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Bandini A, Dousty M, Hitzig SL, Craven BC, Kalsi-Ryan S, Zariffa J. Measuring Hand Use in the Home after Cervical Spinal Cord Injury Using Egocentric Video. J Neurotrauma 2022; 39:1697-1707. [PMID: 35747948 DOI: 10.1089/neu.2022.0156] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Egocentric video has recently emerged as a potential solution for monitoring hand function in individuals living with tetraplegia in the community, especially for its ability to detect functional use in the home environment. The aim of this study was to develop and validate a wearable vision-based system for measuring hand use in the home among individuals living with tetraplegia. Several deep learning algorithms for detecting functional hand-object interactions were developed and compared. The most accurate algorithm was used to extract measures of hand function from 65 h of unscripted video recorded at home by 20 participants with tetraplegia. These measures were: the percentage of interaction time over total recording time (Perc); the average duration of individual interactions (Dur); and the number of interactions per hour (Num). To demonstrate the clinical validity of the technology, egocentric measures were correlated with validated clinical assessments of hand function and independence (Graded Redefined Assessment of Strength, Sensibility and Prehension [GRASSP], Upper Extremity Motor Score [UEMS], and Spinal Cord Independent Measure [SCIM]). Hand-object interactions were automatically detected with a median F1-score of 0.80 (0.67-0.87). Our results demonstrated that higher UEMS and better prehension were related to greater time spent interacting, whereas higher SCIM and better hand sensation resulted in a higher number of interactions performed during the egocentric video recordings. For the first time, measures of hand function automatically estimated in an unconstrained environment in individuals with tetraplegia have been validated against internationally accepted measures of hand function. Future work will necessitate a formal evaluation of the reliability and responsiveness of the egocentric-based performance measures for hand use.
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Affiliation(s)
- Andrea Bandini
- KITE Research Institute and Toronto, Ontario, Canada.,The BioRobotics Institute and Scuola Superiore Sant'Anna, Pisa, Italy.,Department of Excellence in Robotics and AI, Scuola Superiore Sant'Anna, Pisa, Italy
| | - Mehdy Dousty
- KITE Research Institute and Toronto, Ontario, Canada.,Institute of Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada
| | - Sander L Hitzig
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada.,St. John's Rehab Research Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.,Department of Occupational Science and Occupational Therapy, and University of Toronto, Toronto, Ontario, Canada
| | - B Catharine Craven
- KITE Research Institute and Toronto, Ontario, Canada.,Brain and Spinal Cord Rehabilitation Program Toronto Rehabilitation Institute - University Health Network, Toronto, Ontario, Canada.,Division of Physical Medicine and Rehabilitation Temerty Faculty of Medicine, and University of Toronto, Toronto, Ontario, Canada
| | - Sukhvinder Kalsi-Ryan
- KITE Research Institute and Toronto, Ontario, Canada.,Department of Physical Therapy and University of Toronto, Toronto, Ontario, Canada
| | - José Zariffa
- KITE Research Institute and Toronto, Ontario, Canada.,Institute of Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada.,Edward S. Rogers Sr. Department of Electrical and Computer Engineering, University of Toronto, Toronto, Ontario, Canada
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2
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Capturing hand use of individuals with spinal cord injury at home using egocentric video: a feasibility study. Spinal Cord Ser Cases 2021; 7:17. [PMID: 33674553 DOI: 10.1038/s41394-021-00382-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 12/27/2020] [Accepted: 02/10/2021] [Indexed: 11/09/2022] Open
Abstract
STUDY DESIGN Feasibility study. OBJECTIVE The objective of this study is to explore the feasibility of capturing egocentric (first person) video recordings in the home of individuals with cervical spinal cord injury (SCI) for hand function evaluation. SETTING Community-based study in Toronto, Ontario, Canada. METHODS Three participants with SCI recorded activities of daily living (ADLs) at home without the presence of a researcher. Information regarding recording characteristics and compliance was obtained as well as structured and semi-structured interviews involving privacy, usefulness, and usability. A video processing algorithm capable of detecting interactions between the hand and objects was applied to the home recordings. RESULTS In all, 98.58 ± 1.05% of the obtained footage was usable and included four to eight unique activities over a span of 3-7 days. The interaction detection algorithm yielded an F1 score of 0.75 ± 0.15. CONCLUSIONS Capturing ADLs using an egocentric camera in the home environment after SCI is feasible. Considerations regarding privacy, ease of use of the devices, and scheduling of recordings are provided.
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Dousty M, Zariffa J. Towards Clustering Hand Grasps of Individuals with Spinal Cord Injury in Egocentric Video. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2020; 2020:2151-2154. [PMID: 33018432 DOI: 10.1109/embc44109.2020.9175918] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Cervical spinal cord injury (cSCI) can cause paralysis and impair hand function. Existing assessments in clinical settings do not reflect an individual's performance in their daily environment. Videos from wearable cameras (egocentric video) provide a novel avenue to analyze hand function in non-clinical settings. Due to the large amounts of video data generated by this approach, automated analysis methods are necessary. We propose to employ an unsupervised learning process to produce a summary of the grasping strategies used in an egocentric video. To this end, an approach was developed consisting of hand detection, pose estimation, and clustering algorithms. The performance of the method was examined with external evaluation indicators and internal evaluation indicators for an uninjured and injured participant, respectively. The results demonstrated that a Gaussian mixture model obtained the highest accuracy in terms of the maximum match, 0.63, and the Rand index, 0.26, for the uninjured participant, and a silhouette score of 0.13 for the injured participant.
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Bandini A, Dousty M, Zariffa J. A wearable vision-based system for detecting hand-object interactions in individuals with cervical spinal cord injury: First results in the home environment. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2020; 2020:2159-2162. [PMID: 33018434 DOI: 10.1109/embc44109.2020.9176274] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Cervical spinal cord injury (cSCI) causes the paralysis of upper and lower limbs and trunk, significantly reducing quality of life and community participation of the affected individuals. The functional use of the upper limbs is the top recovery priority of people with cSCI and wearable vision-based systems have recently been proposed to extract objective outcome measures that reflect hand function in a natural context. However, previous studies were conducted in a controlled environment and may not be indicative of the actual hand use of people with cSCI living in the community. Thus, we propose a deep learning algorithm for automatically detecting hand-object interactions in egocentric videos recorded by participants with cSCI during their daily activities at home. The proposed approach is able to detect hand-object interactions with good accuracy (F1-score up to 0.82), demonstrating the feasibility of this system in uncontrolled situations (e.g., unscripted activities and variable illumination). This result paves the way for the development of an automated tool for measuring hand function in people with cSCI living in the community.
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Tomaschek R, Gemperli A, Rupp R, Geng V, Scheel-Sailer A. A systematic review of outcome measures in initial rehabilitation of individuals with newly acquired spinal cord injury: providing evidence for clinical practice guidelines. Eur J Phys Rehabil Med 2019; 55:605-617. [DOI: 10.23736/s1973-9087.19.05676-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Likitlersuang J, Sumitro ER, Cao T, Visée RJ, Kalsi-Ryan S, Zariffa J. Egocentric video: a new tool for capturing hand use of individuals with spinal cord injury at home. J Neuroeng Rehabil 2019; 16:83. [PMID: 31277682 PMCID: PMC6612110 DOI: 10.1186/s12984-019-0557-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 06/25/2019] [Indexed: 11/10/2022] Open
Abstract
Background Current upper extremity outcome measures for persons with cervical spinal cord injury (cSCI) lack the ability to directly collect quantitative information in home and community environments. A wearable first-person (egocentric) camera system is presented that aims to monitor functional hand use outside of clinical settings. Methods The system is based on computer vision algorithms that detect the hand, segment the hand outline, distinguish the user’s left or right hand, and detect functional interactions of the hand with objects during activities of daily living. The algorithm was evaluated using egocentric video recordings from 9 participants with cSCI, obtained in a home simulation laboratory. The system produces a binary hand-object interaction decision for each video frame, based on features reflecting motion cues of the hand, hand shape and colour characteristics of the scene. Results The output from the algorithm was compared with a manual labelling of the video, yielding F1-scores of 0.74 ± 0.15 for the left hand and 0.73 ± 0.15 for the right hand. From the resulting frame-by-frame binary data, functional hand use measures were extracted: the amount of total interaction as a percentage of testing time, the average duration of interactions in seconds, and the number of interactions per hour. Moderate and significant correlations were found when comparing these output measures to the results of the manual labelling, with ρ = 0.40, 0.54 and 0.55 respectively. Conclusions These results demonstrate the potential of a wearable egocentric camera for capturing quantitative measures of hand use at home.
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Affiliation(s)
- Jirapat Likitlersuang
- Institute of Biomaterials & Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada.,KITE, Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
| | - Elizabeth R Sumitro
- Institute of Biomaterials & Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada.,KITE, Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
| | - Tianshi Cao
- KITE, Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
| | - Ryan J Visée
- Institute of Biomaterials & Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada.,KITE, Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
| | - Sukhvinder Kalsi-Ryan
- KITE, Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada.,Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada
| | - José Zariffa
- Institute of Biomaterials & Biomedical Engineering, University of Toronto, Toronto, Ontario, Canada. .,KITE, Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada.
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Behrman AL, Argetsinger LC, Roberts MT, Stout D, Thompson J, Ugiliweneza B, Trimble SA. Activity-Based Therapy Targeting Neuromuscular Capacity After Pediatric-Onset Spinal Cord Injury. Top Spinal Cord Inj Rehabil 2019; 25:132-149. [PMID: 31068745 PMCID: PMC6496965 DOI: 10.1310/sci2502-132] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Background: Activity-based therapies aim to improve neuromuscular capacity after spinal cord injury (SCI). Objective: The purpose of this prospective study was to report the impact of Activity-based Locomotor Training (AB-LT) on neuromuscular capacity in pediatric patients with SCI. Methods: Participants were enrolled for their first episode of AB-LT for a minimum of 60 daily, 1.5-hour sessions. The Segmental Assessment of Trunk Control (SATCo) and the Pediatric Neuromuscular Recovery Scale (Pediatric NRS) were assessed initially, every 20 sessions, and post 60 sessions. Results: Twenty-six consecutive patients, mean age 5 years (SD = 3), completed a mean 55 sessions (SD = 4) within 63 weekdays (SD = 9). The Pediatric NRS total score improved significantly, adjusted mean 11.4, from initial to post-60 sessions (p < .05) with an average adjusted evaluation-to-evaluation 3.7 change. SATCo scores improved significantly across 60 sessions, mean change 5.2, an estimated 1.7 change between evaluations (p < .05). Age at enrollment and chronicity had no effect; however, initial neuromuscular capacity scores were negatively correlated with change scores (p < .05). Conclusion: Sixty AB-LT sessions significantly improved trunk and neuromuscular capacity in children with SCI, regardless of age or chronicity at enrollment. Patients with lower initial scores made greater improvements than patients with higher initial neuromuscular capacity. Anecdotal parent reports of their child's functional change in the home and community highlight the synergy between quantitative change in neuromuscular capacity and meaningful, improved quality of life and the need for formal investigation of this relationship.
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Affiliation(s)
- Andrea L. Behrman
- Department of Neurological Surgery, Kentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, Kentucky
| | - Laura C. Argetsinger
- Pediatric NeuroRecovery Program, Spinal Cord Injury Outpatient Program, Frazier Rehab Institute, Louisville, Kentucky
| | - MacKenzie T. Roberts
- Pediatric NeuroRecovery Program, Spinal Cord Injury Outpatient Program, Frazier Rehab Institute, Louisville, Kentucky
| | - Danielle Stout
- Pediatric NeuroRecovery Program, Spinal Cord Injury Outpatient Program, Frazier Rehab Institute, Louisville, Kentucky
| | - Jennifer Thompson
- Department of Pediatrics, University of Louisville, Louisville, Kentucky
| | - Beatrice Ugiliweneza
- Department of Neurological Surgery, Kentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, Kentucky
| | - Shelley A. Trimble
- Pediatric NeuroRecovery Program, Spinal Cord Injury Outpatient Program, Frazier Rehab Institute, Louisville, Kentucky
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Marino RJ, Sinko R, Bryden A, Backus D, Chen D, Nemunaitis GA, Leiby BE. Comparison of Responsiveness and Minimal Clinically Important Difference of the Capabilities of Upper Extremity Test (CUE-T) and the Graded Redefined Assessment of Strength, Sensibility and Prehension (GRASSP). Top Spinal Cord Inj Rehabil 2018; 24:227-238. [PMID: 29997426 DOI: 10.1310/sci2403-227] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Background: The Capabilities of Upper Extremity Test (CUE-T) and the Graded Redefined Assessment of Strength, Sensibility and Prehension (GRASSP) were both developed to detect change in upper extremity (UE) function in persons with tetraplegia. Objective: To compare the responsiveness and minimal clinically important difference (MCID) of the CUE-T and the quantitative prehension (QtP) scale of the GRASSP. Methods: Subjects included 69 persons with tetraplegia: 60 with acute and 9 with chronic injuries. Subjects were assessed twice 3 months apart using the CUE-T, QtP-GRASSP, and upper extremity motor scores (UEMS). Subjects rated their impression of change in overall and right/left UE function from -7 to +7. The standardized response mean (SRM) was determined for acute subjects. MCID was estimated using a small subjective change (2-3 points) and change in UEMS. Results: Subjects were 41.9 ± 18.1 years old, neurological levels C1-C7; 25 were motor complete. For acute subjects, the SRMs for total/side CUE-T scores were 1.07/0.96, and for the QtP-GRASSP they were 0.88/0.78. MCIDs based on subjective change for total/side CUE-T scores were 11.7/6.1 points and for QtP-GRASSP were 6.4/3.0 points. Based on change in UEMS, MCIDs for total/side were 11.9/6.3 points for CUE-T and 6.0/3.3 points for QtP-GRASSP. Some subjects had changes in the CUE-T due to its arm items that were not seen with the QtP-GRASSP. Conclusion: Both the CUE-T and QtP-GRASSP are responsive to change in persons with acute cervical spinal cord injury with large SRMs. The CUE-T detects some changes in UE function not seen with the QtP-GRASSP.
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Affiliation(s)
- Ralph J Marino
- Department of Rehabilitation Medicine, Sidney Kimmel Medical College, Jefferson (Philadelphia University + Thomas Jefferson University), Philadelphia, Pennsylvania
| | - Rebecca Sinko
- Department of Occupational Therapy, Jefferson College of Health Professions, Jefferson (Philadelphia University + Thomas Jefferson University), Philadelphia, Pennsylvania
| | - Anne Bryden
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio
| | - Deborah Backus
- Crawford Research Institute, Shepherd Center Hospital, Atlanta, Georgia
| | - David Chen
- Department of Physical Medicine and Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, Illinois.,Center for Rehabilitation Outcomes Research, Shirley Ryan AbilityLab, Chicago, Illinois
| | - Gregory A Nemunaitis
- MetroHealth Medical Center/MetroHealth Rehabilitation Institute of Ohio, Cleveland, Ohio.,Department of Physical Medicine & Rehabilitation, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Benjamin E Leiby
- Division of Biostatics, Department of Pharmacology and Experimental Therapeutics, Sidney Kimmel Medical College at, Jefferson (Philadelphia University + Thomas Jefferson University), Philadelphia, Pennsylvania
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Slavin MD, Ni P, Tulsky DS, Kisala PA, Heinemann AW, Charlifue S, Fyffe DC, Graves DE, Marino RJ, Morse LR, Rosenblum D, Tate D, Worobey LA, Dawson MB, Jette AM. Spinal Cord Injury–Functional Index/Assistive Technology Short Forms. Arch Phys Med Rehabil 2016; 97:1745-1752.e7. [DOI: 10.1016/j.apmr.2016.03.029] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Revised: 03/02/2016] [Accepted: 03/04/2016] [Indexed: 10/21/2022]
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Hossain MS, Harvey LA, Rahman MA, Bowden JL, Islam MS, Taylor V, Muldoon S, Herbert RD. A pilot randomised trial of community-based care following discharge from hospital with a recent spinal cord injury in Bangladesh. Clin Rehabil 2016; 31:781-789. [DOI: 10.1177/0269215516654207] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- MS Hossain
- Centre for the Rehabilitation of the Paralysed, Dhaka, Bangladesh
| | - LA Harvey
- John Walsh Centre for Rehabilitation Research, University of Sydney, St Leonards, NSW, 2065, Australia
| | - MA Rahman
- Centre for the Rehabilitation of the Paralysed, Dhaka, Bangladesh
| | - JL Bowden
- John Walsh Centre for Rehabilitation Research, University of Sydney, St Leonards, NSW, 2065, Australia
| | - MS Islam
- Centre for the Rehabilitation of the Paralysed, Dhaka, Bangladesh
| | - V Taylor
- Centre for the Rehabilitation of the Paralysed, Dhaka, Bangladesh
| | - S Muldoon
- Livability, Enniskillen, Co Fermanagh, N Ireland
| | - RD Herbert
- Neuroscience Research Australia, Randwick, NSW, 2031, Australia
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Hossain MS, Harvey LA, Rahman MA, Muldoon S, Bowden JL, Islam MS, Jan S, Taylor V, Cameron ID, Chhabra HS, Lindley RI, Biering-Sørensen F, Li Q, Dhakshinamurthy M, Herbert RD. Community-based InterVentions to prevent serIous Complications (CIVIC) following spinal cord injury in Bangladesh: protocol of a randomised controlled trial. BMJ Open 2016; 6:e010350. [PMID: 26743709 PMCID: PMC4716220 DOI: 10.1136/bmjopen-2015-010350] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Accepted: 10/28/2015] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION In low-income and middle-income countries, people with spinal cord injury (SCI) are vulnerable to life-threatening complications after they are discharged from hospital. The aim of this trial is to determine the effectiveness and cost-effectiveness of an inexpensive and sustainable model of community-based care designed to prevent and manage complications in people with SCI in Bangladesh. METHODS AND ANALYSIS A pragmatic randomised controlled trial will be undertaken. 410 wheelchair-dependent people with recent SCI will be randomised to Intervention and Control groups shortly after discharge from hospital. Participants in the Intervention group will receive regular telephone-based care and three home visits from a health professional over the 2 years after discharge. Participants in the Control group will receive standard care, which does not involve regular contact with health professionals. The primary outcome is all-cause mortality at 2 years. Recruitment started on 12 July 2015 and the trial is expected to take 5 years to complete. ETHICS AND DISSEMINATION Ethical approval was obtained from the Institutional Ethics Committee at the site in Bangladesh and from the University of Sydney, Australia. The study will be conducted in compliance with all stipulations of its protocol, the conditions of ethics committee approval, the NHMRC National Statement on Ethical Conduct in Human Research (2007), the Note for Guidance on Good Clinical Practice (CPMP/ICH-135/95) and the Bangladesh Guidance on Clinical Trial Inspection (2011). The results of the trial will be disseminated through publications in peer-reviewed scientific journals and presentations at scientific conferences. TRIAL REGISTRATION NUMBERS ACTRN12615000630516, U1111-1171-1876.
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Affiliation(s)
- Mohammad S Hossain
- Centre for the Rehabilitation of the Paralysed, Savar, Dhaka, Bangladesh
| | - Lisa A Harvey
- John Walsh Centre for Rehabilitation Research, Kolling Institute, Sydney Medical School/Northern, University of Sydney, c/o Royal North Shore Hospital, St Leonards, New South Wales, Australia
| | | | - Stephen Muldoon
- Livability International, Enniskillen, Co Fermanagh N, Ireland
| | - Jocelyn L Bowden
- John Walsh Centre for Rehabilitation Research, Kolling Institute, Sydney Medical School/Northern, University of Sydney, c/o Royal North Shore Hospital, St Leonards, New South Wales, Australia
| | - Md. Shofiqul Islam
- Centre for the Rehabilitation of the Paralysed, Savar, Dhaka, Bangladesh
| | - Stephen Jan
- George Institute for Global Health, University of Sydney, Camperdown, New South Wales, Australia
| | - Valerie Taylor
- Centre for the Rehabilitation of the Paralysed, Savar, Dhaka, Bangladesh
| | - Ian D Cameron
- John Walsh Centre for Rehabilitation Research, Kolling Institute, Sydney Medical School/Northern, University of Sydney, c/o Royal North Shore Hospital, St Leonards, New South Wales, Australia
| | | | - Richard I Lindley
- George Institute for Global Health, University of Sydney, Camperdown, New South Wales, Australia
| | - Fin Biering-Sørensen
- Clinic for Spinal Cord Injuries, Rigshospitalet, University of Copenhagen, Hornbæk, Denmark
| | - Qiang Li
- George Institute for Global Health, University of Sydney, Camperdown, New South Wales, Australia
| | | | - Robert D Herbert
- Neuroscience Research Australia (NeuRA), Randwick, New South Wales, Australia
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Ardolino EM, Mulcahey MJ, Trimble S, Argetsinger L, Bienkowski M, Mullen C, Behrman AL. Development and Initial Validation of the Pediatric Neuromuscular Recovery Scale. Pediatr Phys Ther 2016; 28:416-426. [PMID: 27428576 DOI: 10.1097/pep.0000000000000285] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
PURPOSE The Neuromuscular Recovery Scale (NRS) was developed to assess the capacity of adults' post-spinal cord injury (SCI) to perform functional tasks without compensation. Application of the NRS to children has been challenging. The purpose of this study was to develop and complete the initial validation of a pediatric version of the NRS. METHODS First, the investigative team developed a draft Pediatric NRS. Next, a Delphi method was used to amend the draft by 12 pediatric experts. Finally, the revised Pediatric NRS was field-tested on a sample of children with SCI (n = 5) and without (n = 7). RESULTS After the Delphi process and field testing, the Pediatric NRS consists of 13 items scored on a 12-point scale. All items, except 1, achieved 80% agreement by experts. CONCLUSIONS This is the first step in development and validation of a pediatric SCI scale that evaluates neuromuscular capacity, in the context of pediatric function, without compensation.
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Affiliation(s)
- Elizabeth M Ardolino
- Doctor of Physical Therapy Program-Austin (Dr Ardolino), University of St. Augustine for Health Sciences, Austin, Texas; Jefferson School of Health Professions (Dr Mulcahey), Thomas Jefferson University, Philadelphia, Pennsylvania; Kosair Charities Center for Pediatric NeuroRecovery (Ms Trimble and Dr Argetsinger), Frazier Rehab Institute, Louisville, Kentucky; Shriners Hospitals for Children (Drs Bienkowski and Mullen), Philadelphia, Pennsylvania; and Department of Neurological Surgery (Dr Behrman), University of Louisville, Louisville, Kentucky
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Marino RJ, Kern SB, Leiby B, Schmidt-Read M, Mulcahey MJ. Reliability and validity of the capabilities of upper extremity test (CUE-T) in subjects with chronic spinal cord injury. J Spinal Cord Med 2015; 38:498-504. [PMID: 25297342 PMCID: PMC4612205 DOI: 10.1179/2045772314y.0000000272] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVE To determine the reliability and validity of the capabilities of upper extremity test (CUE-T), a measure of functional limitations, in patients with chronic tetraplegia. DESIGN Repeated measures. SETTING Outpatient rehabilitation center. PARTICIPANTS Fifty subjects (36 male/14 female) with spinal cord injury (SCI) of ≥1-year duration participated. Subjects were 17-81 years old (mean 48.1 ± 18.2); neurological levels ranged from C2 through T6, American Spinal Injury Association Impairment Scale grades A-D. INTERVENTIONS Not applicable. OUTCOME MEASURES Intraclass correlation coefficients (ICC), weighted kappa and repeatability values for CUE-T; Spearman correlations of CUE-T with upper extremity motor scores (UEMS), and self-care and mobility portions of the Spinal Cord Independence Measure, vIII (SCIM III). RESULTS Score ranges for UEMS were 8-50, CUE-T 7-135, self-care SCIM 0-20, and mobility SCIM 0-40. The ICC values for total, right, and left side scores were excellent (0.97-0.98; 95% confidence interval 0.96-0.99). Item weighted kappa values were ≥0.60 for all but five items, four of which were right and left pronation and supination. Repeatability of total score was 10.8 points, right and left sides 6.3 and 6.1 points. Spearman correlations of the total CUE-T with the UEMS and SCIM self-care and mobility scores were 0.83, 0.70, and 0.55 respectively. CONCLUSIONS The CUE-T displays excellent test-retest reliability, and good-excellent correlation with impairment and capacity measures in persons with chronic SCI. After revising pronation and supination test procedures, the sensitivity to change should be determined.
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Affiliation(s)
- Ralph J. Marino
- Department of Rehabilitation Medicine, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA,Correspondence to: Ralph J. Marino, Thomas Jefferson University, 132 South 10th Street, 375 Main Building, Philadelphia, PA 19107, USA.
| | - Stephen B. Kern
- Department of Occupational Therapy, College of Health Professions, Thomas Jefferson University, Philadelphia, PA, USA
| | - Benjamin Leiby
- Department of Pharmacology and Experimental Therapeutics, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
| | | | - M. J. Mulcahey
- Department of Occupational Therapy, College of Health Professions, Thomas Jefferson University, Philadelphia, PA, USA
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Jette AM, Slavin MD, Ni P, Kisala PA, Tulsky DS, Heinemann AW, Charlifue S, Tate DG, Fyffe D, Morse L, Marino R, Smith I, Williams S. Development and initial evaluation of the SCI-FI/AT. J Spinal Cord Med 2015; 38:409-18. [PMID: 26010975 PMCID: PMC4445031 DOI: 10.1179/2045772315y.0000000003] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES To describe the domain structure and calibration of the Spinal Cord Injury Functional Index for samples using Assistive Technology (SCI-FI/AT) and report the initial psychometric properties of each domain. DESIGN Cross sectional survey followed by computerized adaptive test (CAT) simulations. SETTING Inpatient and community settings. PARTICIPANTS A sample of 460 adults with traumatic spinal cord injury (SCI) stratified by level of injury, completeness of injury, and time since injury. INTERVENTIONS None MAIN OUTCOME MEASURE SCI-FI/AT RESULTS: Confirmatory factor analysis (CFA) and Item response theory (IRT) analyses identified 4 unidimensional SCI-FI/AT domains: Basic Mobility (41 items) Self-care (71 items), Fine Motor Function (35 items), and Ambulation (29 items). High correlations of full item banks with 10-item simulated CATs indicated high accuracy of each CAT in estimating a person's function, and there was high measurement reliability for the simulated CAT scales compared with the full item bank. SCI-FI/AT item difficulties in the domains of Self-care, Fine Motor Function, and Ambulation were less difficult than the same items in the original SCI-FI item banks. CONCLUSION With the development of the SCI-FI/AT, clinicians and investigators have available multidimensional assessment scales that evaluate function for users of AT to complement the scales available in the original SCI-FI.
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Affiliation(s)
- Alan M. Jette
- New England Regional Spinal Cord Injury Center, Boston, MA, USA,Correspondence to: Alan M. Jette, Health and Disability Research Institute, Boston University School of Public Health, 715 Albany Street T5 W, Boston, MA 02118, USA. Reprints are available from David S. Tulsky at
| | - Mary D. Slavin
- New England Regional Spinal Cord Injury Center, Boston, MA, USA
| | - Pengsheng Ni
- New England Regional Spinal Cord Injury Center, Boston, MA, USA
| | - Pamela A. Kisala
- Department of Physical Therapy, University of Delaware, Newark, DE, USA
| | | | | | - Susie Charlifue
- The Rocky Mountain Regional Spinal Injury System, Englewood, CO, USA
| | - Denise G. Tate
- Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, MI, USA
| | | | - Leslie Morse
- Spaulding Rehabilitation Hospital, Boston, MA, USA
| | - Ralph Marino
- Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA
| | - Ian Smith
- University of Pittsburgh Medical Centers, Pittsburgh, PA, USA
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15
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Responsiveness and concurrent validity of the revised Capabilities of Upper Extremity-Questionnaire (CUE-Q) in patients with acute tetraplegia. Spinal Cord 2014; 52:625-8. [DOI: 10.1038/sc.2014.77] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2013] [Revised: 04/08/2014] [Accepted: 04/14/2014] [Indexed: 11/08/2022]
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16
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P Dijkers M, Hart T, Whyte J, M Zanca J, Packel A, Tsaousides T. Rehabilitation treatment taxonomy: implications and continuations. Arch Phys Med Rehabil 2014; 95:S45-54.e2. [PMID: 24370324 DOI: 10.1016/j.apmr.2013.05.033] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2013] [Revised: 05/23/2013] [Accepted: 05/30/2013] [Indexed: 11/30/2022]
Abstract
In relation to the conceptual framework for a rehabilitation treatment taxonomy (RTT), which has been proposed in other articles in this supplement, this article discusses a number of issues relevant to its further development, including creating distinctions within the major target classes; the nature and quantity of allowable targets of treatment; and bracketing as a way of specifying (1) the skill or knowledge taught; (2) the nature of compensation afforded by changes in the environment, assistive technology, and orthotics/prosthetics; and (3) the ingredients in homework a clinician assigns. Clarification is provided regarding the role of the International Classification of Functioning, Disability and Health, focusing a taxonomy on ingredients versus other observable aspects of treatment, and regarding our lack of knowledge and its impact on taxonomy development. Finally, this article discusses the immediate implications of the work to date and presents the need for rehabilitation stakeholders of all disciplines to be involved in further RTT development.
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Affiliation(s)
- Marcel P Dijkers
- Department of Rehabilitation Medicine, Icahn School of Medicine at Mount Sinai, New York, NY.
| | - Tessa Hart
- Moss Rehabilitation Research Institute, Elkins Park, PA
| | - John Whyte
- Moss Rehabilitation Research Institute, Elkins Park, PA
| | - Jeanne M Zanca
- Department of Rehabilitation Medicine, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Andrew Packel
- Moss Rehabilitation Research Institute, Elkins Park, PA
| | - Theodore Tsaousides
- Department of Rehabilitation Medicine, Icahn School of Medicine at Mount Sinai, New York, NY
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17
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Stiens SA, Fawber HL, Yuhas SA. The person with a spinal cord injury: an evolving prototype for life care planning. Phys Med Rehabil Clin N Am 2013; 24:419-44. [PMID: 23910484 DOI: 10.1016/j.pmr.2013.03.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The sequela of spinal cord injury (SCI) can provide a prototype for life care planning because the segmental design of the vertebrate body allows assessments to be quantitative, repeatable, and predictive of the injured person's impairments, self-care capabilities, and required assistance. Life care planning for patients with SCI uses a standard method that is comparable between planner, yet individualizes assessment and seeks resources that meet unique patient-centered needs in their communities of choice. Clinical care and rehabilitation needs organized with an SCI problem list promotes collaboration by the interdisciplinary team, caregivers, and family in efficient achievement of patient-centered goals and completion of daily care plans.
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Affiliation(s)
- Steven A Stiens
- Department Rehabilitation Medicine, University of Washington, PO Box 356490, Health Sciences Building, 1959 North East Pacific, Seattle, WA 98195, USA.
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18
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Ditunno JF, Ditunno PL, Scivoletto G, Patrick M, Dijkers M, Barbeau H, Burns AS, Marino RJ, Schmidt-Read M. The Walking Index for Spinal Cord Injury (WISCI/WISCI II): nature, metric properties, use and misuse. Spinal Cord 2013; 51:346-55. [DOI: 10.1038/sc.2013.9] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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19
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Jette AM, Tulsky DS, Ni P, Kisala PA, Slavin MD, Dijkers MP, Heinemann AW, Tate DG, Whiteneck G, Charlifue S, Houlihan B, Williams S, Kirshblum S, Dyson-Hudson T, Zanca J, Fyffe D. Development and Initial Evaluation of the Spinal Cord Injury-Functional Index. Arch Phys Med Rehabil 2012; 93:1733-50. [DOI: 10.1016/j.apmr.2012.05.008] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2012] [Revised: 05/04/2012] [Accepted: 05/09/2012] [Indexed: 11/26/2022]
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20
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Behrman AL, Ardolino E, VanHiel LR, Kern M, Atkinson D, Lorenz DJ, Harkema SJ. Assessment of Functional Improvement Without Compensation Reduces Variability of Outcome Measures After Human Spinal Cord Injury. Arch Phys Med Rehabil 2012; 93:1518-29. [DOI: 10.1016/j.apmr.2011.04.027] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2010] [Revised: 04/13/2011] [Accepted: 04/28/2011] [Indexed: 10/28/2022]
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21
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Neurophysiological characterization of the New Anatomy and motor control that results from neurological injury or disease. Clin Neurol Neurosurg 2012; 114:447-54. [DOI: 10.1016/j.clineuro.2012.01.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2011] [Revised: 01/10/2012] [Accepted: 01/11/2012] [Indexed: 12/14/2022]
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22
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23
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Issues in the Conceptualization and Measurement of Participation: An Overview. Arch Phys Med Rehabil 2010; 91:S5-16. [DOI: 10.1016/j.apmr.2009.10.036] [Citation(s) in RCA: 173] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2009] [Accepted: 10/16/2009] [Indexed: 11/19/2022]
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24
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Ditunno JF. Outcome measures: evolution in clinical trials of neurological/functional recovery in spinal cord injury. Spinal Cord 2010; 48:674-84. [DOI: 10.1038/sc.2009.198] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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25
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Difficult to measure constructs: conceptual and methodological issues concerning participation and environmental factors. Arch Phys Med Rehabil 2009; 90:S22-35. [PMID: 19892071 DOI: 10.1016/j.apmr.2009.06.009] [Citation(s) in RCA: 310] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2009] [Revised: 05/09/2009] [Accepted: 06/09/2009] [Indexed: 11/23/2022]
Abstract
For rehabilitation and disability research, participation and environment are 2 crucial constructs that have been placed center stage by the International Classification of Functioning, Disability and Health (ICF). However, neither construct is adequately conceptualized by the ICF, and both are difficult to measure. This article addresses conceptual and methodologic issues related to these ICF constructs, and recommends an improved distinction between activities and participation, as well as elaboration of environment. A division of the combined ICF categories for activity and participation into 2 separate taxonomies is proposed to guide future research. The issue of measuring participation from objective and subjective perspectives is examined, and maintaining these distinct conceptual domains in the measurement of participation is recommended. The methodological issues contributing to the difficulty of measuring participation are discussed, including potential dimensionality, alternative metrics, and the appropriateness of various measurement models. For environment, the need for theory to focus research on those aspects of the environment that interact with individuals' impairments and functional limitations in affecting activities and participation is discussed, along with potential measurement models for those aspects. The limitations resulting from reliance on research participants as reporters on their own environment are set forth. Addressing these conceptual and methodological issues is required before the measurement of participation and environmental factors can advance and these important constructs can be used more effectively in rehabilitation and disability observational research and trials.
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26
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The effectiveness of physical interventions for people with spinal cord injuries: a systematic review. Spinal Cord 2008; 47:184-95. [DOI: 10.1038/sc.2008.100] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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27
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Glinsky J, Harvey L, Korten M, Drury C, Chee S, Gandevia SC. Short-term progressive resistance exercise may not be effective at increasing wrist strength in people with tetraplegia: a randomised controlled trial. ACTA ACUST UNITED AC 2008; 54:103-8. [DOI: 10.1016/s0004-9514(08)70043-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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