Evaluation of secondary complication awareness among individuals with spinal cord injury.

Secondary complications (SCs) are common and cause high morbidity and mortality in individuals with spinal cord injury (SCI). There is no information or a satisfactory scale of measurement for evaluating the opinions of individuals with SCI on whether they have sufficient knowledge about these complications. This study aimed to evaluate the opinions of individuals with SCI about whether they have sufficient information on SCI-related SCs. Demographic and clinical characteristics of 64 SCI individuals were recorded. A questionnaire was applied to evaluate the opinions of the participants and whether they have sufficient information about SCs before and after a multidisciplinary rehabilitation for SCI. A test was performed to measure the knowledge level at admission to the hospital and discharge. The mean value of the total questionnaire score, which was 6.2 at admission, increased to 7.91 at discharge ( P < 0.001). All subgroup scores of the questionnaire were higher at discharge than at admission (all P < 0.05). Total, neurogenic bladder, neurogenic bowel and spasticity test scores increased at discharge compared to admission (all P < 0.05). There is a relationship between the change in questionnaire scores and some demographic and injury characteristics. The opinions of the individuals with SCI on having sufficient information about SCs and their knowledge levels increased after a multidisciplinary rehabilitation program. Applying such a questionnaire and test at admission may have increased the awareness of the participants about SCs and contributed to a higher level of knowledge and opinion.

Effects of splinting and three injection therapies (corticosteroid, autologous blood and prolotherapy) on pain, grip strength, and functionality in patients with lateral epicondylitis.

Objectives: This study aims to compare the efficacy of the wrist splint and the injection of corticosteroid, autologous blood, and hypertonic dextrose in the treatment of lateral epicondylitis (LE). Patients and methods: A total of 120 patients (43 males, 77 females; mean age: 45.7±7.7 years; range, 18 to 65 years) diagnosed with LE between December 2013 and June 2015 were included in the study and randomized into four groups. The first group was administered 20 mg methylprednisolone acetate + 2 mL 2% prilocaine, the second group 2 mL venous blood + 0.5 mL prilocaine, and the third group 2 mL 30% dextrose + 0.5 mL prilocaine injections. A second injection was administered to the third group one month later. The fourth group was recommended to use only a wrist splint. Pre-treatment and post-treatment evaluations of the patients were carried out at one and six months by the Visual Analog Scale (VAS) in terms of pain, by Patient-Rated Tennis Elbow Evaluation (PRTEE) questionnaire in terms of functional level, and by the Jamar dynamometer in terms of grip strength. Results: In all groups, VAS values at one and six months after treatment were found to be lower in comparison to baseline. Except for the splint group, a significant improvement was observed in all three injection groups in terms of grip strength and PRTEE values at six months compared to the baseline values. In the comparison of the groups, no significant difference was observed in terms of improvement in VAS scores and grip strength. While corticosteroid injection was significantly effective in terms of PRTEE pain, function, and total scores only at one month, the autologous injection was effective in terms of PRTEE function and total scores at only six months after treatment. There were no significant differences for splint and prolotherapy groups in terms of PRTEE scores. Conclusion: Corticosteroid injection, autologous blood injection, and prolotherapy are effective and safe long-term methods in LE treatment.

Temporospatial parameters, shoulder kinematics, and acute tendon changes in four different stroke patterns in male wheelchair users with spinal cord injury.

BACKGROUND: Manual wheelchair propulsion causes shoulder tendon pathologies in wheelchair users with spinal cord injury. Four different wheelchair stroke patterns can cause varying amounts of acute changes in the shoulder tendons. OBJECTIVE: To evaluate and compare acute changes in the supraspinatus and biceps tendons and acromiohumeral distance (AHD) after propulsion between different stroke patterns in individuals with spinal cord injury. In addition, to associate tendon changes with demographic and biomechanical characteristics. DESIGN: Prospective and comparative study between four groups. SETTING: Tertiary rehabilitation hospital. PATIENTS: Male wheelchair users with spinal cord injury. INTERVENTIONS: Participants were divided into four groups according to stroke pattern (arcing, semicircular [SC], single-loop [SL], and double-loop [DL]), in which they used their wheelchair on a motorized treadmill at a speed of 1 m/s. A sample of 40 people was created, 10 in each group. All participants performed a propulsion test. MAIN OUTCOME MEASURES: Temporospatial variables and shoulder kinematics were analyzed. Supraspinatus tendon thickness (SSTT), long head of biceps tendon thickness (LHBTT), and AHD were measured before and after the propulsion test. RESULTS: SC pattern had lower cadence and larger contact angle. A reduction in SSTT and LHBTT in arcing pattern, LHBTT and AHD in SC pattern, and LHBTT in DL pattern was observed (all p < .05). However, SL pattern did not differ significantly in all ultrasonographic measurements (all p > .05). Body mass index was associated with a decrease in SSTT. Age and number of daily push-ups were associated with a decrease in AHD. CONCLUSIONS: Fewer tendon changes after the propulsion in the SL pattern suggested that the supraspinatus and biceps tendons were preserved in this pattern. The SL pattern may be a better choice for male wheelchair users with supraspinatus and biceps tendon pathologies.

Demographic and clinical characteristics of patients with transverse myelitis and traumatic spinal cord injury: A comparative retrospective study.

OBJECTIVES: To identify the demographic and clinical characteristics of patients with transverse myelitis (TM) and to compare functional status between those patients and a matched group with traumatic spinal cord injury (T-SCI). STUDY DESIGN: Retrospective study. SETTING: A tertiary rehabilitation hospital. PARTICIPANTS: The demographic and clinical characteristics of 484 T-SCI patients and 25 TM patients were compared. Functional status was further analyzed by matching the two groups. OUTCOME MEASUREMENTS: The matched patients were compared in terms of motor and sensory functions, bladder and bowel symptoms, ambulation level, the Rivermead Mobility Index, and SCI-related medical complications. RESULTS: The mean age of the TM patients was 35.6 years and was similar to that of the T-SCI patients. There were significantly more females in the TM group (P = 0.017). Individuals with TM had fewer cervical injuries (P = 0.032) and a higher rate of paraplegia (P = 0.047) and were more often incomplete (P = 0.009) than those with T-SCI. Sensory function was significantly better in the TM group compared to the matched T-SCI group (P = 0.05). Independent ambulation frequency was higher in the TM patients. The SCI-related complications seen in the TM group were as common as those in the T-SCI group. CONCLUSION: The TM and T-SCI groups differed in terms of the demographic and clinical characteristics recorded. Additionally, when matched for these differences, functional status was slightly better in the TM group. However, like T-SCI, TM was a significant cause of disability and SCI-related complications were common.