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Spinal Cord Injuries: Functional Challenges and Latest Therapeutic Advances
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Spinal Cord Injuries: Functional Challenges and Latest Therapeutic Advances

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Clinical Neurology".

Deadline for manuscript submissions: closed (31 May 2022) | Viewed by 20247

Special Issue Editors

Dr. Yvonne Tran

E-Mail Website
Guest Editor
Australian Institute of Health Innovation, Macquarie University, North Ryde, NSW 2109, Australia
Interests: biomedical signals; psychophysiology; injury; electroencephalography; heart rate variability; machine learning for rehabilitation medicine
Special Issues, Collections and Topics in MDPI journals
Prof. James Middleton

E-Mail Website
Guest Editor
John Walsh Centre for Rehabilitation Research, Sydney Medical School, Northern Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
Interests: rehabilitation medicine; clinical innovation; spinal cord injury; psycho-social outcomes
Prof. Dr. Ashley Craig

E-Mail Website
Guest Editor
1. John Walsh Centre for Rehabilitation Research, The Kolling Institute, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, NSW 2065, Australia
2. Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
Interests: rehabilitaion; clinical psychology; psycho-social outcomes; spinal cord injury
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Spinal cord injuries result in muscle paralysis, sensory disturbance, and disruption of body function, which leads to permanent disability. It affects autonomic control such as bladder, bowel, and sexual function, as well as secondary health conditions, such as cardiovascular dyfunction, chronic pain, sleep disorder, depressive mood, and chronic fatigue. These conditions can be especially debilitating. Consequently, having a spinal cord injury can impose substantial limitations on a person’s autonomy and independence, social participation, physical and mental health, and quality of life. The overarching goal of SCI rehabilitation is to teach individuals to self-manage functional restrictions and secondary complications in a manner that maximizes independence and improves quality of life. The present Special Issue aims to present a collection of reviews and studies that describe latest information on functional challenges and the latest therapeutic advances aimed at improving function and secondary conditions, as well as the care and social well being for people with spinal cord injuries.

Dr. Yvonne Tran
Prof. James Middleton
Prof. Ashley Craig
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Spinal cord injury
  • Motor functions
  • Sensory functions
  • Autonomic functions
  • Secondary conditions
  • Rehabilitation
  • Therapy

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Published Papers (4 papers)

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Research

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19 pages, 2796 KiB  
Article
Investigating Dynamics of the Spinal Cord Injury Adjustment Model: Mediation Model Analysis
by Ashley Craig, Yvonne Tran, Mohit Arora, Ilaria Pozzato and James W. Middleton
J. Clin. Med. 2022, 11(15), 4557; https://doi.org/10.3390/jcm11154557 - 4 Aug 2022
Cited by 19 | Viewed by 2589
Abstract
Spinal cord injury (SCI) is a severe neurological injury that results in damage to multiple bodily systems. SCI rehabilitation requires a significant focus on improving adjustment to the injury. This paper presents a detailed description of the Spinal Cord Injury Adjustment Model (SCIAM), [...] Read more.
Spinal cord injury (SCI) is a severe neurological injury that results in damage to multiple bodily systems. SCI rehabilitation requires a significant focus on improving adjustment to the injury. This paper presents a detailed description of the Spinal Cord Injury Adjustment Model (SCIAM), which clarifies how individuals adjust to SCI and contends that adjustment to SCI is a multifactorial process involving non-linear dynamic adaptation over time. Evidence supporting SCIAM is also discussed. Mediation analyses were conducted to test the mediator dynamics proposed by the model. The analyses tested the relationship between two moderators (self-care and secondary health conditions), mediators (two self-efficacy items and appraisal of quality of life or QoL), and positive versus negative vitality/mental health as outcomes. Results showed that higher self-efficacy and perceived QoL was related to greater independence in self-care and reduced negative impacts of secondary health conditions. This study supported the mediation role of self-efficacy and other appraisals such as perceived QoL in enhancing self-care and buffering the negative impact of health challenges. In conclusion, it is important to employ a holistic model such as SCIAM to conceptualise and increase understanding of the process of adjustment following a severe neurological injury such as SCI. Full article
(This article belongs to the Special Issue Spinal Cord Injuries: Functional Challenges and Latest Therapeutic Advances)
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32 pages, 2379 KiB  
Article
Building and Sustaining Inpatient-Clinician Collaboration in Spinal Cord Injury Rehabilitation: A Case Example Using the Stoke Mandeville Spinal Needs Assessment Checklist (SMS-NAC) and Goal Planning Programme
by Jane Duff, Lucy C. Grant, Helena Gilchrist and Kevin Jones
J. Clin. Med. 2022, 11(13), 3730; https://doi.org/10.3390/jcm11133730 - 28 Jun 2022
Cited by 3 | Viewed by 3977
Abstract
Goal planning is core for the delivery of the biopsychosocial model of rehabilitation and is commonly practiced in spinal cord injury (SCI) and other physical health settings. Despite a strong theoretical basis from several branches of psychology, evidence regarding specific practice, interventions and [...] Read more.
Goal planning is core for the delivery of the biopsychosocial model of rehabilitation and is commonly practiced in spinal cord injury (SCI) and other physical health settings. Despite a strong theoretical basis from several branches of psychology, evidence regarding specific practice, interventions and impact has yet to be established, with no universal standards in this area. Study One outlines the standards used at the National Spinal Injuries Centre (NSIC), Stoke Mandeville Hospital since the inception of the SMS-NAC and goal planning programme in 1989. The results outline the impact of a quality improvement project undertaken since 2016 and track the interventions used to improve inpatient care. Study Two reports on an international survey of rehabilitation measure usage and goal planning practice with inpatient adult and children and young people (CYP) with SCI. Respondents replied that inpatient presence at goal planning meetings only took place in 75% (adult) and 76% (CYP) of services, with more services indicating 4 or more members of the multidisciplinary team being present (85% and 90%, respectively). This paper demonstrates the gains that can be made when a structured quality improvement methodology is used and highlights the need for standards regarding goal planning in SCI rehabilitation to be developed. Full article
(This article belongs to the Special Issue Spinal Cord Injuries: Functional Challenges and Latest Therapeutic Advances)
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16 pages, 1079 KiB  
Article
Comparison of Various Indices in Identifying Insulin Resistance and Diabetes in Chronic Spinal Cord Injury
by Gary J. Farkas, Phillip S. Gordon, Nareka Trewick, Ashraf S. Gorgey, David R. Dolbow, Eduard Tiozzo, Arthur S. Berg and David R. Gater, Jr.
J. Clin. Med. 2021, 10(23), 5591; https://doi.org/10.3390/jcm10235591 - 28 Nov 2021
Cited by 10 | Viewed by 3151
Abstract
The purpose of this screening and diagnostic study was to examine the accord among indices of glucose metabolism, including the Homeostatic Model Assessment for Insulin Resistance (HOMA), HOMA2, Matsuda Index, Quantitative Insulin-sensitivity Check Index (QUICKI), hemoglobin A1C (HbA1C), and fasting plasma glucose (FPG) [...] Read more.
The purpose of this screening and diagnostic study was to examine the accord among indices of glucose metabolism, including the Homeostatic Model Assessment for Insulin Resistance (HOMA), HOMA2, Matsuda Index, Quantitative Insulin-sensitivity Check Index (QUICKI), hemoglobin A1C (HbA1C), and fasting plasma glucose (FPG) against intravenous glucose tolerance test-measured insulin sensitivity (Si) in individuals with chronic motor complete SCI. Persons with chronic (≥12-months post-injury) SCI (n = 29; 79% men; age 42.2 ± 11.4; body mass index 28.6 ± 6.4 kg/m2; C4-T10) were included. Measures were compared using adjusted R2 from linear regression models with Akaike information criterion (AIC, a measure of error). QUICKI had the greatest agreement with Si (adjusted R2 = 0.463, AIC = 91.1, p = 0.0001), followed by HOMA (adjusted R2 = 0.378, AIC = 95.4, p = 0.0008), HOMA2 (adjusted R2 = 0.256, AIC = 99.7, p = 0.0030), and the Matsuda Index (adjusted R2 = 0.356, AIC = 95.5, p = 0.0004). FPG (adjusted R2 = 0.056, AIC = 107.5, p = 0.1799) and HbA1C (adjusted R2 = 0.1, AIC = 106.1, p = 0.0975) had poor agreement with Si. While HbA1C and FPG are commonly used for evaluating disorders of glucose metabolism, QUICKI demonstrates the best accord with Si compared to the other measures. Full article
(This article belongs to the Special Issue Spinal Cord Injuries: Functional Challenges and Latest Therapeutic Advances)
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Review

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16 pages, 792 KiB  
Review
Trans-Spinal Electrical Stimulation Therapy for Functional Rehabilitation after Spinal Cord Injury: Review
by Md. Akhlasur Rahman, Niraj Singh Tharu, Sylvia M. Gustin, Yong-Ping Zheng and Monzurul Alam
J. Clin. Med. 2022, 11(6), 1550; https://doi.org/10.3390/jcm11061550 - 11 Mar 2022
Cited by 32 | Viewed by 8727
Abstract
Spinal cord injury (SCI) is one of the most debilitating injuries in the world. Complications after SCI, such as respiratory issues, bowel/bladder incontinency, pressure ulcers, autonomic dysreflexia, spasticity, pain, etc., lead to immense suffering, a remarkable reduction in life expectancy, and even premature [...] Read more.
Spinal cord injury (SCI) is one of the most debilitating injuries in the world. Complications after SCI, such as respiratory issues, bowel/bladder incontinency, pressure ulcers, autonomic dysreflexia, spasticity, pain, etc., lead to immense suffering, a remarkable reduction in life expectancy, and even premature death. Traditional rehabilitations for people with SCI are often insignificant or ineffective due to the severity and complexity of the injury. However, the recent development of noninvasive electrical neuromodulation treatments to the spinal cord have shed a ray of hope for these individuals to regain some of their lost functions, a reduction in secondary complications, and an improvement in their life quality. For this review, 250 articles were screened and about 150 were included to summarize the two most promising noninvasive spinal cord electrical stimulation methods of SCI rehabilitation treatment, namely, trans-spinal direct current stimulation (tsDCS) and trans-spinal pulsed current stimulation (tsPCS). Both treatments have demonstrated good success in not only improving the sensorimotor function, but also autonomic functions. Due to the noninvasive nature and lower costs of these treatments, in the coming years, we expect these treatments to be integrated into regular rehabilitation therapies worldwide. Full article
(This article belongs to the Special Issue Spinal Cord Injuries: Functional Challenges and Latest Therapeutic Advances)
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