Initial assessment and management of respiratory infections in persons with spinal cord injuries and disorders in the COVID‐19 era

Henzel, M. Kristi; Shultz, James M.; Dyson-Hudson, Trevor; Svircev, Jelena N.; DiMarco, Anthony F.; Gater, David R.

doi:10.1002/emp2.12282

Cited by 9 publications

(7 citation statements)

References 37 publications

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“…SCI can also be caused by non-traumatic conditions such as infection, ischaemia, myelitis, and both primary and secondary malignancies affecting the spinal column. SCI affects all systems of the body below the level of neurological injury (2,3), and can result in permanent impairments including motor paralysis, sensory loss, chronic neuropathic pain, bladder and bowel dysfunction, sexual dysfunction, persistent spasticity, progressive osteoporosis, and potentially life-threatening respiratory insufficiency, cardiovascular and autonomic dysfunction (4)(5)(6)(7)(8). Individuals with SCI are often hospitalized for prolonged periods, and costs in acute management, rehabilitation, and subsequent care remain extremely high (9).…”

Section: Introductionmentioning

confidence: 99%

Functional recovery priorities and community rehabilitation service preferences of spinal cord injury individuals and caregivers of Chinese ethnicity and cultural background

Koljonen

Yip

Su³

et al. 2022

Front. Neurol.

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IntroductionSpinal cord injury (SCI) causes significant and permanent disability affecting motor, sensory and autonomic functions. We conducted a survey on the priorities of functional recovery and preferences for community rehabilitation services in a cohort of Chinese individuals with SCI as well as the primary caregivers. The study also investigated their views on advanced technology and research.MethodsAn online platform with a self-administered questionnaire was used to collect the opinions of clients that received services from an SCI follow-up clinic, a self-help association, or a non-government organization from 1 September−31 December 2021.ResultsEighty-seven subjects (74 individuals with SCI−48 tetraplegic, 26 paraplegic, and 13 caregivers) responded to the survey. Recovery of arm/hand function was given the highest priority among tetraplegics, followed by upper trunk/body strength and balance, and bladder/bowel function. Sexual function had a significant lower ranking than all priority areas except normal sensation (p < 0.05). Paraplegics viewed bladder/bowel function as the most important area of functional recovery, followed by walking movement, upper trunk/body strength and balance, elimination of chronic pain, and regaining normal sensation. There was no statistically significant difference among the top priority areas (p > 0.05). In contrast to previous studies done in Western populations, the study revealed that sexual function was ranked as the lowest by all 3 groups of respondents (tetraplegics, paraplegics, and caregivers). The majority of participants thought community rehabilitation services were inadequate. Most of the respondents were interested to try advanced technology which would facilitate their daily life and rehabilitation. About half of the individuals with SCI thought advance in technology and research could bring significant improvement in their quality of life in the coming 10 years.ConclusionThis survey is the first study specifically looking into the recovery and rehabilitation priorities of a Chinese population of individuals with SCI. This is also the first study to investigate the priorities of the primary caregivers of SCI individuals. The findings are useful as a reference for planning of future research and provision of rehabilitation services for the SCI community locally and in other parts of China.

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Section: Introductionmentioning

confidence: 99%

Functional recovery priorities and community rehabilitation service preferences of spinal cord injury individuals and caregivers of Chinese ethnicity and cultural background

Koljonen

Yip

Su³

et al. 2022

Front. Neurol.

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“…Unopposed vagal influence on the bronchial tree results in bronchiolar constriction, hyper-reactive airways and increased mucus secretion [ 30 ]. Coupled with neurogenic restrictive lung disease, a result of intercostal and abdominal muscle paralysis, individuals with cervical/high thoracic SCI are at high risk of atelectasis, pneumonia and mucus plugging, as they are unable to voluntarily cough/clear pulmonary secretions, even at rest [ 31 ]. Under exercise or “crisis” conditions, in addition to ventilatory insufficiency, inspiratory effort is limited by persistent bronchoconstriction and mucus production despite increased ventilatory requirements at higher workloads [ 32 ].…”

Section: Sci Influence On Ans Dysfunctionmentioning

confidence: 99%

Autonomic Dysfunction and Management after Spinal Cord Injury: A Narrative Review

Henke

Billington

Gater

2022

JPM

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The autonomic nervous system (ANS), composed of the sympathetic and parasympathetic nervous systems, acts to maintain homeostasis in the body through autonomic influences on the smooth muscle, cardiac muscles, blood vessels, glands and organs of the body. The parasympathetic nervous system interacts via the cranial and sacral segments of the central nervous system, and the sympathetic nervous system arises from the T1–L2 spinal cord segments. After a spinal cord injury (SCI), supraspinal influence on the ANS is disrupted, leading to sympathetic blunting and parasympathetic dominance resulting in cardiac dysrhythmias, systemic hypotension, bronchoconstriction, copious respiratory secretions and uncontrolled bowel, bladder, and sexual dysfunction. Further, afferent signals to the sympathetic cord elicit unabated reflex sympathetic outflow in response to noxious stimuli below the level of SCI. This article outlines the pathophysiology of SCI on the ANS, clinical ramifications of autonomic dysfunction, and the potential long-term sequelae of these influences following SCI.

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“…[3] , [4] , [5] , [6] , [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [46] , [47] , [48] , [49] , [50] , [51] , [52] , [53] , [54] , [55] , [56] , [57] , [58] , [59] , [60] , [61] , [62] , [63] , [64] , [65] , [66] , [67] , [68] , [69] , [70] , [71] , [72] , ...…”

Section: Uncited Referencesunclassified

“…Thick mucus formation can become organized in the distal bronchioles and compromise local and then general ventilation characteristics, ultimately affecting gas-exchange at the alveoli apparatus. [38][39][40][41][42][43][44][45][46][47][48][49][50][51][52]…”

Section: Guaifenesinmentioning

confidence: 99%

Application of an evidence-based, out-patient treatment strategy for COVID-19: Multidisciplinary medical practice principles to prevent severe disease

Frohman

Villemarette-Pittman

Rodríguez

et al. 2021

Journal of the Neurological Sciences

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The COVID-19 pandemic has devastated individuals, families, and institutions throughout the world. Despite the breakneck speed of vaccine development, the human population remains at risk of further devastation. The decision to not become vaccinated, the protracted rollout of available vaccine, vaccine failure, mutational forms of the SARS virus, which may exhibit mounting resistance to our molecular strike at only one form of the viral family, and the rapid ability of the virus(es) to hitch a ride on our global transportation systems, means that we are will likely continue to confront an invisible, yet devastating foe. The enemy targets one of our human physiology's most important and vulnerable life-preserving body tissue; our brocho-alveolar gas exchange apparatus. Notwithstanding the fear and the fury of this microbe's potential to raise existential questions across the entire spectrum of human endeavor, the application of an early treatment intervention initiative, may represent a crucial tool in our defensive strategy. This strategy is driven by evidence-based medical practice principles, those not likely to become antiquated, given the molecular diversity and mutational evolution of this very clever “world traveler” .

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Initial assessment and management of respiratory infections in persons with spinal cord injuries and disorders in the COVID‐19 era

Cited by 9 publications

References 37 publications

Functional recovery priorities and community rehabilitation service preferences of spinal cord injury individuals and caregivers of Chinese ethnicity and cultural background

Functional recovery priorities and community rehabilitation service preferences of spinal cord injury individuals and caregivers of Chinese ethnicity and cultural background

Autonomic Dysfunction and Management after Spinal Cord Injury: A Narrative Review

Application of an evidence-based, out-patient treatment strategy for COVID-19: Multidisciplinary medical practice principles to prevent severe disease

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