scholarly journals Relationship Between Neurological Injury and Patterns of Upright Mobility in Children With Spinal Cord Injury

2013 ◽  
Vol 19 (1) ◽  
pp. 31-41 ◽  
Author(s):  
Ross Chafetz ◽  
John P. Gaughan ◽  
Christina Calhoun ◽  
Jennifer Schottler ◽  
Lawrence Vogel ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Neurological Injury ◽  
Cord Injury

scholarly journals Robotic-Assisted, Body-Weight–Supported Treadmill Training in Individuals Following Motor Incomplete Spinal Cord Injury

2005 ◽  
Vol 85 (1) ◽  
pp. 52-66 ◽  
Author(s):  
T George Hornby ◽  
David H Zemon ◽  
Donielle Campbell
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Body Weight ◽  
Physical Therapists ◽  
Treadmill Training ◽  
Neurological Injury ◽  
Walking Ability ◽  
Incomplete Spinal Cord Injury ◽  
Robotic Assisted ◽  
Cord Injury

AbstractBackground and Purpose. Performance of therapist-assisted, body-weight–supported treadmill training (BWSTT) to enhance walking ability of people with neurological injury is an area of intense research. Its application in the clinical setting, however, is limited by the personnel and labor requirements placed on physical therapists. Recent development of motorized (“robotic”) rehabilitative devices that provide assistance during stepping may improve delivery of BWSTT. Case Description. This case report describes the use of a robotic device to enhance motor recovery and ambulation in 3 people following motor incomplete spinal cord injury. Interventions. Changes in motor impairment, functional limitations, and locomotor disability were monitored weekly during robotic-assisted BWSTT and following transition to therapist-assisted BWSTT with the assistance of one therapist. Outcomes. Following this training, 2 patients recovered independent over-ground walking and another improved his gait speed and endurance. Discussion. The use of robotic devices may assist physical therapists by providing task-specific practice of stepping in people following neurological injury.

Pediatric spinal injury: the very young

1988 ◽  
Vol 68 (1) ◽  
pp. 25-30 ◽  
Author(s):  
John R. Ruge ◽  
Grant P. Sinson ◽  
David G. McLone ◽  
Leonard J. Cerullo
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Spinal Cord Injuries ◽  
Spinal Injury ◽  
Causative Factor ◽  
Important Variable ◽  
Neurological Injury ◽  
Content Type ◽  
Significant Difference ◽  
Cord Injury

✓ Maturity of the spine and spine-supporting structures is an important variable distinguishing spinal cord injuries in children from those in adults. Cinical data are presented from 71 children aged 12 years or younger who constituted 2.7% of 2598 spinal cord-injured patients admitted to the authors' institutions from June, 1972, to June, 1986. The 47 children with traumatic spinal cord injury averaged 6.9 years of age and included 20 girls (43%). The etiology of the pediatric injuries differed from that of adult injuries in that falls were the most common causative factor (38%) followed by automobile-related injuries (20%). Ten children (21.3%) had spinal cord injury without radiographic abnormality (SCIWORA), whereas 27 (57%) had evidence of neurological injury. Complete neurological injury was seen in 19% of all traumatic pediatric spinal cord injuries and in 40% of those with SCIWORA. The most frequent level of spinal injury was C-2 (27%, 15 cases) followed by T-10 (13%, seven cases). Upon statistical examination of the data, a subpopulation of children aged 3 years or younger emerged. These very young children had a significant difference in level of injury, requirement for surgical stability, and sex distribution compared to 4- to 12-year-old children.

scholarly journals The Potential of Curcumin in Treatment of Spinal Cord Injury

2016 ◽  
Vol 2016 ◽  
pp. 1-11 ◽  
Author(s):  
Raghavendra Sanivarapu ◽  
Vijayalakshmi Vallabhaneni ◽  
Vivek Verma
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Treatment Options ◽  
Current Treatment ◽  
Neurological Injury ◽  
Standards Of Care ◽  
Current Therapy ◽  
Clinical Perspective ◽  
Cord Injury ◽  
Immense Potential

Current treatment for spinal cord injury (SCI) is supportive at best; despite great efforts, the lack of better treatment solutions looms large on neurological science and medicine. Curcumin, the active ingredient in turmeric, a spice known for its medicinal and anti-inflammatory properties, has been validated to harbor immense effects for a multitude of inflammatory-based diseases. However, to date there has not been a review on curcumin’s effects on SCI. Herein, we systematically review all known data on this topic and juxtapose results of curcumin with standard therapies such as corticosteroids. Because all studies that compare the two show superior results for curcumin over corticosteroids, it could be true that curcumin better acts at the inflammatory source of SCI-mediated neurological injury, although this question remains unanswered in patients. Because curcumin has shown improvements from current standards of care in other diseases with few true treatment options (e.g., osteoarthritis), there is immense potential for this compound in treating SCI. We critically and systematically summarize available data, discuss clinical implications, and propose further testing of this well-tolerated compound in both the preclinical and the clinical realms. Analyzing preclinical data from a clinical perspective, we hope to create awareness of the incredible potential that curcumin shows for SCI in a patient population that direly needs improvements on current therapy.

scholarly journals Vagus Nerve Stimulation Paired With Rehabilitative Training Enhances Motor Recovery After Bilateral Spinal Cord Injury to Cervical Forelimb Motor Pools

2020 ◽  
Vol 34 (3) ◽  
pp. 200-209 ◽  
Author(s):  
Michael J. Darrow ◽  
Miranda Torres ◽  
Maria J. Sosa ◽  
Tanya T. Danaphongse ◽  
Zainab Haider ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Vagus Nerve ◽  
Motor Neurons ◽  
Nerve Stimulation ◽  
Vagus Nerve Stimulation ◽  
Closed Loop ◽  
Neurological Injury ◽  
Injury Model ◽  
Cord Injury

Closed-loop vagus nerve stimulation (VNS) paired with rehabilitative training has emerged as a strategy to enhance recovery after neurological injury. Previous studies demonstrate that brief bursts of closed-loop VNS paired with rehabilitative training substantially improve recovery of forelimb motor function in models of unilateral and bilateral contusive spinal cord injury (SCI) at spinal level C5/6. While these findings provide initial evidence of the utility of VNS for SCI, the injury model used in these studies spares the majority of alpha motor neurons originating in C7-T1 that innervate distal forelimb muscles. Because the clinical manifestation of SCI in many patients involves damage at these levels, it is important to define whether damage to the distal forelimb motor neuron pools limits VNS-dependent recovery. In this study, we assessed recovery of forelimb function in rats that received a bilateral incomplete contusive SCI at C7/8 and underwent extensive rehabilitative training with or without paired VNS. The study design, including planned sample size, assessments, and statistical comparisons, was preregistered prior to beginning data collection ( https://osf.io/ysvgf/ ). VNS paired with rehabilitative training significantly improved recovery of volitional forelimb strength compared to equivalent rehabilitative training without VNS. Additionally, VNS-dependent enhancement of recovery generalized to 2 similar, but untrained, forelimb tasks. These findings indicate that damage to alpha motor neurons does not prevent VNS-dependent enhancement of recovery and provides additional evidence to support the evaluation of closed-loop VNS paired with rehabilitation in patients with incomplete cervical SCI.

Pediatric spinal injury: review of 174 hospital admissions

1992 ◽  
Vol 77 (5) ◽  
pp. 700-704 ◽  
Author(s):  
Mark G. Hamilton ◽  
S. Terence Mylks
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Hospital Admissions ◽  
Spinal Injury ◽  
Neurological Injury ◽  
Cervical Cord ◽  
Mature Adult ◽  
Younger Patients ◽  
Cord Injury ◽  
Radiological Abnormality

✓ Injury to the spinal column and spinal cord occurs relatively infrequently in the pediatric population. A review of 174 pediatric patients is presented, representing 5.4% of all patients admitted with spinal injury, Spinal cord injury was present in 45% of patients. A distinct injury profile, explained by anatomical and biomechanical features, distinguishes the young patient with an immature spine from older adolescents with a more mature, adult-like spine. The younger patients, while less likely to have spinal injury, had a higher incidence of neurological injury, in addition to a higher frequency of both spinal cord injury without radiological abnormality and upper cervical cord injury. In addition, younger patients with spinal cord injury and no radiological abnormality were more likely to have complete or severe cord injury. Prognosis was determined by the severity of spinal cord injury. Patients with complete cord injuries showed little improvement, while patients with incomplete injuries generally fared much better, with 74% showing significant improvement and 59% experiencing a complete recovery of neurological functions. There were six deaths, but none was attributed solely to spinal injury. The authors conclude that outcome is quite good after pediatric spinal cord injury that does not produce a physiologically complete cord deficit.

scholarly journals Targeted, activity-dependent spinal stimulation produces long-lasting motor recovery in chronic cervical spinal cord injury

2015 ◽  
Vol 112 (39) ◽  
pp. 12193-12198 ◽  
Author(s):  
Jacob G. McPherson ◽  
Robert R. Miller ◽  
Steve I. Perlmutter
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Neural Plasticity ◽  
Enhanced Recovery ◽  
Cervical Spinal Cord ◽  
Spike Timing ◽  
Neurological Injury ◽  
Partial Recovery ◽  
Cord Injury ◽  
Activity Dependent

Use-dependent movement therapies can lead to partial recovery of motor function after neurological injury. We attempted to improve recovery by developing a neuroprosthetic intervention that enhances movement therapy by directing spike timing-dependent plasticity in spared motor pathways. Using a recurrent neural–computer interface in rats with a cervical contusion of the spinal cord, we synchronized intraspinal microstimulation below the injury with the arrival of functionally related volitional motor commands signaled by muscle activity in the impaired forelimb. Stimulation was delivered during physical retraining of a forelimb behavior and throughout the day for 3 mo. Rats receiving this targeted, activity-dependent spinal stimulation (TADSS) exhibited markedly enhanced recovery compared with animals receiving targeted but open-loop spinal stimulation and rats receiving physical retraining alone. On a forelimb reach and grasp task, TADSS animals recovered 63% of their preinjury ability, more than two times the performance level achieved by the other therapy groups. Therapeutic gains were maintained for 3 additional wk without stimulation. The results suggest that activity-dependent spinal stimulation can induce neural plasticity that improves behavioral recovery after spinal cord injury.

scholarly journals Management of cervical deformity in ankylosing spondylitis

2008 ◽  
Vol 24 (1) ◽  
pp. E9 ◽  
Author(s):  
Daniel J. Hoh ◽  
Paul Khoueir ◽  
Michael Y. Wang
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Ankylosing Spondylitis ◽  
Spinal Instrumentation ◽  
Primary Treatment ◽  
Neurological Injury ◽  
Flexion Deformity ◽  
Cervical Kyphosis ◽  
Effective Treatment Modality ◽  
Cord Injury

✓ Ankylosing spondylitis can lead to severe cervical kyphosis, causing problems with forward vision, swallowing, hygiene, patient functionality, and social outlook. Evaluation of patients with cervical flexion deformity includes assessment of global sagittal balance and chin–brow angle. The primary treatment in extreme disabling cases is surgical correction involving a posterior cervical extension osteotomy, which is a technically demanding procedure with considerable risk of neurological injury. To address the potential complications with extension osteotomy, the authors of several reports have described modifications to the surgical technique. These developments incorporate recent advances in anesthesia, neuromonitoring, and spinal instrumentation. Complications associated with the procedure include subluxation at the osteotomy level, spinal cord injury, radiculopathy, dysphagia, and pseudarthrosis. Although the risks of spinal correction are considerable, extension osteotomy remains an effective treatment modality for patients with disabling cervical flexion deformity.

scholarly journals Effects of Dopamine on Motor Recovery and Training in Adults and Children With Nonprogressive Neurological Injuries: A Systematic Review

2019 ◽  
Vol 33 (5) ◽  
pp. 331-344 ◽  
Author(s):  
Catherine L. Bradley ◽  
Diane L. Damiano
Keyword(s):  
Systematic Review ◽  
Traumatic Brain Injury ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Brain Injury ◽  
Neurological Injury ◽  
Cord Injury ◽  
Dopamine Transmission ◽  
Neurological Injuries ◽  
Motor Outcomes

Background. The strong link between dopamine and motor learning has been well-established in the animal literature with similar findings reported in healthy adults and the elderly. Objective. We aimed to conduct the first, to our knowledge, systematic review of the literature on the evidence for the effects of dopaminergic medications or genetic variations in dopamine transmission on motor recovery or learning after a nonprogressive neurological injury. Methods. A PubMed search was conducted up until April 2018 for all English articles including participants with nonprogressive neurological injury such as cerebral palsy, stroke, spinal cord injury, and traumatic brain injury; quantitative motor outcomes; and assessments of the dopaminergic system or medications. Results. The search yielded 237 articles, from which we identified 26 articles meeting all inclusion/exclusion criteria. The vast majority of articles were related to the use of levodopa poststroke; however, several studies assessed the effects of different medications and/or were on individuals with traumatic brain injury, spinal cord injury or cerebral palsy. Conclusions. The evidence suggests that a brain injury can decrease dopamine transmission and that levodopa may have a positive effect on motor outcomes poststroke, although evidence is not conclusive or consistent. Individual variations in genes related to dopamine transmission may also influence the response to motor skill training during neurorehabilitation and the extent to which dopaminergic medications or interventions can augment that response. More rigorous safety and efficacy studies of levodopa and dopaminergic medications in stroke and particularly other neurological injuries including genetic analyses are warranted.

scholarly journals Identifying the Biomarkers of Spinal Cord Injury and the effects of Neurotrophin-3 Based on MicroRNA and mRNA Signature

2020 ◽  
Author(s):  
Shuang Qi ◽  
Zinan Li ◽  
Shanshan Yu
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Molecular Mechanisms ◽  
Ion Homeostasis ◽  
Metabolic Process ◽  
Neurological Injury ◽  
Receptor Interaction ◽  
Transcription Profile ◽  
Neurotrophin 3 ◽  
Cord Injury

Abstract Background To gain a better understanding of the molecular mechanisms of spinal cord injury and the effects of Neurotrophin-3, differentially expressed microRNAs (DEmiRNAs) and genes (DEGs) were analyzed. Methods The miRNA transcription profile of GSE82195 and the mRNA transcription profile of GSE82196 were downloaded from the Gene Expression Omnibus (GEO). Then, DERs were identified using limma. The noise-robust soft clustering of the intersection DERs was performed using Mfuzz package. Additionally, the integrated miRNAs–targets regulatory network was constructed using Cytoscape. Finally, the Comparative Toxicogenomics Database 2019 update was used to search the central nervous system injury related pathway. Results A total of 444 DERs including 382 DEGs and 62 DEmiRNAs were screened between group injury and group none whlie 576 DERs including 523 DEGs and 55 DEmiRNAs were screened between group NT-3 and group injury. Moreover, 80 intersections DERs were identified. DREs in cluster 1 were firstly significantly down-regulated in group injury and subsequently were significantly up-regulated in group NT-3. DERs in cluster 2 were firstly up-regulated in group injury and subsequently down-regulated in group NT-3. OPRL1 and GHSR were enriched in the KEGG pathway of Neuroactive ligand-receptor interaction. OPRL1 was involved in the chemical homeostasis and ion homeostasis while GHSR was related to the regulation of fatty acid metabolic process and regulation of cellular ketone metabolic process. Conclusion rno-miR-3072 and rno-miR-667-5p and OPRL1 and GHSR might participate in the pathogenesis of neurological injury and the neurotrophin-3 treatment.

scholarly journals Evaluation of Head and Spinal Cord Injury Care in Ecuador using the IATSIC/WHO Essential Guidelines for Trauma Care

2012 ◽  
Vol 1 (1) ◽  
pp. 6-11 ◽  
Author(s):  
EM Johnston ◽  
FE Mora ◽  
EB Rodas ◽  
JC Salamea ◽  
RR Ivatury
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Trauma Care ◽  
Trauma Surgery ◽  
Public Hospitals ◽  
World Health ◽  
Neurological Injury ◽  
Initial Assessment ◽  
Cord Injury ◽  
Neurological Injuries

ABSTRACT Background Neurological trauma represents a major cause of global death and disability, with low and middle income countries representing the greatest burden of disease. The goal of this study was to assess the capability of Ecuadorian hospitals to manage head and spinal cord injury utilizing the International Association for Trauma Surgery and Intensive Care (IATSIC)/World Health Organization (WHO) Guidelines for Essential Trauma Care (EsTC). Materials and methods Site visits were performed at 24 hospitals in 7 provinces of southeastern Ecuador. The 23 human and physical resources required for management of head injury (HI) and spinal injury (SI) were evaluated using EsTC criteria. Resource capabilities were graded as 3 (adequate, >90%), 2 (partially adequate, >50%), 1 (inadequate, <50%), or 0 (absent). Results Five tertiary (TH) and 12 general (GH) public hospitals were included in the final assessment. Initial assessment of neurological injuries was at least partially adequate for HI (100% TH/GH) and partially adequate for SI (100%TH, 83.3% GH). Maintenance of normotension and oxygenation to prevent secondary neurological injury was partially adequate in TH (100% HI/SI) and inadequate in GH (only 58.3% were partially adequate for HI and 67.7% for SI). Surgical capabilities for treatment of neurological injuries were partially adequate with wide variability in TH. Familiarity or compliance with AANS guidelines and international classifi cation systems for HI and SI were absent at all facilities. CT and MRI capabilities were universally inadequate. Conclusion Based on WHO/IATSIC EsTC guidelines, signifi cant improvement in physical and human resources is needed for proper management of neurologically injured patients in Southeastern Ecuador. How to cite this article Aboutanos MB, Johnston EM, Mora FE, Rodas EB, Salamea JC, Ivatury RR. Evaluation of Head and Spinal Cord Injury Care in Ecuador using the IATSIC/WHO Essential Guidelines for Trauma Care. Panam J Trauma Critical Care Emerg Surg 2012;1(1):6-11.

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