Kessler Institute for Rehabilitation

West Orange, NJ, United States

Kessler Institute for Rehabilitation

West Orange, NJ, United States
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News Article | November 28, 2016
Site: news.mit.edu

Four MIT students — Matthew Cavuto, Zachary Hulcher, Kevin Zhou, and Daniel Zuo — are winners in this year’s prestigious Marshall Scholarship competition. Another student, Charlie Andrews-Jubelt, was named an alternate. The newest Marshall Scholars come from the MIT departments of Mechanical Engineering, Physics, Mathematics, and Electrical Engineering and Computer Science. Funded by the British government, the Marshall Scholarships provide exceptional young Americans the opportunity for two years of graduate study in any field at a U.K. institution. Up to 40 scholarships are awarded each year in the rigorous nationwide competition. Scholars are selected on the basis of academic merit, leadership potential, and ambassadorial potential. “The Presidential Committee on Distinguished Fellowships is so proud — as am I, personally — to have had the opportunity to help all the nominated MIT students through the Marshall Scholarship process,” says Kim Benard, assistant dean of distinguished fellowships and academic excellence. “Matthew, Zach, Kevin, and Daniel represent the very best of MIT. We have also had the great pleasure to work with students who ultimately didn’t win, but who will have extraordinary careers that will increase the reputation of MIT.” Matthew Cavuto, from Skillman, New Jersey, is an MIT senior majoring in mechanical engineering with a concentration in biomechanics and biomedical devices. As a Marshall Scholar, Cavuto will engage in advanced prosthetic and assistive technology research over the course of two years of study in the U.K. at Imperial College London and Cambridge University. In his first year, Cavuto will pursue an MS in biomedical engineering (concentrating in neurotechnology) at Imperial College London, working with Tim Constandinou on the SenseBack Project, an initiative aimed at allowing amputees to feel through their prostheses. In his second year, he will earn an MPhil in Engineering at Cambridge University, under the supervision of Fumiya Iida in the Bio-Inspired Robotics Laboratory, designing assistive technologies and exoskeletons through imitating nature. Cavuto plans to eventually earn a PhD in biomechatronics with the goal of revolutionizing accessible mobility for the paralyzed by designing the world’s first successful robotic exoskeleton. Cavuto became interested in creating the next generation of prostheses and assistive devices while volunteering at New Jersey’s Kessler Institute for Rehabilitation, where he observed firsthand the challenges faced by amputees. During a summer internship through MIT International Science and Technology Initiatives (MISTI) at Germany’s Technical University of Berlin, Cavuto investigated the development of a prosthetic exoskeleton to rehabilitate stroke patients. As a researcher at the MIT Global Engineering and Research (GEAR) Lab, Cavuto has investigated and prototyped new designs for prosthetic knees tailored for people living in developing countries. He currently leads a team that, with nongovernmental organizations in India, has developed and field-tested a low-cost device that allows above-knee amputees to cross their legs. With a patent pending, he hopes to soon transition to manufacturing and distribution of the device to the millions of amputees living in the developing world. In extracurricular activities, Cavuto participates in varsity fencing and is an award-winning ballroom dancer and woodworker. Amos Winter, assistant professor in the Department of Mechanical Engineering and the director of GEAR, says, “Matt represents the finest of our students at MIT. He has taken just about every hands-on engineering design course offered at MIT, and he is a prolific carpenter, designer, and artist. Matt exemplifies MIT’s motto of ‘mens et manus,’ or, mind and hand.” Zachary Hulcher, from Montgomery, Alabama, is pursuing a dual major in electrical engineering and computer science and physics, with a minor in mathematics. As a Marshall Scholar, he will study and perform research in high-energy physics at Cambridge University, following in the footsteps of such luminary physicists as Newton, Maxwell, and Hawking. Hulcher plans to earn a PhD and, as a professor of physics, make contributions to expand the field of high energy physics. Hulcher spent his sophomore summer conducting research with Professor Yen-Jie Lee at the Compact Muon Solenoid (CMS) Experiment at CERN’s Large Hadron Collider in Geneva, Switzerland. He returned to CERN his junior summer to continue with and present on his research. Since the fall of 2015, he has been a research assistant in the group of professor Krishna Rajagopal of MIT's Department of Physics and Center for Theoretical Physics, which is part of the Laboratory for Nuclear Science. Hulcher has been improving the analysis and modeling of how CMS measurements can be used to probe quark-gluon plasma, a substance connected to the Big Bang that may lead to greater understanding of the formation of the universe. “Zach took on, mastered, and then drove a theoretical physics research project,” observes Rajagopal. “He will be the principal author of a paper describing an important advance, and he showed fearless confidence in giving a talk at an international workshop in which he showed new results (some only hours old) that garnered much attention. All the while, he is both well-grounded and well-rounded.” Hulcher is also motivated by a desire to teach others. He has been a teaching assistant for the physics department at MIT, a grader in the mathematics department, and a tutor for MIT’s chapter of Eta Kappa Nu, the national honor society for electrical engineering and computer science. Through MISTI's Global Teaching Labs, he traveled to Xalapa, Mexico, to assist with courses focused on mobile and internet technologies, and he taught courses on physics to high school students in Italy and Israel. Since his freshman year, Hulcher has been an offensive lineman with MIT’s varsity football team and was named this year to the NEWMAC all-academic team for his outstanding scholarly and athletic performance. Hulcher also serves on the executive board for the MIT chapter of the Tau Beta Pi engineering honor society. Kevin Zhou, from Carlsbad, California, will graduate next June with dual bachelor’s degrees in physics and mathematics. He will then embark on a two-year course of study at Cambridge University and the University of Durham. In his first year, Zhou will acquire an MAst in Cambridge’s department of applied mathematics and theoretical physics by completing part III of the Mathematical Tripos course. In his second year, he will earn an MS at Durham’s Institute for Particle Physics Phenomenology. When he returns to the U.S., Zhou will pursue a PhD in particle physics. He ultimately plans to be a research professor in theoretical physics and contribute to new methods to teach physics. Zhou is currently involved in two MIT physics research groups. In the Physics of Living Systems Group, led by Jeremy England, the Thomas D. and Virginia W. Cabot Career Development Associate Professor of Physics, Zhou is researching the thermodynamics of DNA damage and repair, and has co-authored a paper on nonequilibrium states that has been submitted to Physical Review Letters. “Kevin has a polyglot sort of fluency in different idea-spaces that makes him able to see where the math might be applicable in ways that very few people can,” says England. Zhou is also working with associate professor Jesse Thaler of MIT's Department of Physics and Center for Theoretical Physics, whose research group uses quantum chromodynamics to analyze the structure of jets, the sprays of particles produced in high-energy collisions. Zhou has been developing cutting-edge analytic techniques for determining the problem of quark/gluon discrimination; his efforts will be applied in the search for new physics at the Large Hadron Collider at CERN. Zhou received honorable mention at this year’s prestigious Putnam Mathematical Competition for college students. In addition to his passion for pure mathematics, Zhou is intrigued by computer science and has interned as a software engineer at Dropbox and Facebook. Zhou is committed to helping the next generation of physics students and researchers. As vice president of the Society of Physics Students, he directed a summer reading group for his peers on advanced mathematical methods and taught STEM classes to middle school students through the MIT Splash program. He is a junior coach for the U.S. Physics Olympiad where he has developed and taught classes on physics concepts and mentored students at yearly training camps. Zhou also enjoys singing and has performed with the MIT Concert Choir and MIT Centrifugues. Daniel Zuo, from Memphis, Tennessee, is graduating next June with a bachelor’s degree in electrical engineering and computer science, an MEng in electrical engineering and computer science, and a minor in creative writing. At Cambridge University, Zuo will do two consecutive one-year master’s degree programs: an MPhil in advanced computer science and an MPhil in machine learning, speech, and language technology. After completing his studies in the U.K., Zuo will pursue a PhD and hopes to develop a startup venture that will advance internet connectivity in the developing world. He ultimately plans to teach and conduct research as a professor of computer science. Zuo is particularly interested in lossless datacenter architectures and their potential to help people interact more effectively with massive amounts of data. He is currently a research assistant for TIBCO Career Development Assistant Professor Mohammad Alizadeh in the Networks and Mobile Systems group at MIT’s Computer Science and Artificial Intelligence Laboratory (CSAIL). Alizadeh’s group works to improve the performance, usability, and robustness of networks and cloud services; Zuo has been investigating algorithms that provide scheduling and congestion control to enhance network performance. “Daniel is brilliant,” Alizadeh says. “It’s been a joy to work with him. He is one of those rare students that can jump into an unfamiliar area and quickly figure out exactly the right way to think about the hard technical problems.” Zuo has also conducted research in Professor Manolis Kellis’ group at CSAIL, which focuses on computational methods for accessing large data sets for the analysis of human disease. He developed “greedy” algorithms to produce a comprehensive set of overlapping enhancers across cell types for a specific gene. He has also worked as a software engineer at several technology and finance companies, including Electronic Arts, Arcadia Funds, and Complete Solar Solutions. Zuo’s own projects include Fold, a mobile payment service to allow easy and secure peer-to-peer Bitcoin transactions over Bluetooth technology. In his freshman year, Zuo helped launch MakeMIT, the largest hardware hackathon in the nation, and has continued his involvement with the project as a committee member with the MIT student organization TechX. Zuo is also active in public service in the Boston community through his leadership roles with the Phi Kappa Theta fraternity.


News Article | December 2, 2016
Site: www.marketwired.com

Kessler Foundation and University of New Hampshire release nTIDE Report for November -- Monthly Update EAST HANOVER, NJ--(Marketwired - December 02, 2016) - While the employment picture brightens in the United States, more than one billion people with disabilities worldwide continue to face challenges as they strive for inclusion in their communities, according to today's National Trends in Disability Employment -- Monthly Update (nTIDE), issued by Kessler Foundation and University of New Hampshire's Institute on Disability (UNH-IOD). We are reminded of global efforts to support their dignity, rights, and well-being on December 3, the UN International Day of Persons with Disabilities. In the Bureau of Labor Statistics Jobs Report released Friday, December 2, the employment-to-population ratio for working-age people with disabilities increased from 26.0 percent in November 2015 to 27.7 percent in November 2016 (up 6.5 percent; 1.7 percentage points). For working-age people without disabilities, the employment-to-population ratio also increased from 72.6 percent in November 2015 to 73.1 percent in November 2016 (up 0.7 percent; 0.5 percentage points). The employment-to-population ratio, a key indicator, reflects the percentage of people who are working relative to the total population (the number of people working divided by the number of people in the total population multiplied by 100). "The improvement in the proportion of people with disabilities working continues its upward trend and once again outpaces improvements made by people without disabilities," noted John O'Neill, PhD, director of employment and disability research at Kessler Foundation. "In addition, the relative magnitude of this month's gain is larger than the average monthly gain over the previous seven months. So this is a pretty good month." The labor force participation rate for working-age people with disabilities increased from 29.9 percent in November 2015 to 31.1 percent in November 2016 (up 4.0 percent; 1.2 percentage points). For working-age people without disabilities, the labor force participation rate increased slightly from 76.1 percent in November 2015 to 76.4 percent in November 2016 (up 0.4 percent; 0.3 percentage points). "This is indeed a pretty good month," said Andrew Houtenville, PhD, associate professor of economics at UNH. "Both the employment-to-population ratio and the labor force participation rate going up at the same time, it suggests that more people with disabilities have jobs and more people with disabilities are engaging in the labor market, looking for work, compared to the same time last year." On December 3, Kessler Foundation joins the world community in commemorating the UN International Day of Persons with Disabilities and supporting this year's theme of a more inclusive and equitable world through sustainable development. Long before this UN Day was established, Henry H. Kessler MD, PhD (1896-1978), understood the value of comprehensive rehabilitation services for all people with disabilities. Dr. Kessler, who founded Kessler Institute for Rehabilitation in 1948, advocated preparing people for full community participation, including employment, through "...the development of a complete program of rehabilitation services: vocational guidance, counseling and training..." In the aftermath of World War II, he implemented a worldwide effort by the UN Relief and Rehabilitation Administration to help member nations establish desperately needed rehabilitation services. Dr. Kessler viewed victory over disability as a way to foster international cooperation, human development and world peace. "Through its expanding international connections, the Foundation continues to build on Dr. Kessler's legacy," noted Dr. O'Neill. "Collaborative research is accelerating the development of new strategies for overcoming cognitive and motor disabilities. Through its international training program, the Foundation educates young professionals from around the world in rehabilitation science, which extends the influence of our research to the global community." In November 2016, among workers ages 16-64, the 4,405,000 workers with disabilities represented 3.1 percent of the total 143,375,000 workers in the U.S. The next nTIDE will be issued on Friday, January 6, 2017. Join our nTIDE Lunch & Learn series, starting today, December 2 at 12:00pm EST. This live broadcast, hosted via Zoom Webinar, will offer attendees Q&A on the latest nTIDE findings, provide news and updates from the field, as well as host invited panelists to discuss current disability-related findings and events. Retired Senator Tom Harkin, joins Drs. Houtenville, O'Neill, and Michael Gamel-McCormick of the Association of University Centers on Disabilities (AUCD) to discuss today's findings as well as International Disability Employment. You can join live, or watch the recordings at: www.ResearchonDisability.org/nTIDE. NOTE: The statistics in the National Trends in Disability Employment Update are based on Bureau of Labor Statistics numbers, but are NOT identical. They've been customized by the University of New Hampshire to efficiently combine the statistics for men and women of working age (16 to 64). NTIDE is funded, in part, by grants from the National Institute on Disability, Independent Living and Rehabilitation Research (NIDILRR) (9ORT5022-02-00 & 90RT5017) and Kessler Foundation. Kessler Foundation, a major nonprofit organization in the field of disability, is a global leader in rehabilitation research that seeks to improve cognition, mobility, and long-term outcomes -- including employment -- for people with neurological disabilities caused by diseases and injuries of the brain and spinal cord. Kessler Foundation leads the nation in funding innovative programs that expand opportunities for employment for people with disabilities. For more information, visit www.KesslerFoundation.org. About the Institute on Disability at the University of New Hampshire The Institute on Disability (IOD) at the University of New Hampshire (UNH) was established in 1987 to provide a coherent university-based focus for the improvement of knowledge, policies, and practices related to the lives of persons with disabilities and their families. For information on the NIDILRR-funded Employment Policy and Measurement Rehabilitation Research and Training Center, visit www.ResearchonDisability.org.


News Article | November 1, 2016
Site: globenewswire.com

EAST HANOVER, N.J., Nov. 1, 2016 (GLOBE NEWSWIRE) -- Kessler Foundation has been awarded a Spinal Cord Injury Model System (SCIMS) grant valued at $2,300,000 over 5 years (2016-2021) from the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR). This federal grant, one of only 14 awarded to centers across the U.S. this year, continues funding for the Northern New Jersey SCI System (NNJSCIS). A collaboration of Kessler Foundation, Kessler Institute for Rehabilitation, and University Hospital in Newark, the NNJSCIS has been supported by NIDILRR since 1990.  Kessler is also a federally funded Traumatic Brain Injury Model System, and is one of only nine centers in the U.S. to hold both grants. The SCIMS grants fund Model Systems across the nation that provide a multidisciplinary system of rehabilitative care specifically designed to meet the needs of individuals with SCI, encompassing acute care and extending through rehabilitation, reintegration to the community and the workplace, and aging with SCI. "Research is the cornerstone of the SCIMS," noted Trevor Dyson-Hudson, MD, director of SCI Research at Kessler Foundation. "Each model system enrolls newly injured patients and collects data that are contributed to the National SCIMS Statistical Center, the world's largest and longest database for SCI research. This database helps us identify medical complications that occur after SCI and to focus our research efforts on what individuals need to live full and productive lives after their injury. Through the NNJSCIS, we have contributed to improved care for respiratory complications, for example, and we are continuing to study the effects of a medication combined with therapy that may help restore mobility." "The renewal of this grant has real implications for the community we serve," said Steven Kirshblum, MD, of Kessler Institute for Rehabilitation, where he is medical director and director of SCI Services. "Each year, we treat more than 120 newly injured persons and more than 300 individuals with spinal cord dysfunction, and we provide followup care to more than 1500 persons with chronic spinal cord injury. In addition to current projects, this new grant will enable us to explore pharmacologic approaches to managing bladder dysfunction, a complication that adversely affects quality of life for many individuals living with SCI." Drs. Dyson-Hudson and Kirshblum are co-directors of the NNJSCIS. Funded by the National Institute on Disability, Independent Living, and Rehabilitation Research, Administration for Community Living, U.S. Department of Health and Human Services # 90SI5026 Kessler Foundation, a major nonprofit organization in the field of disability, is a global leader in rehabilitation research that seeks to improve cognition, mobility and long-term outcomes, including employment, for people with neurological disabilities caused by diseases and injuries of the brain and spinal cord. Kessler Foundation leads the nation in funding innovative programs that expand opportunities for employment for people with disabilities. For more information, visit KesslerFoundation.org. Kessler Institute for Rehabilitation provides comprehensive programs services for individuals with spinal cord injury, brain injury, stroke, neurologic diseases, amputation, musculoskeletal/orthopedic conditions, cancer and cardiac recovery.  Top-ranked in rehabilitation by U.S News & World Report for 24 consecutive years, Kessler Institute has three hospital campuses in West Orange, Saddle Brook and Chester, N.J., and more than 95 outpatient Kessler Rehabilitation Center locations throughout the state.  For more information, visit www.kessler-rehab.com. A photo accompanying this release is available at: http://www.globenewswire.com/newsroom/prs/?pkgid=41804


Goedert K.M.,Seton Hall University | Chen P.,Kessler Foundation | Boston R.C.,University of Pennsylvania | Foundas A.L.,University of Missouri - Kansas City | And 2 more authors.
Neurorehabilitation and Neural Repair | Year: 2014

Background. Spatial neglect is a debilitating disorder for which there is no agreed on course of rehabilitation. The lack of consensus on treatment may result from systematic differences in the syndrome's characteristics, with spatial cognitive deficits potentially affecting perceptual-attentional "Where" or motor-intentional "Aiming" spatial processing. Heterogeneity of response to treatment might be explained by different treatment impacts on these dissociated deficits: prism adaptation, for example, might reduce Aiming deficits without affecting Where spatial deficits. Objective. Here, we tested the hypothesis that classifying patients by their profile of Where-versus-Aiming spatial deficit would predict response to prism adaptation and specifically that patients with Aiming bias would have better recovery than those with isolated Where bias. Methods. We classified the spatial errors of 24 subacute right stroke survivors with left spatial neglect as (1) isolated Where bias, (2) isolated Aiming bias, or (3) both. Participants then completed 2 weeks of prism adaptation treatment. They also completed the Behavioral Inattention Test and Catherine Bergego Scale (CBS) tests of neglect recovery weekly for 6 weeks. Results. As hypothesized, participants with only Aiming deficits improved on the CBS, whereas those with only Where deficits did not improve. Participants with both deficits demonstrated intermediate improvement. Conclusion. These results support behavioral classification of spatial neglect patients as a potential valuable tool for assigning targeted, effective early rehabilitation. © The Author(s) 2013.


Kirshblum S.,Kessler Institute for Rehabilitation | Waring W.,Medical College of Wisconsin
Physical Medicine and Rehabilitation Clinics of North America | Year: 2014

The International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) is the most widely used classification in the field of spinal cord injury medicine. Since its first publication in 1982, multiple revisions refining the recommended examination, scaling, and classification have taken place to improve communication, consistency, and clarity. This article describes a brief historical perspective on the development and changes over the years leading to the current ISNCSCI, detailing the most recent updates of 2011 and the worksheet 2013 as well as issues facing the ISNCSCI for the future. © 2014 Elsevier Inc.


Cohen E.E.W.,University of California at San Diego | Lamonte S.J.,Louisiana State University Health Sciences Center | Erb N.L.,American Cancer Society Inc. | Beckman K.L.,American Cancer Society | And 8 more authors.
CA Cancer Journal for Clinicians | Year: 2016

Answer questions and earn CME/CNE The American Cancer Society Head and Neck Cancer Survivorship Care Guideline was developed to assist primary care clinicians and other health practitioners with the care of head and neck cancer survivors, including monitoring for recurrence, screening for second primary cancers, assessment and management of long-term and late effects, health promotion, and care coordination. A systematic review of the literature was conducted using PubMed through April 2015, and a multidisciplinary expert workgroup with expertise in primary care, dentistry, surgical oncology, medical oncology, radiation oncology, clinical psychology, speech-language pathology, physical medicine and rehabilitation, the patient perspective, and nursing was assembled. While the guideline is based on a systematic review of the current literature, most evidence is not sufficient to warrant a strong recommendation. Therefore, recommendations should be viewed as consensus-based management strategies for assisting patients with physical and psychosocial effects of head and neck cancer and its treatment. CA Cancer J Clin 2016;66:203-239. © 2016 American Cancer Society.


Linsenmeyer T.A.,Kessler Institute for Rehabilitation | Linsenmeyer T.A.,Kessler Foundation
Journal of Spinal Cord Medicine | Year: 2013

Background: Botulinum neurotoxin (BoNT) injection into the bladder wall has been shown to be an effective alternative to anticholinergic (antimuscarinic) medications and more invasive surgery in those with multiple sclerosis and spinal cord injury with neurogenic detrusor overactivity (NDO) and urinary incontinence who are not tolerating anticholinergic medications. In August 2011, Botox® (onabotulinumtoxinA) received Food and Drug Administration (FDA) approval for this use. Clinically, intradetrusor injection of BoNT has been found to decrease urinary incontinence and improve quality of life. Its impact on urodynamic parameters is an increase in the maximum cystometric (bladder) capacity and decrease in the maximum detrusor pressures. The most common side effects are urinary tract infections and urinary retention. There have been rare reports and a black box warning of distant spread of BoNT. BoNT has gained popularity because of its effectiveness and long duration of action, relative ease of administration, easy learning curve, reproducibility of results on repeated administration, and low incidence of complications. Objective: To discuss the structure and function, mechanisms of action, clinical and urodynamic studies, injection technique, potential beneficial and adverse effects, and potential areas of research of BoNT. Methods: Literature search focused on botulinum toxin in MEDLINE/PubMed. Search terms included botulinum toxin, neurogenic bladder, NDO, botox bladder, botox spinal cord injury, botox, FDA, botox side effects. All papers identified were English language, full-text papers. In addition, English abstracts of non-English papers were noted. The reference list of identified articles was also searched for further papers. Conclusion: Botulinum toxin is an alternative treatment for individuals with NDO who fail to tolerate anticholinergic medications. Its popularity has increased because of the literature, which has supported its effectiveness, safety, easy use and learning curve, reproducibility of results on repeated use, and recent FDA approval of Botox® (onabotulinumtoxinA). © The Academy of Spinal Cord Injury Professionals, Inc. 2013.


Wendel I.,Doctors Office Center | Cole J.,Kessler Institute for Rehabilitation
PM and R | Year: 2014

Extensor digitorum brevis manus (EDBM) muscles are accessory dorsal hand muscles that are present in 1%-3% of the population. These muscles are not commonly symptomatic, but they can occasionally cause pain and discomfort and may be misdiagnosed as tenosynovitis or a ganglion cyst. In this case, we describe an appropriate workup of dorsal hand masses and myalgia that are suspected to be related to EDBM muscles. The patient's symptoms were controlled with injections of botulinum toxin into the EDMB muscle belly, which allowed thepatient to be relatively pain free for a considerable amount of time and avoid surgery. © 2014 American Academy of Physical Medicine and Rehabilitation.


Linsenmeyer T.A.,Kessler Institute For Rehabilitation
NeuroRehabilitation | Year: 2012

Urinary incontinence and other voiding dysfunctions are common sequelae post CVA (cerebrovascualar accident). Urinary incontinence declines over time; however, other voiding issues appear. Voiding dysfunctions not only have a significant impact on a person's quality of life and mortality, but also impact the person's caregiver. Urodynamic studies are important to help further understand, develop and direct bladder management. However, studies evaluating urodynamic findings in those with urinary incontinence shortly after CVA (within 3 months) are limited. While uninhibited contractions are the most common urodynamic finding in post-CVA incontinence, a number of men and women have other urodynamic findings causing incontinence. The type, onset, resolution and urodynamics of post-CVA symptoms other than urinary incontinence are rarely discussed. A literature review emphasizes that further research is needed not only in the evaluation of the most effective bladder management strategies for urinary incontinence, but also in the area of post stroke voiding dysfunction as a whole. © 2012 - IOS Press and the authors. All rights reserved.


Linsenmeyer T.A.,Kessler Institute for Rehabilitation | Linsenmeyer T.A.,Kessler Foundation | Linsenmeyer M.A.,Kessler Foundation | Linsenmeyer M.A.,Rutgers University
Journal of Spinal Cord Medicine | Year: 2013

Study design: A single-center institutional review board-approved prospective cross-sectional observational study. Context: Urodynamic studies are essential to accurately direct bladder management following spinal cord injury (SCI). There is no consensus on how often testing should be performed. Objective: To determine the impact of annual urodynamic studies on guiding bladder management following SCI. Methods: Individuals with traumatic SCI undergoing annual urological evaluations were enrolled in this study. They had to be injured for at least 2 years so that urodynamic changes could be compared with their previous annual urodynamic evaluation. Changes in the urodynamic parameters and autonomic dysreflexia were determined by comparing this study with the previous year's study. All studies were done with the same physician and nursing staff. Demographic data, bladder management, urodynamic parameters, and the need and type of interventions based on the urodynamic study were obtained. The main outcome measure was whether or not there was a need for an intervention based on the urodynamics. Interventions were classified as urological intervention, non-urological intervention, or a combination of urological and nonurological intervention. The impact of the type of bladder management, length of injury, and level of injury was also evaluated. Results: Ninety-six consecutive individuals with SCI undergoing annual urodynamic evaluations were enrolled over a 5-month period. Overall, 47.9% of individuals required at least one type of intervention based on urodynamic studies: 82.6% were urological interventions (medication changes were most common, comprising 54.3% of urological interventions); 13.0% were non-urological interventions; and 4.3% were a combination of non-urological and urological interventions. The need for interventions did not appear to be influenced by the type of bladder management, the length of time post-injury or level of injury. Conclusion: Annual urodynamic evaluation plays an important role in guiding bladder management following SCI. © The Academy of Spinal Cord Injury Professionals, Inc. 2013.

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