo Sasaki, Kyoko Nagayoshi, Kenta Nagai, Yuki Aoyama, Shuto Takita, Teppei Wada, Yoshinori Kitade
Drug Discoveries & Therapeutics.2024; 18(5): 314. CrossRef
3D finite-element modeling of air-cell-based cushions and buttock tissues during prolonged sitting
Chenhao Yu, Joel Martin Sacris, Yan Gai, Chi Hou Lei
Computers in Biology and Medicine.2022; 142: 105229. CrossRef
Evaluation of interface pressure and temperature management in five wheelchair seat cushions and their effects on user satisfaction
Pablo García-Molina, Sergio Roig Casasus, Enrique Sanchis-Sánchez, Evelin Balaguer-López, Manuel Ruescas-López, José-María Blasco
Journal of Tissue Viability.2021; 30(3): 402. CrossRef

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Effect of Family Caregiving on Depression in the First 3 Months After Spinal Cord Injury: Min-Gu Kang, Chul-Hyun Kim, Eunhee Park, Jae-Won Huh, Won-Jong Yang, Tae-Woo Nam, Yu-Sun Min, Tae-Du Jung; Ann Rehabil Med 2018;42(1):130-136. Published online February 28, 2018; DOI: https://doi.org/10.5535/arm.2018.42.1.130

Abstract
PDF

Objective

To investigate the effect of family caregiving on depression in the first 3 months after spinal cord injury (SCI).

Methods

A retrospective study was carried out on 76 patients diagnosed with an SCI from January 2013 to December 2016 at the Department of Physical Medicine and Rehabilitation of Kyungpook National University Hospital, Korea. Clinical characteristics including age, gender, level of injury, completeness of the injury, time since injury, caregiver information, etiology, and functional data were collected through a retrospective review of medical records. Depression was assessed using the Beck Depression Inventory (BDI). Patients with 14 or more points were classified as depressed and those with scores of 13 or less as non-depressed group.

Results

Of the 76 patients, 33 were in the depressed group with an average BDI of 21.27±6.17 and 43 patients included in the non-depressed group with an average BDI of 4.56±4.20. The BDI score of patients cared by unlicensed assistive personnel (UAP) was significantly higher than that of patients cared by their families (p=0.020). Univariate regression analysis showed that motor complete injury (p=0.027), UAP caregiving (p=0.022), and Ambulatory Motor Index (p=0.019) were associated with depression after SCI. Multivariate binary logistic regression analysis showed that motor completeness (p=0.002) and UAP caregiving (p=0.002) were independent risk factors.

Conclusion

Compared with UAP, family caregivers lowered the prevalence of depression in the first 3 months after SCI.

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Identification of Mood and Body Mass Index as Modifiable Factors for Health Improvement in Spinal Cord Injury
Ruby Aikat, Varsha Singh
Archives of Rehabilitation Research and Clinical Translation.2022; 4(1): 100174. CrossRef
Comparison Between Comprehensive Nursing Care Ward and Private Care Ward on Functional Recovery in Stroke Patients
Yang Rok Hur, Woo Sup Song, Kyung Min Kim, Ki Hun Hwang
Brain & Neurorehabilitation.2022;[Epub] CrossRef
Differential eligibility for paid leave benefits in OECD countries: the impact of tenure requirements for young workers
Nicolas de Guzman Chorny, Amy Raub, Alison Earle, Jody Heymann
Community, Work & Family.2021; 24(2): 193. CrossRef
Factors associated with discharge destination following inpatient functional rehabilitation in patients with traumatic spinal cord injury
Antoine Dionne, Andréane Richard-Denis, Victor Lim, Jean-Marc Mac-Thiong
Spinal Cord.2021; 59(6): 642. CrossRef
The psychological and psychiatric care for the children after severe spinal cord injury in the framework of the combined early rehabilitative treatment
S. A. Valiullina, Yu. G. Sidneva, E. A. Lvova
Voprosy kurortologii, fizioterapii i lechebnoi fizicheskoi kul'tury.2019; 96(2): 45. CrossRef
Aging With Disability: Populations, Programs, and the New Paradigm An Introduction to the Special Issue
Ivan R. Molton, Anne Ordway
Journal of Aging and Health.2019; 31(10_suppl): 3S. CrossRef

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Degree of Contribution of Motor and Sensory Scores to Predict Gait Ability in Patients With Incomplete Spinal Cord Injury: Jinkyoo Moon, Junghoon Yu, Jaewoo Choi, MinYoung Kim, Kyunghoon Min; Ann Rehabil Med 2017;41(6):969-978. Published online December 28, 2017; DOI: https://doi.org/10.5535/arm.2017.41.6.969

Abstract
PDF

Objective

To identify different contributions of motor and sensory variables for independent ambulation of patients with incomplete spinal cord injury (SCI), and reveal the most significant contributors among the variables.

Methods

The retrospective study included 30 patients with incomplete SCI and lesions were confirmed by magnetic resonance imaging. Motor and sensory scores were collected according to the International Standards for Neurological Classification of Spinal Cord Injury. The variables were analyzed by plotting ROC (receiver operating characteristic) curves to estimate their differential contributions for independent walking. The most significant functional determinant was identified through the subsequent logistic regression analysis.

Results

Motor and sensory scores were significantly different between the ambulators and non-ambulators. The majority was associated to the function of lower extremities. Calculation of area under ROC curves (AUC) revealed that strength of hip flexor (L2) (AUC=0.905, p<0.001) and knee extensor (L3) (AUC=0.820, p=0.006) contributed the greatest to independent walking. Also, hip flexor strength (L2) was the single most powerful predictor of ambulation by the logistic regression analysis (odds ratio=6.3, p=0.049), and the model fit well to the data.

Conclusion

The most important potential contributor for independent walking in patients with incomplete SCI is the muscle strength of hip flexors, followed by knee extensors compared with other sensory and motor variables.

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Classifying clinical phenotypes of functional recovery for acute traumatic spinal cord injury. An observational cohort study
Pascal Mputu Mputu, Marie Beauséjour, Andréane Richard-Denis, Nader Fallah, Vanessa K. Noonan, Jean-Marc Mac-Thiong
Disability and Rehabilitation.2024; 46(25): 6069. CrossRef
Gait recovery in patients with late assessment of incomplete spinal cord injury: A retrospective study in Argentina
Marcelo A. Gatti, Yamila Dieni, Lucia Yaccuzzi, María E. Rivas, Daniela G. L. Terson de Paleville
The Journal of Spinal Cord Medicine.2024; : 1. CrossRef
Walking Outcome After Traumatic Paraplegic Spinal Cord Injury: The Function of Which Myotomes Makes a Difference?
Adrian Cathomen, Doris Maier, Jiri Kriz, Rainer Abel, Frank Röhrich, Michael Baumberger, Giorgio Scivoletto, Norbert Weidner, Rüdiger Rupp, Catherine R. Jutzeler, John D. Steeves, Armin Curt, Marc Bolliger
Neurorehabilitation and Neural Repair.2023; 37(5): 316. CrossRef
Development of an unsupervised machine learning algorithm for the prognostication of walking ability in spinal cord injury patients
Zachary DeVries, Mohamad Hoda, Carly S Rivers, Audrey Maher, Eugene Wai, Dita Moravek, Alexandra Stratton, Stephen Kingwell, Nader Fallah, Jérôme Paquet, Philippe Phan
The Spine Journal.2020; 20(2): 213. CrossRef
Does prolonged walking cause greater muscle fatigability in individuals with incomplete spinal cord injury compared with matched-controls?
Jefferson Rodrigues Dorneles, Frederico Ribeiro Neto, Carlos Wellington Gonçalves, Rodrigo Rodrigues Gomes Costa, Rodrigo Luiz Carregaro
Gait & Posture.2020; 78: 65. CrossRef
Gait rehabilitation in persons with spinal cord injury using innovative technologies: an observational study
Giulia Stampacchia, Matteo Olivieri, Alessandro Rustici, Carla D’Avino, Adriana Gerini, Stefano Mazzoleni
Spinal Cord.2020; 58(9): 988. CrossRef

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Effect of Patient Education on Reducing Medication in Spinal Cord Injury Patients With Neuropathic Pain: Ji Cheol Shin, Na Young Kim, Shin Hye Chang, Jae Joong Lee, Han Kyul Park; Ann Rehabil Med 2017;41(4):621-630. Published online August 31, 2017; DOI: https://doi.org/10.5535/arm.2017.41.4.621

Abstract
PDF

Objective

To determine whether providing education about the disease pathophysiology and drug mechanisms and side effects, would be effective for reducing the use of pain medication while appropriately managing neurogenic pain in spinal cord injury (SCI) patients.

Methods

In this prospective study, 109 patients with an SCI and neuropathic pain, participated in an educational pain management program. This comprehensive program was specifically created, for patients with an SCI and neuropathic pain. It consisted of 6 sessions, including educational training, over a 6-week period.

Results

Of 109 patients, 79 (72.5%) initially took more than two types of pain medication, and this decreased to 36 (33.0%) after the educational pain management program was completed. The mean pain scale score and the number of pain medications decreased, compared to the baseline values. Compared to the non-response group, the response group had a shorter duration of pain onset (p=0.004), and a higher initial number of different medications (p<0.001) and certain types of medications.

Conclusion

This study results imply that an educational pain management program, can be a valuable complement to the treatment of spinal cord injured patients with neuropathic pain. Early intervention is important, to prevent patients from developing chronic SCI-related pain.

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Enxhi Qama, Nicola Diviani, Clara Häfliger, Xavier Jordan, Anke Scheel-Sailer, Claudia Zanini, Sara Rubinelli
Patient Education and Counseling.2025; 136: 108763. CrossRef
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Ekaterina K. Kerimova, Aleksei I. Isaikin, Anastasia S. Romanova, Mikhail G. Bashlachev, Kinan Mouki
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Persefoni Kritikou, Athina Vadalouca, Martina Rekatsina, Giustino Varrassi, Ioanna Siafaka
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A scoping review of medication self-management intervention tools to support persons with traumatic spinal cord injury
Lauren Cadel, Stephanie R. Cimino, Glyneva Bradley-Ridout, Sander L. Hitzig, Tanya L. Packer, Lisa M. McCarthy, Tejal Patel, Aisha K. Lofters, Shoshana Hahn-Goldberg, Chester H. Ho, Sara J. T. Guilcher, Saeed Ahmed
PLOS ONE.2023; 18(4): e0284199. CrossRef
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Gabriel Guízar-Sahagún, Israel Grijalva, Rebecca E. Franco-Bourland, Ignacio Madrazo
Ageing Research Reviews.2023; 90: 102020. CrossRef
Spinal cord injury/dysfunction and medication management: a qualitative study exploring the experiences of community-dwelling adults in Ontario, Canada
Lauren Cadel, Sander L. Hitzig, Tanya L. Packer, Tejal Patel, Aisha K. Lofters, Alison Thompson, Sara J. T. Guilcher
Disability and Rehabilitation.2022; 44(1): 24. CrossRef
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Christine B. Sieberg, Keerthana Deepti Karunakaran, Barry Kussman, David Borsook
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Divya Kohli, Giannina Katzmann, Rafael Benoliel, Olga A. Korczeniewska
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Lauren Cadel, Amanda C. Everall, Sander L. Hitzig, Tanya L. Packer, Tejal Patel, Aisha Lofters, Sara J. T. Guilcher
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Subgroup Perspectives on Chronic Pain and Its Management After Spinal Cord Injury
Eva Widerström-Noga, Kim D. Anderson, Salomé Perez, Alberto Martinez-Arizala, Jessica M. Cambridge
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Case Report

Extravasation of the Contrast Material During Voiding Cystourethrography in a Chronic Spinal Cord Injury Patient: A Case Report: Sohyun Kwon, Donghwi Park, Hoon Hoon Lee, Ju Seok Ryu; Ann Rehabil Med 2017;41(2):323-327. Published online April 27, 2017; DOI: https://doi.org/10.5535/arm.2017.41.2.323

Abstract
PDF

Neurogenic bladder is common in most spinal cord injury patients. Voiding cystourethrography (VCUG) is recommended in these patients to detect urinary tract complications. However, rare but serious complications may occur during VCUG, although VCUG is generally safe. There are several case reports of bladder rupture occurring in pediatric patients. Here, we report the first case of iatrogenic bladder rupture in an adult spinal cord injury patient in Korea. Particularly, extravasation of contrast without manual instillation has hardly ever been reported. To the best of our knowledge, this is the first reported case of bladder rupture without manual instillation during VCUG. We report a case of a 59-year-old female with paraplegia due to tuberculous spondylitis who underwent VCUG as a part of routine evaluation of neurogenic bladder. Extravasation of the contrast media during VCUG developed as a complication and the patient recovered spontaneously without any intervention. Therefore, VCUG should be performed properly in chronic spinal cord injury patients.

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Iatrogenic bladder rupture in individuals with disability related to spinal cord injury and chronic indwelling urethral catheters
Seth L. Teplitsky, Joon Yau Leong, Patrick J. Shenot
Spinal Cord Series and Cases.2020;[Epub] CrossRef