International Collaboration on Repair Discoveries

Canada

International Collaboration on Repair Discoveries

Canada
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Cragg J.J.,University of Sfax | Noonan V.K.,Rick Hansen Institute | Dvorak M.,Vancouver General Hospital | Krassioukov A.,International Collaboration on Repair Discoveries | And 5 more authors.
Neurology | Year: 2013

Objective: The objective of this study was to evaluate the association between spinal cord injury (SCI) and type 2 diabetes in a large representative sample and to determine whether an association exists irrespective of known risk factors for type 2 diabetes. Methods: Data were obtained on 60,678 respondents to the Statistics Canada 2010 Cycle of the cross-sectional Canadian Community Health Survey. Multivariable logistic regression, incorporating adjustment for confounders and probability weights to account for the Canadian Community Health Survey sampling method, was conducted to quantify this association. Results: After adjustment for both sex and age, SCI was associated with a significant increased odds of type 2 diabetes (adjusted odds ratio 5 1.66, 95%confidence interval 1.16-2.36). These heightened odds persisted after additional adjustment for smoking status, hypertension status, body mass index, daily physical activity, alcohol intake, and daily consumption of fruits and vegetables (fully adjusted odds ratio 5 2.45, 95% confidence interval 1.34-4.47). Conclusions: There is a strong association between SCI and type 2 diabetes, which is not explained by known risk factors for type 2 diabetes. © 2013 American Academy of Neurology.


Krassioukov A.,International Collaboration on Repair Discoveries | Krassioukov A.,Strong Rehabilitation Center | Krassioukov A.,University of British Columbia | Cragg J.J.,International Collaboration on Repair Discoveries | And 3 more authors.
Spinal Cord | Year: 2015

Study design: Despite significant progress in bladder management, urinary tract infections (UTIs) are still common among individuals with spinal cord injury (SCI), and could negatively impact their health and quality of life. However, there are no data available on bladder management and frequency of UTIs among elite athletes with SCI. Methods: Athletes were assessed during the London 2012 Paralympic Games and 2013 Paracycling World Championships. Athletes completed the standard form of the International Standards to Document remaining Autonomic Functions after SCI, along with the standardized Autonomic Function Questionnaire. Results: A total of 61 (age=35.5±7.7 years (mean±s.d.); time since injury=16.0±7.6 years) elite athletes from 15 countries with traumatic SCI and who used clean intermittent catheterization were included in this study. The majority (75%) were from developed nations. Athletes catheterized on average 6±2 times per day. We found that individuals who reused catheters experienced more frequent UTIs (P<0.001). We also demonstrated that 83% of individuals from developed nations never reused a single-use catheter, whereas only 27% of individuals from developing nations used a new catheter each time (P<0.001). We also noted a twofold increase in the frequency of UTIs in individuals from developing nations (P=0.027). Conclusions: This study demonstrates that catheter reuse is intimately linked to UTI frequency and provides novel insight on bladder function and management in elite athletes with SCI. Reasons for catheter reuse may be due to a lack of health education and/or a lack of bladder-management resources. (Support: Craig Neilsen Foundation, ICORD, IPC). © 2015 International Spinal Cord Society.


PubMed | University of British Columbia, International Collaboration on Repair Discoveries, Canada 3 Strong Rehabilitation Center and University of Manitoba
Type: Journal Article | Journal: Spinal cord | Year: 2015

Despite significant progress in bladder management, urinary tract infections (UTIs) are still common among individuals with spinal cord injury (SCI), and could negatively impact their health and quality of life. However, there are no data available on bladder management and frequency of UTIs among elite athletes with SCI.Athletes were assessed during the London 2012 Paralympic Games and 2013 Paracycling World Championships. Athletes completed the standard form of the International Standards to Document remaining Autonomic Functions after SCI, along with the standardized Autonomic Function Questionnaire.A total of 61 (age=35.57.7 years (means.d.); time since injury=16.07.6 years) elite athletes from 15 countries with traumatic SCI and who used clean intermittent catheterization were included in this study. The majority (75%) were from developed nations. Athletes catheterized on average 62 times per day. We found that individuals who reused catheters experienced more frequent UTIs (P<0.001). We also demonstrated that 83% of individuals from developed nations never reused a single-use catheter, whereas only 27% of individuals from developing nations used a new catheter each time (P<0.001). We also noted a twofold increase in the frequency of UTIs in individuals from developing nations (P=0.027).This study demonstrates that catheter reuse is intimately linked to UTI frequency and provides novel insight on bladder function and management in elite athletes with SCI. Reasons for catheter reuse may be due to a lack of health education and/or a lack of bladder-management resources. (Support: Craig Neilsen Foundation, ICORD, IPC).


MacGillivray M.K.,University of British Columbia | Manocha R.H.K.,University of Western Ontario | Sawatzky B.,International Collaboration on Repair Discoveries | Sawatzky B.,University of British Columbia
Medical Engineering and Physics | Year: 2016

Forearm crutch technology has evolved slowly compared to other assistive mobility devices, despite the highly repetitive nature of forearm crutch gait and the high incidence of overuse injuries. Using 13 able-bodied volunteers between the ages of 19 and 27, we compared the ground reaction forces of a novel crutch design featuring an elastomeric polymer situated below the handle to an identical design without a damper system and to a commercially available generic rigid forearm crutch model. There were no differences in peak vertical force or impulse between crutches. The crutch with the damper system demonstrated a significantly smaller peak braking force and impulse compared to the generic forearm crutch model. However, the crutch with the damper system demonstrated a significantly larger peak propulsive force and impulse compared to both crutch models. This finding indicates that a forearm crutch with a damper system may help to propel the crutch forward when walking on level surfaces, which could impact forward momentum. © 2016.


Scott J.M.,University of British Columbia | Warburton D.E.R.,University of British Columbia | Williams D.,McMaster University | Whelan S.,McMaster University | And 4 more authors.
Spinal Cord | Year: 2011

Introduction: Similarities between the clinical presentation of individuals living with spinal cord injury (SCI) and astronauts are remarkable, and may be of great interest to clinicians and scientists alike.Objectives: The primary purpose of this review is to outline the manner in which cardiovascular, musculoskeletal, renal, immune and sensory motor systems are affected by microgravity and SCI.Methods: A comprehensive review of the literature was conducted (using PubMed) to evaluate the hallmark symptoms seen after spaceflight and SCI. This literature was then examined critically to determine symptoms common to both populations.Results: Both SCI and prolonged microgravity exposure are associated with marked deteriorations in various physiological functions. Atrophy in muscle and bone, cardiovascular disturbances, and alterations in renal, immune and sensory motor systems are conditions commonly observed not only in individuals with SCI, but also in those who experience prolonged gravity unloading.Conclusion: The preponderance of data indicates that similar physiological changes occur in both SCI and prolonged space flight. These findings have important implications for future research in SCI and prolonged space flight. © 2011 International Spinal Cord Society All rights reserved.


PubMed | University of British Columbia, GF Strong Rehabilitation Research Laboratory, International Collaboration on Repair Discoveries and Vancouver Coastal Health Research Institute
Type: Journal Article | Journal: Spinal cord | Year: 2016

Cross-sectional national survey.To explore the association between fatigue and community participation frequency and provide an adjusted model of the relationship including important covariates.Canada; Community.Data were obtained from the Rick Hansen Spinal Cord Injury Registry Community Survey. We used multi-variable regression analyses with hierarchical backward elimination, including variable specification, interaction assessment and confounding assessment. Variables with statistically significant correlation with the primary-dependent variable (participation) were included for modeling.The crude model of association between fatigue and participation accounted for 7.2% of the variance in participation scores. The full model with all a priori selected variables accounted for 25.1% of variance in participation scores. The adjusted model, including the identified confounders (pain, depressive mood, comorbidities and level of injury), accounted for 21.1% of variance in participation scores. Depressive mood variables had the highest standardized beta coefficients, reflecting the largest contribution to this model.Fatigue has a statistically significant negative association with participation for individuals with spinal cord injury, when controlling for pain, depressive mood, comorbidities and level of injury. Multifaceted clinical interventions and research addressing fatigue, pain and depressive symptoms are warranted.


PubMed | University of British Columbia, University of Toronto, International Collaboration on Repair Discoveries and UBC
Type: Journal Article | Journal: European journal of applied physiology | Year: 2016

To non-invasively examine the effect of acute hypoxia and inspiratory threshold loading (ITL) on inspiratory muscles [sternocleidomastoid (SCM), scalene (SA) and parasternal (PS)] oxygenation in healthy adults using near-infrared spectroscopy (NIRS).Twenty healthy adults (12 M/8 F) were randomly assigned to perform two ITL tests while breathing a normoxic or hypoxic (FIO2 = 15 %) gas mixture. NIRS devices were placed over the SCM, PS, SA, and a control muscle, tibialis anterior (TA), to monitor oxygenated (O2Hb), deoxygenated (HHb), total hemoglobin (tHb) and tissue saturation index (TSI). With the nose occluded, subjects breathed normally for 4 min through a mouthpiece that was connected to a weighted threshold loading device. ITL began by adding a 100-g weight to the ITL device. Then, every 2 min 50-g was added until task failure. Vital signs, ECG and ventilatory measures were monitored throughout the protocol.Participants were 31 12 year and had normal spirometry. At task failure, the maximum load and ventilatory parameters did not differ between the hypoxic and normoxic ITL. At hypoxic ITL task failure, SpO2 was significantly lower, and HHb increased more so in SA, SCM and PS than normoxic values. SCM TSI decreased more so during hypoxic compared to normoxic ITL. tHb in the inspiratory muscles (SCM, PS and SA) increased significantly compared to the decrease in TA during both hypoxic and normoxic ITL.The SCM, an accessory inspiratory muscle was the most vulnerable to deoxygenation during incremental loading and this response was accentuated by acute hypoxia.


PubMed | University of British Columbia and International Collaboration on Repair Discoveries
Type: Journal Article | Journal: Spinal cord | Year: 2016

This was a cross-over efficacy study design.To determine spasticity differences between static and dynamic standing training in individuals with spinal cord injury (SCI).Vancouver, Canada.Ten individuals with SCI who could stand with or without bracing or supports participated in both dynamic and static standing training (one session each, 2 days apart) using a Segway. The primary outcome was spasticity as measured by Visual Analog Scale (VAS), Modified Ashworth Scale (MAS) and electromyography (EMG) of the quadriceps, hamstrings, adductors and gastrocnemius.There was no statistically detectable difference in spasticity between dynamic and static standing training in individuals with SCI as measured by VAS, MAS or EMG, although there was a trend towards decreased spasticity after the dynamic training.There is no significant difference in spasticity outcomes between static and dynamic standing training on a Segway for individuals with SCI.This research was funded by Natural Sciences and Engineering Research Council of Canada and International Collaboration on Repair Discoveries.


PubMed | International Collaboration on Repair Discoveries and Vancouver Coastal Health Research Institute
Type: Journal Article | Journal: Spinal cord | Year: 2016

Prospective cohort study.To determine the prevalence and course of fatigue following acute spinal cord injury (SCI) during rehabilitation and after discharge.Tertiary spinal cord rehabilitation facility.Fifty-two patients with traumatic SCI were assessed after admission to rehabilitation and followed until 6-months post discharge into the community. Fatigue was measured using the Fatigue Severity Scale (FSS) and the Modified Fatigue Impact Scale for Spinal Cord Injury (MFIS-SCI) at admission, discharge and 6 months after discharge. Clinically significant fatigue was defined as FSS scores 4 or MFIS-SCI scores 24.5.The mean (s.d.) age of our mainly male (78.8%) sample was 46.3 (17.8) years of age. Half had cervical and 61.6% had complete injuries. Mean (s.d.) FSS scores were 3.7 (1.6) at baseline, 3.4 (1.5) at discharge and 3.7 (1.7) post discharge. Mean (s.d.) MFIS-SCI scores were 24.4 (16.1) at baseline, 23.4 (16.3) at discharge and 27.8 (17.5) post discharge. Fatigue on the FSS was present in 51.9% at baseline, 38.3% at discharge and 48.1% post discharge. Fatigue on the MFIS-SCI was present in 44.2% at baseline, 44.7% at discharge and 51.9% post discharge. There was no relationship between fatigue and injury level or completeness.Fatigue is common in SCI patients admitted to rehabilitation. Fatigue remained stable during rehabilitation and after discharge into the community. Clinicians should consider early screening for fatigue and interventions to reduce the consequences of fatigue in people with SCI.The British Columbia Medical Services Foundation funded our study.


Zariffa J.,International Collaboration On Repair Discoveries
Conference proceedings : ... Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Conference | Year: 2011

Monitoring the activity of specific neural pathways in a peripheral nerve is a task with numerous applications in implanted neuroprosthetic systems. Achieving selective recording using multi-contact nerve cuff electrodes is appealing because these devices are well suited for chronic use, but no viable general solution to the task of discriminating combinations of active pathways from extra-neural recordings has yet been proposed. Bioelectric source localization approaches have been suggested, but their effectiveness is limited by the accuracy of the nerve model used to solve the forward problem. We propose a model-free alternative to the pathway discrimination task, in which experimental data is used to estimate a solution to the forward problem. The method was evaluated using a 56-channel cuff placed on the rat sciatic nerve. 3 pathways were discriminated with a 94.2% success rate when individually active, whereas further improvements are needed in order to recover combinations of simultaneously active pathways.

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