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Availability and need of home adaptations for personal mobility among individuals with spinal cord injury.

ABSTRACT: To identify the availability and unmet need of home adaptations (HAs) among the Swiss population with spinal cord injury (SCI).Cross-sectional study.Swiss Spinal Cord Injury Community Survey 2012.Individuals aged 16 or older with chronic SCI living in Switzerland.Not applicable.The availability of ten HAs (self-report) was analyzed by sex, age, living situation, indoor mobility, SCI severity, SCI etiology and time since SCI. The unmet need (self-report of not having a HA but needing it) of HAs was analyzed by financial hardship.Among the 482 study participants (mean age 55.2 years, standard deviation 15.0 years, 71.6% males), 85.1% had at least one HA. The most frequent HA was a wheelchair accessible shower (62.7%). Availability of HAs markedly varied with indoor mobility (e.g. 38.4% of participants using a wheelchair had a stair lift compared to 17.4% of those walking) and with SCI severity (e.g. 54.8% of those with complete paraplegia had a wheelchair accessible kitchen worktop compared to 26.0% of those with incomplete paraplegia). Unmet need was highest for adjustable kitchen worktops (78.7% of those with a need) and adjustable kitchen cabinets (75.7%) and lowest for wheelchair accessible showers (9.4%) and grab bars next to the toilet (8.5%). No significant differences in unmet need were found when stratifying for financial hardship.Availability of HAs is dependent on indoor mobility and SCI severity. There is a considerable degree of unmet need for selected HAs, which couldn't be explained by financial hardship.

SUBMITTER: Hertig-Godeschalk A

PROVIDER: S-EPMC5810812 | biostudies-other | 2018 Jan

REPOSITORIES: biostudies-other

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Availability and need of home adaptations for personal mobility among individuals with spinal cord injury.

Hertig-Godeschalk Anneke A Gemperli Armin A Arnet Ursina U Hinrichs Timo T

The journal of spinal cord medicine 20170330 1

<h4>Objective</h4>To identify the availability and unmet need of home adaptations (HAs) among the Swiss population with spinal cord injury (SCI).<h4>Design</h4>Cross-sectional study.<h4>Setting</h4>Swiss Spinal Cord Injury Community Survey 2012.<h4>Participants</h4>Individuals aged 16 or older with chronic SCI living in Switzerland.<h4>Interventions</h4>Not applicable.<h4>Outcome measures</h4>The availability of ten HAs (self-report) was analyzed by sex, age, living situation, indoor mobility, S ...[more]

PMID: 28359190

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Project description:BackgroundTranscutaneous spinal cord stimulation (tSCS) is a non-invasive modality in which electrodes can stimulate spinal circuitries and facilitate a motor response. This review aimed to evaluate the methodology of studies using tSCS to generate motor activity in persons with spinal cord injury (SCI) and to appraise the quality of included trials.MethodsA systematic search for studies published until May 2021 was made of the following databases: EMBASE, Medline (Ovid) and Web of Science. Two reviewers independently screened the studies, extracted the data, and evaluated the quality of included trials. The electrical characteristics of stimulation were summarised to allow for comparison across studies. In addition, the surface electromyography (EMG) recording methods were evaluated.ResultsA total of 3753 articles were initially screened, of which 25 met the criteria for inclusion. Studies were divided into those using tSCS for neurophysiological investigations of reflex responses (n = 9) and therapeutic investigations of motor recovery (n = 16). The overall quality of evidence was deemed to be poor-to-fair (10.5 ± 4.9) based on the Downs and Black Quality Checklist criteria. The electrical characteristics were collated to establish the dosage range across stimulation trials. The methods employed by included studies relating to stimulation parameters and outcome measurement varied extensively, although some trends are beginning to appear in relation to electrode configuration and EMG outcomes.ConclusionThis review outlines the parameters currently employed for tSCS of the cervicothoracic and thoracolumbar regions to produce motor responses. However, to establish standardised procedures for neurophysiological assessments and therapeutic investigations of tSCS, further high-quality investigations are required, ideally utilizing consistent electrophysiological recording methods, and reporting common characteristics of the electrical stimulation administered.

Project description:Key factors positively influencing rehabilitation and functional recovery after spinal cord injury (SCI) include training variety, intensive movement repetition, and motivating training tasks. Systems supporting these aspects may provide profound gains in rehabilitation, independent of the subject's treatment location. In the present study, we test the hypotheses that virtual reality (VR)-augmented training at home (i.e., unsupervised) is feasible with subjects with an incomplete SCI (iSCI) and that it improves motor functions such as lower limb muscle strength, balance, and functional mobility. In the study, 12 chronic iSCI subjects used a home-based, mobile version of a lower limb VR training system. The system included motivating training scenarios and combined action observation and execution. Virtual representations of the legs and feet were controlled via movement sensors. The subjects performed home-based training over 4?weeks, with 16-20 sessions of 30-45?min each. The outcome measures assessed were the Lower Extremity Motor Score (LEMS), Berg Balance Scale (BBS), Timed Up and Go (TUG), Spinal Cord Independence Measure mobility, Walking Index for Spinal Cord Injury II, and 10?m and 6?min walking tests. Two pre-treatment assessment time points were chosen for outcome stability: 4?weeks before treatment and immediately before treatment. At post-assessment (i.e., immediately after treatment), high motivation and positive changes were reported by the subjects (adapted Patients' Global Impression of Change). Significant improvements were shown in lower limb muscle strength (LEMS, P?=?0.008), balance (BBS, P?=?0.008), and functional mobility (TUG, P?=?0.007). At follow-up assessment (i.e., 2-3?months after treatment), functional mobility (TUG) remained significantly improved (P?=?0.005) in contrast to the other outcome measures. In summary, unsupervised exercises at home with the VR training system led to beneficial functional training effects in subjects with chronic iSCI, suggesting that it may be useful as a neurorehabilitation tool. Trial registration:Canton of Zurich ethics committee (EK-24/2009, PB_2016-00545), ClinicalTrials.gov: NCT02149186. Registered 24 April 2014.

Dataset Information

Availability and need of home adaptations for personal mobility among individuals with spinal cord injury.

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Availability and need of home adaptations for personal mobility among individuals with spinal cord injury.

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