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Journal of Sport Rehabilitation Mar 2019Physical training improves the strength of upper limbs, contributing directly to the performance of activities of daily life, confirming one more time that the...
CONTEXT
Physical training improves the strength of upper limbs, contributing directly to the performance of activities of daily life, confirming one more time that the strengthened muscle is imperative for a rapid rehabilitation.
OBJECTIVE
To investigate the scientific implications of the impact of physical training on the strength of the upper limbs of people with paraplegias.
EVIDENCE ACQUISITION
The search strategy with truncations and Boolean operator was defined as: (spinal cord inju* OR traumatic myelopat* OR paraplegi*) AND (physical exercise OR strength training OR resisted training) AND (upper limb* OR arm OR armrest), for all of the databases. There were included experimental and quasi-experimental studies, published in the English language and with the complete text available, with at least 1 physical exercise that worked with the strength of the upper limbs. Two independent evaluators extracted from each article data on study characteristics (publishing year, country of origin, and study design), of the subjects (gender and age), and of the disability (level of lesion and cause).
EVIDENCE SYNTHESIS
Seven articles were included in the systematic revision. The procedure used the most for measuring the maximum strength was the 1-repetition maximum test, followed by the isokinetic dynamometer and Quantitative Muscle Testing System. Furthermore, the most commonly associated variables in the included studies were pain in the shoulder, cardiorespiratory capacity, and functionality, respectively. The results showed that all of the variables improved because of the training.
CONCLUSIONS
The training improved the strength, the functionality, and reduced the pain in the shoulder of the people with paraplegia.
Topics: Exercise Therapy; Humans; Muscle Strength; Muscle Strength Dynamometer; Paraplegia; Randomized Controlled Trials as Topic; Resistance Training; Upper Extremity
PubMed: 29364066
DOI: 10.1123/jsr.2017-0062 -
Hawai'i Journal of Medicine & Public... Feb 2017Novice surfers are at risk for a rare but potentially devastating form of atraumatic myelopathy. There are 16 published studies on this condition, including 66 cases.... (Review)
Review
Novice surfers are at risk for a rare but potentially devastating form of atraumatic myelopathy. There are 16 published studies on this condition, including 66 cases. The most common suggested mechanism of injury is static hyperextension. However, active mechanisms, in contrast to static, have also been proposed and may be contributory. First time surfers, defined as those who have never been on a surfboard prior to the day of injury, are at particular risk. These individuals make up 89.5%-100% of the reported novice surfers found in the various reports. Multiple neurologic deficits occur and often include paraparesis, paraplegia, urinary retention, and hyperesthesia. While these deficits resolve in some cases, there are reports of multiple instances of permanent injury. Increased awareness of this condition is arguably the most effective preventative measure, as it may lead to avoidance of the predisposing postures. It may also lead to earlier diagnosis in the acute setting, which will become relevant as treatment modalities continue to be refined.
Topics: Athletic Injuries; Hawaii; Humans; Paraplegia; Spinal Cord Injuries
PubMed: 28210528
DOI: No ID Found -
The Journal of Spinal Cord Medicine 2008To examine the lipoprotein profiles of men and women with paraplegia and tetraplegia. Impairment of the sympathetic nervous system (dependent on the level of injury) and...
BACKGROUND/OBJECTIVE
To examine the lipoprotein profiles of men and women with paraplegia and tetraplegia. Impairment of the sympathetic nervous system (dependent on the level of injury) and the extent of physical capacity and activity were correlated with the lipid profile in men with spinal cord injury (SCI). Sex-related differences of the lipoprotein profiles could be found in nondisabled and premenopausal women with SCI mainly because of the different effects of sexual hormones.
METHODS
Lipoprotein profiles of 112 participants with SCI (32 premenopausal women, 80 men) were analyzed and correlated to sex, lesion level, and physical performance capacity.
RESULTS
Women with tetraplegia or paraplegia showed significantly higher levels of high-density lipoprotein and lower ratios of total cholesterol to high-density lipoprotein-cholesterol compared with men with corresponding lesion levels, without a difference in peak oxygen consumption. Concentrations of very-low-density lipoproteins were lower in women with paraplegia than in men with paraplegia; no differences were found in total cholesterol, low-density lipoprotein-cholesterol, and triglycerides. Sex-independent elevations in total cholesterol and low-density lipoprotein-cholesterol were associated with paraplegia, and sex-independent elevations in triglyceride levels were associated with tetraplegia.
CONCLUSIONS
Persons with SCI showed sex-related differences in their lipoprotein profiles. Independent of physical fitness, the lipoprotein profile of premenopausal women with SCI did not exhibit the adverse lipoprotein characteristics observed in men with SCI, probably because of the influence of sexual hormones independent of lesion level.
Topics: Adult; Body Mass Index; Cholesterol, LDL; Exercise Test; Female; Humans; Lipids; Lipoproteins, HDL; Male; Paraplegia; Quadriplegia; Severity of Illness Index; Sex Characteristics; Statistics, Nonparametric; Triglycerides
PubMed: 18795478
DOI: 10.1080/10790268.2008.11760724 -
European Journal of Vascular and... Nov 2009Preoperative knowledge of the spinal cord (SC) vasculature could be useful for stratifying and decreasing the risk of perioperative paraplegia after thoracic and... (Review)
Review
INTRODUCTION
Preoperative knowledge of the spinal cord (SC) vasculature could be useful for stratifying and decreasing the risk of perioperative paraplegia after thoracic and thoraco-abdominal aortic surgery. Recent advances in magnetic resonance (MR) and computed tomography (CT) angiography and post-processing techniques have improved this knowledge.
METHODS
A search of MEDLINE/Pubmed and SCOPUS databases identified 1414 pertinent abstracts; 123 full-length manuscripts were screened to identify relevant studies with acceptable design and patient numbers. Forty-three were selected.
RESULTS
SC circulation was studied in 1196 patients to detect the great radicular artery: 522 by MR-angiography and 674 by CT angiography. Detection rates were 67-100% (mean 80.8%) with MR-angiography being 18-100% (mean 72%) with CT angiography. The side and level of the great radicular artery were consistent between the methods. Several authors tried to use the imaging results to guide clinical management.
CONCLUSIONS
Non-invasive imaging of the SC blood supply allows preoperative definition of the vasculature in many, but not all, cases. The impact of these findings on clinical management is potentially beneficial but still uncertain. Further improvements in image acquisition and post-processing techniques are needed. Future studies need to be large enough to compensate for inter-individual variability in SC vasculature in health and disease; however, even a partial reduction of paraplegia rate offers a formidable motivation for further research in this area.
Topics: Aortic Diseases; Arteries; Catheterization; Humans; Image Interpretation, Computer-Assisted; Magnetic Resonance Angiography; Paraplegia; Predictive Value of Tests; Risk Assessment; Spinal Cord; Spinal Cord Ischemia; Tomography, X-Ray Computed; Vascular Surgical Procedures
PubMed: 19713133
DOI: 10.1016/j.ejvs.2009.07.011 -
Soins; La Revue de Reference Infirmiere 2019Paraplegia results in deficiencies and impairments which have an impact on the somatic and psychological state of patients. Powered exoskeleton orthoses can be used in...
Paraplegia results in deficiencies and impairments which have an impact on the somatic and psychological state of patients. Powered exoskeleton orthoses can be used in certain conditions. Studies assessing the criteria for walking with an exoskeleton have highlighted interesting parameters for the creation of a functional orthosis.
Topics: Exoskeleton Device; Humans; Orthotic Devices; Paraplegia; Walking
PubMed: 31345312
DOI: 10.1016/j.soin.2019.05.010 -
Journal of the American Veterinary... Nov 2018
Topics: Animals; Dog Diseases; Dogs; Fractures, Compression; Male; Paraplegia; Spondylitis
PubMed: 30311530
DOI: 10.2460/javma.253.9.1117 -
Journal of the American Veterinary... Sep 2017
Topics: Animals; Dog Diseases; Dogs; Histiocytic Sarcoma; Male; Neurologic Examination; Paraplegia
PubMed: 28828953
DOI: 10.2460/javma.251.5.511 -
European Spine Journal : Official... Jun 2013Spinal tuberculosis (TB) accounts for approximately half of all cases of musculoskeletal tuberculosis. Kyphosis is the rule in spinal tuberculosis and has potential... (Review)
Review
INTRODUCTION
Spinal tuberculosis (TB) accounts for approximately half of all cases of musculoskeletal tuberculosis. Kyphosis is the rule in spinal tuberculosis and has potential detrimental effects on both the spinal cord and pulmonary function. Late-onset paraplegia is best avoided with the surgical correction of severe kyphosis, where at the same time anterior decompression of the cord is performed and the remnants of the tuberculosis-destroyed vertebral bodies are excised.
MATERIAL AND METHODS
Review of the literature on late surgical treatment of TB-associated kyphosis; description and comparative analysis of the different surgical techniques.
RESULTS
Kyphosis can be corrected either at the acute stage or at the healed late stage of tuberculous infection. In the late stage, the stiffness of the spine and chronic lung disease are additional considerations for the surgical approach and technique. Contrary to the traditional anterior transpleural approach used in the acute spinal tuberculosis infection, extrapleural approaches, either antero-lateral or direct posterior, are favored in late treatment.
CONCLUSION
The correction of deformity is only feasible with three-column osteotomies, and posterior vertebral column resection (PVCR) is the treatment of choice in extreme kyphosis. The prognosis of the neurologic deficit (late paraplegia) is dependent on the extent of gliosis of the spinal cord.
Topics: Decompression, Surgical; Humans; Kyphosis; Paraplegia; Spinal Fusion; Tuberculosis, Spinal
PubMed: 22627623
DOI: 10.1007/s00586-012-2338-4 -
The Journal of Spinal Cord Medicine 2016To describe neurological and functional outcomes after traumatic paraplegia.
OBJECTIVE
To describe neurological and functional outcomes after traumatic paraplegia.
DESIGN
Retrospective analysis of longitudinal database.
SETTING
Spinal Cord Injury Model Systems.
PARTICIPANTS
Six hundred sixty-one subjects enrolled in the Spinal Cord Injury Model Systems database, injured between 2000 and 2011, with initial neurological level of injury from T2-12. Two hundred sixty-five subjects had second neurological exams and 400 subjects had Functional Independence Measure (FIM) scores ≥6 months after injury.
OUTCOME MEASURES
American Spinal Injury Association Impairment Scale (AIS) grade, sensory level (SL), lower extremity motor scores (LEMS), and FIM.
RESULTS
At baseline, 73% of subjects were AIS A, and among them, 15.5% converted to motor incomplete. The mean SL increase for subjects with an AIS A grade was 0.33 ± 0.21; 86% remained within two levels of baseline. Subjects with low thoracic paraplegia (T10-12) demonstrated greater LEMS gain than high paraplegia (T2-9), and also had higher 1-year FIM scores, which had not been noted in earlier reports. Better FIM scores were also correlated with better AIS grades, younger age and increase in AIS grade. Ability to walk at 1 year was associated with low thoracic injury, higher initial LEMS, incomplete injury and increase in AIS grade.
CONCLUSION
Little neurological recovery is seen in persons with complete thoracic SCI, especially with levels above T10. Persons who are older at the time of injury have poorer functional recovery than younger persons. Conversion to a better AIS grade is associated with improvement in self-care and mobility at 1 year.
Topics: Adolescent; Adult; Aged; Female; Humans; Male; Middle Aged; Neurologic Examination; Paraplegia; Recovery of Function; Spinal Cord Injuries; Thoracic Vertebrae
PubMed: 25520184
DOI: 10.1179/2045772314Y.0000000280 -
Clinical Rehabilitation Apr 2007To describe the effects of upper body training on the physical capacity of people with a spinal cord injury. (Review)
Review
OBJECTIVE
To describe the effects of upper body training on the physical capacity of people with a spinal cord injury.
DATA SOURCES
The databases of PubMed, CINAHL, Sport Discus and Cochrane were searched from 1970 to May 2006.
REVIEW METHODS
The keywords 'spinal cord injury', 'paraplegia', 'tetraplegia' and 'quadriplegia' were used in combination with 'training'. The methodological quality of the included articles (both randomized controlled trials and controlled clinical trials) was assessed with the modified 'van Tulder et al.' checklist. Studies were described with respect to population, test design, training protocol and mode of training. The training effects on physical capacity, reflected by peak power output (PO(peak)) and oxygen uptake (VO(2peak)), were summarized.
RESULTS
Twenty-five studies were included with a mean score of 8.8 out of 17 items on the quality checklist. The methodological quality was quite low, mostly because of the absence of randomized controlled trials. Therefore no meta-analysis was possible. In the 14 articles of acceptable quality the mean (SD) increase in VO( 2peak) and PO(peak,) following a period of training, was 17.6 (11.2)% and 26.1 (15.6)%, respectively.
CONCLUSIONS
Due to the overall low quality of studies it is not possible to draw definitive conclusions on training effects for different lesion groups or training modes. The results of the relatively few studies with an acceptable quality seem to support the view that upper body exercise may increase the physical capacity of people with spinal cord injury. The magnitude of improvement in PO( peak) and VO(2peak), however, varies considerably among studies.
Topics: Humans; Paraplegia; Physical Education and Training; Physical Fitness; Quadriplegia; Spinal Cord Injuries; Upper Extremity
PubMed: 17613572
DOI: 10.1177/0269215507073385