A prospective assessment of mortality in chronic spinal cord injury

Garshick, Eric; Kelley, Alyson; Cohen, SA; Garrison, Anne; Tun, C. G.; Gagnon, David; Brown, Robert H.

doi:10.1038/sj.sc.3101729

Cited by 557 publications

(437 citation statements)

References 28 publications

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“…This model hypothesizes that both disability factors, such as the presence of impairment or significant restrictions in activity or participation, as well as age-related factors (such as chronological age, age at disability onset, disability inception era and duration of disability), can have direct effects on the development and trajectory of SHCs. The model also hypothesizes that disability and age-related variables can influence the effects of 38,39 Chronic pain 40 Constipation 41 Contractures 27 Deep vein thrombosis/pulmonary embolism 42 Depression 42 Fractures 27 Heterotopic ossification 43 Imobilization hypercalcemia 44 Insomnia/sleep difficulties 37 Kidney stones 18,27 Neurogenic bladder 45 Neurogenic bowel 46 Non-urinary tract infections 27 Obesity 29 Osteoporosis/Bone density loss 15,17,29 Pressure sores 18,41 Restrictive lung disease 47 Septicemia 41 Sexual dysfunction 48,49 Sleep apnea 50 …”

Section: Proposed Definition and Conceptual Model Proposed Definitionmentioning

confidence: 99%

Secondary health conditions in individuals aging with SCI: Terminology, concepts and analytic approaches

et al. 2011

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Study design: Literature review. Objectives: Utilizing individuals with spinal cord injury (SCI) as a representative population for physical disability, this paper: (1) reviews the history of the concept of secondary conditions as it applies to the health of individuals aging with long-term disabilities; (2) proposes a definition of secondary health conditions (SHCs) and a conceptual model for understanding the factors that are related to SHCs as individuals age with a disability; and (3) discusses the implications of the model for the assessment of SHCs and for developing interventions that minimize their frequency, severity and negative effects on the quality of life of individuals aging with SCI and other disabilities. Methods: Key findings from research articles, reviews and book chapters addressing the concept of SHCs in individuals with SCI and other disabilities were summarized to inform the development of a conceptual approach for measuring SCI-related SHCs. Conclusions: Terms used to describe health conditions secondary to SCI and other physical disabilities are used inconsistently throughout the literature. This inconsistency represents a barrier to improvement, measurement and for the development of effective interventions to reduce or prevent these health conditions and mitigate their effects on participation and quality of life. A working definition of the term SHCs is proposed for use in research with individuals aging with SCI, with the goal of facilitating stronger evidence and increased knowledge upon which policy and practice can improve the health and well-being of individuals aging with a disability.

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Section: Proposed Definition and Conceptual Model Proposed Definitionmentioning

confidence: 99%

Secondary health conditions in individuals aging with SCI: Terminology, concepts and analytic approaches

et al. 2011

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“…It has been suggested that much of the excessive (and early) morbidity and mortality in people with chronic SCI is caused by inactivity related illnesses, such as cardiovascular disease, type II diabetes and osteoporosis. 1 In addition, the loss of fitness and independence associated with physical inactivity significantly impacts quality of life and community participation. 2 These facts highlight the importance of promoting physical activity (PA) to improve health, fitness and overall quality of life within the SCI population.…”

Section: Introductionmentioning

confidence: 99%

The development of evidence-informed physical activity guidelines for adults with spinal cord injury

et al. 2011

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Objectives: To systematically develop evidence-informed physical activity guidelines to improve physical fitness in people with spinal cord injury (SCI). Setting: This study was conducted in Canada Methods: The Appraisal of Guidelines, Research and Evaluation II guideline development protocol was used to develop exercise guidelines to improve physical capacity and muscular strength. The evidence base for the guideline development process consisted of a systematic review and quality appraisal of research examining the effects of exercise on physical fitness among people with SCI. A multidisciplinary expert panel deliberated the evidence and generated the guidelines. Pilot testing led to refinement of the wording and presentation of the guidelines. Results: The expert panel generated the following guidelines: for important fitness benefits, adults with a SCI should engage in (a) at least 20 min of moderate to vigorous intensity aerobic activity two times per week and (b) strength training exercises two times per week, consisting of three sets of 8-10 repetitions of each exercise for each major muscle group. Conclusion: People with SCI, clinicians, researchers and fitness programmers are encouraged to adopt these rigorously developed guidelines.Spinal Cord (2011Cord ( ) 49, 1088Cord ( -1096 doi:10.1038/sc.2011 published online 7 June 2011 Keywords: exercise; strength training; aerobic training; clinical practice guidelines; spinal cord injuries IntroductionThe amount of disability associated with a spinal cord injury (SCI) is unique to each injury and depends on both the level and completeness of damage to the spinal cord. However, physical deconditioning is a common consequence of most SCIs, and can further exacerbate the impact of the injury and lead to an increased risk for chronic secondary health complications. It has been suggested that much of the excessive (and early) morbidity and mortality in people with chronic SCI is caused by inactivity related illnesses, such as cardiovascular disease, type II diabetes and osteoporosis. 1 In addition, the loss of fitness and independence associated with physical inactivity significantly impacts quality of life and community participation. 2 These facts highlight the importance of promoting physical activity (PA) to improve health, fitness and overall quality of life within the SCI population. 3,4 PA promotion is very difficult in the absence of information regarding the types, amounts and intensities of activity that yield fitness benefits. Such information would assist clinicians and exercise programmers in prescribing and promoting exercise and PA. The able-bodied population has access to this type of information in the form of PA guidelines. [5][6][7] However, the able-bodied PA guidelines are not necessarily appropriate for people with SCI. The rigorous development of evidence-based PA guidelines that are specific to the needs and capabilities of the SCI population is long overdue. 8,9 This paper describes the methodological www.nature.com/sc approach underlyin...

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“…1 As such, they may experience the same chronic conditions as able-bodied persons. 2 Over the past several decades cardiovascular disease (CVD) has become a leading cause of death in the SCI population. 2 The increase in CVD with aging in individuals with SCI reflects that of able-bodied individuals, though at an accelerated rate, higher prevalence, and earlier onset.…”

Section: Introductionmentioning

confidence: 99%

“…2 Over the past several decades cardiovascular disease (CVD) has become a leading cause of death in the SCI population. 2 The increase in CVD with aging in individuals with SCI reflects that of able-bodied individuals, though at an accelerated rate, higher prevalence, and earlier onset. 3 In recent years, researchers have used pulse wave analysis to show that arterial stiffness is associated with CVD, specifically atherosclerotic burden.…”

Section: Introductionmentioning

confidence: 99%

The effects of functional electrical stimulation leg cycle ergometry training on arterial compliance in individuals with spinal cord injury

et al. 2008

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Study design: A prospective intervention of functional electrical stimulation leg cycle ergometry (FES-LCE) of four women with spinal cord injury (SCI). Objective: To evaluate the effect of FES-LCE training on arterial compliance in individuals with chronic SCI of traumatic origin. Setting: Tertiary rehabilitation center in Canada. Methods: Large and small artery compliance were measured at the radial artery before and after a 3-month training program using FES-LCE. Results: There was no significant change in large artery compliance after FES-LCE (16.0 ± 4.2 to 16.8±6.1 ml mm Hg À1 Â 10, P ¼ NS). There was a marked (63%) increase in small artery compliance after the FES training program (4.2 ± 1.8 to 6.9 ± 3.2 ml mm Hg À1 Â 100, Po0.05).Conclusion: It appears that FES-LCE is effective in improving small artery compliance in females with SCI.

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A prospective assessment of mortality in chronic spinal cord injury

Cited by 557 publications

References 28 publications

Secondary health conditions in individuals aging with SCI: Terminology, concepts and analytic approaches

Secondary health conditions in individuals aging with SCI: Terminology, concepts and analytic approaches

The development of evidence-informed physical activity guidelines for adults with spinal cord injury

The effects of functional electrical stimulation leg cycle ergometry training on arterial compliance in individuals with spinal cord injury

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