Physiral and Rehabilitation Medicine (PRM) is the Medicine of Functioning in light of health conditions, under consideration of the person and in interaction with the environment[1-2].PRM focuses on the application of...Physiral and Rehabilitation Medicine (PRM) is the Medicine of Functioning in light of health conditions, under consideration of the person and in interaction with the environment[1-2].PRM focuses on the application of rehabilitation, the third health strategy which complements the preventive and curative health strategies.Thanks to the increasing survival of people after injury and formerly conditions as well as aging populations and an associated increase in chronic conditions, PRM as the leader of the rehabilitation will, over the next decades, assume an ever more important role in the health care systems worldwide.展开更多
The objective of the current work was to examine the relationships between quality of life(QOL)domains in persons with spinal cord injury(SCI)and their levels of weekly leisure-time physical activity(LTPA),anthropomet...The objective of the current work was to examine the relationships between quality of life(QOL)domains in persons with spinal cord injury(SCI)and their levels of weekly leisure-time physical activity(LTPA),anthropometric variables,and body composition variables.This exploratory cross-sectional study consisted of baseline data collected as part of a randomized clinical trial at a VA Medical Center and SCI center.A convenience sample of 36 community-dwelling persons with SCI participated in the current study.Outcome measures included the World Health Organization Quality of Life Short Form(WHOQOL-BREF),Leisure-Time Physical Activity Questionnaire for People with Spinal Cord Injury(LTPAQ-SCI),anthropomorphic measures(waist,hip,and abdominal circumference),and dual-energy x-ray absorptiometry(DXA)to quantify regional and total body composition.Multiple regression models suggested that engagement in LTPA accounted for 35.7%of the variance in physical health QOL,33.5%in psychological QOL,14.2%in social relationships QOL,and 38.2%in environmental QOL.Anthropometric measures accounted for 11.3%,3.1%,12.0%,and 6.7%of the variance in these QOL indices,respectively,and DXA indices accounted for 18.7%,17.5%,27.4%,and 21.9%.Within these models,the number of minutes of heavy LTPA per day uniquely predicted physical health QOL,the number of mild LTPA days per week uniquely predicted psychological QOL,and the amount of mild LTPA per day uniquely predicted environmental QOL.Bivariate analyses also suggested that android and trunk fat,as well as supine waist and abdominal circumferences,were positively associated with social relationships QOL.Encouraging individuals with SCI to engage in LTPA may robustly enhance multiple aspects of QOL while reducing the risk for cardiovascular and metabolic morbidities associated with SCI.Moreover,this may lead to a further understanding of how QOL may impact longitudinal intervention trials.The study protocol and procedures were reviewed and approved by the McGuire VA Research Institutional Review Board(IRB#02152,approval date August 9,2015;IRB#02375,approval date May 2,2018).展开更多
The overall goal of this project is to develop a humane non-human primate model of traumatic spinal cord injury that will facilitate the development and evaluation of therapeutic interventions. The model utilizes neur...The overall goal of this project is to develop a humane non-human primate model of traumatic spinal cord injury that will facilitate the development and evaluation of therapeutic interventions. The model utilizes neurophysiological techniques to identify the location of the upper motor neuron axons that innervate the lower motor neurons that control tail musculature. This facilitates the placement of a selective lesion that partially disconnects the upper and lower motor neuron supply to the musculature of the tail. An implanted transmitter quantitatively measures electromyography data from the tail. The preliminary data indicates that this model is feasible. The subject was able to tolerate the implantation of the transmitter, without adverse effects. As well, there was no limb impairment, bowel dysfunction or bladder dysfunction. The histopathologic and electromyographic features of the selective experimental lesion were similar to human spinal cord injury.展开更多
Background: This paper describes and displays the spinal radiological anatomy and associated pathology in a Macaca fascicularis and compares it to the spinal anatomy of humans. Animal models are commonly used in resea...Background: This paper describes and displays the spinal radiological anatomy and associated pathology in a Macaca fascicularis and compares it to the spinal anatomy of humans. Animal models are commonly used in research. As compared to Macaca mulatta, the anatomy of M. fascicularis is less well described in the literature. Materials and methods: The authors anatomically reconstructed and reviewed the defleshed spine of a single adult M. fascicularis visually, radiographically, and with high resolution CT. Results: 7 cervical, 12 thoracic, 6 lumbar, 3 sacral, and 16 caudal vertebrae were identified. Similarities in the spine to humans were seen as well as differences such as the beaked anterior arch of C1, the anterior pointed lower lumbar vertebrae, the upward curved transverse processes, and presence of three sacral segments. Degenerative changes were seen at multiple locations similar to humans though most pronounced at T3-4. Conclusions: This paper addresses the normal spinal anatomy and degenerative changes in an adult M. fascicularis and compares it to humans.展开更多
A valid non human primate model of traumatic spinal cord injury (TSCI) is essential to evaluate and develop new treatments. In previous experiments, it has been demonstrated that a transmitter can be implanted in the ...A valid non human primate model of traumatic spinal cord injury (TSCI) is essential to evaluate and develop new treatments. In previous experiments, it has been demonstrated that a transmitter can be implanted in the macaque fasicularis monkey that measures electromyographic data from the musculature of the tail. As well, previous experiments have demonstrated that selective lesions can be created in the lower thoracic spinal cord that does not cause limb weakness and/or bowel dysfunction. The histopathological features of these lesions appear similar to human TSCI. This paper describes a method by which the EMG data can be transformed into a quantitative metric of volitional limb movement (“Q”). This metric permits an objective assessment of injury, natural recovery as well as potential efficacy of candidate treatments.展开更多
Spinal cord injury (SCI) is a devastating condition that not only results in a loss of motor functions but also severe autonomic dysfunctions (Krassioukov and Claydon, 2006). Autonomic dysreflexia (AD) is a life...Spinal cord injury (SCI) is a devastating condition that not only results in a loss of motor functions but also severe autonomic dysfunctions (Krassioukov and Claydon, 2006). Autonomic dysreflexia (AD) is a life threatening episode of tran- sient hypertension that occurs up to 30x/day (1 Ix/day on average) in those with cervical or high thoracic SCI (Hubli et al., 2015). Most common triggers of AD are from stimuli such as a full bowel and/or bladder, or sexual arousal (Teasell et al., 2000). Penile vibrostimulation (PVS) is a clinical pro- cedure for sperm retrieval used for the purpose of family planning or fertility assessment that unfortunately iatrogenically induces episodes of AD (Elliott, 2006). Recently, we published a clinical trial highlighting that prazosin may be a viable option for treating AD secondary to PVS (Phillips et al., 2014).展开更多
The purpose of this study was to test whether modafinil is effective in alleviating the symptoms of fatigue in postpolio patients, because it has been helpful for such symptoms in other neurologic disorders. Using a d...The purpose of this study was to test whether modafinil is effective in alleviating the symptoms of fatigue in postpolio patients, because it has been helpful for such symptoms in other neurologic disorders. Using a double-blind, randomized, placebo-controlled cross-over design, 14 postpolio patients with moderate to severe fatigue were assigned to receive modafinil or placebo first. Piper Fatigue Scale, Epworth Sleepiness Scale, digit span, and reaction time tests were done at baseline and then at weekly intervals. The Piper Fatigue Scale scores im proved by 27 ±40%(mean ±SD) following modafinil and by 43 ±36%following pla cebo. Scores for most of the other tests did not change during the study. Therefore, we conclude that modafinil was not effective in alleviating the symptoms of fatigue in postpolio patients.展开更多
文摘Physiral and Rehabilitation Medicine (PRM) is the Medicine of Functioning in light of health conditions, under consideration of the person and in interaction with the environment[1-2].PRM focuses on the application of rehabilitation, the third health strategy which complements the preventive and curative health strategies.Thanks to the increasing survival of people after injury and formerly conditions as well as aging populations and an associated increase in chronic conditions, PRM as the leader of the rehabilitation will, over the next decades, assume an ever more important role in the health care systems worldwide.
基金the Department of Defense-Congressionally Directed Medical Research Program(DoD-CDMRP)(W81XWH-14-SCIRP-CTAto ASG).
文摘The objective of the current work was to examine the relationships between quality of life(QOL)domains in persons with spinal cord injury(SCI)and their levels of weekly leisure-time physical activity(LTPA),anthropometric variables,and body composition variables.This exploratory cross-sectional study consisted of baseline data collected as part of a randomized clinical trial at a VA Medical Center and SCI center.A convenience sample of 36 community-dwelling persons with SCI participated in the current study.Outcome measures included the World Health Organization Quality of Life Short Form(WHOQOL-BREF),Leisure-Time Physical Activity Questionnaire for People with Spinal Cord Injury(LTPAQ-SCI),anthropomorphic measures(waist,hip,and abdominal circumference),and dual-energy x-ray absorptiometry(DXA)to quantify regional and total body composition.Multiple regression models suggested that engagement in LTPA accounted for 35.7%of the variance in physical health QOL,33.5%in psychological QOL,14.2%in social relationships QOL,and 38.2%in environmental QOL.Anthropometric measures accounted for 11.3%,3.1%,12.0%,and 6.7%of the variance in these QOL indices,respectively,and DXA indices accounted for 18.7%,17.5%,27.4%,and 21.9%.Within these models,the number of minutes of heavy LTPA per day uniquely predicted physical health QOL,the number of mild LTPA days per week uniquely predicted psychological QOL,and the amount of mild LTPA per day uniquely predicted environmental QOL.Bivariate analyses also suggested that android and trunk fat,as well as supine waist and abdominal circumferences,were positively associated with social relationships QOL.Encouraging individuals with SCI to engage in LTPA may robustly enhance multiple aspects of QOL while reducing the risk for cardiovascular and metabolic morbidities associated with SCI.Moreover,this may lead to a further understanding of how QOL may impact longitudinal intervention trials.The study protocol and procedures were reviewed and approved by the McGuire VA Research Institutional Review Board(IRB#02152,approval date August 9,2015;IRB#02375,approval date May 2,2018).
文摘The overall goal of this project is to develop a humane non-human primate model of traumatic spinal cord injury that will facilitate the development and evaluation of therapeutic interventions. The model utilizes neurophysiological techniques to identify the location of the upper motor neuron axons that innervate the lower motor neurons that control tail musculature. This facilitates the placement of a selective lesion that partially disconnects the upper and lower motor neuron supply to the musculature of the tail. An implanted transmitter quantitatively measures electromyography data from the tail. The preliminary data indicates that this model is feasible. The subject was able to tolerate the implantation of the transmitter, without adverse effects. As well, there was no limb impairment, bowel dysfunction or bladder dysfunction. The histopathologic and electromyographic features of the selective experimental lesion were similar to human spinal cord injury.
文摘Background: This paper describes and displays the spinal radiological anatomy and associated pathology in a Macaca fascicularis and compares it to the spinal anatomy of humans. Animal models are commonly used in research. As compared to Macaca mulatta, the anatomy of M. fascicularis is less well described in the literature. Materials and methods: The authors anatomically reconstructed and reviewed the defleshed spine of a single adult M. fascicularis visually, radiographically, and with high resolution CT. Results: 7 cervical, 12 thoracic, 6 lumbar, 3 sacral, and 16 caudal vertebrae were identified. Similarities in the spine to humans were seen as well as differences such as the beaked anterior arch of C1, the anterior pointed lower lumbar vertebrae, the upward curved transverse processes, and presence of three sacral segments. Degenerative changes were seen at multiple locations similar to humans though most pronounced at T3-4. Conclusions: This paper addresses the normal spinal anatomy and degenerative changes in an adult M. fascicularis and compares it to humans.
文摘A valid non human primate model of traumatic spinal cord injury (TSCI) is essential to evaluate and develop new treatments. In previous experiments, it has been demonstrated that a transmitter can be implanted in the macaque fasicularis monkey that measures electromyographic data from the musculature of the tail. As well, previous experiments have demonstrated that selective lesions can be created in the lower thoracic spinal cord that does not cause limb weakness and/or bowel dysfunction. The histopathological features of these lesions appear similar to human TSCI. This paper describes a method by which the EMG data can be transformed into a quantitative metric of volitional limb movement (“Q”). This metric permits an objective assessment of injury, natural recovery as well as potential efficacy of candidate treatments.
基金AAP is supported by the Heart and Stroke Foundation of Canadathe Michael Smith Foundation for Health Research+3 种基金AVK is supported by the Paralyzed Veterans of Americathe Craig Neilson Foundationthe Canadian Institute of Health Researchthe Heart and Stroke Foundation of Canada
文摘Spinal cord injury (SCI) is a devastating condition that not only results in a loss of motor functions but also severe autonomic dysfunctions (Krassioukov and Claydon, 2006). Autonomic dysreflexia (AD) is a life threatening episode of tran- sient hypertension that occurs up to 30x/day (1 Ix/day on average) in those with cervical or high thoracic SCI (Hubli et al., 2015). Most common triggers of AD are from stimuli such as a full bowel and/or bladder, or sexual arousal (Teasell et al., 2000). Penile vibrostimulation (PVS) is a clinical pro- cedure for sperm retrieval used for the purpose of family planning or fertility assessment that unfortunately iatrogenically induces episodes of AD (Elliott, 2006). Recently, we published a clinical trial highlighting that prazosin may be a viable option for treating AD secondary to PVS (Phillips et al., 2014).
文摘The purpose of this study was to test whether modafinil is effective in alleviating the symptoms of fatigue in postpolio patients, because it has been helpful for such symptoms in other neurologic disorders. Using a double-blind, randomized, placebo-controlled cross-over design, 14 postpolio patients with moderate to severe fatigue were assigned to receive modafinil or placebo first. Piper Fatigue Scale, Epworth Sleepiness Scale, digit span, and reaction time tests were done at baseline and then at weekly intervals. The Piper Fatigue Scale scores im proved by 27 ±40%(mean ±SD) following modafinil and by 43 ±36%following pla cebo. Scores for most of the other tests did not change during the study. Therefore, we conclude that modafinil was not effective in alleviating the symptoms of fatigue in postpolio patients.