No abstract

The following three themes emerged from this analysis: (1) more comprehensive provider training about spinal cord injury is needed; (2) increased communication between consumer and family would be beneficial; and (3) an increase in the flexibility and availability of services would help to ensure access to essential care.

The contractile characteristics of 47 twitch and 3 nontwitch lateral rectus motor units in 11 cats were examined using two different stimulation paradigms derived from observed motoneuron firing frequencies in alert animals. The twitch units showed an average twitch tension (46.0 ± 8.1 mg), contraction time (6.15 ± 0.26 ms) and median fusion frequency (170 Hz) consistent with previous studies, kt value, defined as the slope of the relation between a series of constant frequency tetanic stimulation trains (lasting 200 ms) and tetanic tension, correlated with maximum tetanic tension (r = 0.984, p < 0.05). kt_ps value, defined as the slope of the relation between tetanic tension and a series of constant frequency stimulation trains (lasting 1975 ms) that immediately followed a 25-ms high-frequency burst (pulse/step paradigm), was similarly correlated (r = 0.853, p < 0.05) with maximum tetanic tension (× = 256.5 ± 35.2 mg). ktps values were lower that kt values for each unit, but the units did not change their position in the numerical hierarchy. Eighty-four percent of the motor units produced different maximum tetanic tensions (× = 24 ± 3%), when comparing pulse/step to constant frequency stimulation, but only 14% of those units produced a greater maximum tetanic tension during pulse/step stimulation. In contrast, 46% of the motor units contracted with more force during the step phase of the pulse/step paradigm than with constant frequency stimulation when the stimulation rate was below 120 Hz: 24% of the units contracted with less force. In addition, pulse/step stimulation frequency ranges above 120 Hz (step phase) were ineffective in increasing tension while higher frequencies continued to elicit tension increases during constant frequency stimulation. The impact of these tension variations on eye movement is discussed.

Centers for Independent Living (CILs) have long been in the business of providing a variety of community-based support services to people with disabilities. The provision of transition services to youth and young adults, however, has for the most part been the responsibility of regional school systems and, to some extent, of other state rehabilitative service agencies. In the last few years, CILs have played an increasing role in the provision of transition services through the development and implementation of CIL-specific programs and services and as part of collaborative, multidisciplinary, community-based transition teams. Because of their unique administrative and operational organization, CILs have begun to play an integral role in the support of youth and young adults in transition. As a result, local, state, and federal agencies are continuing to determine the short- and long-term role of ClLs in support of transition.

This paper represents the results of a cohort study comparing functional outcomes of individuals with violent and non-violent traumatic spinal cord injury (SCI) following inpatient rehabilitation. Twenty-seven consecutive patients with a diagnosis of traumatic SCI of violent etiology (gunshot wound, stabbing or assault) and 27 patients with non-violent etiology (motor vehicle accident and falls) were matched for neurological level of injury and classification. Demographic comparison of violent versus non-violent groups revealed mean age 30 versus 39, gender 93 percent versus 78 percent male, race 89 percent versus 59 percent non-white, 7 4 percent versus 41 percent unmarried and 56 percent versus 22 percent unemployed, respectively. Violent and non-violent traumatic SCI groups had similar lengths of stay, admission and discharge functional independent measures (FIM), FIM improvement, payor sources, hospital charges and discharge to home rates. Despite the differences noted in the demographics of violent and non-violent traumatic SCI, these two matched groups achieved similar functional outcomes and discharge disposition following inpatient rehabilitation. (J Spinal Cord Med 1998;21 :32-36)