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Port Glasgow, United Kingdom

Coulter E.H.,Glasgow Caledonian University | Dall P.M.,Glasgow Caledonian University | Rochester L.,Newcastle University | Hasler J.P.,Queen Elizabeth National Spinal Injuries Unit | Granat M.H.,Glasgow Caledonian University
Spinal Cord | Year: 2011

Study design:Keeping physically active is important for people who mobilize using a wheelchair. However, current tools to measure physical activity in the wheelchair are either not validated or limited in their application. The purpose of this study was to develop and validate a monitoring system to measure wheelchair movement.Methods:The system developed consisted of a tri-axial accelerometer placed on the wheel of a wheelchair and an analysis algorithm to interpret the acceleration signals. The two accelerometer outputs in the plane of the wheel were used to calculate the angle of the wheel. From this, outcome measures of wheel revolutions, absolute angle and duration of movement were derived and the direction of movement (forwards or backwards) could be distinguished. Concurrent validity was assessed in comparison with video analysis in 14 people with spinal cord injury using their wheelchair on an indoor track and outdoor wheelchair skills course. Validity was assessed using intraclass correlation coefficients (ICC(2,1)) and Bland-Altman plots.Results:The monitoring system demonstrated excellent validity for wheel revolutions, absolute angle and duration of movement (ICC(2,1)0.999, 0.999, 0.981, respectively) in both manual and powered wheelchairs, when the wheelchair was propelled forwards and backwards, and for movements of various durations.Conclusion:This study has found this monitoring system to be an accurate and objective tool for measuring detailed information on wheelchair movement and manoeuvring regardless of the propulsion technique, direction and speed. © 2011 International Spinal Cord Society. All rights reserved.

Anwar F.,Queen Elizabeth National Spinal Injuries Unit
Rawal Medical Journal | Year: 2011

Objective: To highlight the importance and incidence of associated injuries with spinal cord trauma. Patients and Methods: Retrospective analysis of 375 spinal cord injury patients admitted to spinal injury unit, from November 2006 to October 2009 was performed. Data were collected from the medical records. Results: The incidence of associated injuries along with spinal cord injury was 40%. Motor vehicle accident was the most common etiology of spinal injury. The most common level of injury was C5-C6 fracture dislocation. The common associated injuries were chest (24%) abdomen (22.7%), limb (21.3%) head (16.7%) and facial trauma (15.3%). Conclusion: An associated injury with spinal cord injuries is a common occurrence and may increase mortality and morbidity.

Hassan M.A.,University of Glasgow | Hassan M.A.,NED University of Engineering and Technology | Fraser M.,Queen Elizabeth National Spinal Injuries Unit | Conway B.A.,University of Strathclyde | And 2 more authors.
BMC Neurology | Year: 2015

Background: Central neuropathic pain has a prevalence of 40% in patients with spinal cord injury. Electroencephalography (EEG) studies showed that this type of pain has identifiable signatures, that could potentially be targeted by a neuromodulation therapy. The aim of the study was to investigate the putative mechanism of neurofeedback training on central neuropathic pain and its underlying brain signatures in patients with chronic paraplegia. Methods: Patients' EEG activity was modulated from the sensory-motor cortex, electrode location C3/Cz/C4/P4 in up to 40 training sessions Results. Six out of seven patients reported immediate reduction of pain during neurofeedback training. Best results were achieved with suppressing and higher β (20-30Hz) power and reinforcing aα power at C4. Four patients reported clinically significant long-term reduction of pain (>30%) which lasted at least a month beyond the therapy. EEG during neurofeedback revealed a wide spread modulation of power in all three frequency bands accompanied with changes in the coherence most notable in the beta band. The standardized low resolution electromagnetic tomography analysis of EEG before and after neurofeedback therapy showed the statistically significant reduction of power in beta frequency band in all tested patients. Areas with reduced power included the Dorsolateral Prefrontal Cortex, the Anterior Cingulate Cortex and the Insular Cortex. Conclusions: Neurofeedback training produces both immediate and longer term reduction of central neuropathic pain that is accompanied with a measurable short and long term modulation of cortical activity. Controlled trials are required to confirm the efficacy of this neurofeedback protocol on treatment of pain. The study is a registered UKCRN clinical trial Nr 9824. © 2015 Hassan et al.

Anderson J.,Queen Elizabeth National Spinal Injuries Unit | Allan D.B.,Queen Elizabeth National Spinal Injuries Unit
Journal of Spinal Cord Medicine | Year: 2011

Objective: To establish occurrence, method of injury, length of stay (LOS), psychiatric diagnosis, rehabilitation outcome, and demographic data for those admitted to a Scottish Spinal Injuries Rehabilitation Unit as a consequence of deliberate self-harm (DSH). Design: A retrospective audit of case-notes and electronic databases of admissions and rehabilitation outcome in a spinal cord injury (SCI) unit where the mechanism of injury was (DSH). Results: Forty-six (44 having detailed data available) patients were identified with 95% of injuries resulting from falls. Thirty-six people had pre-existing mental health problems (82%) with 15 (34%) having this diagnosis established shortly after admission. Seventy-five per cent received follow-up from mental health services. Ninety-five per cent returned to their pre-injury (or similar) residence. LOS and functional independence measure (FIM) for the DSH group were compared with a non-DSH group. No differences were found in those with SCI. LOS was significantly longer in the patients with vertebral fracture and no neurological impairment (32 versus 22 days). Sixty-four per cent of those who had self-harmed had substance dependence problems. The predominance of falls (63%) occurred in a residential setting. Annual admissions due to individuals self-harming were stable across the studied period. Conclusions: Spinal column fracture in the DSH group is predominantly caused by falls. High levels of mental health and substance abuse problems are noted necessitating formal mental health assessment and followup. DSH as a mechanism for injury appears to have a significant impact on LOS only if the patient has fracture without SCI. Immediate rehabilitation outcomes are similar to that of non-DSH group. © The Academy for Spinal Cord Injury Professionals, Inc. 2011.

McLachlan A.J.,University of Glasgow | McLachlan A.J.,Scottish Center for Innovation in Spinal Cord Injury | McLean A.N.,Scottish Center for Innovation in Spinal Cord Injury | McLean A.N.,Queen Elizabeth National Spinal Injuries Unit | And 4 more authors.
Journal of Spinal Cord Medicine | Year: 2013

Objective: To demonstrate the effect of a passive abdominal functional electrical stimulation (AFES) training program on unassisted respiratory measures in tetraplegia. Design: Longitudinal feasibility study. Setting: National spinal injuries unit in a university teaching hospital. Participants: Twelve patients with tetraplegic spinal cord injury, who could breathe independently, with reduced vital capacity and no visible abdominal movement. Intervention: Three weeks of abdominal muscle conditioning using transcutaneous AFES. Main outcome measures: Forced vital capacity (FVC), forced exhaled volume in 1 second (FEV1), peak expiratory flow rate (PEF), and maximum exhaled pressure (MEP). Results: Mean (SD) FVC increased by 0.36 l (0.23) during training (P = 0.0027). Mean (SD) FEV1 and PEF tended to increase by 0.18 l (0.16) and 0.39 l/seconds (0.35), respectively, but this was not significant. No significant change was found in the outcome measures during a 1-week pre-training control phase and during a 3-week post-training phase. Conclusions: The increase in FVC over the training period and the absence of change before or after training suggest that passive abdominal FES training can be used for respiratory rehabilitation in tetraplegia. © The Academy of Spinal Cord Injury Professionals, Inc. 2013.

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