A tele-assessment system for monitoring treatment effects in subjects with spinal cord injury.

We developed a method for remote measurement of balance and leg force in patients with spinal cord injury (SCI). In a group of 21 patients, both telemedicine and conventional clinical assessments were conducted at baseline and six months later. Telemedicine assessments were successfully acquired and transmitted at first attempt. The time required to set up the telemedicine equipment, position the subject, perform the measurements, and then send the data to the university laboratory was approximately 30 minutes. After six months, several motor and sensory functions showed significant changes. There were significant correlations between changes in remotely-measured leg force and changes in several of the American Spinal Injury Association (ASIA) sensory and motor scores. Changes in balance did not show any significant correlations with changes in the ASIA scores. Intra-rater reliability was better than inter-rater reliability. Use of telemedicine to remotely monitor changes in patients with SCI appears promising

Improved quality of life and body satisfaction in response to activity-based therapy in adults with spinal cord injury

Aim: The decline in ambulation characteristic of spinal cord injury (SCI) dramatically modifies quality of life and body composition. To examine changes in quality of life, body satisfaction, and body composition in response to 6 months of activity-based therapy in individuals with spinal cord injury (SCI).Methods: Men and women with complete or incomplete SCI (12 with tetraplegia and 13 with paraplegia; mean age and duration of injury of 35.8 ± 12.9 years and 3.8 ± 5.5 years, respectively) completed 6 months of activity-based therapy consisting of load bearing, locomotor training, whole-body resistance training, functional electrical stimulation, and assisted/unassisted walking for 8.5 ± 4.3 h/week. At baseline and at 3 and 6 months of training, body satisfaction, perceived quality of life, depression, and bodily pain were assessed using various questionnaires, and whole-body and regional fat mass and fat-free mass were determined with dual-energy X-ray absorptiometry. One-way analysis of variance with repeated measures was used to examine changes in outcome measures during the study.Results: Measures of body satisfaction (+23%) and quality of life (+8%) were improved (P < 0.05) in response to training, yet no change in depression or pain was demonstrated (P > 0.05). Percent body fat increased (P = 0.02), yet no change (P > 0.05) was seen in whole-body or regional fat free mass.Conclusion: Data suggest that chronic high-volume activity-based therapy enhances various indices of quality of life in men and women with SCI, but may be an ineffective approach to reduce fat deposition and increase muscle mass after SCI

Efficacy of Acute Intermittent Hypoxia on Physical Function and Health Status in Humans with Spinal Cord Injury: A Brief Review

Spinal cord injury (SCI) results in a loss of motor and sensory function and is consequent with reductions in locomotion, leading to a relatively sedentary lifestyle which predisposes individuals to premature morbidity and mortality. Many exercise modalities have been employed to improve physical function and health status in SCI, yet they are typically expensive, require many trained clinicians to implement, and are thus relegated to specialized rehabilitation centers. These characteristics of traditional exercise-based rehabilitation in SCI make their application relatively impractical considering the time-intensive nature of these regimens and patients’ poor access to exercise. A promising approach to improve physical function in persons with SCI is exposure to acute intermittent hypoxia (IH) in the form of a small amount of sessions of brief, repeated exposures to low oxygen gas mixtures interspersed with normoxic breathing. This review summarizes the clinical application of IH in humans with SCI, describes recommended dosing and potential side effects of IH, and reviews existing data concerning the efficacy of relatively brief exposures of IH to modify health and physical function. Potential mechanisms explaining the effects of IH are also discussed. Collectively, IH appears to be a safe, time-efficient, and robust approach to enhance physical function in chronic, incomplete SCI

A tele-assessment system for monitoring treatment effects in subjects with spinal cord injury.

We developed a method for remote measurement of balance and leg force in patients with spinal cord injury (SCI). In a group of 21 patients, both telemedicine and conventional clinical assessments were conducted at baseline and six months later. Telemedicine assessments were successfully acquired and transmitted at first attempt. The time required to set up the telemedicine equipment, position the subject, perform the measurements, and then send the data to the university laboratory was approximately 30 minutes. After six months, several motor and sensory functions showed significant changes. There were significant correlations between changes in remotely-measured leg force and changes in several of the American Spinal Injury Association (ASIA) sensory and motor scores. Changes in balance did not show any significant correlations with changes in the ASIA scores. Intra-rater reliability was better than inter-rater reliability. Use of telemedicine to remotely monitor changes in patients with SCI appears promising