Gait Training in Acute Spinal Cord Injury Rehabilitation—Utilization and Outcomes Among Nonambulatory Individuals: Findings From the SCIRehab Project

Rigot, Stephanie K.; Worobey, Lynn A.; Boninger, Michael L.

doi:10.1016/j.apmr.2018.01.031

Cited by 9 publications

(6 citation statements)

References 46 publications

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“…A patient who falls on the favorable end of the CPR might be assigned to an intensive locomotor training program aimed at promoting neurorestoration and functional plasticity to return to outdoor walking 20–22. A patient who falls on the less-favorable end of the CPR will likely not return to outdoor walking, thus a rehabilitation program focusing on compensatory strategies such as wheelchair skills and other nongait interventions might be implemented 23,24. In time, neuromodulatory interventions such as noninvasive spinal cord stimulation or surgically implanted spinal cord stimulation may be more widely available for this latter group 25–27.…”

Section: Discussionmentioning

confidence: 99%

“…[20][21][22] A patient who falls on the less-favorable end of the CPR will likely not return to outdoor walking, thus a rehabilitation program focusing on compensatory strategies such as wheelchair skills and other nongait interventions might be implemented. 23,24 In time, neuromodulatory interventions such as noninvasive spinal cord stimulation or surgically implanted spinal cord stimulation may be more widely available for this latter group. [25][26][27] Furthermore, the outdoor walking CPR could help with anticipating equipment and caregiver needs at time of discharge from rehabilitation.…”

Section: Discussionmentioning

confidence: 99%

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Predicting Outdoor Walking 1 Year After Spinal Cord Injury: A Retrospective, Multisite External Validation Study

Draganich

Weber

Thornton

et al. 2023

Journal of Neurologic Physical Therapy

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Background and Purpose: Predicting future outdoor walking ability after spinal cord injury (SCI) is important, as this is associated with community engagement and social participation. A clinical prediction rule (CPR) was derived for predicting outdoor walking 1 year after SCI. While promising, this CPR has not been validated, which is necessary to establish its clinical value. The objective of this study was to externally validate the CPR using a multisite dataset. Methods: This was a retrospective analysis of US SCI Model Systems data from 12 centers. L3 motor score, L5 motor score, and S1 sensory score were used as predictor variables. The dataset was split into testing and training datasets. The testing dataset was used as a holdout dataset to provide an unbiased estimate of prediction performance. The training dataset was used to determine the optimal CPR threshold through a “leave-one-site-out” cross-validation framework. The primary outcome was self-reported outdoor walking ability 1 year after SCI. Results: A total of 3721 participants' data were included. Using the optimal CPR threshold (CPR ≥ 33 threshold value), we were able to predict outdoor walking 1 year with high cross-validated accuracy and prediction performance. For the entire dataset, area under receiver operator characteristic curve was 0.900 (95% confidence interval: 0.890-0.910; P < 0.0001). Discussion and Conclusions: The outdoor walking CPR has been externally validated. Future research should conduct a clinical outcomes and cost-benefit impact analysis for implementing this CPR. Our results support that clinicians may use this 3-variable CPR for prediction of future outdoor walking ability. Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A411).

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Predicting Outdoor Walking 1 Year After Spinal Cord Injury: A Retrospective, Multisite External Validation Study

Draganich

Weber

Thornton

et al. 2023

Journal of Neurologic Physical Therapy

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“…Patients with spinal cord injury frequently exhibit motor and sensory dysfunction in the limbs, as well as lack of control over defecation and urination. Thus, patients need further rehabilitation such as strength training[ 16 ] of paralyzed limbs, joint movement, balance and gait training[ 17 ], neuromuscular electrical stimulation[ 18 ] to promote muscle contraction, and management training of intestine and bladder. Our patient underwent strength training of the trunk and key lower limb muscles, muscle stretching, and postural balance training, followed by supported standing/walking and gait training.…”

Section: Discussionmentioning

confidence: 99%

Rehabilitation and pharmacotherapy of neuromyelitis optica spectrum disorder: A case report

Wang

Xia

Yang

et al. 2021

WJCC

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BACKGROUND Neuromyelitis optica spectrum disorder (NMOSD) is a demyelinating autoimmune disease that affects the central nervous system. It typically manifests as optic neuritis or extensive longitudinal myelitis, with or without the presence of anti-aquaporin protein 4 autoantibodies (immunoglobulin G). CASE SUMMARY We report the case of a 45-year-old woman with a history of Sjogren's syndrome who was diagnosed with NMOSD accompanied by spinal cord injury and left calf intermuscular vein thrombosis. The patient received hormone shock and gamma globulin therapy in the acute phase and standard rehabilitation treatment during convalescence. Upon discharge, the patient was able to control urination and defecation, stand independently, and walk short distances with the aid of a walker. CONCLUSION This case suggests that pharmacotherapy and standard rehabilitation treatment can improve the prognosis of NMSOD patients.

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“…F or individuals with spinal cord injury (SCI), recovery of walking function is a primary patient goal and a common focus of physical therapy rehabilitation interventions. 1,2 Rehabilitation lengths of stay for this population are decreasing. 3 It is vital, therefore, for physical therapists to select the most effective intervention at the optimal time to maximize neurological recovery following SCI, and to have evidence-based methods to predict who will recover the ability to walk.…”

mentioning

confidence: 98%

“…For individuals with spinal cord injury (SCI), recovery of walking function is a primary patient goal and a common focus of physical therapy rehabilitation interventions 1,2. Rehabilitation lengths of stay for this population are decreasing 3.…”

mentioning

confidence: 99%

Commentary on: “Predicting Outdoor Walking 1 Year After Spinal Cord Injury: A Retrospective, Multisite External Validation Study”

Kandilakis

Hobbs

Rozwod

2023

Journal of Neurologic Physical Therapy

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Gait Training in Acute Spinal Cord Injury Rehabilitation—Utilization and Outcomes Among Nonambulatory Individuals: Findings From the SCIRehab Project

Cited by 9 publications

References 46 publications

Predicting Outdoor Walking 1 Year After Spinal Cord Injury: A Retrospective, Multisite External Validation Study

Predicting Outdoor Walking 1 Year After Spinal Cord Injury: A Retrospective, Multisite External Validation Study

Rehabilitation and pharmacotherapy of neuromyelitis optica spectrum disorder: A case report

Commentary on: “Predicting Outdoor Walking 1 Year After Spinal Cord Injury: A Retrospective, Multisite External Validation Study”

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