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Full-Text Articles in Medicine and Health Sciences
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 …
Application Of Digital Volume Pulse Analysis In Patients With Spinal Cord Injury, Wei-Lun Tsai, Alice May-Kuen Wong, Yu-Cheng Pei, Yu-Ru Lin, Yu-Hsin Liao, Shu-Chun Huang
Application Of Digital Volume Pulse Analysis In Patients With Spinal Cord Injury, Wei-Lun Tsai, Alice May-Kuen Wong, Yu-Cheng Pei, Yu-Ru Lin, Yu-Hsin Liao, Shu-Chun Huang
Rehabilitation Practice and Science
Orthostatic hypotension is a common complication following spinal cord injury (SCI). However, an easy method to quantify the degree of vasomotor impairment below the level of injury is lacking. We postulated that SCI patients with different sympathetic reserves exhibited different digital volume pulse contours. Thirty-one patients with high chronic SCI (above the T6 neurologic level) and 28 low-level SCI patients (below T6) were recruited. Thirty-two age- and BMI-matched healthy participants were enrolled in the control group. All participants were positioned on a tilting table for five minutes in each of the following: supine rest (SR), 60-degree head-up tilt (HUT), and …
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 …
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 …
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 …
Down Syndrome With Os Odontoideum And Spinal Cord Injury: A Casereport, Li-Chen Tung, Yu-Lin Wang, Chen-Yu Chou, Hui-Chun Juan, I-Hsien Wu, Willy Chou
Down Syndrome With Os Odontoideum And Spinal Cord Injury: A Casereport, Li-Chen Tung, Yu-Lin Wang, Chen-Yu Chou, Hui-Chun Juan, I-Hsien Wu, Willy Chou
Rehabilitation Practice and Science
Down syndrome is a genetic disorder caused by trisomy on chromosome 21 that occurs in 1 of every 800 live births. Down syndrome can involve skeletal malformations that include patella or hip dislocation, genu valgus and atlanto-axial instability (AAI). Prompt recognition and treatment of the latter is important. This casereport describes an odontoid fracture due to AAI in a seven-year-old with Down syndrome.
Since October 2000, the child had involved in robust activities including floor tumbling and hand stands. Beginning in April 2001, the right extremities showed signs of weakness and there was an unsteady gait. Upon physical examination, AAI …
Does Shortwave Diathermy Reduce The Intractable Spasticity Of Patients With Spinal Cord Injury?, Hung-Tzu Su, Tien-Wen Chen, Ming-Cheng Weng, Chia-Ling Lee, Mao-Hsiung Huang
Does Shortwave Diathermy Reduce The Intractable Spasticity Of Patients With Spinal Cord Injury?, Hung-Tzu Su, Tien-Wen Chen, Ming-Cheng Weng, Chia-Ling Lee, Mao-Hsiung Huang
Rehabilitation Practice and Science
Spasticity is a hallmark of an upper motor neuron disorder and represents the most important impairments for individuals who care for patients with central nervous system disease. It may have an adverse effect on rehabilitation training. Shortwave diathermy is a modality that produces deep heat. It is usually used to relieve pain and stiffness, promote wound healing and relieve deep muscle spasm.In the present case, we show a 52-year-old male patient with spinal cord injury who has severe spastic hypertonia. He is disabling in motor and daily living. We have tried in vain with various physical therapy and medications. He …