Patients and physicians understand the importance of self-care following spinal cord injury (SCI), yet many individuals with SCI do not adhere to recommended self-care activities despite logistical supports. Neurobeha...Patients and physicians understand the importance of self-care following spinal cord injury (SCI), yet many individuals with SCI do not adhere to recommended self-care activities despite logistical supports. Neurobehavioral determinants of SCI self-care behavior, such as impulsivity, are not widely studied, yet understanding them could inform efforts to improve SCI self-care. We explored associations between impulsivity and self-care in an observational study of 35 US adults age 18 - 50 who had traumatic SCI with paraplegia at least six months before assessment. The primary outcome measure was self-reported self-care. In LASSO regression models that included all neurobehavioral measures and demographics as predictors of self-care, dispositional measures of greater impulsivity (negative urgency, lack of premeditation, lack of perseverance), and reduced mindfulness were associated with reduced self-care. Outcome (magnitude) sensitivity, a latent decision-making parameter derived from computationally modeling successive choices in a gambling task, was also associated with self-care behavior. These results are preliminary;more research is needed to demonstrate the utility of these findings in clinical settings. Information about associations between impulsivity and poor self-care in people with SCI could guide the development of interventions to improve SCI self-care and help patients with elevated risks related to self-care and secondary health conditions.展开更多
目的探索多节段退变性腰椎管狭窄症腰骶椎融合术后脊柱骨盆参数变化及其临床疗效。方法2018年6月至2020年6月,共85例多节段退变性腰椎管狭窄症患者经腰骶椎体间融合手术,随访(24.00±2.18)个月,根据术前及末次随访SVA(sagittal vert...目的探索多节段退变性腰椎管狭窄症腰骶椎融合术后脊柱骨盆参数变化及其临床疗效。方法2018年6月至2020年6月,共85例多节段退变性腰椎管狭窄症患者经腰骶椎体间融合手术,随访(24.00±2.18)个月,根据术前及末次随访SVA(sagittal vertical axis,SVA)≤50 mm分为平衡组,SVA>50 mm分为非平衡组,测量术前及末次随访脊柱骨盆相关参数,并进行ODI(OSWESTRY disability index)与SF-36(the MOS item short from health survey,SF-36)评分,在末次随访时根据改良MacNab标准评定疗效,统计学分析脊柱骨盆参数变化及其临床疗效。结果在术前分组中,非平衡组SVA术前术后比较明显改善(P<0.01),平衡组术前术后变化差异无统计学意义;两组术后ODI、SF-36评分均较术前改善(P<0.01),两组之间差异无统计学意义(P>0.05)。在术后分组中,两组之间ODI、SF-36评分差异有统计学意义(P<0.01),平衡组优于非平衡组;两组之间△LL(lumbar lordosis,LL)与△HOD/n(height of disc,HOD)差异有统计学意义(P<0.01),平衡组HOD、LL增加明显。根据改良MacNab标准评定:优50例,良22例,可7例,差6例,优良率84.7%(72/85)。结论多节段退变性腰椎管狭窄症减压融合手术疗效满意,恢复椎间盘高度以增加LL从而改善矢状面平衡,能够提高患者术后疗效。展开更多
目的:观察补中益气汤合真武汤加减联合膀胱功能训练治疗脊髓损伤尿失禁疗效及其卫生经济学评价。方法:将200例脊髓损伤尿失禁患者,采用真实世界研究方法分为观察组和对照组,观察组100例,对照组100例。观察组采用中医药补中益气汤合真武...目的:观察补中益气汤合真武汤加减联合膀胱功能训练治疗脊髓损伤尿失禁疗效及其卫生经济学评价。方法:将200例脊髓损伤尿失禁患者,采用真实世界研究方法分为观察组和对照组,观察组100例,对照组100例。观察组采用中医药补中益气汤合真武汤加减联合膀胱功能训练,对照组采用单纯膀胱训练,两组分别治疗3个月,然后使用尿失禁生活质量问卷(Urinary incontinence quality of life questionnaire,I-QOL)和国际尿失禁咨询委员会尿失禁问卷简表(Brief form of the International Counseling Committee on Urinary Incontinence Questionnaire,ICI-Q-SF)评价两组患者临床疗效,比较两组患者住院费用,并进行成本-效果分析。结果:治疗后观察组I-QOL评分增加程度和ICI-Q-SF评分减少程度均较对照组明显。观察组和对照组直接花费的医疗费用比较差异具有统计学意义(P<0.05),直接非医疗费用及间接费用比较差异有统计学意义(P<0.05);I-QOL评分每增加1分,ICI-Q-SF评分每减少1分,观察组所需直接费用、直接非医疗费用、间接费用及平均成本低于对照组。结论:补中益气汤合真武汤加减联合膀胱功能训练可改善尿失禁患者排尿功能和生存质量,减轻患者经济负担。展开更多
文摘Patients and physicians understand the importance of self-care following spinal cord injury (SCI), yet many individuals with SCI do not adhere to recommended self-care activities despite logistical supports. Neurobehavioral determinants of SCI self-care behavior, such as impulsivity, are not widely studied, yet understanding them could inform efforts to improve SCI self-care. We explored associations between impulsivity and self-care in an observational study of 35 US adults age 18 - 50 who had traumatic SCI with paraplegia at least six months before assessment. The primary outcome measure was self-reported self-care. In LASSO regression models that included all neurobehavioral measures and demographics as predictors of self-care, dispositional measures of greater impulsivity (negative urgency, lack of premeditation, lack of perseverance), and reduced mindfulness were associated with reduced self-care. Outcome (magnitude) sensitivity, a latent decision-making parameter derived from computationally modeling successive choices in a gambling task, was also associated with self-care behavior. These results are preliminary;more research is needed to demonstrate the utility of these findings in clinical settings. Information about associations between impulsivity and poor self-care in people with SCI could guide the development of interventions to improve SCI self-care and help patients with elevated risks related to self-care and secondary health conditions.
文摘目的探索多节段退变性腰椎管狭窄症腰骶椎融合术后脊柱骨盆参数变化及其临床疗效。方法2018年6月至2020年6月,共85例多节段退变性腰椎管狭窄症患者经腰骶椎体间融合手术,随访(24.00±2.18)个月,根据术前及末次随访SVA(sagittal vertical axis,SVA)≤50 mm分为平衡组,SVA>50 mm分为非平衡组,测量术前及末次随访脊柱骨盆相关参数,并进行ODI(OSWESTRY disability index)与SF-36(the MOS item short from health survey,SF-36)评分,在末次随访时根据改良MacNab标准评定疗效,统计学分析脊柱骨盆参数变化及其临床疗效。结果在术前分组中,非平衡组SVA术前术后比较明显改善(P<0.01),平衡组术前术后变化差异无统计学意义;两组术后ODI、SF-36评分均较术前改善(P<0.01),两组之间差异无统计学意义(P>0.05)。在术后分组中,两组之间ODI、SF-36评分差异有统计学意义(P<0.01),平衡组优于非平衡组;两组之间△LL(lumbar lordosis,LL)与△HOD/n(height of disc,HOD)差异有统计学意义(P<0.01),平衡组HOD、LL增加明显。根据改良MacNab标准评定:优50例,良22例,可7例,差6例,优良率84.7%(72/85)。结论多节段退变性腰椎管狭窄症减压融合手术疗效满意,恢复椎间盘高度以增加LL从而改善矢状面平衡,能够提高患者术后疗效。
文摘目的:观察补中益气汤合真武汤加减联合膀胱功能训练治疗脊髓损伤尿失禁疗效及其卫生经济学评价。方法:将200例脊髓损伤尿失禁患者,采用真实世界研究方法分为观察组和对照组,观察组100例,对照组100例。观察组采用中医药补中益气汤合真武汤加减联合膀胱功能训练,对照组采用单纯膀胱训练,两组分别治疗3个月,然后使用尿失禁生活质量问卷(Urinary incontinence quality of life questionnaire,I-QOL)和国际尿失禁咨询委员会尿失禁问卷简表(Brief form of the International Counseling Committee on Urinary Incontinence Questionnaire,ICI-Q-SF)评价两组患者临床疗效,比较两组患者住院费用,并进行成本-效果分析。结果:治疗后观察组I-QOL评分增加程度和ICI-Q-SF评分减少程度均较对照组明显。观察组和对照组直接花费的医疗费用比较差异具有统计学意义(P<0.05),直接非医疗费用及间接费用比较差异有统计学意义(P<0.05);I-QOL评分每增加1分,ICI-Q-SF评分每减少1分,观察组所需直接费用、直接非医疗费用、间接费用及平均成本低于对照组。结论:补中益气汤合真武汤加减联合膀胱功能训练可改善尿失禁患者排尿功能和生存质量,减轻患者经济负担。
