Exercise in the Aquatic Environment for Patients With Chronic Spinal Cord Injury and Invasive Appliances: Successful Integration and Therapeutic Interventions

Conclusions Spinal cord injury patients with various invasive appliances can safely participate in specialized aquatic therapy without complications and seem to achieve clinically significant benefits. We recommend that spinal cord injury rehabilitation centers seek out and connect with opportunities for aquatic therapy within their institutions and communities.
Source: American Journal of Physical Medicine and Rehabilitation - Category: Rehabilitation Tags: Original Research Articles Source Type: research

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CONCLUSION In the year following the initiation of the mPATH team, we observed earlier time to occupational, physical, and speech therapist evaluation, decreased length of stay, and cost savings in severe traumatic brain and spinal cord injury patients requiring tracheostomy compared with our historical control. These benefits were observed without adversely impacting 30-day readmission or mortality. LEVEL OF EVIDENCE Therapeutic/care management, Level III.
Source: The Journal of Trauma: Injury, Infection, and Critical Care - Category: Orthopaedics Tags: ORIGINAL ARTICLES Source Type: research
AbstractMany neurological diseases may cause acute respiratory failure (ARF) due to involvement of bulbar respiratory center, spinal cord, motoneurons, peripheral nerves, neuromuscular junction, or skeletal muscles. In this context, respiratory emergencies are often a challenge at home, in a neurology ward, or even in an intensive care unit, influencing morbidity and mortality. More commonly, patients develop primarily ventilatory impairment causing hypercapnia. Moreover, inadequate bulbar and expiratory muscle function may cause retained secretions, frequently complicated by pneumonia, atelectasis, and, ultimately, hypoxe...
Source: Neurological Sciences - Category: Neurology Source Type: research
AbstractOver the past three decades, the use of noninvasive ventilation or “NIV” to assuage symptoms of hypoventilation for patients with early onset or mild ventilatory pump failure has been extended to up to the use of continuous noninvasive ventilatory support (CNVS) at full ventilatory support settings as a definitive alternative to tracheostomy mechanical ventilat ion. NVS, along with mechanical insufflation-exsufflation, now provides a noninvasive option for the management of both chronic and acute respiratory failure for these patients. The most common diagnoses for which these methods are useful include...
Source: Multidisciplinary Respiratory Medicine - Category: Respiratory Medicine Source Type: research
CONCLUSIONS: Concomitant upper body perfusion by the transapical aortic approach contributes to avoidance of brain and heart complications and maintaining spinal cord circulation under deep hypothermic DTAA/TAAA surgery. PMID: 31640318 [PubMed - as supplied by publisher]
Source: The Journal of Cardiovascular Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: J Cardiovasc Surg (Torino) Source Type: research
Conclusion: This study suggests that females with AST present with a greater number of pre-existing co-morbidities, a higher frequency of thoraco-lumbar trauma, less severe neurological impairment and a greater proportion of MVA-related injuries. However, females and males have a similar length of stay in the acute spine center, and comparable in-hospital survival, need for mechanical ventilation, and tracheostomy after AST. PMID: 31573442 [PubMed - in process]
Source: Journal of Spinal Cord Medicine - Category: Orthopaedics Tags: J Spinal Cord Med Source Type: research
This report presents a novel technique termed the pharyngeal clearance maneuver, which uses a modified application of the mechanical insufflation-exsufflation device to mobilize “secretion burden” at the portion of the trachea above the tracheostomy cuff during cuff deflation. Utilization of this strategy may reduce the risk of aspiration, infection, and respiratory compromise for patients with high cervical spinal cord injury in the acute rehabilitation setting. It is of particular benefit for those whose cuffs are being deflated for the first time and who may have large secretion volumes above the cuff. It ca...
Source: American Journal of Physical Medicine and Rehabilitation - Category: Rehabilitation Tags: Brief Reports Source Type: research
Authors: Toki A, Nakamura T, Nishimura Y, Sumida M, Tajima F Abstract STUDY DESIGN: Retrospective study. OBJECTIVES: To determine the best time to introduce non-invasive ventilation (NIV), clinical effectiveness of NIV, and complications of long-term use of NIV in patients with high-level cervical spinal cord injuries (CSCI). SETTING: Public Hospital, Japan. METHODS: The subjects were 14 tracheostomy ventilator-dependent patients, with above C3 spinal lesions, and American Spinal Cord Injury Association Impairment Scale A (ASIA A). They were referred to our clinic between 2005 and 2010 for switching mec...
Source: Journal of Spinal Cord Medicine - Category: Orthopaedics Tags: J Spinal Cord Med Source Type: research
CONCLUSION: The high age of 60 years, combined facet dislocation, C4 level high, and ASIA A and B scale are indispensable to predict the need for tracheostomy in patients with CSCI at the acute stage. PMID: 31319757 [PubMed - in process]
Source: Journal of Orthopaedic Surgery - Category: Orthopaedics Authors: Tags: J Orthop Surg (Hong Kong) Source Type: research
CONCLUSION Use of the trach score identified the majority of patients requiring prolonged VS in our study. An early tracheostomy protocol using predictive modeling could aid in reduction of intensive care unit length of stay and improving ventilator weaning in these patients. External verification of this predictive tool and of an early tracheostomy protocol is needed. LEVEL OF EVIDENCE This work is a retrospective prognostic cohort study and meets evidence Level III criteria.
Source: The Journal of Trauma: Injury, Infection, and Critical Care - Category: Orthopaedics Tags: ORIGINAL ARTICLES Source Type: research
This article considers the extent of the damage being caused by this.
Source: American Journal of Physical Medicine and Rehabilitation - Category: Rehabilitation Tags: Analysis & Perspective Source Type: research
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