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Full-Text Articles in Medicine and Health Sciences
Effect Of Repetitive Transcranial Magnetic Stimulation On Gait Function And Strength Among Patients With Spinal Cord Injury: A Meta-Analysis, Yen-Ting Chen, Yu-Chi Su, Yu-Ching Lin
Effect Of Repetitive Transcranial Magnetic Stimulation On Gait Function And Strength Among Patients With Spinal Cord Injury: A Meta-Analysis, Yen-Ting Chen, Yu-Chi Su, Yu-Ching Lin
Rehabilitation Practice and Science
Purpose: This meta-anaylysis investigated the efficacy of repetitive transcranial magnetic stimulation (rTMS) in the context of spinal cord injury (SCI). The study focused on assessing its impact on muscle strength and gait speed, measured through the lower extremities motor score of the American Spinal Injury Association (ASIA) and 10-Meter Walk Test scores(10MWT). Methods: The PubMed, Cochrane Library, and Embase databases were searched for articles published through Oct 2023. We enrolled only randomized controlled trials. The Cochrane Collaboration risk of bias tool was used for quality assessment. Outcomes were analyzed as standardized mean differences (SMDs) with 95% confidence intervals (CIs). We …
Prognosis Of Paraplegia After Receiving Transarterial Chemoembolization For Recurrent Hepatocellular Carcinoma: A Case Report, I-Wei Chen, Hsueh-Chou Lai, Chien-Lin Lin
Prognosis Of Paraplegia After Receiving Transarterial Chemoembolization For Recurrent Hepatocellular Carcinoma: A Case Report, I-Wei Chen, Hsueh-Chou Lai, Chien-Lin Lin
Rehabilitation Practice and Science
Transarterial chemoembolization (TACE) is the standard treatment for patients with Barcelona clinic liver cancer staging system stage B hepatocellular carcinoma. However, various TACE complications have been reported, and spinal infarction is one of the rarest. To date, only six specific case reports written in English have been published. We report a rare case of TACE-related spinal cord infarction and compare this case with cases in other reports and literature reviews. The patient experienced a sudden onset of paraplegia, sensory impairment below the T8 dermatome and had difficultly voiding immediately after TACE. The T2WI and DWI found hyperintensity 3.5 hours after …
The Health Insurance Resources Utilization And Rehabilitation Intervention In Patients With Traumatic Spinal Cord Injury: A Pilot Study, Pao Huang, Jen-Hung Wang, Chih-Cheng Fan, Po-Ting Chen, Chung-Chao Liang
The Health Insurance Resources Utilization And Rehabilitation Intervention In Patients With Traumatic Spinal Cord Injury: A Pilot Study, Pao Huang, Jen-Hung Wang, Chih-Cheng Fan, Po-Ting Chen, Chung-Chao Liang
Rehabilitation Practice and Science
Spinal cord injury is associated with a substantial and long-term economic burden on both the patients and the national health insurance. Due to the advancements in medical techniques, the mortality rate of patients with spinal cord injury has decreased. Moreover, as the life expectancy has increased in Taiwan, patients with spinal cord injury may need long-term rehabilitation to restore their functions of daily living and prevent further complications. Nonetheless, long-term rehabilitation would increase the economic burden on the long-term care facilities, as expected. This study aimed to analyze the impact (from admission to 3-year follow-up after discharge) of medical expenses …
The Investigation Between Voiding Function Medication And The Risk Of Bladder Cancer In Patients With Spinal Cord Injury, Kai-Hua Chen, Ting-Yao Wang, Chien-Min Chen, Chuan-Pin Lee, Yao-Hsu Yang, Chu-Hsu Lin, Kuan-Yu Kung, Vincent Chin-Hung Chen
The Investigation Between Voiding Function Medication And The Risk Of Bladder Cancer In Patients With Spinal Cord Injury, Kai-Hua Chen, Ting-Yao Wang, Chien-Min Chen, Chuan-Pin Lee, Yao-Hsu Yang, Chu-Hsu Lin, Kuan-Yu Kung, Vincent Chin-Hung Chen
Rehabilitation Practice and Science
Bladder cancer (BC) is a chronic complication of spinal cord injury (SCI). Limited studies have focused on the risks of BC in SCI patients using voiding function medication for bladder dysfunction. In this retrospective, national-wide, population-based cohort study, SCI patients with registration in the National Health Insurance Research Database (NHIRD) from 1998 to 2013 were included. We investigated the risk of BC in SCI patients administered voiding function medications and other comorbidities by 2-year landmark analysis. SCI patients were divided into medication user (bethanechol, oxybutynin, or tolterodine) and non-medication user groups at landmark period. They were followed until the development …
The Effects Of The Rewalk^(Tm) Robotic System On Walking Capability In Paraplegic Spinal Cord Injury Patients In Taiwan, Alice Cw Tang, Shao An Lee, Albert Ck Chen, Ching Yu Wang, Wan Yu Chou, Show Chun Chen, Chih Lin Wu, Simon Fuk Tan Tang
The Effects Of The Rewalk^(Tm) Robotic System On Walking Capability In Paraplegic Spinal Cord Injury Patients In Taiwan, Alice Cw Tang, Shao An Lee, Albert Ck Chen, Ching Yu Wang, Wan Yu Chou, Show Chun Chen, Chih Lin Wu, Simon Fuk Tan Tang
Rehabilitation Practice and Science
Background: The ReWalk^(TM) system is an exoskeleton robotic device developed for ambulation assistance in patients with paraplegic spinal cord injury (SCI). The purpose of this study is to evaluate the safety and walking capability of the ReWalk^(TM) system for patients with paraplegic spinal cord injury in Taiwan. Methods: Eight patients with SCI and paraplegia were recruited for the study in a period from April 2015 to April 2016. The level of injuries ranged from T4 to T11. Assessments included the continuous walking time, the continuous walking distance, 6-minute walking test and 10-meter walking test after training for forty hours. Results: …
Increased Risk Of Arrhythmia In Patients With Cervical Spinal Cord Injury: A Nationwide Population-Based Matched Cohort Study, Chia-Hsuan Lin, Yan-Yuh Lee, Chun-En Kuo, Po-Cheng Chen
Increased Risk Of Arrhythmia In Patients With Cervical Spinal Cord Injury: A Nationwide Population-Based Matched Cohort Study, Chia-Hsuan Lin, Yan-Yuh Lee, Chun-En Kuo, Po-Cheng Chen
Rehabilitation Practice and Science
Objective: To investigate the risk of cardiac arrhythmias among adults with spinal cord injury (SCI). Methods: This is a retrospective population-based matched cohort study. Data were derived from the National Health Insurance Research Database. This study identified all patients diagnosed with SCI from January 1, 2000 to December 31, 2013. Patients with SCI were categorized into the cervical SCI (C-SCI) and other SCI (O-SCI) groups according to the level of injury. The cumulative incidence of cardiac arrhythmias was compared between patients with C-SCI, those with O-SCI, and those without SCI. Cox proportional hazards regression model was used to assess the …
A Rare Presentation Of Myelopathy In Novice Surfers: A Casereport And Literature Reviewarticle, Ming-Hsuan Huang, Shu-Fen Sun, Min-Hui Li, Ping-Hong Lai
A Rare Presentation Of Myelopathy In Novice Surfers: A Casereport And Literature Reviewarticle, Ming-Hsuan Huang, Shu-Fen Sun, Min-Hui Li, Ping-Hong Lai
Rehabilitation Practice and Science
Introduction: Surfer's myelopathy is a nontraumatic, ischemic spinal cord injury that predominantly affects the lower thoracic cord. Owing to its clinical rarity, its pathophysiology and treatment protocol remain controversial. Frequently discussed hypotheses regarding its cause include ischemic change due to trunk hyperextension and the Valsalva maneuver, leading to back pain, weakness in the lower extremities, and bowel and bladder dysfunction. The prognosis varies widely, ranging from full recovery to paraplegia. casereport: We report the case of a 22-year-old female patient experiencing progressive loss of strength in the lower extremities and soreness in her lower back while surfing for the first …
Coinstantaneous Brachial Plexus Injuries In A 55-Year-Old Man With Traumatic Spinal Cord Injury: A Casereport And Literature Reviewarticle, Hong-Yi Lin, Jia-Yin Guo, Su-Ju Tsai
Coinstantaneous Brachial Plexus Injuries In A 55-Year-Old Man With Traumatic Spinal Cord Injury: A Casereport And Literature Reviewarticle, Hong-Yi Lin, Jia-Yin Guo, Su-Ju Tsai
Rehabilitation Practice and Science
脊髓損傷合併臂神經叢損傷臨床上少見且不易診斷與處置。過去研究的報告發生率約為0.6％到1.8％。在脊髓損傷的病人處置時，通常優先處理危及生命的傷害，且臂神經叢損傷的臨床表現也可能歸因於脊髓損傷而被忽略。本文報告一名55歲因車禍意外導致第四節脊髓損傷的男性病人，根據病人的身體檢查、神經學檢查發現右上肢深肌腱反射無反應，以及明顯不對稱的右上肢與左上肢肌力，經過神經傳導檢查及肌電圖檢查，確定該名病人為脊髓損傷合併臂神經叢損傷。同時罹患脊髓損傷及臂神經叢損傷的病人數量可能被低估，治療計畫及復健也更為複雜，早期診斷與適當治療是此類病人上肢功能恢復的重要關鍵。除了詳細探查脊髓損傷病人的臨床症狀、身體檢查、神經學檢查之外，電學診斷對於合併臂神經叢損傷的確診最有效益。
Retrospective Study Of Neurogenic Bladder Complications In Patients With Chronic Spinal Cord Injury, Sheng-Min Chang, Sheng-Wei Zeng
Retrospective Study Of Neurogenic Bladder Complications In Patients With Chronic Spinal Cord Injury, Sheng-Min Chang, Sheng-Wei Zeng
Rehabilitation Practice and Science
Recent advances in medicine have greatly prolonged the average lifespan of patients with chronic spinal cord injury (SCI). However, many complications arise as the disease enters the chronic phase. SCI is known to cause limb weakness and paresthesia, it also causes multiple system abnormalities that cannot be easily ignored. Particularly troublesome issues develop due to the urinary system complications resulting from the neurogenic bladder. These include overactive bladder, detrusor external sphincter dyssynergia, vesicoureteral reflux, urolithiasis, urinary tract infection (UTI), and even chronic kidney disease. All these issues cause annoying problems that disturb the patient’s health and quality of life. The …
Effect Of Individualized Bladder Rehabilitation Program In Patients With Neurogenic Lower Urinary Tract Dysfunction, A Pilot Study, Peir-Renn Wang, Wei-Che Wang, Sung-Lang Chen, Yu-Hui Huang, Yu-Fen Lai, Hsiu-Chun Yang
Effect Of Individualized Bladder Rehabilitation Program In Patients With Neurogenic Lower Urinary Tract Dysfunction, A Pilot Study, Peir-Renn Wang, Wei-Che Wang, Sung-Lang Chen, Yu-Hui Huang, Yu-Fen Lai, Hsiu-Chun Yang
Rehabilitation Practice and Science
Objectives: Neurogenic lower urinary tract dysfunction (NLUTD) is one of the major sequelae after spinal cord injury (SCI) and a cause of increased morbidity and mortality in SCI patients. Current treatment strategies for NLUTD include medication, non-invasive conservative management, minimally invasive therapy, and surgical intervention. However, there are no studies regarding non-invasive conservative management that combines pelvic floor muscle (PFM) exercises and electrical stimulation (ES). This study was designed to evaluate the efficacy of individualized bladder rehabilitation programs, which included education on voiding behavior, PFM exercise training combined with electromyography (EMG) biofeedback, and ES (for bladder inhibition or PFM strengthening), …
The Prevalence And Related Factors Of Posttraumatic Stress Disorder Among Subjects With Spinal Cord Injury, Ching-Chi Chang, Yu-Ting Yang, Shu-Han Yu, Nai-Yin Chang, Vincent Chin-Hung Chen, Su-Ju Tsai
The Prevalence And Related Factors Of Posttraumatic Stress Disorder Among Subjects With Spinal Cord Injury, Ching-Chi Chang, Yu-Ting Yang, Shu-Han Yu, Nai-Yin Chang, Vincent Chin-Hung Chen, Su-Ju Tsai
Rehabilitation Practice and Science
There are approximately 1200 new cases of traumatic spinal cord injury (SCI) each year in Taiwan. Traumatic SCI often results from motor vehicle crashes, acts of violence or sports injuries. These are potentially leading patients to suffer from posttraumatic stress disorder (PTSD). The characteristic symptoms of PTSD include persistent re-experiencing of the event, increased arousal and avoidance of stimuli associated with the trauma and numbing of general responsiveness. The symptoms must cause clinically significant distress or impairment in social, occupational or other important areas of functioning. Our purpose was to identify the prevalence and related factors of posttraumatic stress disorder …
Influence Of Pain On Depression And Quality Of Life In Patients With Spinal Cord Injury, Yao-Jen Chen, Hong-Ye Chen
Influence Of Pain On Depression And Quality Of Life In Patients With Spinal Cord Injury, Yao-Jen Chen, Hong-Ye Chen
Rehabilitation Practice and Science
Objective: To assess pain prevalence in a spinal cord injury (SCI) population and the influence of pain on depression and quality of life in patients with SCI. Methods: Two hundred twenty six SCI patients were asked to participate in this study after completing a questionnaire. The questionnaire included demographic data, clinical characteristics of SCI, performance of daily activities and pain intensity on a Numerical Rating Scale (NRS). The Chinese version of Identification (ID) of pain questionnaire was used to detect the neuropathic form of pain. The Taiwanese Depression Questionnaire (TDQ) was used for screening of depression and the Taiwan version …
T12 Compression Fracture Complicated With Delayed Spinal Epidural Hematoma: A Casereport, Chia-Wei Wu, Ching-Shiang Tseng, Lin-Fen Hsieh
T12 Compression Fracture Complicated With Delayed Spinal Epidural Hematoma: A Casereport, Chia-Wei Wu, Ching-Shiang Tseng, Lin-Fen Hsieh
Rehabilitation Practice and Science
Delayed spinal epidural hematoma (SEH) after a spinal compression fracture is a very rare but important cause of symptomatic spinal cord compression. We report a patient with spinal cord compression and cauda equina syndrome due to delayed SEH after a traumatic T12 compression fracture. A 74-year-old male patient had severe back pain without neurologic deficits after a traumatic T12 compression fracture. He developed progressive bilateral lower extremity weakness, sensory loss, and sphincter dysfunction 2.5 months after the injury. Magnetic resonance imaging of the spine revealed a huge spinal epidural hematoma at the level of T12 to L5. He then received …
Concurrent Ankylosing Spondylitis And Tophaceous Gout In Spine Causing Spinal Cord Compression: A Casereport, Chia-Chen Lin, Nai-Hsin Meng
Concurrent Ankylosing Spondylitis And Tophaceous Gout In Spine Causing Spinal Cord Compression: A Casereport, Chia-Chen Lin, Nai-Hsin Meng
Rehabilitation Practice and Science
Ankylosing spondylitis (AS) rarely coexists with tophaceous gout in the spine. We present a case of a 57-year-old businessman with AS who did not have previous history of hyperuricemia or gouty arthritis. He had a three-month history of progressive bilateral lower limb weakness caused by spinal cord compression (rooted on a tophaceous gout), leading to incomplete paraplegia. He received surgical decompressive laminectomy, which removed the hypertrophic ligamentum flavum and tophus in the level of thoracolumbar junction. There was no obvious neurologic recovery after the surgery. We reviewarticleed the incidence, clinical manifestations, and management of the spinal tophaceous gout coexisting with …
The Effect Of Body Weight Support Treadmill Training On Walking Ability In Patients With Incomplete Spinal Cord Injury, Chien-Hsing Tseng
The Effect Of Body Weight Support Treadmill Training On Walking Ability In Patients With Incomplete Spinal Cord Injury, Chien-Hsing Tseng
Rehabilitation Practice and Science
In modern health care systems that attach importance to acute treatment and health care, there is an increasing number of patients with incomplete spinal cord injury that have increased chance of regaining their ability to walk. However, how to effectively achieve this target of promoting the ability to walk is a question that must be urgently addressed by rehabilitation medicine and public health authorities. International research has already confirmed that body weight support treadmill training has a positive therapeutic effect on walking ability in patients with incomplete spinal cord injury, but in Taiwan not many relevant studies have been performed. …
Spinal Cord Injury And Diffuse Asymptomatic Pulmonary Embolism After Percutaneous Vertebroplasty: A Casereport, Yao-Jen Chen, Pei-Pi Shih, Su-Ju Tsai
Spinal Cord Injury And Diffuse Asymptomatic Pulmonary Embolism After Percutaneous Vertebroplasty: A Casereport, Yao-Jen Chen, Pei-Pi Shih, Su-Ju Tsai
Rehabilitation Practice and Science
A 30-year-old woman with a history of 9th to 11th thoracic vertebral compression fracture developed complete thoracic spinal cord injury immediately after percutaneous vertebroplasty. The patient did not have any sign of neurological recovery after two operations for spinal decompression. The postoperative chest X ray and thoracic computed tomography scan revealed diffuse asymptomatic pulmonary embolism, but the patient did not have dyspnea or chest pain.Percutaneous vertebroplasty has been generally considered a minimally invasive and effective procedure for treatment of painful compression fracture. Complications after percutaneous vertebroplasty include infection, spinal cord injury, cardiopulmonary complications and stroke. In previous literature search, there …
Acute Abdominal Pain In Spinal Cord Injury Patient Induced By Indwelling Urethral Catheter Placed Into The Right Ureter Through The Ureteral Orifice: A Casereport, Chang-Jheng Wu, Huei-Yu Lo, Yau-Wai Wai, Han-Tin Lu
Acute Abdominal Pain In Spinal Cord Injury Patient Induced By Indwelling Urethral Catheter Placed Into The Right Ureter Through The Ureteral Orifice: A Casereport, Chang-Jheng Wu, Huei-Yu Lo, Yau-Wai Wai, Han-Tin Lu
Rehabilitation Practice and Science
Diagnosis of acute abdomen in spinal cord injury (SCI) patients remains challenging. Classic peritoneal signs, such as rigid abdomen, rebounding pain and abdominal muscle guarding may be not reliable. It is still an important cause of morbidity and mortality in patients with SCI.A 45-year-old woman with SCI and 7th and 8th thoracic vertebrae fractures suffered from lower abdominal pain, fever and chills for three days. Physical examination revealed diffuse abdominal tenderness with muscle guarding. Laboratory studies showed severe leukocytosis and mild pyuria. Abdominal contrast-enhanced computed tomography scans (CTS) revealed a urinary catheter, which had been accidentally inserted into the right …
The Therapeutic Effect Of Selective Dorsal Rhizotomy On Severe Spasticity Related Spinal Cord Injury: A Casereport, Shin-Yo Lu, Tsui-Fen Yang, Tai-Tong Wong, Rai-Chi Chan, Chung-Yu Ho, Hung-Yi Chang
The Therapeutic Effect Of Selective Dorsal Rhizotomy On Severe Spasticity Related Spinal Cord Injury: A Casereport, Shin-Yo Lu, Tsui-Fen Yang, Tai-Tong Wong, Rai-Chi Chan, Chung-Yu Ho, Hung-Yi Chang
Rehabilitation Practice and Science
Spasticity refers to a velocity-dependent resistance to passive motion which was characterized as a symptom of upper motor neuron lesion. Though mild spasticity can help patients compensate for muscle weakness which is benefit for transferring and some daily living function, severe spasticity may cause difficulty in positioning, motor performance and predispose to pressure ulcer. The treatment option for spasticity includes physical therapy (positioning, stretching, range of motion exercise), splinting, oral medication (baclofen and diazepam are most commonly used), botulinum toxin or phenal block for focal spasticity, and more invasively, intrathecal baclofen pump (ITB) and selective dorsal rhizotomy (SDR). Selective dorsal …
Electric Stimulation For The Bladder Dysfunction In Patients With Spinal Cord Injury, Chao-Min Wang, Yen-Ho Wang
Electric Stimulation For The Bladder Dysfunction In Patients With Spinal Cord Injury, Chao-Min Wang, Yen-Ho Wang
Rehabilitation Practice and Science
Bladder dysfunction makes huge impact on the patients with spinal cord injury. It not only causes inconvenience in daily living, but also leads to many complications, including life-threatening renal failure. Traditional methods had been brought into greater use for the management of bladder dysfunction, such as indwelling catheter, clean intermittent catheterization, external condom catheter, bladder augmentation and so on. Electric stimulation is an effective treatment for both bladder voiding and storage dysfunction and it can be used in many different location. The electrodes can be placed on spinal cord, nerve root, peripheral nerve, bladder and skin by surgical implantation, needle …
Assessments Of Spasticity By Hoffmann Reflex Parameters In Patients With Spinal Cord Injury, Juei-Hsiang Wang, Yen-Ho Wang, Chein-Wei Chang, Shin-Liang Pan, Che-Sheng Lin
Assessments Of Spasticity By Hoffmann Reflex Parameters In Patients With Spinal Cord Injury, Juei-Hsiang Wang, Yen-Ho Wang, Chein-Wei Chang, Shin-Liang Pan, Che-Sheng Lin
Rehabilitation Practice and Science
Muscle spasticity is a common problem that affects patients who have suffered spinal cord injury (SCI). It can affect the motor skills, activities of daily living, and quality of life of these patients. The modified Ashworth scale (MAS) is a widely used clinical rating scale for spasticity, but its validity and reliability have been questioned. Much attention has been devoted to the evaluation of spasticity by using electrophysiological approaches. Increased excitation of motor neurons, exaggerated stretch reflex, decreased presynaptic inhibition, and reduced reciprocal inhibition have been found to be associated with spasticity. In several previous studies, the Hoffmann (H) reflex …
The Recovery Index Of Oxygen Saturation From Orthostatic Syncope In Patients With Spinal Cord Injury, David S. Liu, Alice M. K. Wong, Shih-Ching Chen, Kang-Ping Lin, Chien-Hung Lai, Walter H. Chang
The Recovery Index Of Oxygen Saturation From Orthostatic Syncope In Patients With Spinal Cord Injury, David S. Liu, Alice M. K. Wong, Shih-Ching Chen, Kang-Ping Lin, Chien-Hung Lai, Walter H. Chang
Rehabilitation Practice and Science
Orthostatic hypotension (OH) is a common clinical problem for patients with spinal cord injury (SCI) at the cervical or high thoracic level when they move from the supine position to the upright position. Patients with severe SCI frequently suffer from symptoms of OH during head-up tilt, ranging from slight lightheadedness to full syncope. Tilt-table training is commonly used in clinical physiotherapy to overcome OH syncope, but this also relies on carefully manual control of the tilt angle and training time by the therapist during training. Up till now, it still has no method to estimate the recovery process of OH …
A Pilot Trial Of A Telephone-Linked Patient Service System: Spinal Cord Injury Patients As An Example, Tsung-Yu Wei, Shao-Li Han, Wen-Hsien Tseng, Fong-Bin Yan, Kwan-Yu Chan, Polun Chang, Wai-Keung Lee
A Pilot Trial Of A Telephone-Linked Patient Service System: Spinal Cord Injury Patients As An Example, Tsung-Yu Wei, Shao-Li Han, Wen-Hsien Tseng, Fong-Bin Yan, Kwan-Yu Chan, Polun Chang, Wai-Keung Lee
Rehabilitation Practice and Science
The pressure of lack of enough resources on our National Health Insurance program and an increasing population of the aged and chronic patients has made the tele-home care technology an important choice. The tele-home care service is also regarded by our government as one of the core new service businesses for 2008. In this study, a prototype Tele-Home Care system, composed of Telephone-linked Care (TLC), Automatic Speech Recognition (ASR), Text-To-Speech (TTS) and automatic questionnaire recognition, was developed and evaluated for spinal cord injury patient care.The prototype systems included a personal computer with an EASYTAPI voice card, a Fax card and …
Bladder Management And Urologic Outcome In Patients With Chronic Spinal Cord Lesions, Je-Kuei Yang, Su-Ju Tsai, I-Chun Chen, Liu-Ing Bih
Bladder Management And Urologic Outcome In Patients With Chronic Spinal Cord Lesions, Je-Kuei Yang, Su-Ju Tsai, I-Chun Chen, Liu-Ing Bih
Rehabilitation Practice and Science
Between February and September 2004, 73 patients with spinal cord lesions of greater than 2 years duration were enrolled in this study. A chart reviewarticle was conducted to record the manner in which the patients' bladder management, previous urologic complications, and any corresponding treatments and effects. Among the patients, 55 were male and 18 were female, with an average age of 29.3±12.1 and 32.0±13.0 years, respectively. The mean duration of the patients' injuries was 9.5±6.9 years in men, and 7.0±4.5 years in women, respectively.Group Ⅰ included 8 patients (11.0%) who had indwelling catheters since the time of their injury and …
Autonomic Dysreflexia In Ankylosing Spondylitis With Double Spinal Cord Injuries: A Casereport, Shu-Chun Huang, Wun-Jhong Tsai, Shih-Wei Chou, Chin-Man Wang, Alice M. K. Wong
Autonomic Dysreflexia In Ankylosing Spondylitis With Double Spinal Cord Injuries: A Casereport, Shu-Chun Huang, Wun-Jhong Tsai, Shih-Wei Chou, Chin-Man Wang, Alice M. K. Wong
Rehabilitation Practice and Science
This 54-year-old man underlying ankylosing spondylitis suffered from double spinal cord injuries with traumatic C6/7 dislocation and a neglected L1 vertebral body fracture which progressed to transverse fracture three weeks after the injury, acting as a powerful precipitant to autonomic dysreflexia. The dysreflexic symptoms happened at least three times when he practiced sitting during mat exercise and ameliorated soon by virtue of lying down. Compared with the previous record checked three weeks ago, neurologic examination revealed alteration of sensory level and loss of deep anal sensation. The patient received L1 laminectomy as well as T12 and L2 transpedicle screws fixation, …
Follow-Up And Treatment Of Neurogenic Bladder Dysfunction With Compromised Upper Urinary Tract: A Casereport, Su-Ju Tsai, Yu-Hui Huang, Yu-Pei Chien, Fan-Fei Tseng
Follow-Up And Treatment Of Neurogenic Bladder Dysfunction With Compromised Upper Urinary Tract: A Casereport, Su-Ju Tsai, Yu-Hui Huang, Yu-Pei Chien, Fan-Fei Tseng
Rehabilitation Practice and Science
In spinal cod injury (SCI) patients with neurogenic bladder dysfunction (NBD), detrusor hyperreflexia and poor bladder compliance may lead to increased intravesical pressure and other adversities, including urinary tract infection, hydronephrosis, vesicoureteral reflux, and impairment of renal function. The primary objectives of urologic care after SCI are to provide an acceptable method for managing the lower urinary tract, to prevent urinary complications, and to preserve renal function. Because urologic status can change or deteriorate many years after the initial injury, sometimes without symptoms, lifelong urologic follow-up is fundamental for all SCI patients with NBD. Strategy of bladder management in individuals …
Retrospective Study Of Long-Term Medical Complications In Spinal Cord Injured Patients, Hui-Wen Yu, Su-Ju Tsai, Fan-Fei Tseng, Yu-Hui Huang, Ying-Ju Shih, Liu-Ing Bih
Retrospective Study Of Long-Term Medical Complications In Spinal Cord Injured Patients, Hui-Wen Yu, Su-Ju Tsai, Fan-Fei Tseng, Yu-Hui Huang, Ying-Ju Shih, Liu-Ing Bih
Rehabilitation Practice and Science
In order to determine the prevalence of medical complications after spinal cord injury, 52 patients who received regular follow up in a rehabilitation hospital (average 14.1 years) were studied. Medical records were reviewarticleed and analyzed, including demographic data, onset duration, neurological level, locomotion, reason for visiting doctor's office, rehospitalization, medication usage, and surgical intervention. The most common complication encountered was constipation (82.7%). Other common complications were neurogenic bladder dysfunction (80.8%), urinary tract infection (75.0%), musculoskeletal pain (71.2%), spasticity (67.3%) and gastrointestinal disturbance (51.9%). reviewarticleing the medical records in the most recent year, constipation was still the most common complication (46.2%). …
Survey Of Spinal Cord Injuries Due To Diving Accidents In Taiwan, Ya-Wen Tu, Huey-Wen Liang, Yen-Ho Wang, Jiunn-Horng Kang, Liu-Ing Bih, Fuk-Tan Tang
Survey Of Spinal Cord Injuries Due To Diving Accidents In Taiwan, Ya-Wen Tu, Huey-Wen Liang, Yen-Ho Wang, Jiunn-Horng Kang, Liu-Ing Bih, Fuk-Tan Tang
Rehabilitation Practice and Science
Objective: To examine the clinical characteristics of diving-related spinal cord injuries (SCI) in Taiwan.Methods: This study is a retrospective reviewarticle of all hospitalized patients with spinal cord injuries due to diving accidents in three rehabilitation centers between January 1982 and July 2002. Demographic data and clinical features were presented and analyzed. Results: A total of 1216 spinal cord injuries were reviewarticleed, and 16 cases (1.3%) met the inclusion criteria. Their mean age at the time of injury was 26.8 years and 15 (94.0%) of the cases were male. All of the injuries resulted in tetraplegia and 11 (69.0%) were neurologically …
Gabapentin For Treatment Of Neuropathic Pain In Patients With Spinal Cord Injury, Chao-Min Wang, Yen-Ho Wang
Gabapentin For Treatment Of Neuropathic Pain In Patients With Spinal Cord Injury, Chao-Min Wang, Yen-Ho Wang
Rehabilitation Practice and Science
The patients with spinal cord injury suffer from motor and sensory impairment with bowel and bladder dysfunction. However, chronic neuropathic pain is also a common complaint after spinal cord injury and is usually refractory to many therapies. The exact mechanism of relieving hyperalgesia and allodynia is still unknown, but most believed it is related to N-methyl-D-aspartate (NMDA) receptor and voltage-dependent calcium channel. Gabapentin is supposed to be an antagonist of NMDA receptor complex which mediates an influx of calcium ions when activated. In addition, gabapentin inhibits neuronal calcium influx in a calcium channel by binding to the α2δ subunit of …
The Bony Fractures In Patients With Chronic Spinal Cord Injury In Southern Taiwan, Liang-Shiuan Chen, Ta-Shen Kuan, Jo-Tong Chen, Wei-Jang Yen, Shu-Min Chen
The Bony Fractures In Patients With Chronic Spinal Cord Injury In Southern Taiwan, Liang-Shiuan Chen, Ta-Shen Kuan, Jo-Tong Chen, Wei-Jang Yen, Shu-Min Chen
Rehabilitation Practice and Science
Immobilization following spinal cord injury (SCI) is a condition known to be associated with osteoporosis, which leads to increased risk of fractures. The aim of this study was to survey the incidence of bony fractures and its associated factors among chronic SCI patients in southern Taiwan. We recruited 194 patients, including 153 men and 41 women. Their mean age was 46 years old. The average duration of SCI was 12 years. There were 110 paraplegics (56.7%) and 84 tetraplegics (43.3%). Fractures after SCI were noted in 16 of the 194 patients (8.2%). There were no significant differences in age, sex, …
Bimalleolar Fracture After Spinal Cord Injury: A Casereport, Shie-Fu Shieh, Huey-Wen Liang, Wen-Hsung Hou, Yen-Ho Wang, Shih-Fong Huang
Bimalleolar Fracture After Spinal Cord Injury: A Casereport, Shie-Fu Shieh, Huey-Wen Liang, Wen-Hsung Hou, Yen-Ho Wang, Shih-Fong Huang
Rehabilitation Practice and Science
The incidence of fracture is higher in patients with chronic spinal cord injury (SCI), particularly female and elderly patients, than in healthy people. Functional impairment due to SCI may lead to accidental falls and fractures, most of which are due to trivial injury or without known trauma. In addition, the inevitable osteoporosis in the paralyzed limbs of individuals with chronic SCI increases their risk of fracture. The lower limbs are more often involved than the upper limbs. Because of the sensory impairment associated with SCI, fractures may be difficult to diagnose, and treatment may be delayed. The treatment of fractures …