Development and Implementation of an Evidence-Based Guideline for Spinal Cord Injury/Disorder Patients Requiring Colonoscopy

2021 ◽  
Author(s):  
◽  
Tanya Young
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Bowel Preparation ◽  
Spinal Cord Injuries ◽  
The United States ◽  
Evidence Based ◽  
Usual Practice ◽  
Cord Injury ◽  
Bowel Prep ◽  
Evidence Based Guideline

Practice Problem: Colorectal cancer is one of the leading causes of preventable cancer death in the United States. Spinal cord injury/disorder (SCI/D) patients present with unique challenges for maximizing bowel prep and successful attainment of screening and therapeutic colonoscopy procedures. Current practice for bowel prep regimen does not take into consideration the specific needs of the SCI/D population resulting in significant patient dissatisfaction. PICOT: The PICOT question that guided this project was in adult patients with spinal cord injuries/disorders requiring colonoscopy (P), how does the development and implementation of evidence-based guideline for the care of the spinal cord injury/disorder patient requiring colonoscopy (I) compared to usual practice (C) affect the rate of first attempt successful colonoscopy procedure completion (O) within eight weeks (T). Evidence: SCI/D patients resulting neurogenic bowel increases difficulty with standard bowel prep tolerance. Quality bowel preparation is required for successful colonoscopy with inadequate bowel preparations present in 20-25% of all colonoscopies (Johnson et al., 2014). Evidence supports a clinical guideline for bowel preparation adapted to the needs of the SCI/D population. Intervention: Development and implementation of an SCI/D bowel prep guideline enhanced clinical decision support and evidence-based tools for improved bowel prep with initial attempt. Outcome: The rate of first-time colonoscopies for patients with SCI/D with the guideline improved by over 214% over pre-guideline time. Conclusion: The evidenced-based guideline reinforced clinical practice for the SCI/D population related to their unique requirements. Clinically significant improvement was noted in successful bowel prep completion, first attempt colonoscopy completion, improved access to the endoscopy suite, and reduced length of stay. All combined improved both patient and provider satisfaction with the evidence-based practice change.

Men’s Adjustment to Spinal Cord Injury: The Unique Contributions of Conformity to Masculine Gender Norms

2009 ◽  
Vol 4 (2) ◽  
pp. 157-166 ◽  
Author(s):  
Shaun Michael Burns ◽  
Sigmund Hough ◽  
Briana L. Boyd ◽  
Justin Hill
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Spinal Cord Injuries ◽  
Gender Norms ◽  
The United States ◽  
Future Research ◽  
Masculine Norms ◽  
Cord Injury ◽  
Future Research Directions ◽  
The Impact

Men constitute 82% of the approximately 250,000 people in the United States living with a spinal cord injury. Unfortunately, however, little is known about the impact of men’s adherence to gender norms on their adjustment to such injuries. The present investigation examined the utility of masculine norms in explaining variance in depression beyond that accounted for by commonly identified predictors of men’s adjustment following spinal cord injury. As hypothesized, results suggested that men’s adherence to masculine norms accounted for unique variance in their depression scores beyond that contributed by social support, environmental barriers/access, and erectile functioning. Respondents who adhered to norms stressing the primacy of men’s work demonstrated lower rates of depression, whereas those who conformed to norms for self-reliance demonstrated higher depression scores. The authors discuss future research directions and potential psychotherapeutic strategies for working with men with spinal cord injuries.

Role of Microglia and Astrocytes in Spinal Cord Injury Induced Neuropathic Pain

2021 ◽  
pp. 097275312110463
Author(s):  
Gurwattan S. Miranpuri ◽  
Parul Bali ◽  
Justyn Nguyen ◽  
Jason J Kim ◽  
Shweta Modgil ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Neuropathic Pain ◽  
Spinal Cord Injuries ◽  
Medical Condition ◽  
The United States ◽  
Current Treatment ◽  
Treatment Modalities ◽  
Cord Injury

Spinal cord injuries incite varying degrees of symptoms in patients, ranging from weakness and incoordination to paralysis. Common amongst spinal cord injury (SCI) patients, neuropathic pain (NP) is a debilitating medical condition. Unfortunately, there remain many clinical impediments in treating NP because there is a lack of understanding regarding the mechanisms behind SCI-induced NP (SCINP). Given that more than 450,000 people in the United States alone suffer from SCI, it is unsatisfactory that current treatments yield poor results in alleviating and treating NP. In this review, we briefly discussed the models of SCINP along with the mechanisms of NP progression. Further, current treatment modalities are herein explored for SCINP involving pharmacological interventions targeting glia cells and astrocytes. The studies presented in this review provide insight for new directions regarding SCINP alleviation. Given the severity and incapacitating effects of SCINP, it is imperative to study the pathways involved and find new therapeutic targets in coordination with stem cell research, and to develop a new gold-standard in SCINP treatment.

scholarly journals Exoskeletons, Rehabilitation and Bodily Capacities

2021 ◽  
pp. 1357034X2110256
Author(s):  
Denisa Butnaru
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Crucial Role ◽  
Spinal Cord Injuries ◽  
Main Task ◽  
Cerebrovascular Accidents ◽  
Complex Processes ◽  
Cord Injury ◽  
Neurological Conditions

Motility impairments resulting from spinal cord injuries and cerebrovascular accidents are increasingly prevalent in society, leading to the growing development of rehabilitative robotic technologies, among them exoskeletons. This article outlines how bodies with neurological conditions such as spinal cord injury and stroke engage in processes of re-appropriation while using exoskeletons and some of the challenges they face. The main task of exoskeletons in rehabilitative environments is either to rehabilitate or ameliorate anatomic functions of impaired bodies. In these complex processes, they also play a crucial role in recasting specific corporeal phenomenologies. For the accomplishment of these forms of corporeal re-appropriation, the role of experts is crucial. This article explores how categories such as bodily resistance, techno-inter-corporeal co-production of bodies and machines, as well as body work mark the landscape of these contemporary forms of impaired corporeality. While defending corporeal extension rather than incorporation, I argue against the figure of the ‘cyborg’ and posit the idea of ‘residual subjectivity’.

Therapeutic trial of hypercarbia and hypocarbia in acute experimental spinal cord injury

1984 ◽  
Vol 61 (5) ◽  
pp. 925-930 ◽  
Author(s):  
Ronald W. J. Ford ◽  
David N. Malm
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Spinal Cord Injuries ◽  
Mortality Rates ◽  
Therapeutic Trial ◽  
Tissue Preservation ◽  
Content Type ◽  
Experimental Spinal Cord Injury ◽  
Cord Injury ◽  
Fine Print

✓ Hypocarbia, normocarbia, or hypercarbia was maintained for an 8-hour period beginning 30 minutes after acute threshold spinal cord injuries in cats. No statistically significant differences in neurological recovery or histologically assessed tissue preservation were found among the three groups of animals 6 weeks after injury. No animal recovered the ability to walk. It is concluded that maintenance of hypercarbia or hypocarbia during the early postinjury period is no more therapeutic than maintenance of normocarbia. Mortality rates and tissue preservation data suggest, however, that postinjury hypocarbia may be less damaging than hypercarbia.

scholarly journals Evidence-Based Practice in Primary Prevention of Spinal Cord Injury

2013 ◽  
Vol 19 (1) ◽  
pp. 25-30 ◽  
Author(s):  
Kimberly Bellon ◽  
Stephanie Kolakowsky-Hayner ◽  
David Chen ◽  
Shari McDowell ◽  
Bridget Bitterman ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Primary Prevention ◽  
Evidence Based Practice ◽  
Evidence Based ◽  
Cord Injury

scholarly journals The Effect of Intraspinal Micro Stimulation With Variable Stimulating Pattern in Adult Rat With Induction of Spinal Cord Injury in the Treatment of Spinal Cord Injuries

2019 ◽  
Vol 6 (3) ◽  
pp. 83-91
Author(s):  
Mohaddeseh Hedayatzadeh ◽  
Hamid Reza Kobravi ◽  
Maryam Tehranipour
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Electrical Stimulation ◽  
Spinal Cord Injuries ◽  
Animal Movement ◽  
Specific Treatment ◽  
Male Rats ◽  
Gait Dynamics ◽  
Variable Pattern ◽  
Cord Injury

Background: Spinal cord injury is one of the diseases that, no specific treatment has yet found despite the variety of works that have done in this field. Different approaches to treat such injuries have investigated today. One of them is invasive intra-spinal interventions such as electrical stimulation. Therefore, in this study, the effect of the protocol for intra-spinal variable and fixed electrical stimulation has been investigated in order to recover from spinal cord injury. Methods: In the study, 18 Wistar male rats randomly divided into Three groups, including intraspinal electrical stimulation (IES), IES with variable pattern of stimulation (VP IES) and a sham group. Animals initially subjected to induced spinal cord injury. After one week, the animal movement was recorded on the treadmill during practice using a camera and angles of the ankle joint were measured using the Tracker software. Then, the obtained data were analyzed by nonlinear evaluations in the phase space. Results: The motion analyses and kinematic analyses were carried out on all groups. According to the achieved results, the gait dynamics of the VP IES group has the most conformity to the gait dynamics of the healthy group. Also, the best quality of the balance preservation observed in the VP IES group. Conclusion: It can be concluded that the IES with variable pattern of stimulation along with exercise therapy has significant gait restorative effects and increases the range of motion in rats with induced spinal cord injury.

scholarly journals SOME ASPECTS OF PEDIATRIC SPINAL CORD INJURY

2005 ◽  
pp. 015-019
Author(s):  
Igor Ivanovich Larkin ◽  
Valery Ivanovich Larkin
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Spinal Cord Injuries ◽  
Spinal Injury ◽  
Radiological Diagnostics ◽  
Cord Injury ◽  
Pediatric Spinal Cord Injury ◽  
Mri Changes

Objective. To analyse the possibility of diagnostics improvement in children with spinal cord injuries. Material and Methods. The observations of 147 cases of various spinal cord injuries in children at the age of 11 months to 15 years have been analyzed. Causes of trauma, age peculiarities of spinal injury manifestations, and difficulties of clinical and radiological diagnostics are discussed. Results. Most cases of spinal cord injury in children could be revealed and adequately managed at a prehospital stage. It should be noted that the spine lesion and MRI changes do not always accompany spinal cord injury in children. This observation must be taken into account while making diagnosis. Conclusion. Electromyography is an important examination confirming spinal cord injury without radiographic abnormalities (SCIWORA syndrome) in children.

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