Search

Purpose: The aim of the study is to use the World Health Organization community-based rehabilitation matrix for understanding services' contributions to foster community participation for people with traumatic spinal cord injury., Methods: This study used a convergent mixed-methods design with a quantitative arm describing the frequency with which services contributed to 22 of the community-based rehabilitation-matrix elements and a qualitative arm involving document reviews and stakeholder interviews. Results were integrated following Onwuegbuzie and Teddlie's method (i.e., quan + QUAL)., Results: Twenty of the 22 (91%) of the World Health Organization community-based rehabilitation elements were addressed by traumatic spinal cord injury services. Five types of services were identified. Integrated results showed that the strengths of traumatic spinal cord injury services were as follows: (1) comprehensiveness; (2) essential medical services publicly funded; (3) numerous social protections available; and (4) highly active community-based organizations. Identified opportunities to improve these services were as follows: (1) increase specificity for traumatic spinal cord injury and (2) increase communication and integration among services., Conclusions: Services available for people with traumatic spinal cord injury in the province studied address most of the elements of the World Health Organization community-based rehabilitation matrix. However, lack of cohesion between services could create gaps that hinder community participation. Addressing these gaps could improve the quality of life and outcomes of people with traumatic spinal cord injury., Competing Interests: Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

In a 43-yr-old male subject with a chronic T3 AIS A spinal cord injury, the acute cardiorespiratory responses to active upper-extremity exercise alone and combined active-arm passive-leg exercise (AAPLE) were investigated, along with the cardiorespiratory, cardiac, vascular, and body composition responses to a 6-wk AAPLE interval training intervention. AAPLE elicited superior acute maximal cardiorespiratory responses compared with upper-extremity exercise alone. In response to a 6-wk interval training regimen, AAPLE caused a 25% increase in peak oxygen uptake, a 10% increase in resting stroke volume, and a 4-fold increase in brachial artery blood flow. Conversely, there were no changes in femoral arterial function, body composition, or bone mineral density in response to training. As a potential clinical intervention, AAPLE may be advantageous over other forms of currently available exercise, owing to the minimal setup time and cost involved and the nonreliance on specialized equipment that is required for other exercise modalities.