Recovery of ambulation in motor-incomplete tetraplegia

Burns, Stephen P.; Golding, Daphne G.; Rollé, William A.; Graziani, Virginia; Ditunno, John F.

doi:10.1016/s0003-9993(97)90326-9

Cited by 205 publications

(111 citation statements)

References 18 publications

Supporting

Mentioning

105

Contrasting

Unclassified

Order By: Relevance

“…27 Later on, presynaptic mechanisms (synapse growth and formation of new circuits through collateral sprouting) may occur in cortical and subcortical centres and in the spinal cord. 28 Data on the effect of age on SCI patient outcomes have already been reported in several studies, 7,12,14,21 but their methodologies differ from ours. Our results compare favourably with Penrod et al 12 and Burns et al 14 study on incomplete tetraplegic subjects, in regard to better outcomes for younger subjects in neurological recovery and walking although Penrod et al 12 utilised Frankel grades rather than the ASIA Impairment Scale to predict differences in ambulatory function, and did not define the grades for C and D. This is important, because the interpretation of 'functional muscles' for the C and D levels may change from one classification system to another.…”

Section: Discussionmentioning

confidence: 69%

“…7,10,12,14,21 The matching procedure reduced the possible effects of lesion to admission interval, of level and completeness of lesion and the differences between traumatic and nontraumatic aetiology. Precise measures of motor recovery were used, correlated with walking recovery that was evaluated by BI, RMI and WISCI, rather than a global measure alone, such as the FIM.…”

Section: Discussionmentioning

confidence: 99%

“…The choice of age 50 years, although arbitrary, was made on the basis of previous reports. [12][13][14] Only patients who had the cognitive ability to participate in the rehabilitation programme were included. Whenever a patient was discharged or transferred for more than 3 weeks, the readmission was considered a second admission and the patient was excluded.…”

Section: Subjectsmentioning

confidence: 99%

See 2 more Smart Citations

Effects on age on spinal cord lesion patients' rehabilitation

et al. 2003

View full text Add to dashboard Cite

Study design: The present study was undertaken to focus the age-related characteristics of a population of traumatic and nontraumatic spinal cord patients. Objectives: to examine demographic, injury and outcome characteristics of older adults with spinal cord lesions as a result of trauma and nontrauma, and to compare these characteristics with those of younger patients in matched cohorts. Setting: Spinal Cord Unit, Fondazione Santa Lucia IRCCS, a large rehabilitation hospital of the centre-south of Italy. Methods: In total, 284 consecutive newly injured patients with traumatic and nontraumatic spinal cord lesions were retrospectively reviewed and divided according to age into two groups: under 50 years (group 1) and over 50 years (group 2). The following information was collected: onset of lesion to admission; injury variables: aetiology, level, associated injuries, medical complications and surgical intervention; length of stay; American Spinal Injury Association (ASIA) impairment and motor scores; Barthel Index (BI) and Rivermead Mobility Index (RMI) to assess independence in daily living; Walking Index for Spinal Cord Injury to assess ambulation; patients destination at discharge. In a subset of 130 subjects, a block design, matching procedure was used to control for the covariant effects of injury characteristics, time from lesion and aetiology on age effects. Results: In the entire group of 284 patients, older subjects had a higher probability of having incomplete tetraplegia of nontraumatic origin; they also showed a shorter length of stay and a higher rate of complications. In the matched cohorts, younger patients showed better neurologic recovery (intended as ASIA impairment grade improvement and motor scores increase), significantly higher Barthel Index and RMI at discharge, a higher level of independence in spontaneous bladder and bowel management and a higher frequency of independent walking. Conclusion: Older individuals with spinal cord injury and disease do well, but have a less favourable outcome in regard to walking, bladder and bowel independence than younger subjects and have more associated medical problems. Different rehabilitative strategies, therefore, are required for older subjects, which maximises the shorter length of stay and provides the necessary medical care and increased physical assistant resources following discharge.

show abstract

Section: Discussionmentioning

confidence: 69%

Section: Discussionmentioning

confidence: 99%

Section: Subjectsmentioning

confidence: 99%

See 1 more Smart Citation

Effects on age on spinal cord lesion patients' rehabilitation

et al. 2003

View full text Add to dashboard Cite

show abstract

“…In such cases, the majority of people will likely experience useful recovery (to ASIA grade C or D 4 ), including the ability to walk. 5 Rehabilitation interventions and outcomes of SCI have thus tended to particularly focus on functional status.…”

Section: Introductionmentioning

confidence: 99%

A structured review of outcome measures used for the assessment of rehabilitation interventions for spinal cord injury

2008

View full text Add to dashboard Cite

Objectives: To review the measurement properties of outcome measures of function or mobility currently used in the context of spinal cord injury (SCI). Methods: A keyword search of multiple databases to identify original papers. Papers were reviewed where they had included an evaluation, of people with SCI, of the psychometric properties of an outcome measure, which included functional or mobility domains. Information was extracted concerning item generation, ease and intended method of use and scale properties, in particular: reliability, validity and responsiveness. Conclusions were reached concerning the psychometric properties of each instrument. Results: Eight outcome measures were identified (plus adapted versions). Five had originally been developed specifically for evaluating patients with SCI (chiefly reflecting clinicians' perspectives), the remaining three had not. The psychometric properties of the instruments varied, with some mixed/ contradictory evidence likely relating to differing study sample sizes, characteristics and variable quality. Instruments also varied in stated purpose or emphasis. Conclusion: In addition to weighing evidence concerning measurement properties, users need to consider the stated purpose and item content of instruments in relation to their specific aims. With regard to the former, while reviewed instruments had some flaws, the Spinal cord Independence Measure (revised version III), Quadriplegia Index of Function (Short-form), Needs Assessment Checklist and SIP68 appeared the best, despite limited evidence of their responsiveness.

show abstract

“…Depending on the type of injury and rehabilitation program most patients can recover some degree of gait capability. [1][2][3] In recent years many studies have focused on the design of gait improvement programs for this patient population. 4 Some of these training strategies include partial weight support on a treadmill, driven gait orthosis (Lokomat), ambulatory therapy, functional electrical stimulation (FES) or conventional indoor techniques.…”

Section: Introductionmentioning

confidence: 99%

Comparison of gait performance on different environmental settings for patients with chronic spinal cord injury

et al. 2007

View full text Add to dashboard Cite

Study design: Observational cross-section study. Objectives: The objective of our study was to determine if the influence of a community environment would impact on ASIA D spinal cord injured (SCI) gait performance patients. Our main hypothesis is that an outdoor community environment may influence gait speed and endurance on community ambulating patients. Methods: Ten-Meter Walking (10MWT) and Six-Minute Walking (6MWT) tests were performed on community ambulating SCI research participants (n ¼ 18) in two different environmental conditions: (1) Experimental (indoors Gymnasium) and (2) Natural (community setting). Average gait speed and endurance values were obtained for the two different conditions and analyzed for statistical significance on the nonparametric two-tailed Wilcoxon signed rank test. Results: While no difference was observed on the 10MWT we found an improvement on gait performance on the 6 MWT on a community setting. Conclusions: Our study showed mixed results on environmental influence on gait speed and endurance on ASIA D patient population. While there is no difference on the 10 MWT, there is an improvement on gait performance on the communitary 6MWT.

show abstract

Recovery of ambulation in motor-incomplete tetraplegia

Cited by 205 publications

References 18 publications

Effects on age on spinal cord lesion patients' rehabilitation

Effects on age on spinal cord lesion patients' rehabilitation

A structured review of outcome measures used for the assessment of rehabilitation interventions for spinal cord injury

Comparison of gait performance on different environmental settings for patients with chronic spinal cord injury

Contact Info

Product

Resources

About