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Background: The Capabilities of Upper Extremity Test (CUE-T) is a spinal cord injury (SCI)-specific instrument based on the CUE Questionnaire (CUE-Q). Objective: To evaluate the psychometric properties of CUE-T in children with cervical SCI and determine the lowest age appropriate for test administration. Method: In this repeated measures multicenter study, 39 youths, mean age 12.3 years and mean time post injury 5.14 years, completed two administrations of the CUE-T. Test-retest reliability, internal consistency, and known groups validity were measured. Concurrent and discriminant validity were measured against previously validated measures: CUE-Q, Graded Redefined Assessment of Strength, Sensibility and Prehension (GRASSP), Spinal Cord Independence Measure (SCIM) III, SCIM III-Self Care (SCIM-SC), and SCIM-Mobility. Results: The CUE-T scores demonstrated strong test-retest reliability (ICC ≥ 0.95), strong internal consistency (α ≥ 0.90), and acceptable individual item agreement (κ ≥ 0.49). The hand subscale had better scores (p < .05) for the motor incomplete versus complete known groups, and the arm, hand, and side subscales had better scores (p < .05) for higher versus lower strength groups. The CUE-T had strong concurrent validity with the CUE-Q (r = 0.85-0.87), GRASSP (r = 0.78-0.90), and SCIM-SC (r = 0.70) and moderate-to-weak correlation with the total SCIM (r = 0.65) and SCIM-Mobility (r = 0.51). Children older than 6 years with mature grasp patterns were able to complete the CUE-T. Conclusion: The CUE-T scores are reliable and valid for use in children with cervical SCI older than 6 years of age.

Coaching-in-Context (CinC) is a conversation-based process for working with people that draws on the tenets of positive psychology, is solution-focused and strength-based, and uses evidence-informed coaching techniques that create opportunities for clients to be at their best when engaging in the roles and activities that are desired, required, or expected of them. To explore the use of CinC with informal maternal care partners (mothers, grandmothers) of children with spinal cord injury (SCI). This study was a multicenter, single group, pre-post treatment design. Participants received up to 10 sessions of CinC over a 10-week period. The Canadian Occupational Performance Measure (COPM), Parenting Stress Index, Fourth Edition Short Form (PSI-4-SF), and Pediatric Measure of Participation Short Form (PMoP SF) were administered before and after coaching. The number of coaching sessions completed, missed, and rescheduled was recorded. Descriptive and nonparametric statistics were used to summarize sample characteristics and to evaluate changed COPM scores. PSI-4-SF stress percentiles were examined descriptively. Wilcoxon signed-rank test was used to determine whether there was a statistically significant change between baseline and postcoaching COPM and PMoP SF scores. Nine caregivers enrolled in the study; two had face-to-face coaching, five had phone coaching, and two dropped out. The seven who completed were mothers with an average age of 37.14 (range, 32–45; SD = 5.15) years, with children an average age of 10 (range, 7–13; SD = 2.89) years with paraplegia (n = 4) or tetraplegia (n = 3) sustained an average of 6.71 (range, 2–13; SD = 3.73) years prior to the study. Fifty-five (average = 7.86, mode = 9; range, 3–10) coaching sessions were provided; two sessions were missed and nine were rescheduled. After coaching, mean COPM performance scores increased by 2.48 (SD = 2.01) (Z = −4.057, p <.001), mean COPM satisfaction scores increased by 2.81 (SD = 1.33) (Z = −4.812, p <.001), and PMoP self scores increased (Z = −2.023, p <.043). This study provides preliminary support for CinC with informal care partners of children with SCI. It also highlights several factors that are important to consider when implementing a coaching program, namely mode of delivery and time commitment. [ABSTRACT FROM AUTHOR]

Objectives: Tract-based spatial statistics (TBSS) is a diffusion tensor imaging (DTI)–based processing technique that aims to improve the objectivity and interpretability of analysis of multisubject diffusion imaging studies. This study used TBSS to measure quantitative changes in brain white matter structures following spinal cord injury (SCI). Methods: Eighteen SCI subjects aged 8–20 years old (mean age, 16.5 years) were scanned using a conventional single-shot EPI DTI protocol using a 3.0T Siemens MR scanner. All participants underwent a complete International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) examination to determine the level and severity of injury. Five participants were classified as American Spinal Injury Association Impairment Scale (AIS) A, nine as AIS B, and four as AIS C/D. Imaging parameters used for data collection were as follows: 20 directions, b = 1000 s/mm2, voxel size = 1.8 mm x 1.8 mm, slice thickness = 5 mm, TE = 95 ms, TR = 4300 ms, slices = 30, TA = 4:45 min. To generate TBSS, nonparametric permutation tests were used for voxel-wise statistical analysis of the fractional anisotropy (FA) skeletons between AIS groups. A two-tailed t test was applied to extract voxels with significant differences at p <.05. Results: Notable significant changes occurred throughout the corticospinal, spinothalamic, and dorsal column/medial lemniscus tracts. Altered regions in the temporal, occipital, and parietal lobes were also identified. Conclusion: These results suggest that white matter structures are altered differently between people with different AIS classifications. TBSS has the potential to serve as a screening tool to identify white matter changes in regions of interest. [ABSTRACT FROM AUTHOR]

Introduction: A scoping review provides a means to synthesize and present a large body of literature on a broad topic, such as methods for various upper extremity activity-based therapy (ABT) interventions. Objectives: To describe our scoping review protocol to evaluate peer-reviewed articles focused on ABT interventions for individuals with neurologically impaired upper extremities. Methods: At Jefferson College of Health Professions and Sidney Kimmel Medical College at Jefferson, Philadelphia, the authors will follow this protocol to conduct a scoping review by establishing a research question and conducting a search of bibliographic databases to identify relevant studies. Using specific inclusion and exclusion criteria, abstracts will be screened and full-text articles will be reviewed for inclusion in charting, summarizing, and reporting results of appropriate studies. Conclusion: This protocol will guide the scoping review process to develop a framework for establishing a noninvasive ABT intervention informed by evidence for individuals with neurologically impaired upper extremities. [ABSTRACT FROM AUTHOR]