ISSN:1079-0268    

DOI:10.1080/10790268.1995.11719373

出版商:Taylor&Francis    

年代:1995

数据来源: Taylor

ISSN:1079-0268    

DOI:10.1080/10790268.1995.11719380

出版商:Taylor&Francis    

年代:1995

数据来源: Taylor

摘要:

AbstractThis review is concerned with changes that have occurred during the past forty years in surgery as acute therapy for spinal cord injury. Included is a summary of experimental and clinical information upon which many of the decisions for change were based. Despite the evidence, following World War II, of improvement of mortality and morbidity with non-invasive treatment of spinal cord injuries, increased utilization of surgery has continued to the present. Reasons include a decrease in mortality and morbidity with modern surgical techniques, easier handling of the patient with an unstable spine who has early fusion, and the decrease in hospital and rehabilitation costs with earlier stabilization and earlier mobilization. (J Spinal Cord Med; 18:3–8)

ISSN:1079-0268    

DOI:10.1080/10790268.1995.11719446

出版商:Taylor&Francis    

年代:1995

数据来源: Taylor

摘要:

AbstractSpinal cord injury (SCI) patients experience varying degrees of wrist and shoulder pain. Previous studies indicated that 30 to 64 percent of SCI patients reported chronic shoulder pain. The purpose of this study was to identify the prevalence of chronic wrist and shoulder pain, to determine which activities caused or exacerbated the pain, and assess functional and emotional responses to chronic pain and identify ways in which the pain might be reduced. Eight hundred SCI patients were surveyed by questionnaire with 451 (66 percent) responding. In addition, 30 patients were available for clinical observation and evaluation. Data was evaluated using the Statistical Analysis System and the Cornell Personal Adjustment Scale. Results indicated that wrist and shoulder pain were more prevalent than previously indicated (72.7 percent of respondents reported some degree of chronic pain in one or both of these areas), wheelchair propulsion and transfers caused most pain and also increased the degree of pain. Patient’s age, neurologic level and time since injury were not statistically significant in the study and emotional responses did not significantly vary between groups with and without pain. Further, it was noted that among the pain group, various routine therapies were not effective. We conclude that alternative methods for wheelchair propulsion and transfers, which lessen stress and cumulative trauma, need to be developed for SCI patients in order to diminish the incidence of chronic upper limb pain.(J Spinal Cord Med;18:9–13)

ISSN:1079-0268    

DOI:10.1080/10790268.1995.11719374

出版商:Taylor&Francis    

年代:1995

数据来源: Taylor

摘要:

AbstractThe Functional Standing Test (FST) has been proposed and described as an evaluative tool to assess a person’s ability to perform one-handed reaching tasks while standing. The test items, several of which are identical to those in the Jebson Test of Hand Function, require the manipulation of objects on a counter top and on simulated kitchen shelves while the person is standing. The purpose of this study was to assess the inter-rater reliability of FST when it is administered to adolescents with spinal cord injuries who stand with braces, and to able-bodied young adults. Two testers administered the FST separately to three individuals with spinal cord injuries (SCI) below T-2 who stood with knee-ankle-foot orthoses (KAFOs) and to 10 able-bodied people who stood unassisted. The order in which the testers operated was randomized and the Intraclass Correlation Coefficient (ICC (2,1)) was used to analyze inter-rater reliability. Eighty percent of the subtests were found to be moderately to very reliable when applied to either group on the same day. Half of the test items were categorized as having the same level of inter-rater reliability between the two sample populations. A modified version of the test eliminating unreliable components could serve as a valuable and inexpensive means of evaluating the effectiveness of various therapies and technologies to provide or assist standing function. Validity and specificity of the test remain the focus of future research.(J Spinal Cord Med;18:14–22)

ISSN:1079-0268    

DOI:10.1080/10790268.1995.11719375

出版商:Taylor&Francis    

年代:1995

数据来源: Taylor

摘要:

AbstractOssification of the posterior longitudinal ligament of the spine (OPLL) is a common cause of severe myelopathy and radiculopathy in Oriental populations. It typically involves the cervical spine. We present a 60-year-old Asian male with OPLL who developed progressively worsening cervical myopathy. The diagnosis and management are discussed.(J Spinal Cord Med;18:23–27)

ISSN:1079-0268    

DOI:10.1080/10790268.1995.11719376

出版商:Taylor&Francis    

年代:1995

数据来源: Taylor

摘要:

AbstractThis is a study of the reaction of large nerves to implantation using a flexible, thin-film cuff electrode. Cuff electrodes were implanted on the sciatic nerve of three cats. An implantation period of six weeks allowed sufficient time for any injury responses in the nerve and connective tissue sheath around the cuff to develop. The electrode came off the nerve in one of the cats. In the remaining two cats, gross observation following explantation of the electrodes revealed encapsulation of the cuffs without swelling of nerve tissue. Histological evaluation did not demonstrate nerve injury. The nerve cuff electrodes, which are comprised of titanium and iridium coatings on a fluorocarbon polymer substrate, appeared unaffected by the implantation, and connective tissue encapsulation did not adhere to either the polymer substrate or metallization. Evaluation of the electrodes using activated iridium oxide charge injection sites in more extended studies is now being undertaken.(J Spinal Cord Med; 18:28–32)

ISSN:1079-0268    

DOI:10.1080/10790268.1995.11719377

出版商:Taylor&Francis    

年代:1995

数据来源: Taylor

摘要:

AbstractWe recorded Frankel Scale, Yale Scale, Motor Index Score, Modified Barthel Index, Functional Independence Measurement scores, and important clinical parameters simultaneously and repetitively for 35 consecutive acute spinal cord injury patients. We found that 1) these scores can be determined as long as“yes/no”communication can be obtained reliably, pharmacological paralysis is not present, and a reliable observer with a flexible schedule is available, 2) impairment based scores (FS, YS, MIS) have little tendency to change during acute care, 3) function based scales (MBI, FIM) can be distorted by acute care phenomena which limit self care, 4) impairment-based and disability-based scales do not convert reliably, 5) none of these scales correlated strongly with common milestones for mobility or nutrition and 6) a good description of a population of ASCI patients can be made by a combination of two scales, one based on impairment and the other on disability.(J Spinal Cord Med;18:33–41)

ISSN:1079-0268    

DOI:10.1080/10790268.1995.11719378

出版商:Taylor&Francis    

年代:1995

数据来源: Taylor

摘要:

AbstractWe investigated the influence of four substances on the excitability of lumbar motoneurons. These substances, three of which coexist in the same bulbospinal descending pathways that end, for the most part, around motoneurons (MNS), are: 5-hydroxytryptamine (5-HT), substance P (SP) and thyrotropin-releasing hormone (TRH). We also studied the effects of Clonidine, an alpha 2 noradrenergic (NA) agonist. This study was carried out in rats spinalized at T5 and treated three weeks earlier with 5–7 dihydroxytryptamine (5–7 DHT). Under these conditions, the following responses were observed: 5-HTP (5-HT precursor) intraperitoneally (I.P.), 5-HT intrathecally (I.T.), TRH (I.P. or I.T.) and substance P (I.T.) all elicited strong excitation of MNS as measured by integrated EMG of the hindlimb muscles; substance P reduced by almost half the response to 5-HTP given onehourand 24hourslater; TRH given acutely did not modify the response to 5-HTP, but given chronically for 21 days markedly increased the response to this substance. Clonidine by itself decreased the excitability of MNS and antagonized the excitatory effects of 5-HTP and TRH. In two separate pilot trials, cyproheptadine, a 5-HTP antagonist, decreased the manifestations of spasticity in a patient with a partial spinal lesion. Itwouldappear thatClonidinemay have potential use in the management of spasticity.(J Spinal Cord Med; 18:42–46)

ISSN:1079-0268    

DOI:10.1080/10790268.1995.11719379

出版商:Taylor&Francis    

年代:1995

数据来源: Taylor

ISSN:1079-0268    

DOI:10.1080/10790268.1995.11719447

出版商:Taylor&Francis    

年代:1995

数据来源: Taylor