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Systematic Review.To review systematically the clinical evidence of the effectiveness of various intermittent catheter cleaning methods that have been proposed as methods to prepare catheters for reuse.A keyword search in Medline, Excerpta Medica dataBASE, the Cumulative Index to Nursing and Allied Health Literature, Web of Science and Cochrane Central Register of Controlled Trials, was undertaken to identify all English, Russian and German language literature evaluating the effectiveness of various intermittent catheter cleaning methods. Studies selected for review included analytical experimental, prospective cohort and cross-sectional. Cleaning methods reviewed included heat-based sterilization, chemical cleaning solutions, mechanical abrasion, photocatalytic sterilization, and combined methods.Overall, 12 studies were included. Heat-based sterilization and mechanical abrasion methods were either not effective or damaged the physical properties of catheters. Two studies reported evidence that their chemical cleaning methods (i.e., soaked catheters in a 70% alcohol solution for 5 min or combined approach detergent wash followed by soaking in Milton sterilizing fluid also known as the Milton method) both preserved the structural integrity of their catheters and were bactericidal.Numerous cleaning methods resulted in the destruction of catheters. However, there are two reported cleaning methods, submersion for 5 min in 70% alcohol and the "Milton method", that eliminate bacterial colonization while leaving the physical properties of the catheters unchanged. While these cleaning methods are promising, each was published in just one study, therefore higher-powered / longitudinal studies confirming the safety and efficacy of these cleaning methods must be obtained before current clinical recommendations can be modified.

Study Design: A cross-sectional design. Objectives:This is an exploratory study to better understand how individuals with SCI in these diverse countries are managing and coping with bladder and bowel dysfunction. Setting: Our project is a collaboration between two centers: the International Collaboration on Repair Discoveries (ICORD)/Blusson Spinal Cord Center in Vancouver, Canada and the Indian Spinal Injuries Centre in New Delhi, India. Methods: Data from thirty-three participants was analyzed. Participants completed an online questionnaire that included demographic information and assessed bowel and bladder functioning using the Neurogenic Bowel Dysfunction (NBD) score, Wexner Incontinence score (WIS), Neurogenic Bladder Symptom Score (NBSS) and the Incontinence QOL (I-QOL). Continuous data were compared using t-tests; for not normally distributed data Mann-Whitney U tests used. For evaluation of association between categorical variables, Fisher’s exact test or Chi-square was used. Results: The Canadian sample reported higher NBD total scores indicating more severe bowel dysfunction, less daily bowel movements, and was more likely to experience uneasiness, headaches, and perspiration during bowel movements. The NBSS indicated a higher proportion of the Indian sample was unsatisfied or unhappy with their bladder function. The distribution of the WIS and I-QOL scores were the same across both countries. Conclusion: Potential explanations for differences include diet, methods of management, financial resources, as well as patient and caregiver education. These variables are heavily influenced by cultural, geographical, and economic circumstances.

Supplemental material, sj-pdf-1-nro-10.1177_10738584221145570 for Mapping the Iceberg of Autonomic Recovery: Mechanistic Underpinnings of Neuromodulation following Spinal Cord Injury by Soshi Samejima, Claire Shackleton, Tiev Miller, Chet T. Moritz, Thomas M. Kessler, Klaus Krogh, Rahul Sachdeva and Andrei V. Krassioukov in The Neuroscientist

Additional file 1. Supplementary Information including Supplementary Tables 1–2 and Supplementary Figures 1–2.

Spinal cord injury (SCI) results in both motor and autonomic impairments, which can negatively affect independence and quality of life and increase morbidity and mortality. Despite emerging evidence supporting the benefits of activity-based training and spinal cord stimulation as two distinct interventions for sensorimotor and autonomic recovery, the combined effects of these modalities are currently uncertain. This scoping review evaluated the effectiveness of paired interventions (exercise + spinal neuromodulation) for improving sensorimotor and autonomic functions in individuals with SCI. Four electronic databases were searched for peer-reviewed manuscripts (Medline, Embase, CINAHL, and EI-compedex Engineering Village) and data were independently extracted by two reviewers using pre-established extraction tables. A total of 15 studies representing 79 participants were included in the review, of which 73% were conducted within the past 5 years. Only two of the studies were randomized controlled studies, while the other 13 studies were case or case-series designs. Compared with activity-based training alone, spinal cord stimulation combined with activity-based training improved walking and voluntary muscle activation, and augmented improvements in lower urinary tract, bowel, resting metabolic rate, peak oxygen consumption, and thermoregulatory function. Spinal neuromodulation in combination with use-dependent therapies may provide greater neurorecovery and induce long-term benefits for both motor and autonomic function beyond the capacity of traditional activity-based therapies. However, evidence for combinational approaches is limited and there is no consensus for outcome measures or optimal protocol parameters, including stimulation settings. Future large-scale randomized trials into paired interventions are warranted to further investigate these preliminary findings.

Background: The coronavirus disease 2019 (COVID-19) pandemic has disrupted the lives of people around the world since 2020. This study aims to reveal perceived impact of the coronavirus pandemic on physical and mental health and eating behaviors among people with disabilities and without disabilities in South Korea, as compared to other countries.Methods: A secondary analysis of a prospective cross-sectional study which was conducted with a web-based global survey.Results: Among the 3,550 responses from 65 countries, 2,621 responses with nation information were set as full data, 189 for South Korea and 2,432 for other countries. In Korea, there was no significant difference in healthy lifestyle behaviors between people with and without disabilities before the COVID-19 pandemic. Perceived physical and mental health and changes in eating habits during the COVID-19 pandemic showed no significant difference between people with and without disabilities in Korea. There were significant differences in physical health and dietary habits, but no differences in its effect on mental health between people living in Korea and other countries in both people with and without disabilities groups. In other words, more than 60% of people in all groups (disability vs. non-disability, Korea vs. non-Korea) reported worse mental health than before the COVID-19 pandemic.Conclusion: In Korea and other countries, mental health showed a tendency to deteriorate regardless of the presence or absence of disability during the COVID-19 pandemic. In terms of healthy eating habits, Koreans were relatively less affected than people from other countries

OBJECTIVE: To investigate the incidence of cardiac arrhythmias at six months following traumatic spinal cord injury (SCI) and to compare the prevalence of arrhythmias between participants with cervical and thoracic SCI. DESIGN: A prospective observational study using continuous twenty-four-hour Holter monitoring. SETTING: Inpatient rehabilitation unit of a university research hospital and patient home setting. PARTICIPANTS: Fifty-five participants with acute traumatic SCI were prospectively included. For each participant, the SCI was characterized according to the International Standards for Neurological Classification of SCI by the neurological level and severity according to the American Spinal Injury Association Impairment Scale. OUTCOME MEASURES: Comparisons between demographic characteristics and arrhythmogenic occurrences as early as possible after SCI (4 ± 2 days) followed by 1, 2, 3, 4 weeks and 6 month time points of Holter monitoring. RESULTS: Bradycardia (heart rate [HR]

Administrative and financial support provided by Paralyzed Veterans of America © Copyright 2020, Paralyzed Veterans of AmericaThese guidelines have been prepared based on scientific and professiona...

The aim of this pilot study was to assess the short-term microbiological burden and surface damage of catheters for intermittent catheterization (IC) in adult individuals with chronic (> 1-year) spinal cord injury (SCI). Three participants (two females, one male mean age 52 years) were asked to clean and reuse polyvinyl chloride catheters for IC over three days. Urine and catheter swab samples were collected on each day for microbiological analysis. After reuse, all catheters were analyzed via electron microscopy. Of all catheter swab cultures, 14 were negative, 12 were contaminated (i.e. skin or mixed flora), and one had growth of Haematomicrobium sanguinis. All urine cultures revealed either growth of Escherichia coli (n=10) in participants 1 and 2, or Klebsiella pneumoniae (n=4) or mixed enteric flora (n=1) in participant 3. Since all participants had asymptomatic bacteriuria with a significant number of colony-forming units per liter (CFU/L, i.e. > 100’000’000) prior to the study, we could not observe additional increases in the microbial growth (i.e. urine culture). Electron microscopy showed signs of surface damage, accumulation of debris and bacterial colonization on the exterior surface and lumen of the reused catheters. Thus, future studies should exclude participants with pre-study bacteriuria. Furthermore, a longer study duration as well as conducting electron microscopy of catheters after varied days of reuse could provide even better evidence on how structural and microbial changes of reused catheters progress over time.

Background: Spinal cord stimulation (SCS) is an emerging tool in physical medicine and rehabilitation which shows tremendous promise as a therapeutic modality for addressing a wide range of symptoms and functional impairments associated with chronic disease and disability. Although the standardized application of this tool is still in its nascence, there is growing demand for information related to SCS among the general public. Objective: This scoping review aimed to identify and assess web-based information regarding the use or application of SCS for the treatment or management of health conditions and symptoms. Methods: A systematic search was performed using the Joanna Briggs Institute’s methodology for scoping reviews. Google Trends was used to identify the top trending, worldwide search queries (i.e., keyword terms) within a specified time frame (February 02, 2012 to February 02, 2022). From these results, “spinal stimulator” was identified as the top queried term. After entering this term in the 4 most widely used search engines (Google, Baidu, Yahoo, and Bing), information on SCS found on primary websites within the first two pages of returned results were assessed. Results: One hundred and three websites were identified for the term “spinal stimulator” (Google=30, Baidu=20, Yahoo=29, Bing=24). After duplicate removal, 46 unique primary sites were identified. Primary sites were scientific resources (n=5), non-profit (n=8), for-profit (n=17), news/media (n=3), independent/blogs (n=3), or peer-reviewed journal articles (n=10). Linked sites (n=55) with additional resources were also identified. Conclusions: Publicly available web-based information on the use of SCS mainly targets people with chronic pain. 29 websites described epidural SCS exclusively but did not describe any contraindications. Our preliminary search results suggest that more than half of all websites curating information on invasive (i.e., epidural) SCS did not describe potential risk factors and harms associated with these procedures. This review is currently on-going.

Spinal cord injury (SCI) results in devastating cardiovascular dysfunction. Noxious stimuli from the rectum during bowel routine often trigger life-threatening blood pressure surges, termed autonomic dysreflexia (AD). Rectal application of anesthetic lidocaine jelly has been recommended during bowel care to reduce AD severity by mitigating sensory input. However, clinical studies have reported contradicting evidence. We performed a pre-clinical study on the efficacy of rectal lidocaine in a standardized rodent T3 transection model. We found that 2% and 10% lidocaine significantly reduced AD severity by 32% and 50%, respectively, compared with control (