Study design: Cross-sectional study. Objectives: To evaluate the physical activity scale for individuals with physical disabilities (PASIPD) in people with spinal cord injury (SCI). Setting: Eight Dutch rehabilitation centers with a specialized SCI unit. Methods: The PASIPD was examined by comparing group scores of people with different personal (age, gender and body mass index) and lesion characteristics (level (paraplegia/tetraplegia), completeness, time since injury (TSI)) in 139 persons with SCI 1 year after discharge from in-patient rehabilitation. Relationships between PASIPD scores and measures of activities (wheelchair skills, Utrecht Activity List, mobility range and social behavior subscales of the SIP68) and fitness (peak oxygen uptake, peak power output and muscular strength) were determined. Results: Persons with tetraplegia had significantly lower PASIPD scores than those with paraplegia (Po0.02). Persons with longer TSI had lower PASIPD scores than persons with shorter TSI (Po0.03). PASIPD scores showed moderate correlations with activities (0.36-0.51, Po0.01) and weak-tomoderate correlations with fitness parameters (0.25-0.36, Po0.05). Conclusion: In a fairly homogeneous group of persons with SCI, 1 year after in-patient rehabilitation, the PASIPD showed weak-to-moderate relationships with activity and fitness parameters. There seems to be a limited association between self-reported activity level and fitness in people with SCI.

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Abstract-Pressure ulcers (PUs) are highly prevalent in people with spinal cord injury (SCI). Electrical stimulation (ES) activates muscles and might reduce risk factors. Our objectives were to study and compare the effects of two duty cycles during 3 h of ES-induced gluteal and hamstring activation on interface pressure distribution in sitting individuals with SCI and study the usability of a newly developed electrode garment (ES shorts). Ten individuals with SCI participated in this study, in which two ES protocols with different duty cycles (1:1 s vs 1:4 s on-off) were applied in counterbalanced order using a custom-made garment with built-in electrodes. Outcome variables included interface pressure of the ischial tuberosities (ITs) and pressure gradient. A questionnaire was used to determine usability of the ES shorts. In both protocols, ES caused a significant decrease in average IT pressure compared with rest (no ES); on average, 35% for protocol 1:4 and 13% for protocol 1:1. The ES on-off duty cycle of protocol 1:4 showed less muscle fatigue. In general, participants scored the usability of the ES shorts as satisfactory. In this study, the application of ES resulted in a significant decrease in IT pressure. The ES on-off duty cycle of 1:4 s is recommended because of the less fatiguing effect. ES of the hamstrings and gluteal muscles might be a promising method in preventing PUs, but further study is needed.

Introduction:The eect of spinal deformity with posttraumatic kyphosis and stenosis of the spinal canal in producing secondary changes of the spinal cord has been discussed for quite some time. Since the advent of magnetic resonance imaging (MRI), 20 ± 40% of patients with posttraumatic paraplegia are found to develop hydromyelia. Purpose of our study: To evaluate the in¯uence of residual spinal deformity, de®ned by the extent of the posttraumatic kyphosis and stenosis, in the development of posttraumatic hydromyelia. Material and methods: Two hundred and seven cases of traumatic paraplegia with MRI follow-up were reviewed retrospectively. A minimum of 3 years duration between trauma and MRI study was required (mean 10.6 years [3.2 ± 38.3]). For statistical analysis two groups of patients were formed: with hydromyelia and without hydromyelia. After healing of the fracture, the extent of the kyphosis and stenosis, as well as the characteristics of the paraplegia were noted. Results: We found that 53 patients had hydromyelia. A highly signi®cant correlation was found for the extent of spinal stenosis and the amount of kyphosis. Cluster analysis indicated that patients with more than 15 degrees of posttraumatic kyphosis and more than 25% of stenosis were twice as likely to develop hydromyelia. The level of the lesion and the remaining neurological function was not proven to have any in¯uence towards the development of hydromyelia. Conclusions: These results support the idea that chronic mechanical stress to the spinal cord increases the risk for the development of hydromyelia. Surgical reconstruction should be considered for all patients to prevent secondary changes of the spinal cord.