Rehabilitation of spinal cord injuries

Nas, Kemal; Yazmalar, Levent; Şah, Volkan; Aydin, Ayşe; Öneş, Kadriye

doi:10.5312/wjo.v6.i1.8

Cited by 388 publications

(328 citation statements)

References 47 publications

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“…Conversely, people with SCI often require assistance with activities of daily life (e.g. transfers, dressing)(34) and most do not work outside of the home (34,46). These factors severely limit the potential for most people with SCI to engage in routine low-level activity.…”

Section: Discussionmentioning

confidence: 99%

Low-Force Muscle Activity Regulates Energy Expenditure after Spinal Cord Injury

Woelfel

Kimball

Yen³

et al. 2017

Medicine &Amp; Science in Sports &Amp; Exercise

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Reduced physical activity is a primary risk factor for increased morbidity and mortality, People with spinal cord injury (SCI) have reduced activity for a lifetime, as they cannot volitionally activate affected skeletal muscles. We explored whether low force and low frequency stimulation is a viable strategy to enhance systemic energy expenditure in people with SCI. Purpose To determine the effects of low stimulation frequency (1 Hz, 3 Hz) and stimulation intensity (50 mA and 100 mA) on energy expenditure in people with SCI. We also examined the relationship between body mass index (BMI) and visceral adipose tissue (VAT) on energy expenditure during low frequency stimulation. Methods Ten individuals with complete SCI underwent oxygen consumption monitoring during electrical activation of the quadriceps and hamstrings at 1 Hz and 3 Hz and at 50 and 100 mA. We calculated the difference in energy expenditure between stimulation and rest and estimated the number of days that would be necessary to burn 1 pound of body fat (3,500 kcal) for each stimulation protocol (1 Hz versus 3 Hz). Results Both training frequencies induced a significant increase in oxygen consumption above a resting baseline level (p < 0.05). Energy expenditure positively correlated with stimulus intensity (muscle recruitment) and negatively correlated with adiposity (reflecting the insulating properties of adipose tissue). We estimated that 1 pound of body fat could be burned more quickly with 1 Hz training (58 days) as compared to 3 Hz training (87 days) if an identical number of pulses were delivered. Conclusion Low-frequency stimulation increased energy expenditure per pulse and may be a feasible option to subsidize physical activity to improve metabolic status after SCI.

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Section: Discussionmentioning

confidence: 99%

Low-Force Muscle Activity Regulates Energy Expenditure after Spinal Cord Injury

Woelfel

Kimball

Yen³

et al. 2017

Medicine &Amp; Science in Sports &Amp; Exercise

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“…Then associate the proprioceptive training stimulating the patient to sit in a progressive manner, so he doesn´t present a hypotensive crisis. When the patient already carries out the exercise to sit correctly, we will start the balance proprioceptive exercises(Nas, Yazmalar, Aydin, Ones, et al, 2015).…”

Section: Robotic Training (Rt); Endurance Training; Transcutaneous Elmentioning

confidence: 99%

Functional Neurorehabilitation - The Locomotor Quadrupedal Animal Training Adapted to the Bipedal Human

Martins¹

2015

Int Arch Med

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This article intends to be based on the similarities between the neuroanatomy and neurophysiology of the quadrupedal animal and bipedal human. Through this standard explain the locomotor training of functional neurorehabilitation to both. And also demonstrate the importance of bipedal locomotor training and quadrupedal locomotor training, making the conversion of the quadrupedal locomotor training of the quadruped animal to human biped, and also demonstrate the importance of electromyostimulation and laser therapy. In the article we conclude that the functional neurorehabilitation (FNR) should be applied as soon as possible within the limitation of spinal diseases, stroke or Parkinson's disease, repeatedly and progressively involving the three types of training proprioceptive, fortification and resistance to obtain an improved mobility. With our article we also considered that more robotic locomotor training should be applied in both areas of medicine, both human and animal, looking as an evidence model the dog and cat.

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“…In general, rehabilitation following SCI is divided into acute and long-term phases. 57 In the acute hospital setting, the goals for physical therapy are to prevent muscle contracture and muscle wasting, and to reduce the risk of pressure ulcers. For patients suffering paraplegia, physical therapy often focuses on building upper-extremity strength to assist with mobility.…”

mentioning

confidence: 99%

Update on critical care for acute spinal cord injury in the setting of polytrauma

Yue

Winkler

Rick

et al. 2017

Neurosurgical Focus

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Traumatic spinal cord injury (SCI) often occurs in patients with concurrent traumatic injuries in other body systems. These patients with polytrauma pose unique challenges to clinicians. The current review evaluates existing guidelines and updates the evidence for prehospital transport, immobilization, initial resuscitation, critical care, hemodynamic stability, diagnostic imaging, surgical techniques, and timing appropriate for the patient with SCI who has multisystem trauma. Initial management should be systematic, with focus on spinal immobilization, timely transport, and optimizing perfusion to the spinal cord. There is general evidence for the maintenance of mean arterial pressure of > 85 mm Hg during immediate and acute care to optimize neurological outcome; however, the selection of vasopressor type and duration should be judicious, with considerations for level of injury and risks of increased cardiogenic complications in the elderly. Level II recommendations exist for early decompression, and additional time points of neurological assessment within the first 24 hours and during acute care are warranted to determine the temporality of benefits attributable to early surgery. Venous thromboembolism prophylaxis using low-molecular-weight heparin is recommended by current guidelines for SCI. For these patients, titration of tidal volumes is important to balance the association of earlier weaning off the ventilator, with its risk of atelectasis, against the risk for lung damage from mechanical overinflation that can occur with prolonged ventilation. Careful evaluation of infection risk is a priority following multisystem trauma for patients with relative immunosuppression or compromise. Although patients with polytrauma may experience longer rehabilitation courses, long-term neurological recovery is generally comparable to that in patients with isolated SCI after controlling for demographics. Bowel and bladder disorders are common following SCI, significantly reduce quality of life, and constitute a focus of targeted therapies. Emerging biomarkers including glial fibrillary acidic protein, S100β, and microRNAs for traumatic SCIs are presented. Systematic management approaches to minimize sources of secondary injury are discussed, and areas requiring further research, implementation, and validation are identified.

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Rehabilitation of spinal cord injuries

Cited by 388 publications

References 47 publications

Low-Force Muscle Activity Regulates Energy Expenditure after Spinal Cord Injury

Low-Force Muscle Activity Regulates Energy Expenditure after Spinal Cord Injury

Functional Neurorehabilitation - The Locomotor Quadrupedal Animal Training Adapted to the Bipedal Human

Update on critical care for acute spinal cord injury in the setting of polytrauma

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