Measuring Spinal Cord Injury

This book describes validated outcome measures for the international Spinal Cord Injury population. Based on rigorous systematic reviews of ca. 80,000 scientific articles, the authors present assessment tools for various clinical uses in the health sciences, following parameters of validity, reliability, and responsiveness. It is important for the development of clinical practice and research that practical and appropriate measures become universally accepted; this would allow comparisons and meta- analysis of high-quality randomized controlled trials of people with this increasingly common injury. This book emphasizes the need for consensus among researchers as to which tools must be studied in depth or adapted to other national contexts, or which measurement instruments should be standardized in order to develop universal norms and standards for the performance of people with Spinal Cord Injury. It offers a valuable practical guide for clinicians, rehabilitation professionals and nurses, but will also help researchers to gain more confidence in using valid and reliable assessment tools for comparable clinical trials.

An estimated 11,000 spinal cord injuries occur each year in the United States and more than 200,000 Americans suffer from maladies associated with spinal cord injury. This includes paralysis, bowel and bladder dysfunction, sexual dysfunction, respiratory impairment, temperature regulation problems, and chronic pain. During the last two decades, longstanding beliefs about the inability of the adult central nervous system to heal itself have been eroded by the flood of new information from research in the neurosciences and related fields. However, there are still no cures and the challenge of restoring function in the wake of spinal cord injuries remains extremely complex. Spinal Cord Injury examines the future directions for research with the goal to accelerate the development of cures for spinal cord injuries. While many of the recommendations are framed within the context of the specific needs articulated by the New York Spinal Cord Injury Research Board, the Institute of Medicine's panel of experts looked very broadly at research priorities relating to future directions for the field in general and make recommendations to strengthen and coordinate the existing infrastructure. Funders at federal and state agencies, academic organizations, pharmaceutical and device companies, and non-profit organizations will all find this book to be an essential resource as they examine their opportunities.

This comprehensive and practical reference is the perfect resource for the medical specialist treating persons with spinal cord injuries. The book provides detail about all aspects of spinal cord injury and disease. The initial seven chapters present the history, anatomy, imaging, epidemiology, and general acute management of spinal cord injury. The next eleven chapters deal with medical aspects of spinal cord damage, such as pulmonary management and the neurogenic bladder. Chapters on rehabilitation are followed by nine chapters dealing with diseases that cause non-traumatic spinal cord injury. A comprehensive imaging chapter is included with 30 figures which provide the reader with an excellent resource to understand the complex issues of imaging the spine and spinal cord.

Combining 25 years of clinical, research and teaching experience, Dr Lisa Harvey provides an innovative 5-step approach to the physiotherapy management of people with spinal cord injury. Based on the International Classification of Functioning, this approach emphasises the importance of setting goals which are purposeful and meaningful to the patient. These goals are related to performance of motor tasks analysed in terms of 6 key impairments. The assessment and treatment performance of each of these impairments for people with spinal cord injury is described in the following chapters: training motor tasks strength training contracture management pain management respiratory management cardiovascular fitness training Dr Harvey develops readers' problem-solving skills equipping them to manage all types of spinal cord injuries. Central to these skills is an understanding of how people with different patterns of paralysis perform motor tasks and the importance of differentmuscles for motor tasks such as: transfers and bed mobility of people wheelchair mobility hand function for people with tetraplegia standing and walking with lower limb paralysis This book is for students and junior physiotherapists with little or no experience in the area of spinal cord injury but with a general understanding of the principles of physiotherapy. It is also a useful tool for experienced clinicians, including those keen to explore the evidence base that supports different physiotherapy interventions.

This open access book offers an essential overview of brain, head and neck, and spine imaging. Over the last few years, there have been considerable advances in this area, driven by both clinical and technological developments. Written by leading international experts and teachers, the chapters are disease-oriented and cover all relevant imaging modalities, with a focus on magnetic resonance imaging and computed tomography. The book also includes a synopsis of pediatric imaging. IDKD books are rewritten (not merely updated) every four years, which means they offer a comprehensive review of the state-of-the-art in imaging. The book is clearly structured and features learning objectives, abstracts, subheadings, tables and take-home points, supported by design elements to help readers navigate the text. It will particularly appeal to general radiologists, radiology residents, and interventional radiologists who want to update their diagnostic expertise, as well as clinicians from other specialties who are interested in imaging for their patient care.

This comprehensive, up-to-date guide to the rehabilitation care of persons with spinal cord injuries and disorders draws on the ever-expanding scientific and clinical evidence base to provide clinicians with all the knowledge needed in order to make optimal management decisions during the acute, subacute, and chronic phases. A wealth of information is presented on the diverse medical consequences and complications encountered in these patients and on the appropriate rehabilitative measures in each circumstance. The coverage encompasses all forms of spinal cord injury and all affected organ systems. Readers will also find chapters on the basics of functional anatomy, neurological classification and evaluation, injuries specifically in children and the elderly, and psychological issues. The book will be an invaluable aid to assessment and medical care for physicians and other professional personnel in multiple specialties, including physiatrists, neurosurgeons, orthopedic surgeons, internists, critical care physicians, urologists, neurologists, psychologists, and social workers.

In the course of evaluating the patient with spinal disease, a myriad of measurements need to be performed before determining the diagnosis and the severity of the disease process. This text explicitly outlines the measurement of the spine from a clinical, laboratory, and radiographic approach. A detailed description of the actual technique of measurement and the clinical implication are presented with accompanying illustrations. This amalgamation of measurement tools for the spine is a beneficial reference for a wide spectrum of healthcare providers: students, nurses, residents, fellows, and established surgeons. In addition to its detailed illustrated presentation, each measurement technique has been graded for scientific and clinical utility with a score that specifically grades: Interobserver reliability Intraobserver reliability Universality Disease specificity Ease of application Simplicity Patient tolerability Expense The detail presented in this text will not only serve as a reference, but will also allow the reader to accurately reproduce measurement techniques, thus enhancing inter-physician communication, research of the spine, and improvement of patient care.

Following injury or disease, neural circuitry can be altered to varying degrees leading to highly individualized characteristics that may or may not resemble original function. In addition, lost or partially damaged circuits and the effects of biological recovery processes coupled with learned compensatory strategies create a new neuroanatomy with capabilities that are often not functional or may interfere with daily life. To date, the majority of approaches used to treat neurological dysfunction have focused on the replacement of lost or damaged function, usually through the suppression of surviving neural activity and the application of mechanical assistive devices. Restorative Neurology of Spinal Cord Injury offers a different and novel approach. Focusing on the spinal cord and its role in motor control, the book details the clinical and neurophysiological assessment process and methods developed throughout the past half century by basic and clinical scientists. Then, through the use of specialized clinical and neurophysiological testing methods, conduction and processing performed within the surviving neural circuitry is examined and characterized in detail. Based on the results of such assessment, treatment strategies, also described in this book, are applied to augment, rather than replace, the performance of surviving neural circuitry and improve the functional capacity of people who have experienced injury to their spinal cords.