Published Research

Some recent papers published by ICORD researchers are listed below. Links to each of our researchers’ most recent publications are included at the bottom of their respective researcher profile.

Myelinogenic Plasticity of Oligodendrocyte Precursor Cells following Spinal Cord Contusion Injury

Authors: Assinck P, Duncan GJ, Plemel JR, Lee MJ, Stratton JA, Manesh SB, Liu J, Ramer LM, Kang SH, Bergles DE, Biernaskie J, Tetzlaff W.
Published in: J Neurosci. 2017 Sept 6. doi:
About: The objective of this study is to assess the origin of new myelin following SCI through genetic fate mapping of platelet-derived growth factor receptor α, Olig2+, and P0+ cells.

A systematic review of the effectiveness of task-specific rehabilitation interventions for improving independent sitting and standing function in spinal cord injury

Authors: Tse CM, Chisholm AE, Lam T, Eng JJ; SCIRE Research Team.
Published in: J Spinal Cord Med. 2017 Jul 24:1-13. doi: 10.1080/10790268.2017.1350340. [Epub ahead of print]
About: The objective of this study is to assess the evidence on the effectiveness of task-specific training on sitting and standing function in individuals with SCI across the continuum of care.

Protective effects of acute exercise prior to doxorubicin on cardiac function of breast cancer patients: A proof-of-concept RCT

Authors: Kirkham AA, Shave RE, Bland KA, Bovard JM, Eves ND, Gelmon KA, McKenzie DC, Virani SA, Stöhr EJ, Warburton DER, Campbell KL.
Published in: Int J Cardiol. 2017 Jul 14. pii: S0167-5273(17)32213-1. doi: 10.1016/j.ijcard.2017.07.037. [Epub ahead of print]
About: Preclinical studies have reported that a single treadmill session performed 24h prior to doxorubicin provides cardio-protection. We aimed to characterize the acute change in cardiac function following an initial doxorubicin treatment in humans and determine whether an exercise session performed 24h prior to treatment changes this response.

Effects of exercise on fitness and health of adults with spinal cord injury: A systematic review

Authors: van der Scheer JW, Martin Ginis KA, Ditor DS, Goosey-Tolfrey VL, Hicks AL, West CR, Wolfe DL.
Published in 2017 Jul 21. pii: 10.1212/WNL.0000000000004224. doi: 10.1212/WNL.0000000000004224. [Epub ahead of print]
About: The objective of this study is to synthesize and appraise research testing the effects of exercise interventions on fitness, cardiometabolic health, and bone health among adults with spinal cord injury (SCI).

Health conditions: impact on function, health-related quality of life, and life satisfaction following traumatic spinal cord injury. A prospective observational registry cohort study

Authors: Rivers CS, Fallah N, Noonan VK, Whitehurst DG, Schwartz C, Finkelstein J, Craven BC, Ethans K, O’Connell C, Truchon C, Ho C, Linassi AG, Short C, Tsai E, Drew B, Ahn H, Dvorak MF, Paquet J, Fehlings MG, Noreau L, RHSCIR Network.
Published in: Arch Phys Med Rehabil. 2017 Jul 18. pii: S0003-9993(17)30468-9. doi: 10.1016/j.apmr.2017.06.012. [Epub ahead of print]
About: The objective of this study is to analyze relationships among injury, demographic and environmental factors on function, HRQoL and life satisfaction in individuals with traumatic SCI.

Feasibility of the trial procedures for a randomized controlled trial of a community-based peer-led wheelchair training program for older adults

Authors: Best KL, Miller WC, Routhier F, Eng JJ.
Published in: Pilot Feasibility Stud. 2017 Jul 17;4:18. doi: 10.1186/s40814-017-0158-3. eCollection 2018.
About: A novel peer-led manual wheelchair (MWC) training program may support the training needs of older adults, but establishing program feasibility is a pragmatic first step. The purpose of this study was to evaluate the feasibility of a peer-led Wheelchair training Self-Efficacy Enhanced for Use (WheelSeeU) program.

Focal application of low-dose-rate brachytherapy for prostate cancer: a pilot study

Authors: Mahdavi SS, Spadinger IT, Salcudean SE, Kozlowski P, Chang SD, Ng T, Lobo J, Nir G, Moradi H, Peacock M, Morris WJ.
Published in: J Contemp Brachytherapy. 2017 Jun;9(3):197-208. doi: 10.5114/jcb.2017.68424. Epub 2017 Jun 13.
About: The objective of this study is to evaluate the feasibility and to report the early outcomes of focal treatment of prostate cancer using low-dose-rate brachytherapy (LDR-PB).

Bilateral Reflex Fluctuations during Rhythmic Movement of Remote Limb Pairs

Authors: Mezzarane RA, Nakajima T, Zehr EP.
Published in: Front Hum Neurosci. 2017 Jul 5;11:355. doi: 10.3389/fnhum.2017.00355. eCollection 2017.
About: The modulation of spinal cord excitability during rhythmic limb movement reflects the neuronal coordination underlying actions of the arms and legs. Integration of network activity in the spinal cord can be assessed by reflex variability between the limbs, an approach so far very little studied. The present work addresses this question by eliciting Hoffmann (H-) reflexes in both limbs to assess if common drive onto bilateral pools of motoneurons influence spinal cord excitability simultaneously or with a delay between sides.

The Untold Story of Granzymes in Oncoimmunology: Novel Opportunities with Old Acquaintances

Authors: Arias M, Martínez-Lostao L, Santiago L, Ferrandez A, Granville DJ, Pardo J.
Published in: Trends Cancer. 2017 Jun;3(6):407-422. doi: 10.1016/j.trecan.2017.04.001. Epub 2017 Jun 9.
About: We review the diverse roles of granzymes in cancer progression, and new therapeutic opportunities emerging from targeting these protumoral roles.

 Goal satisfaction improves with individualized powered wheelchair skills training

Authors: MacGillivray MK, Sawatzky BJMiller WC, Routhier F, Kirby RL.
Published in: Disabil Rehabil Assist Technol. 2017 Jul 16:1-4. doi: 10.1080/17483107.2017.1353651. [Epub ahead of print]
About: The objective of this study is to determine improvements in goal satisfaction following individualized mobility-related powered wheelchair skills training and whether changes in satisfaction are maintained 3 months post-training.

A comparison of passive hind-limb cycling and active upper-limb exercise provides new insights into systolic dysfunction following spinal cord injury

Authors: DeVeau KM, Harman KA, Squair JW, Krassioukov AV, Magnuson D, West CR.
Published in: Am J Physiol Heart Circ Physiol. 2017 Jul 14:ajpheart.00046.2017. doi: 10.1152/ajpheart.00046.2017. [Epub ahead of print]
About: Active upper-limb and passive lower-limb exercise are two interventions used in the spinal cord injury (SCI) population. While the global cardiac responses have been previously studied, it is unclear how either exercise influences contractile cardiac function. Here, the cardiac contractile and volumetric responses to upper-limb (swim) and passive lower-limb exercise are investigated in rodents with a severe high-thoracic SCI.

Health benefits of physical activity: a systematic review of current systematic reviews

AuthorsWarburton DER, Bredin SSD.
Published in: Curr Opin Cardiol. 2017 Jul 13. doi: 10.1097/HCO.0000000000000437. [Epub ahead of print]
About: The health benefits of physical activity and exercise are clear; virtually everyone can benefit from becoming more physically active. Most international guidelines recommend a goal of 150 min/week of moderate-to-vigorous intensity physical activity. Many agencies have translated these recommendations to indicate that this volume of activity is the minimum required for health benefits. However, recent evidence has challenged this threshold-centered messaging as it may not be evidence-based and may create an unnecessary barrier to those who might benefit greatly from simply becoming more active. This systematic review evaluates recent systematic reviews that have examined the relationship between physical activity and health status.

Assessing structure and function of myelin in cervical spondylotic myelopathy: Evidence of demyelination

Authors: Liu H, MacMillian EL, Jutzeler CR, Ljungberg E, MacKay AL, Kolind SH, Mädler B, Li DKB, Dvorak MF, Curt A, Laule CKramer JLK.
Published in: Neurology. 2017 Jul 12. pii: 10.1212/WNL.0000000000004197. doi: 10.1212/WNL.0000000000004197. [Epub ahead of print]
About: The objective of this study is to assess the extent of demyelination in cervical spondylotic myelopathy (CSM) using myelin water imaging (MWI) and electrophysiologic techniques.

Repeatability of a dislocation spinal cord injury model in a rat – a high-speed biomechanical analysis

Authors: Mattucci S, Liu J, Fijal P, Tetzlaff W, Oxland TR.
Published in: J Biomech Eng. 2017 Jul 11. doi: 10.1115/1.4037224. [Epub ahead of print]
About: Dislocation is the most common, and severe, spinal cord injury (SCI) mechanism in humans, yet there are few preclinical models. While dislocation in the rat model has been shown to produce unique outcomes, like other closed column models it exhibits higher outcome variability. Refinement of the dislocation model will enhance the testing of neuroprotective strategies, further biomechanical understanding, and guide therapeutic decisions. The overall objective of this study is to improve biomechanical repeatability of a dislocation SCI model in the rat, through the following specific aims: i) design new injury clamps that pivot and self-align to the vertebrae; ii) measure intervertebral kinematics during injury using the existing and redesigned clamps; and iii) compare relative motion at the vertebrae-clamp interface to determine which clamps provide the most rigid connection.

The impact of spine stability on cervical spinal cord injury with respect to demographics, management and outcome: a prospective cohort from a national SCI registry

Authors: Paquet J, Rivers CS, Kuerban D, Finkelstein J, Tee JW, Noonan VK, Kwon BK, Hurlbert RJ, Christie S, Tsai EC, Ahn H, Drew B, Bailey CS, Fourney DR, Attabib N, Johnson MG, Fehlings MG, Parent S, Dvorak MF.
Published in: PLoS One. 2017 Jun 30;12(6):e0180195. doi: 10.1371/journal.pone.0180195. eCollection 2017.
About: Emergent surgery for patients with a traumatic spinal cord injury (SCI) is seen as the gold standard in acute management. However, optimal treatment for those with the clinical diagnosis of central cord syndrome (CCS) is less clear and classic definitions of CCS do not identify a unique population of patients. The purpose of this study is to test the authors’ hypothesis that spine stability can identify a unique group of patients with regards to demographics, management, and outcomes, which classic CCS definitions do not.

Dynamic wheelchair seating positions impact cardiovascular function after spinal cord injury

Authors: Inskip JA, Ravensbergen HRJC, Sahota IS, Zawadzki C, McPhail LT, Borisoff JFClaydon VE.
Published in: PLoS One. 2017 Jun 30;12(6):e0180195. doi: 10.1371/journal.pone.0180195. eCollection 2017.
About: Innovative wheelchairs allow individuals to change position easily for comfort and social situations. While these wheelchairs are beneficial in multiple ways, the effects of position changes on blood pressure might exacerbate hypotension and cerebral hypoperfusion, particularly in those with spinal cord injury (SCI) who can have injury to autonomic nerves that regulate cardiovascular control. Conversely, cardiovascular benefits may be obtained with lowered seating. Here we investigate the effect of moderate changes in wheelchair position on orthostatic cardiovascular and cerebrovascular reflex control.

Global implementation of advanced urological care: Policy implementation research

Authors: Stothers L, Macnab A.
Published in: Physiol Rep. 2017 Jun;5(12). pii: e13220. doi: 10.14814/phy2.13220.
About: In high-resource countries, modern treatments for urological diseases have led to significant reductions in mortality and morbidity; however, the benefits of modern treatment have yet to reach the majority of people worldwide. As attention is focused on improving urological care in the global community, policy and implementation research (PIR) offers a platform for effective organization and engagement. We have compiled a photo essay to illustrate the fundamental components of PIR.

New indices from microneurography to investigate the arterial baroreflex

Authors: Laurin A, Lloyd MG, Hachiya T, Saito M, Claydon VE, Blaber A.
Published in: Physiol Rep. 2017 Jun;5(12). pii: e13220. doi: 10.14814/phy2.13220.
About: Baroreflex-mediated changes in heart rate and vascular resistance in response to variations in blood pressure are critical to maintain homeostasis. We aimed to develop time domain analysis methods to complement existing cross-spectral techniques in the investigation of the vascular resistance baroreflex response to orthostatic stress. A secondary goal was to apply these methods to distinguish between levels of orthostatic tolerance using baseline data.

Data Logger Technologies for Powered Wheelchairs: A Scoping Review

Authors: Routhier F, Lettre J, Miller WCBorisoff JF, Keetch K, Mitchell IM, The CanWheel Research Team.
Published in: Assist Technol. 2017 Jun 29. doi: 10.1080/10400435.2017.1340913. [Epub ahead of print]
About: In recent years, studies have increasingly employed data loggers to record the objective behaviours of powered wheelchair users. Of the data logging work reported in the literature, the technologies used offer marked differences in characteristics. In order to identify and describe the extent of published research activity that relies on data logger technologies for powered wheelchairs, we performed a scoping review of the scientific and grey literature.

Perspectives of health care professionals on the facilitators and barriers to the implementation of a stroke rehabilitation guidelines cluster randomized controlled trial

Authors: Munce SEP, Graham ID, Salbach NM, Jaglal SB, Richards CL, Eng JJ, Desrosiers J, MacKay-Lyons M, Wood-Dauphinee S, Korner-Bitensky N, Mayo NE, Teasell RW, Zwarenstein M, Mokry J, Black S, Bayley MT.
Published in: BMC Health Serv Res. 2017 Jun 26;17(1):440. doi: 10.1186/s12913-017-2389-7.
About: The Stroke Canada Optimization of Rehabilitation by Evidence Implementation Trial (SCORE-IT) was a cluster randomized controlled trial that evaluated two knowledge translation (KT) interventions for the promotion of the uptake of best practice recommendations for interventions targeting upper and lower extremity function, postural control, and mobility. Twenty rehabilitation centers across Canada were randomly assigned to either the facilitated or passive KT intervention. The objective of the current study was to understand the factors influencing the implementation of the recommended treatments and KT interventions from the perspective of nurses, occupational therapists and physical therapists, and clinical managers following completion of the trial.

Glial and Neuronal Protein Tyrosine Phosphatase Alpha (PTPα) Regulate Oligodendrocyte Differentiation and Myelination

Authors: Shih Y, Ly PTT, Wang J, Pallen CJ.
Published in: J Mol Neurosci. 2017 Jun 24. doi: 10.1007/s12031-017-0941-x. [Epub ahead of print]
About: CNS myelination defects occur in mice deficient in receptor-like protein tyrosine phosphatase alpha (PTPα). Here, we investigated the role of PTPα in oligodendrocyte differentiation and myelination using cells and tissues from wild-type (WT) and PTPα knockout (KO) mice.

Non-Digital Game Playing by Older Adults

AuthorsMortenson WB, Sixsmith A, Kaufman D.
Published in: Can J Aging. 2017 Jun 22:1-9. doi: 10.1017/S0714980817000162. [Epub ahead of print]
About: Research on video games’ effect on cognition and behaviour has been extensive, yet little research has explored non-digital forms of game playing, especially among older adults. As part of a larger survey on game playing, 886 respondents (≥ age 55) filled out questionnaires about non-digital game play. The study aims were to determine perceived benefits of non-digital game play and to determine socio-demographic factors that might predict perceived benefits.

Stationary cycling exergame use among inactive children in the family home: a randomized trial

Authors: Rhodes RE, Blanchard CM, Bredin SSD, Beauchamp MR, Maddison R, Warburton DER.
Published in: J Behav Med. 2017 Jun 19. doi: 10.1007/s10865-017-9866-7. [Epub ahead of print]
About: Exergames may be one way to increase child physical activity, but long term adherence has seen little research attention. The primary objective of this study was to evaluate the usage of an exergame bike in comparison to a stationary bike in front of a TV across 3-months within a family home environment among children aged 10-14 years old.

Myelin regulatory factor drives remyelination in multiple sclerosis

Authors: Duncan GJ, Plemel JR, Assinck P, Manesh SB, Muir FGW, Hirata R, Berson M, Liu J, Wegner M, Emery B, Moore GRWTetzlaff W.
Published in: Acta Neuropathol. 2017 Jun 19. doi: 10.1007/s00401-017-1741-7. [Epub ahead of print]
About: Remyelination is limited in the majority of multiple sclerosis (MS) lesions despite the presence of oligodendrocyte precursor cells (OPCs) in most lesions. This observation has led to the view that a failure of OPCs to fully differentiate underlies remyelination failure. OPC differentiation requires intricate transcriptional regulation, which may be disrupted in chronic MS lesions. The expression of few transcription factors has been differentially compared between remyelinating lesions and lesions refractory to remyelination. In particular, the oligodendrocyte transcription factor myelin regulatory factor (MYRF) is essential for myelination during development, but its role during remyelination and expression in MS lesions is unknown. To understand the role of MYRF during remyelination, we genetically fate mapped OPCs following lysolecithin-induced demyelination of the corpus callosum in mice and determined that MYRF is expressed in new oligodendrocytes.

Cardiovascular stress during inpatient spinal cord injury rehabilitation

Authors: Zbogar D, Eng JJMiller WCKrassioukov AV, Verrier MC.
Published in: Arch Phys Med Rehabil. 2017 Jun 13. pii: S0003-9993(17)30385-4. doi: 10.1016/j.apmr.2017.05.009. [Epub ahead of print]
About: The objectives of this study are 1) to measure the amount of a) cardiovascular stress, b) self-reported physical activity and c) accelerometry-measured physical activity by individuals with SCI during physical therapy (PT) and occupational therapy (OT) and, 2) to investigate the relationship between these measures.

Advances in basic science methodologies for clinical diagnosis in female stress urinary incontinence

Authors: Abdulaziz M, Deegan EG, Kavanagh A, Stothers L, Pugash D, Macnab A.
Published in: Clin J Pain. 2017 Jun 12. doi: 10.1097/AJP.0000000000000523. [Epub ahead of print]
About: We provide an overview of advanced imaging techniques currently being explored to gain greater understanding of the complexity of stress urinary incontinence (SUI) through better definition of structural anatomic data.

Evaluation of a Clinical Protocol to Assess and Diagnose Neuropathic Pain During Acute Hospital Admission: Results from Traumatic Spinal Cord Injury

Authors: Bélanger LMA, Umedaly HS, Noonan VK, Park SE, Prince J, Thorogood NP, Shen T, Townson AF, Street JT, Dvorak MF, Negraeff M.
Published in: Clin J Pain. 2017 Jun 12. doi: 10.1097/AJP.0000000000000523. [Epub ahead of print]
About: A clinical protocol was developed for clinicians to routinely assess and initiate treatment for patients with neuropathic pain (NP) in an acute care setting. The objectives of this study were to: (1) determine the incidence and onset of NP in patients with traumatic SCI during acute care and (2) describe how the implementation of a clinical protocol impacts the assessment and diagnosis of NP.

Accounting for spatial variation of trabecular anisotropy with subject-specific finite element modeling moderately improves predictions of local subchondral bone stiffness at the proximal tibia

Authors: Nazemi SM, Kalajahi SMH, Cooper DML, Kontulainen SA, Holdsworth DW, Masri BA, Wilson DR, Johnston JD.
Published in: J Biomech. 2017 Jul 5;59:101-108. doi: 10.1016/j.jbiomech.2017.05.018. Epub 2017 May 31.
About: Previously, a finite element (FE) model of the proximal tibia was developed and validated against experimentally measured local subchondral stiffness. This model indicated modest predictions of stiffness (R2=0.77, normalized root mean squared error (RMSE%)=16.6%). Trabecular bone though was modeled with isotropic material properties despite its orthotropic anisotropy. The objective of this study was to identify the anisotropic FE modeling approach which best predicted (with largest explained variance and least amount of error) local subchondral bone stiffness at the proximal tibia.

Spinal cord injury causes systolic dysfunction and cardiomyocyte atrophy

Authors: Squair JW, DeVeau KM, Harman KA, Poormasjedi-Meibod MS, Hayes B, Liu J, Magnuson DSK, Krassioukov AVWest CR.
Published in: J Neurotrauma. 2017 Jun 9. doi: 10.1089/neu.2017.4984. [Epub ahead of print]
About: Individuals with spinal cord injury (SCI) have been shown to exhibit systolic, and to a lesser extent, diastolic cardiac dysfunction. However, previous reports of cardiac dysfunction in this population are confounded by the changing loading conditions after SCI and as such, whether cardiac dysfunction per se is present is still unknown. Therefore, our aim was to establish if load-independent cardiac dysfunction is present after SCI, to understand the functional cardiac response to SCI, and to explore the changes within the cellular milieu of the myocardium.

Forecasting Financial Resources for Future Traumatic Spinal Cord Injury Care using Simulation Modeling

Authors: Ahn H, Lewis R, Santos A, Cheng CL, Noonan VK, Dvorak MF, Singh A, Linassi AG, Christie S, Goytan M, Atkins D.
Published in: J Neurotrauma. 2017 Jun 8. doi: 10.1089/neu.2016.4936. [Epub ahead of print]
About: Survivors of traumatic spinal cord injury (tSCI) have intense healthcare needs during acute and rehabilitation care and often through rest of life. To prepare for a growing aging population, simulation modeling was used to forecast the change in healthcare financial resources and long-term patient outcomes between 2012 and 2032. The model was developed with data from acute and rehabilitation care facilities across Canada participating in the Access to Care and Timing project.

The effect of caster types on global rolling resistance in manual wheelchairs on indoor and outdoor surfaces

Authors: Chan FHN, Eshraghi M, Alhazmi MA, Sawatzky BJ.
Published in: Assist Technol. 2017 Jun 7:1-7. doi: 10.1080/10400435.2017.1307880. [Epub ahead of print]
About: An important aspect of reducing the strain of wheeling is to decrease rolling resistance. Previous laboratory research, using a treadmill, determined that smaller casters significantly increased rolling resistance. The purpose of this study was to determine the effect of caster size on various indoor and outdoor surfaces on global wheelchair rolling resistance.

The effectiveness of the anti-CD11d treatment is reduced in rat models of spinal cord injury that produce significant levels of intraspinal hemorrhage

Authors: Geremia NM, Hryciw T, Bao F, Streijger F, Okon E, Lee JHT, Weaver LC, Dekaban GA, Kwon BK, Brown A.
Published in: Exp Neurol. 2017 Jun 3;295:125-134. doi: 10.1016/j.expneurol.2017.06.002. [Epub ahead of print]
About: We have previously reported that administration of a CD11d monoclonal antibody (mAb) improves recovery in a clip-compression model of SCI. In this model the CD11d mAb reduces the infiltration of activated leukocytes into the injured spinal cord (as indicated by reduced intraspinal MPO).

Psychometric properties of a Power Mobility Caregiver Assistive Technology Outcome Measure

AuthorsMortenson WB, Demers L, Rushton PW, Auger C, Routhier F, Miller WC.
Published in: J Neurotrauma. 2017 May 31. doi: 10.1089/neu.2016.4938. [Epub ahead of print]
About: Caregiver burnout is a serious concern among informal caregivers, especially for those who provide care to individuals with more severe limitations such as power mobility users. The Power Wheelchair Caregiver Assistive Technology Outcome Measure tool measures device specific and overall burden experienced by informal caregivers of power mobility users. A one-month, test-retest study was conducted to examine the reliability, internal consistency, and construct validity of the Power Wheelchair Caregiver Assistive Technology Outcome Measure.

Using Evidence to Inform Practice and Policy to Enhance the Quality of Care for Persons with Traumatic Spinal Cord Injury

Authors: Fehlings MG, Cheng CL, Chan E, Thorogood NP, Noonan VK, Ahn H, Bailey C, Singh A, Dvorak MF.
Published in: J Neurotrauma. 2017 May 31. doi: 10.1089/neu.2016.4938. [Epub ahead of print]
About: In today’s economic climate there is a need to demonstrate a return on investment for healthcare spending and for clinical practice and policy to be informed by evidence. Navigating this process is difficult for decision-makers, clinicians and researchers alike. This article will describe how a knowledge translation framework and an evidence-based policy-making process were integrated to clarify the problem, frame options, and plan implementation, to impact clinical practice and policy in the area of traumatic spinal cord injury (tSCI).

Comparing executive function, evoked hemodynamic response, and gait as predictors of variations in mobility for older adults

Authors: Halliday DWR, Hundza SR, Garcia-Barrera MA, Klimstra M, Commandeur D, Lukyn TV, Stawski RS, MacDonald SWS.
Published in: J Clin Exp Neuropsychol. 2017 May 31:1-10. doi: 10.1080/13803395.2017.1325453. [Epub ahead of print]
About: Falls represent a major concern for older adults and may serve as clinically salient index events for those presenting in the prodromal stages of mild cognitive impairment. Declines in executive function performance and in gait consistency have shown promise in predicting fall risk; however, associated neurophysiological underpinnings have received less attention. In this study, we used a multimodal approach to assess fall risk in a group of older adults with and without a previous fall history.

Previously Identified Common Post-Injury Adverse Events in Traumatic Spinal Cord Injury-Validation of Existing Literature and Relation to Selected Potentially Modifiable Comorbidities: A Prospective Canadian Cohort Study

Authors: Marion TE, Rivers CS, Kurban D, Cheng CL, Fallah N, Batke J, Dvorak MF, Fisher CG, Kwon BK, Noonan VK, Street JT.
Published in: J Neurotrauma. 2017 Jun 28. doi: 10.1089/neu.2016.4933. [Epub ahead of print]
About: Adverse events (AEs) are common during care in patients with traumatic spinal cord injury (tSCI). Increased risk of AEs is linked to patient factors including pre-existing comorbidities. Our aim was to examine the relationships between patient factors and common post-injury AEs, and identify potentially modifiable comorbidities.

Physical activity: Health impact, prevalence, correlates and interventions

Authors: Rhodes RE, Janssen I, Bredin SSD, Warburton DER, Bauman A.
Published in: Psychol Health. 2017 Aug;32(8):942-975. doi: 10.1080/08870446.2017.1325486. Epub 2017 May 30.
About: The objective of this study is to provide a broad overview of the state of physical activity (PA) research in the form of (1) definitions of PA, (2) health benefits, (3) prevalence, (4) correlates and (5) interventions.

Feasibility of a Systematic, Comprehensive, One-to-One Training (SCOOT) program for new scooter users: study protocol for a randomized control trial

AuthorsMortenson WB, Jang S, Goldsmith CH, Hurd Clarke L, Hobson S, Emery R.
Published inTrials. 2017 May 25;18(1):235. doi: 10.1186/s13063-017-1963-y.
About: Mobility scooters can facilitate community participation among individuals with mobility limitations. However, accidents are a serious concern with scooter use. Scooter training has been recommended to improve safety, but there are currently few validated programs available. Therefore, we developed a Systematic, Comprehensive, One-to-One Training (SCOOT) program for scooter users. We will conduct a study to evaluate the outcomes produced by the provision SCOOT.

Multi-domain assessment of autonomic function in spinal cord injury using a modified autonomic reflex screen

Authors: Berger MJ, Kimpinski K, Currie KD, Nouraei H, Sadeghi M, Krassioukov AV.
Published in: J Neurotrauma. 2017 May 24. doi: 10.1089/neu.2016.4888. [Epub ahead of print]
About: The purpose of this study was to characterize autonomic lesions in participants with spinal cord injury (SCI; n=10) using an autonomic reflex screen, incorporating sudomotor, cardiovagal and sympathetic adrenergic tests, as well as hemodynamic responses to head-up tilt (HUT). Hemodynamic responses were compared to healthy controls (n=20) and previously published normative cutoffs in order better identify autonomic impairments. Sympathetic skin responses (SSRs), heart rate response to deep breathing (HRDB) and heart rate and beat-to-beat blood pressure responses to Valsalva maneuver (VM) and HUT were measured. SCI participants demonstrated impairment in at least one domain, with 7/10 demonstrating autonomic impairment across all domains. No single test was concordant with orthostatic hypotension on HUT, in all participants. Measures of cardiovagal function including, HRDB (SCI=7.7±3.8 beats/min vs. controls=17.6±8.1 beats/min) and Valsalva ratio (SCI=1.53±0.29 vs. controls=1.85±0.37) were significantly reduced in SCI participants, compared to controls (p<0.05). These findings suggest that an autonomic reflex screen, which includes standardized testing protocol and normative data for comparison, is useful for determining the autonomic domains affected by the neurological injury in SCI. We also demonstrated significant cardiovagal impairment in SCI participants compared to controls, which warrants further investigation to determine whether cardiovagal dysfunction is associated with the negative cardiovascular outcomes, which are known to occur in SCI.

Context effects on smooth pursuit and manual interception of a disappearing target

Authors: Kreyenmeier P, Fooken J, Spering M.
Published inJ Neurophysiol. 2017 May 17:jn.00217.2017. doi: 10.1152/jn.00217.2017. [Epub ahead of print]
About: In our natural environment, we interact with moving objects that are surrounded by richly textured, dynamic visual contexts. Yet, most laboratory studies on vision and movement show visual objects in front of uniform grey backgrounds. Context effects on eye movements have been widely studied, but it is less well known how visual contexts affect hand movements. Here we ask whether eye and hand movements integrate motion signals from target and context similarly or differently, and whether context effects on eye and hand change over time. We developed a track-intercept task requiring participants to track the initial launch of a moving object (“ball”) with smooth pursuit eye movements. The ball disappeared after a brief presentation, and participants had to intercept it in a designated “hit zone”. In two experiments (n = 18 human observers each), the ball was shown in front of a uniform or a textured background that was either stationary or moved along with the target. Eye and hand movement latencies and speeds were similarly affected by the visual context, but eye and hand interception (eye position at time of interception, and hand interception timing error) did not differ significantly between context conditions. Eye and hand interception timing errors were strongly correlated on a trial-by-trial basis across all context conditions, highlighting the close relation between these responses in manual interception tasks. Our results indicate that visual contexts similarly affect eye and hand movements, but that these effects may be short-lasting, affecting movement trajectories more than movement end points.

Attentional requirements of postural control in people with spinal cord injury: the effect of dual task

Authors: Tse CM, Carpenter MG, Liu-Ambrose T, Chisholm AE, Lam T.
Published inSpinal Cord. 2017 May 16. doi: 10.1038/sc.2017.42. [Epub ahead of print]
About: The objective of this study is to investigate the attentional requirements for maintaining standing balance in people with spinal cord injury (SCI) using a dual-task paradigm and to compare standing balance performance between SCI and able-bodied (AB) controls.

Understanding the Burden Experienced by Caregivers of Older Adults Who Use a Powered Wheelchair: A Cross-Sectional Study

Authors: Rushton PW, Labbé D, Demers L, Miller WCMortenson WB, Kirby RL.
Published inGerontol Geriatr Med. 2017 Apr 10;3:2333721417703736. doi: 10.1177/2333721417703736. eCollection 2017 Jan-Dec.
About: In this study, we aimed to describe the burden of family caregivers providing powered wheelchair-related and overall assistance and test the hypotheses that caregiver burden correlates with participation, wheelchair skills capacity, anxiety, depression, and social support.

Therapeutic Use of Stem Cells in Treatment of Burn Injuries

Authors: Cheng JZ, Farrokhi A, Ghahary A, Jalili RB.
Published in: J Burn Care Res. 2017 May 8. doi: 10.1097/BCR.0000000000000571. [Epub ahead of print]
About: Burn injuries are one of the most common sources of trauma globally that comprise a significant drain on long-term personal and healthcare cost. Large surface area burn wounds are difficult to manage and may result in significant physiologic and psychologic sequelae. The goal of burn wound healing research is to fully repair and restore skin’s original structure and functionality while minimizing problems such as hypertrophic scarring and contracture. One of the ways this can be achieved is through augmentation of the skin’s natural healing process using the regenerative capability of stem cells. In this review, the authors highlight some recent developments in treatment of burn wounds employing stem cells. We compare and contrast the benefits and drawbacks to various sources of stem cells and techniques of delivery into damaged tissues that have been the focus of established and ongoing research, and avenues of exploration this burgeoning arena offers for the future.

Exploring the ecological validity and variability of a 10-min bout of wheeling

Authors: MacGillivray MK, Lam T, Klimstra M, Zehr EP, Sawatzky BJ.
Published in: Disabil Rehabil Assist Technol. 2017 May 9:1-6. doi: 10.1080/17483107.2017.1323965. [Epub ahead of print]
About: The objective of this study is to determine the ecological validity of using able-bodied participants to perform a 10-min wheeling trial by (1) evaluating changes in biomechanics over the trial in manual wheelchair users and able-bodied participants naïve to wheeling and (2) describing differences in changes and variability between groups.

Quantification of pelvic floor muscle strength in female urinary incontinence: A systematic review and comparison of contemporary methodologies

Authors: Deegan EG, Stothers L, Kavanagh A, Macnab AJ.
Published in: Neurourol Urodyn. 2017 May 4. doi: 10.1002/nau.23285. [Epub ahead of print]
About: There remains no gold standard for quantification of voluntary pelvic floor muscle (PFM) strength, despite international guidelines that recommend PFM assessment in females with urinary incontinence (UI). Methods currently reported for quantification of skeletal muscle strength across disciplines are systematically reviewed and their relevance for clinical and academic use related to the pelvic floor are described.

The Effects of Gain- versus Loss-Framed Messages Following Health Risk Information on Physical Activity in Individuals With Multiple Sclerosis

Authors: Lithopoulos A, Bassett-Gunter RL, Martin Ginis KA, Latimer-Cheung AE.
Published in: J Health Commun. 2017 Jun;22(6):523-531. doi: 10.1080/10810730.2017.1318983. Epub 2017 May 8.
About: Few people with multiple sclerosis engage in physical activity. Messaging interventions may motivate more physical activity among these individuals. The purpose of this online study was to evaluate an intervention presenting participants with multiple sclerosis (N = 237) with risk information (i.e., information demonstrating people with multiple sclerosis are more likely to experience certain health issues) or no risk information followed by gain- or loss-framed physical activity messages. Participants completed questionnaires on Days 1, 6, and 28 and received information material on Days 2-5. The dependent variables were as follows: physical activity intentions and behavior, response and task efficacy, perceived threat (i.e., perception of threat to health issues relevant to people with multiple sclerosis), and avoidance (i.e., avoiding thinking about/doing something about the health issues presented in the messages). Analyses indicated physical activity and response efficacy increased over time. Also, participants receiving risk information had higher levels of physical activity and perceived threat. However, manipulation checks showed no differences between participants regarding perceptions of risk information or gain/loss-framed messages. Despite the lack of impact of the framing intervention, this study suggests that a brief informational intervention can positively influence physical activity and certain correlates of physical activity among people with multiple sclerosis.

The translational importance of establishing biomarkers of human spinal cord injury

Authors: Elizei SS, Kwon BK.
Published in: Neural Regen Res. 2017 Mar;12(3):385-388. doi: 10.4103/1673-5374.202933.
About: The evaluation of such novel therapies for acute spinal cord injury in clinical trials is extremely challenging. Our current dependence upon the clinical assessment of neurologic impairment renders many acute SCI patients ineligible for trials because they are not examinable. Furthermore, the difficulty in predicting neurologic recovery based on the early clinical assessment forces investigators to recruit large cohorts to have sufficient power. Biomarkers that objectively classify injury severity and better predict neurologic outcome would be valuable tools for translational research. As such, the objective of the present review was to describe some of the translational challenges in acute spinal cord injury research and examine the potential utility of neurochemical biomarkers found within cerebrospinal fluid and blood. We focus on published efforts to establish biological markers for accurately classifying injury severity and precisely predict neurological outcome.

Serum MicroRNAs Reflect Injury Severity in a Large Animal Model of Thoracic Spinal Cord Injury

Authors: Tigchelaar S, Streijger F, Sinha S, Flibotte S, Manouchehri N, So K, Shortt K, Okon E, Rizzuto MA, Malenica I, Courtright-Lim A, Eisen A, Keuren-Jensen KV, Nislow C, Kwon BK.
Published in: Sci Rep. 2017 May 3;7(1):1376. doi: 10.1038/s41598-017-01299-x.
About: Therapeutic development for spinal cord injury is hindered by the difficulty in conducting clinical trials, which to date have relied solely on functional outcome measures for patient enrollment, stratification, and evaluation. Biological biomarkers that accurately classify injury severity and predict neurologic outcome would represent a paradigm shift in the way spinal cord injury clinical trials could be conducted. MicroRNAs have emerged as attractive biomarker candidates due to their stability in biological fluids, their phylogenetic similarities, and their tissue specificity. Here we characterized a porcine model of spinal cord injury using a combined behavioural, histological, and molecular approach. We performed next-generation sequencing on microRNAs in serum samples collected before injury and then at 1, 3, and 5 days post injury. We identified 58, 21, 9, and 7 altered miRNA after severe, moderate, and mild spinal cord injury, and SHAM surgery, respectively. These data were combined with behavioural and histological analysis. Overall miRNA expression at 1 and 3 days post injury strongly correlates with outcome measures at 12 weeks post injury. The data presented here indicate that serum miRNAs are promising candidates as biomarkers for the evaluation of injury severity for spinal cord injury or other forms of traumatic, acute, neurologic injury.

Rural and Urban Living in Persons with Spinal Cord Injury and Comparing Environmental Barriers, Their Health, and Quality-of-Life Outcomes

Authors: Glennie RA, Batke J, Fallah N, Cheng CL, Rivers CS, Noonan VK, Dvorak MF, Fisher CG, Kwon BK, Street JT.
Published in: J Neurotrauma. 2017 May 18. doi: 10.1089/neu.2016.4931. [Epub ahead of print]
About: There is worldwide geographic variation in the epidemiology of traumatic spinal cord injury (tSCI). The aim of this study was to determine whether environmental barriers, health status, and quality-of-life outcomes differ between patients with tSCI living in rural or urban settings, and whether patients move from rural to urban settings after tSCI. A cohort review of the Rick Hansen SCI Registry (RHSCIR) was undertaken from 2004 to 2012 for one province in Canada. Rural/urban setting was determined using postal codes. Outcomes data at 1 year in the community included the Short Form-36 Version 2 (SF36v2™), Life Satisfaction Questionnaire, Craig Hospital Inventory of Environmental Factors-Short Form (CHIEF-SF), Functional Independent Measure® Instrument, and SCI Health Questionnaire. Statistical methodologies used were t test, Mann-Whitney U test, and Fisher’s exact or χ2 test. In the analysis, 338 RHSCIR participants were included; 65 lived in a rural setting and 273 in an urban setting. Of the original patients residing in a rural area at discharge, 10 moved to an urban area by 1 year. Those who moved from a rural to urban area reported a lower SF-36v2™ Mental Component Score (MCS; p = 0.04) and a higher incidence of depression at 1 year (p = 0.04). Urban patients also reported a higher incidence of depression (p = 0.02) and a lower CHIEF-SF total score (p = 0.01) indicating fewer environmental barriers. No significant differences were found in other outcomes. Results suggest that although the patient outcomes are similar, some patients move from rural to urban settings after tSCI. Future efforts should target screening mental health problems early, especially in urban settings.

A scoping review of the psychological responses to interval exercise: is interval exercise a viable alternative to traditional exercise?

Authors: Stork MJ, Banfield LE, Gibala MJ, Martin Ginis KA.
Published in: Health Psychol Rev. 2017 Jun 1:1-21. doi: 10.1080/17437199.2017.1326011. [Epub ahead of print]
About: While considerable evidence suggests that interval exercise confers numerous physiological adaptations linked to improved health, its psychological consequences and behavioural implications are less clear and the subject of intense debate. The purpose of this scoping review was to catalogue studies investigating the psychological responses to interval exercise in order to identify what psychological outcomes have been assessed, the research methods used, and the results. A secondary objective was to identify research issues and gaps. Forty-two published articles met the review inclusion/exclusion criteria. These studies involved 1258 participants drawn from various active/inactive and healthy/unhealthy populations, and 55 interval exercise protocols (69% high-intensity interval training [HIIT], 27% sprint interval training [SIT], and 4% body-weight interval training [BWIT]). Affect and enjoyment were the most frequently studied psychological outcomes. Post-exercise assessments indicate that overall, enjoyment of, and preferences for interval exercise are equal or greater than for continuous exercise, and participants can hold relatively positive social cognitions regarding interval exercise. Although several methodological issues (e.g., inconsistent use of terminology, measures and protocols) and gaps (e.g., data on adherence and real-world protocols) require attention, from a psychological perspective, the emerging data support the viability of interval exercise as an alternative to continuous exercise.

Autonomic testing for prediction of competition performance in Paralympic athletes

Authors: Squair JW, Phillips AA, Currie KD, Gee C, Krassioukov AV.
Published in: Scand J Med Sci Sports. 2017 Apr 27. doi: 10.1111/sms.12900. [Epub ahead of print]
About: While we now appreciate that autonomic dysfunction can impact wheelchair rugby performance, this is currently not being assessed during classification, largely due to lack of a standardized and evidence-based strategy to assess autonomic function. Our aim, therefore, was to establish the optimal autonomic testing protocol that best predicts cardiovascular capacity during competition by comprehensively examining autonomic function in elite wheelchair rugby athletes with cervical SCI and thereby enhance the standardized classification. Twenty-six individuals with cervical SCI (C4-C8; AIS A, B, C) participated in this study during the 2015 Parapan American Games in Toronto, Canada. Clinic autonomic testing included: sympathetic skin responses, baseline hemodynamics, orthostatic challenge test, and cold-pressor tests. Further, we completed standard motor/sensory assessments and obtained each participants’ International Wheelchair Rugby Federation classification. These clinic metrics were correlated to in-competition heart rate monitoring obtained during competition. The current study provides novel evidence that the change in systolic blood pressure during an orthostatic challenge test predicts approximately 50% of the in-competition peak heart rate (P<.001). Conversely, International Wheelchair Rugby Federation classification was poorly associated with in-competition peak heart rate (R2 =.204; P<.05). Autonomic testing provides deep insight regarding preserved autonomic control after SCI that is associated with performance in elite wheelchair rugby athletes. As such, incorporating assessments of cardiovascular capacity in classification will help to ensure a level playing field and may obviate the need for practices such as boosting to gain an advantage due to poor cardiovascular control.

The Smartphone Peer Physical Activity Counseling (SPPAC) Program for Manual Wheelchair Users: Protocol of a Pilot Randomized Controlled Trial

Authors: Best KL, Routhier F, Sweet SN, Arbour-Nicitopoulos KP, Borisoff JF, Noreau L, Martin Ginis KA.
Published in: JMIR Res Protoc. 2017 Apr 26;6(4):e69. doi: 10.2196/resprot.7280.
About: Physical activity (PA) must be performed regularly to accrue health benefits. However, the majority of manual wheelchair users do not meet PA recommendations. Existing community-based PA programs for manual wheelchair users appear to work, but effect sizes are small and retention is low. Existing PA programs may not fully implement some psychosocial factors that are strongly linked with PA (eg, autonomy). The use of peers and mobile phone technology in the Smartphone Peer PA Counseling (SPPAC) program represents a novel approach to cultivating a PA-supportive environment for manual wheelchair users.

Manganese Concentration Mapping in the Rat Brain with MRI, PET, and Autoradiography

Authors: Topping GJ, Yung A, Schaffer P, Hoehr C, Kornelsen R, Kozlowski P, Sossi V.
Published in: Med Phys. 2017 Apr 26. doi: 10.1002/mp.12300. [Epub ahead of print]
About: Mn2+ is used a contrast agent and marker for neuronal activity with magnetic resonance imaging (MRI) in rats and mice, but its accumulation is generally not assessed quantitatively. In this work, non-radioactive Mn and 52 Mn are injected simultaneously in rats, and imaged with MRI, positron emission tomography (PET) and autoradiography (AR). Mn distributions are compared between modalities, to assess the potential and limitations on quantification of Mn with MRI, and to investigate the potential of multimodal measurement of Mn accumulation.

Diaphragm Activation in Ventilated Patients Using a Novel Transvenous Phrenic Nerve Pacing Catheter

Authors: Reynolds S, Ebner A, Meffen T, Thakkar V, Gani M, Taylor K, Clark L, Sadarangani G, Meyyappan R, Sandoval R, Rohrs E, Hoffer JA.
Published in: Crit Care Med. 2017 Apr 22. doi: 10.1097/CCM.0000000000002366. [Epub ahead of print]
About: Over 30% of critically ill patients on positive-pressure mechanical ventilation have difficulty weaning from the ventilator, many of whom acquire ventilator-induced diaphragm dysfunction. Temporary transvenous phrenic nerve pacing using a novel electrode-bearing catheter may provide a means to prevent diaphragm atrophy, to strengthen an atrophied diaphragm, and mitigate the harms of mechanical ventilation. We tested the initial safety, feasibility, and impact on ventilation of this novel approach.

Cell transplantation therapy for spinal cord injury

Authors: Assinck P, Duncan GJ, Hilton BJ, Plemel JR, Tetzlaff W.
Published in: Nat Neurosci. 2017 Apr 25;20(5):637-647. doi: 10.1038/nn.4541.
About: Spinal cord injury can lead to severe motor, sensory and autonomic dysfunction. Currently, there is no effective treatment for the injured spinal cord. The transplantation of Schwann cells, neural stem cells or progenitor cells, olfactory ensheathing cells, oligodendrocyte precursor cells and mesenchymal stem cells has been investigated as potential therapies for spinal cord injury. However, little is known about the mechanisms through which these individual cell types promote repair and functional improvements. The five most commonly proposed mechanisms include neuroprotection, immunomodulation, axon regeneration, neuronal relay formation and myelin regeneration. A better understanding of the mechanisms whereby these cells promote functional improvements, as well as an appreciation of the obstacles in implementing these therapies and effectively modeling spinal cord injury, will be important to make cell transplantation a viable clinical option and may lead to the development of more targeted therapies.

Ethnic differences in the cardiac responses to aerobic exercise

Authors: Foulds HJA, Bredin SSD, Warburton DER.
Published in: Ethn Health. 2017 Apr 24:1-14. doi: 10.1080/13557858.2017.1315377. [Epub ahead of print]
About: Cardiovascular disease disproportionately affects North American Indigenous populations. Ethnic differences in cardiac responses to exercise are known, though Indigenous populations response is unknown. The objective of this study is to evaluate cardiac responses to aerobic exercise among Canadian Indigenous and European adults.

Factors predictive of topographical accuracy in spine level localization

Authors: Tee JW, Rutges J, Marion T, Street J, Paquette S, Ailon T, Kwon BKDvorak M, Boyd M.
Published in: J Spine Surg. 2017 Mar;3(1):23-30. doi: 10.21037/jss.2017.02.06.
About: Pre-operative spine level localization by palpation of anatomical landmarks (ribs, spinous processes) in posterior approaches for surgeries from T4 to L2 is often inaccurate. This can lead to ineffective utilization of procedural time, increased radiation dose, potentially longer skin incision and wrong level surgery. Factors affecting topographical accuracy includes body mass index (BMI) of the patient, congenital or acquired deformity and knowledge of topographical anatomy. This study showed that poor spine level localization using anatomical landmarks was associated with pathology related ISPDs of less than 10 mm. Conversely, patients with palpable spinal deformity have their levels easily localized.

Aerobic exercise promotes executive functions and impacts functional neural activity among older adults with vascular cognitive impairment

Authors: Hsu CL, Best JR, Davis JC, Nagamatsu LS, Wang S, Boyd LA, Hsiung GR, Voss MW, Eng JJ, Liu-Ambrose T.
Published in: Br J Sports Med. 2017 Apr 21. pii: bjsports-2016-096846. doi: 10.1136/bjsports-2016-096846. [Epub ahead of print]
About: The objective of this study is to examine the effect of moderate-intensity aerobic training on executive functions and functional neural activity among older adults with mild subcortical ischaemic VCI (SIVCI).

A prospective serial MRI study following acute traumatic cervical spinal cord injury

Authors: Rutges JPHJ, Kwon BK, Heran M, Ailon T, Street JT, Dvorak MF.
Published in: Eur Spine J. 2017 Apr 19. doi: 10.1007/s00586-017-5097-4. [Epub ahead of print]
About: In acute traumatic cervical spinal cord injury (SCI) patients, we sought to characterize how objective MRI measures of injury change during the first 3 week post-injury.

An analysis of ideal and actual time to surgery after traumatic spinal cord injury in Canada

Authors: Glennie RA, Bailey CS, Tsai EC, Noonan VK, Rivers CS, Fourney DR, Ahn H, Kwon BK, Paquet J, Drew B, Fehlings MG, Attabib N, Christie SD, Finkelstein J, Hurlbert RJ, Parent S, Dvorak M.
Published in: Spinal Cord. 2017 Apr 18. doi: 10.1038/sc.2016.177. [Epub ahead of print]
About: The objective of this study is to identify surgeon opinion on ideal practice regarding the timing of decompression/stabilization for spinal cord injury and actual practice. Discrepancies in surgical timing and barriers to ideal timing of surgery were explored.

Overground vs. treadmill-based robotic gait training to improve seated balance in people with motor-complete spinal cord injury: a case report

Authors: Chisholm AE, Alamro RA, Williams AM, Lam T.
Published in: J Neuroeng Rehabil. 2017 Apr 11;14(1):27. doi: 10.1186/s12984-017-0236-z.
About: Robotic overground gait training devices, such as the Ekso, require users to actively participate in triggering steps through weight-shifting movements. It remains unknown how much the trunk muscles are activated during these movements, and if it is possible to transfer training effects to seated balance control. This study was conducted to compare the activity of postural control muscles of the trunk during overground (Ekso) vs. treadmill-based (Lokomat) robotic gait training, and evaluate changes in seated balance control in people with high-thoracic motor-complete spinal cord injury (SCI).

Luminal Water Imaging: A New MR Imaging T2 Mapping Technique for Prostate Cancer Diagnosis

Authors: Sabouri S, Chang SD, Savdie R, Zhang J, Jones EC, Goldenberg SL, Black PC, Kozlowski P.
Published in: Radiology. 2017 Apr 10:161687. doi: 10.1148/radiol.2017161687. [Epub ahead of print]
About: The objective of this study is to assess the feasibility of luminal water imaging, a quantitative T2-based magnetic resonance (MR) imaging technique, for the detection and grading of prostate cancer (PCa).

The role of the autonomic nervous system in arrhythmias and sudden cardiac death

Authors: Franciosi S, Perry FK, Roston TM, Armstrong KR, Claydon VE, Sanatani S.
Published in: Auton Neurosci. 2017 Mar 31. pii: S1566-0702(16)30139-4. doi: 10.1016/j.autneu.2017.03.005. [Epub ahead of print]
About: The autonomic nervous system (ANS) is complex and plays an important role in cardiac arrhythmia pathogenesis. A deeper understanding of the anatomy and development of the ANS has shed light on its involvement in cardiac arrhythmias. Alterations in levels of Sema-3a and NGF, both growth factors involved in innervation patterning during development of the ANS, leads to cardiac arrhythmias. Dysregulation of the ANS, including polymorphisms in genes involved in ANS development, have been implicated in sudden infant death syndrome. Disruptions in the sympathetic and/or parasympathetic systems of the ANS can lead to cardiac arrhythmias and can vary depending on the type of arrhythmia. Simultaneous stimulation of both the sympathetic and parasympathetic systems is thought to lead to atrial fibrillation whereas increased sympathetic stimulation is thought to lead to ventricular fibrillation or ventricular tachycardia. In inherited arrhythmia syndromes, such as Long QT and Catecholaminergic Polymorphic Ventricular Tachycardia, sympathetic system stimulation is thought to lead to ventricular tachycardia, subsequent arrhythmias, and in severe cases, cardiac death. On the other hand, arrhythmic events in Brugada Syndrome have been associated with periods of high parasympathetic tone. Increasing evidence suggests that modulation of the ANS as a therapeutic strategy in the treatment of cardiac arrhythmias is safe and effective. Further studies investigating the involvement of the ANS in arrhythmia pathogenesis and its modulation for the treatment of cardiac arrhythmias is warranted.

The development of an outcome measures toolkit for spinal cord injury rehabilitation

Authors: Chan CW, Miller WC, Querée M, Noonan VK, Wolfe DL; SCIRE Research Team.
Published in: Can J Occup Ther. 2017 Jan 1:8417417690170. doi: 10.1177/0008417417690170. [Epub ahead of print]
About: This study aimed to establish a common set of validated outcome measures specifically for SCI clinical practice.

Validating myelin water imaging with transmission electron microscopy in a rat spinal cord injury model

Authors: Chen HS, Holmes N, Liu J, Tetzlaff WKozlowski P.
Published inNeuroimage. 2017 Apr 2;153:122-130. doi: 10.1016/j.neuroimage.2017.03.065. [Epub ahead of print]
About: Myelin content is an important marker for neuropathology and MRI generated myelin water fraction (MWF) has been shown to correlate well with myelin content. However, because MWF is based on the amount of signal from myelin water, that is, the water trapped between the myelin lipid bilayers, the reading may depend heavily on myelin morphology. This is of special concern when there is a mix of intact myelin and myelin debris, as in the case of injury. To investigate what MWF measures in the presence of debris, we compared MWF to transmission electron microscopy (TEM) derived myelin fraction that measures the amount of compact appearing myelin. A rat spinal cord injury model was used with time points at normal (normal myelin), 3 weeks post-injury (myelin debris), and 8 weeks post-injury (myelin debris, partially cleared). The myelin period between normal and 3 or 8 weeks post-injury cords did not differ significantly, suggesting that as long as the bilayer structure is intact, myelin debris has the same water content as intact myelin. The MWF also correlated strongly with the TEM-derived myelin fraction, suggesting that MWF measures the amount of compact appearing myelin in both intact myelin and myelin debris. From the TEM images, it appears that as myelin degenerates, it tends to form large watery spaces within the myelin sheaths that are not classified as myelin water. The results presented in this study improve our understanding and allows for better interpretation of MWF in the presence of myelin debris.

Frontal TBI increases impulsive decision making in rats: A potential role for the inflammatory cytokine interleukin-12

Authors: Vonder Haar C, Martens KM, Riparip LK, Rosi S, Wellington CL, Winstanley CA.
Published in: J Neurotrauma. 2017 Apr 4. doi: 10.1089/neu.2016.4813. [Epub ahead of print]
About: Traumatic brain injury is associated with the development of numerous psychiatric diseases. Of particular concern for TBI patients is the impact of chronic impulsivity on daily functioning. Despite the scope of the human problem, little has been done to address impulsivity in animal models of brain injury. In the current study, we examined the effects of either a severe or a milder bilateral frontal controlled cortical impact injury on impulsivity using the delay discounting task (DDT), in which preference for smaller-sooner over larger-later rewards is indicative of greater impulsive choice. Both milder and severe TBI caused a significant, chronic increase in impulsive decision-making. Despite these pronounced changes in performance of the DDT, memory function, as assessed by the Morris Water Maze, was not impaired in more mildly injured rats, and only transiently impacted in the severe TBI group. While a significant lesion was only evident in severely injured rats, analysis of cytokine levels within the frontal cortex revealed a selective increase in interleukin-12 that was associated with the magnitude of the change in impulsive choice caused by both milder and severe TBI. These findings suggest that tissue loss alone cannot explain the increased impulsivity observed, and that inflammatory pathways mediated by interleukin-12 may be a contributing factor. The findings from this study highlight the sensitivity of sophisticated behavioral measures designed to assess neuropsychiatric dysfunction in the detection of TBI-induced cognitive impairments, and their utility in identifying potential mechanistic pathways and therapeutic targets.

Emerging Biofabrication Strategies for Engineering Complex Tissue Constructs

Authors: Pedde RD, Mirani B, Navaei A, Styan T, Wong S, Mehrali M, Thakur A, Mohtaram NK, Bayati A, Dolatshahi-Pirouz A, Nikkhah M, Willerth SM, Akbari M.
Published in: Adv Mater. 2017 Apr 3. doi: 10.1002/adma.201606061. [Epub ahead of print]
About: The demand for organ transplantation and repair, coupled with a shortage of available donors, poses an urgent clinical need for the development of innovative treatment strategies for long-term repair and regeneration of injured or diseased tissues and organs. Bioengineering organs, by growing patient-derived cells in biomaterial scaffolds in the presence of pertinent physicochemical signals, provides a promising solution to meet this demand. However, recapitulating the structural and cytoarchitectural complexities of native tissues in vitro remains a significant challenge to be addressed. Through tremendous efforts over the past decade, several innovative biofabrication strategies have been developed to overcome these challenges. This review highlights recent work on emerging three-dimensional bioprinting and textile techniques, compares the advantages and shortcomings of these approaches, outlines the use of common biomaterials and advanced hybrid scaffolds, and describes several design considerations including the structural, physical, biological, and economical parameters that are crucial for the fabrication of functional, complex, engineered tissues. Finally, the applications of these biofabrication strategies in neural, skin, connective, and muscle tissue engineering are explored.

Traumatic brain injury rehabilitation in Riyadh, Saudi Arabia: Time to rehabilitation admission, length of stay and functional outcome

Authors: Qannam H, Mahmoud H, Mortenson WB.
Published in: Brain Inj. 2017 Mar 31:1-7. doi: 10.1080/02699052.2017.1286386. [Epub ahead of print]
About: The objectives of this study are to (1) describe trends in time to rehabilitation admission and rehabilitation length of stay (LOS), (2) compare functional independence at discharge from rehabilitation between patients who arrived directly from acute care versus those from elsewhere and (3) identify independent predictors of functional outcomes following rehabilitation.

Economic evaluation of aerobic exercise training in older adults with vascular cognitive impairment: PROMoTE trial

Authors: Davis JC, Hsiung GR, Bryan S, Best JR, Eng JJ, Munkacsy M, Cheung W, Chiu B, Jacova C, Lee P, Liu-Ambrose T.
Published in: BMJ Open. 2017 Mar 29;7(3):e014387. doi: 10.1136/bmjopen-2016-014387.
About: Evidence suggests that aerobic exercise may slow the progression of subcortical ischaemic vascular cognitive impairment (SIVCI) by modifying cardiovascular risk factors. Yet the economic consequences relating to aerobic training (AT) remain unknown. Therefore, our primary objective was to estimate the incremental cost per quality-adjusted life years (QALYs) gained of a thrice weekly AT intervention compared with usual care.

Prioritizing Functional Capacity as a Principal End Point for Therapies Oriented to Older Adults With Cardiovascular Disease: A Scientific Statement for Healthcare Professionals From the American Heart Association

Authors: Forman DE, Arena R, Boxer R, Dolansky MA, Eng JJ, Fleg JL, Haykowsky M, Jahangir A, Kaminsky LA, Kitzman DW, Lewis EF, Myers J, Reeves GR, Shen WK; American Heart Association Council on Clinical Cardiology; Council on Cardiovascular and Stroke Nursing; Council on Quality of Care and Outcomes Research; and Stroke Council.
Published in: Circulation. 2017 Apr 18;135(16):e894-e918. doi: 10.1161/CIR.0000000000000483. Epub 2017 Mar 23.
About: Adults are living longer, and cardiovascular disease is endemic in the growing population of older adults who are surviving into old age. Functional capacity is a key metric in this population, both for the perspective it provides on aggregate health and as a vital goal of care. Whereas cardiorespiratory function has long been applied by cardiologists as a measure of function that depended primarily on cardiac physiology, multiple other factors also contribute, usually with increasing bearing as age advances. Comorbidity, inflammation, mitochondrial metabolism, cognition, balance, and sleep are among the constellation of factors that bear on cardiorespiratory function and that become intricately entwined with cardiovascular health in old age. This statement reviews the essential physiology underlying functional capacity on systemic, organ, and cellular levels, as well as critical clinical skills to measure multiple realms of function (eg, aerobic, strength, balance, and even cognition) that are particularly relevant for older patients. Clinical therapeutic perspectives and patient perspectives are enumerated to clarify challenges and opportunities across the caregiving spectrum, including patients who are hospitalized, those managed in routine office settings, and those in skilled nursing facilities. Overall, this scientific statement provides practical recommendations and vital conceptual insights.

Geomapping of Traumatic Spinal Cord Injury in Canada and Factors Related to Triage Pattern

Authors: Cheng CL, Noonan VK, Shurgold J, Chen J, Rivers CS, Hamedani HK, Humphreys S, Bailey C, Attabib N, Mac-Thiong JM, Goytan M, Paquet J, Fox R, Ahn H, Kwon BK, Fourney DR.
Published in: J Neurotrauma. 2017 Mar 22. doi: 10.1089/neu.2016.4929. [Epub ahead of print]
About: Current research indicates that more than half of patients with traumatic spinal cord injury (tSCI) experience delays in transfer and receive surgery more than 24 hours post-injury. The objectives of this study were to determine the geographic distribution of tSCI in Canada relative to specialized treatment facilities, to assess clinical and logistical factors at play for indirect admissions to those facilities, and to explore differences in current time to admission and simulated scenarios in an attempt to assess the potential impact of changes to triage protocols. This study included data from 876 patients with tSCI enrolled in the prospectively collected acute Rick Hansen Spinal Cord Injury Registry (RHSCIR) between January 1, 2010 and December 31, 2013 who had data on the location of their injury. Patients transported directly to a RHSCIR acute facility were more likely to reach the facility within 1 h of injury while those transported indirectly were more likely to arrive 7 h later. Considering the injuries occurring within 40 km of a RHSCIR acute facility (n=323), 249 patients (77%) were directly and 74 (23%) were indirectly admitted. In the multivariate regression analysis, only older age and longer road distance remained significantly associated with being indirectly admitted to a RHSCIR facility. Compared to the current status, the median time to admission decreased by 20% (3.5 h) in the 100% direct admission scenario; and increased by 102% (8.9 h) in the 100% indirect admission scenario.

Experiences with and perceptions of an adaptive hiking program

Authors: James L, Shing J, Mortenson WB, Mattie J, Borisoff J.
Published in: Disabil Rehabil. 2017 Mar 21:1-7. doi: 10.1080/09638288.2017.1302006. [Epub ahead of print]
About: Outdoor activities in natural settings have been found to be beneficial for overall health and well-being. However, people with disabilities may have different experiences accessing outdoor activities in natural settings. This research explored the experiences of users, volunteers, and staff, and perspectives of non-users about an adapted hiking program that uses a specialized mobility device called a TrailRider. The research had three objectives: 1. Describe the experiences of users, volunteers, and staff; 2. Identify perceived barriers to or limitations of participating for users, volunteers, staff, and non-users; and 3. Explore the impact of participation for users, volunteers, and staff.

Leisure time physical activity among older adults with long-term spinal cord injury

Authors: Jörgensen S, Martin Ginis KA, Lexell J.
Published in: Spinal Cord. 2017 Mar 21. doi: 10.1038/sc.2017.26. [Epub ahead of print]
About: The objective of this study is to describe participation in leisure time physical activity (LTPA) (amount, intensity and type) among older adults with long-term spinal cord injury (SCI), and to investigate the associations with sociodemographics, injury characteristics and secondary health conditions (SHCs).

Development of the AOSpine Patient Reported Outcome Spine Trauma (AOSpine PROST): a universal disease-specific outcome instrument for individuals with traumatic spinal column injury

Authors: Sadiqi S, Lehr AM, Post MW, Dvorak MF, Kandziora F, Rajasekaran S, Schnake KJ, Vaccaro AR, Oner FC.
Published inEur Spine J. 2017 Mar 17. doi: 10.1007/s00586-017-5032-8. [Epub ahead of print]
About: Ex vivo compression experiments on isolated cadaveric vertebrae. OBJECTIVE: To qualitatively compare the fracture locations identified in video analysis with the locations of high compressive strain measured with DIC on vertebral bodies and to evaluate the timing of local damage to the cortical shell relative to the global yield force. SUMMARY OF BACKGROUND DATA: In previous ex vivo experiments, cortical bone fracture has been identified using various methods including acoustic emission sensors, strain gages, video analysis, or force signals. However, these methods are limited in their ability to detect the location and timing of fracture. We propose use of digital image correlation (DIC), a non-contact optical technique that measures surface displacement, to quantify variables related to damage.

Damage Identification on Vertebral Bodies During Compressive Loading Using Digital Image Correlation

Authors: Santos A, Fallah N, Lewis R, Dvorak MF, Fehlings MG, Burns AS, Noonan VK, Cheng CL, Chan E, Singh A, Belanger LM, Atkins D.
Published in: Spine (Phila Pa 1976). 2017 Mar 16. doi: 10.1097/BRS.0000000000002156. [Epub ahead of print]
About: Ex vivo compression experiments on isolated cadaveric vertebrae OBJECTIVE.: To qualitatively compare the fracture locations identified in video analysis with the locations of high compressive strain measured with DIC on vertebral bodies and to evaluate the timing of local damage to the cortical shell relative to the global yield force SUMMARY OF BACKGROUND DATA.: In previous ex vivo experiments, cortical bone fracture has been identified using various methods including acoustic emission sensors, strain gages, video analysis, or force signals. However, these methods are limited in their ability to detect the location and timing of fracture. We propose use of digital image correlation (DIC), a non-contact optical technique that measures surface displacement, to quantify variables related to damage.

Methodology of the Access to Care and Timing Simulation Model for Traumatic Spinal Cord Injury Care

Authors: Santos A, Fallah N, Lewis R, Dvorak MF, Fehlings MG, Burns AS, Noonan VK, Cheng CL, Chan E, Singh A, Belanger LM, Atkins D.
Published in: J Neurotrauma. 2017 Mar 12. doi: 10.1089/neu.2016.4927. [Epub ahead of print]
About: Despite the relatively low incidence, the management and care of persons with traumatic spinal cord injury (tSCI) can be resource intensive and complex, spanning multiple phases of care and disciplines. Using a simulation model built with a system level view of the healthcare system allows for prediction of the impact of interventions on patient and system outcomes from injury through to community reintegration after tSCI. The Access to Care and Timing (ACT) project developed a simulation model for tSCI care using techniques from operations research and its development has been described previously. The objective of this article is to briefly describe the methodology and the application of the ACT Model as it was used in several of the articles in this focus issue. The approaches employed in this model provide a framework to look into the complexity of interactions both within and among the different SCI programs, sites and phases of care.

Kynurenic acid downregulates IL-17/1L-23 axis in vitro

Authors: Salimi Elizei S, Poormasjedi-Meibod MS, Wang X, Kheirandish M, Ghahary A.
Published in: Mol Cell Biochem. 2017 Mar 11. doi: 10.1007/s11010-017-2975-3. [Epub ahead of print]
About: Exploring the function of interleukin (IL) 17 and related cytokine interactions have been proven useful toward understanding the role of inflammation in autoimmune diseases. Production of the inflammatory cytokine IL-23 by dendritic cells (DC’s) has been shown to promote IL-17 expression by Th17 cells. It is well established that Th17 cells play an important role in several autoimmune diseases including psoriasis and alopecia. Our recent investigations have suggested that Kynurenine-rich environment can shift a pro-inflammatory response to an anti-inflammatory response, as is the case in the presence of the enzyme Indoleamine 2,3 dioxygenase (IDO), the rate-limiting enzyme in tryptophan degradation and Kynurenine (Kyn) production. In this study, we sought to explore the potential role of kynurenic acid (KynA), in modulating the expression of IL-23 and IL-17 by DCs and CD4+ cells, respectively. The result of flow cytometry demonstrated that the frequency of IL-23-producing DCs is reduced with 100 µg/ml of KynA as compared with that of LPS-stimulated DCs. KynA (100 μg/ml) addition to activated T cells significantly decreased the level of IL-17 mRNA and frequency of IL-17+ T cells as compared to that of concanavalin (Con) A-activated T cells. To examine the mechanism of the suppressive role of KynA on IL-23/IL-17 in these cells, cells were treated with 3 μM G-protein-coupled receptor35 (GPCR35) inhibitor (CID), for 60 min. The result showed that the reduction of both adenylate cyclase (AC) and cyclic adenosine monophosphate (cAMP) by KynA is involved in suppression of LPS-induced IL-23p19 expression. Since GPCR35 is also detected on T cells; therefore, it is concluded that KynA plays an important role in modulating the expression of IL-23 and IL-17 in DCs and Th17 cells through inhibiting GPCR35 and downregulation of both AC and cAMP.

Characterizing the community use of an ultralight wheelchair with “on the fly” adjustable seating functions: A pilot study

Authors: Mattie J, Borisoff J, Miller WC, Noureddin B.
Published in: PLoS One. 2017 Mar 9;12(3):e0173662. doi: 10.1371/journal.pone.0173662. eCollection 2017.
About: An ultralight manual wheelchair that allows users to independently adjust rear seat height and backrest angle during normal everyday usage was recently commercialized. Prior research has been performed on wheelchair tilt, recline, and seat elevation use in the community, however no such research has been done on this new class of manual ultralight wheelchair with “on the fly” adjustments. The objective of this pilot study was to investigate and characterize the use of the two adjustable seating functions available on the Elevation™ ultralight dynamic wheelchair during its use in the community. Eight participants had data loggers installed onto their own wheelchair for seven days to measure rear seat height, backrest angle position, occupied sitting time, and distance traveled. Analysis of rear seat height and backrest adjustment data revealed considerable variability in the frequency of use and positions used by participants. There was a wide spread of mean daily rear seat heights among participants, from 34.1 cm to 46.7 cm. Two sub-groups of users were further identified: those who sat habitually at a single typical rear seat height, and those who varied their rear seat height more continuously. Findings also showed that participants used the rear seat height adjustment feature significantly more often than the backrest adjustment feature. This obvious contrast in feature use may indicate that new users of this class of wheelchair may benefit from specific training. While the small sample size and exploratory nature of this study limit the generalizability of our results, our findings offer a first look at how active wheelchairs users are using a new class of ultralight wheelchair with “on the fly” seating adjustments in their communities. Further studies are recommended to better understand the impact of dynamic seating and positioning on activity, participation and quality of life.

Participant experiences and perceptions of physical activity-enhancing interventions for people with physical impairments and mobility limitations: a meta-synthesis of qualitative research evidence

Authors: Williams TL, Ma JK, Martin Ginis KA.
Published in: Health Psychol Rev. 2017 Mar 13:1-18. doi: 10.1080/17437199.2017.1299027. [Epub ahead of print]
About: Disabled people face multiple personal, environmental and social barriers that interfere with leading a physically active lifestyle. Thus, there is an urgent need for behaviour change interventions to increase physical activity (PA) by specifically addressing the situations of disabled people, and barriers to participation. This original meta-synthesis of qualitative research was undertaken to explore participants’ experiences and perceptions of PA-enhancing interventions for adults with physical impairments resulting in mobility limitations. Published articles were identified through a rigorous systematic search. Based on the inclusion/exclusion criteria, 10 articles were included for review. Following a critical appraisal of the articles, methods of thematic synthesis were drawn upon to generate overarching concepts through interpretation and conceptual synthesis. Seven interrelated concepts were constructed representing both components and outcomes of the interventions. These were (i) Diversity of interventions; (ii) Importance of communication; (iii) Need for social support; (iv) Behavioural strategies; (v) Gaining knowledge; (vi) Re-framing thoughts about exercise and the self and (vii) Health and well-being. The results revealed that a combination of informational, social and behavioural interventions is perceived as crucial for PA initiation and maintenance. Furthermore, key elements of effective intervention design and implications for policies and practices to increase PA participation are proposed.

A Targeted Proteomics Analysis of Cerebrospinal Fluid after Acute Human Spinal Cord Injury

Authors: Streijger F, Skinnider M, Rogalski JC, Balshaw R, Shannon CP, Prudova A, Belanger LM, Ritchie L, Tsang A, Christie S, Parent S, Mac-Thiong JM, Bailey C, Urquhart J, Ailon T, Paquette SJ, Boyd MC, Street J, Fisher CG, Dvorak MF, Borchers CH, Foster LJ, Kwon BK.
Published in: J Neurotrauma. 2017 Mar 9. doi: 10.1089/neu.2016.4879. [Epub ahead of print]
About: Efforts to validate novel therapies in acute clinical trials for spinal cord injury (SCI) are impeded by the lack of objective quantitative measures that reflect injury severity and accurately predict neurologic recovery. Therefore, a strong rationale exists to establish neurochemical biomarkers that objectively quantify injury severity and predict outcome. Here, we conducted a targeted proteomics analysis of cerebrospinal fluid (CSF) samples derived from 29 acute SCI patients (AIS A, B, or C) acquired at 24, 48, and 72 hours post-injury. From a total of 165 proteins, we identified 27 potential biomarkers of injury severity (baseline AIS A, B, or C), with triosephosphate isomerase having the strongest relationship to AIS grade. The majority of affected proteins (24 of 27) were more abundant in samples from AIS A patients compared to the AIS C patients, suggesting that for the most part, these proteins are released into the CSF more readily with more severe trauma to the spinal cord. We then analyzed the relationship between CSF protein abundance and neurologic recovery. For AIS grade improvement over 6 months, we identified 34 proteins that were associated with AIS grade conversion (p<0.05), but these associations were not statistically significant after adjusting for multiple comparisons. For (TMS) recovery over 6 months, after adjusting for baseline neurologic injury level, we identified 46 proteins with a statistically significant association with TMS recovery. Twenty-two of these proteins were amongst the 27 proteins that were related to baseline AIS grade, consistent with the notion that protein markers that reflect a more severe injury also appropriately predict a poorer recovery of motor function. In summary, this study provides a description of the CSF proteome changes that occur after acute human SCI, and reveals a number of protein candidates for further validation as potential biomarkers of injury severity.

Defining the biomechanical and biological threshold of murine mild traumatic brain injury using CHIMERA (Closed Head Impact Model of Engineered Rotational Acceleration)

Authors: Namjoshi DR, Cheng WH, Bashir A, Wilkinson A, Stukas S, Martens KM, Whyte T, Abebe ZA, McInnes KA, Cripton PA, Wellington CL.
Published in: Exp Neurol. 2017 Mar 6;292:80-91. doi: 10.1016/j.expneurol.2017.03.003. [Epub ahead of print]
About: CHIMERA (Closed Head Impact Model of Engineered Rotational Acceleration) is a recently described animal model of traumatic brain injury (TBI) that primarily produces diffuse axonal injury (DAI) characterized by white matter inflammation and axonal damage. CHIMERA was specifically designed to reliably generate a variety of TBI severities using precise and quantifiable biomechanical inputs in a nonsurgical user-friendly platform. The objective of this study was to define the lower limit of single impact mild TBI (mTBI) using CHIMERA by characterizing the dose-response relationship between biomechanical input and neurological, behavioral, neuropathological and biochemical outcomes. Wild-type male mice were subjected to a single CHIMERA TBI using six impact energies ranging from 0.1 to 0.7J, and post-TBI outcomes were assessed over an acute period of 14days. Here we report that single TBI using CHIMERA induces injury dose- and time-dependent changes in behavioral and neurological deficits, axonal damage, white matter tract microgliosis and astrogliosis. Impact energies of 0.4J or below produced no significant phenotype (subthreshold), 0.5J led to significant changes for one or more phenotypes (threshold), and 0.6 and 0.7J resulted in significant changes in all outcomes assessed (mTBI). We further show that linear head kinematics are the most robust predictors of duration of unconsciousness, severity of neurological deficits, white matter injury, and microgliosis following single TBI. Our data extend the validation of CHIMERA as a biofidelic animal model of DAI and establish working parameters to guide future investigations of the mechanisms underlying axonal pathology and inflammation induced by mechanical trauma.

Understanding Length of Stay following Spinal Cord Injury: Insights and Limitations from the Access to Care and Timing (ACT) Project

Authors: Burns AS, Santos A, Cheng CL, Chan E, Fallah N, Atkins D, Dvorak MF, Ho C, Ahn H, Paquet J, Kwon BK, Noonan V.
Published in: J Neurotrauma. 2017 Feb 28. doi: 10.1089/neu.2016.4935. [Epub ahead of print]
About: Costs associated with initial hospitalization following spinal cord injury (SCI) are substantial, and a major driver of costs is the length of stay (LOS) the injured individual remains hospitalized prior to community reintegration. Our aim was to study the factors and variables that contribute to LOS following traumatic SCI. Modeling (process mapping of the SCI healthcare delivery system in Canada and discrete event simulation) and regression analysis using a national registry of individuals with acute traumatic SCI in Canada, existing databases and peer-reviewed literature were used to examine the driver of LOS following traumatic SCI. In different jurisdictions, there is considerable variation in the definitions and methods used to determine LOS following SCI. System LOS can be subdivided into subcomponents and progression through these is not unidirectional. Modeling reveals that healthcare organization and processes are important contributors to differences in LOS independent of patient demographics and injury characteristics. Future research is required to identify and improve our understanding of contributors to LOS following traumatic SCI. This will help enhance system performance. Work in this area will be facilitated by the adoption of common terminology and definitions, as well as the use of simulations and modeling.

In vivo imaging reveals that pregabalin inhibits cortical spreading depression and propagation to subcortical brain structures

Authors: Cain SM, Bohnet B, LeDue J, Yung AC, Garcia E, Tyson JR, Alles SR, Han H, van den Maagdenberg AM, Kozlowski P, MacVicar BA, Snutch TP.
Published in: Proc Natl Acad Sci U S A. 2017 Feb 28;114(9):2401-2406. doi: 10.1073/pnas.1614447114. Epub 2017 Feb 21.
About: Migraine is characterized by severe headaches that can be preceded by an aura likely caused by cortical spreading depression (SD). The antiepileptic pregabalin (Lyrica) shows clinical promise for migraine therapy, although its efficacy and mechanism of action are unclear. As detected by diffusion-weighted MRI (DW-MRI) in wild-type (WT) mice, the acute systemic administration of pregabalin increased the threshold for SD initiation in vivo. In familial hemiplegic migraine type 1 mutant mice expressing human mutations (R192Q and S218L) in the CaV2.1 (P/Q-type) calcium channel subunit, pregabalin slowed the speed of SD propagation in vivo. Acute systemic administration of pregabalin in vivo also selectively prevented the migration of SD into subcortical striatal and hippocampal regions in the R192Q strain that exhibits a milder phenotype and gain of CaV2.1 channel function. At the cellular level, pregabalin inhibited glutamatergic synaptic transmission differentially in WT, R192Q, and S218L mice. The study describes a DW-MRI analysis method for tracking the progression of SD and provides support and a mechanism of action for pregabalin as a possible effective therapy in the treatment of migraine.

Development of a chronic disease management program for stroke survivors using intervention mapping: The Stroke Coach

Authors: Sakakibara BM, Lear SA, Barr SI, Benavente O, Goldsmith CH, Silverberg ND, Yao J, Eng JJ.
Published in: Arch Phys Med Rehabil. 2017 Feb 17. pii: S0003-9993(17)30084-9. doi: 10.1016/j.apmr.2017.01.019. [Epub ahead of print]
About: The objective of this study is to describe the systematic development of the Stroke Coach, a theory- and evidence-based intervention to improve control of lifestyle behaviour risk factors in stroke patients.

Association Between Paraspinal Muscle Morphology, Clinical Symptoms, and Functional Status in Patients With Degenerative Cervical Myelopathy

Authors: Fortin M, Dobrescu O, Courtemanche M, Sparrey CJ, Santaguida C, Fehlings MG, Weber MH.
Published in: Spine (Phila Pa 1976). 2017 Feb 15;42(4):232-239. doi: 10.1097/BRS.0000000000001704.
About: The aim of this study was to assess fatty infiltration and asymmetry of the multifidus (MF), semispinalis cervicis (SCer), semispinalis capitis (SCap), and splenius capitis (SPL) muscles in patients with degenerative cervical myelopathy (DCM), and evaluate their correlations with clinical symptoms and functional scores.

Clinicians’ and researchers’ perspectives on manual wheelchair data loggers

Authors: Routhier F, Lettre J, Miller WCBorisoff JF, Keetch K, Mitchell IM, CanWheel Research Team.
Published inArch Phys Med Rehabil. 2017 Feb 12. pii: S0003-9993(17)30078-3. doi: 10.1016/j.apmr.2017.01.013. [Epub ahead of print]
About: Recent studies have employed data loggers to record a wide range of, sometimes differing, objective outcomes associated with the use of manual wheelchairs. To identify which outcomes are broadly perceived to be the most important to measure when objectively documenting manual wheelchair use, a cross-sectional survey was conducted with groups of researchers and clinicians in the field of wheeled mobility. We also surveyed the challenges these groups experienced when using data loggers. The survey was informed by a previous scoping review of the scientific and gray literature. Seventy-four people, with various academic and professional backgrounds, completed the survey: 57 researchers (77.0%) and 17 clinicians (23.0%). Regarding the importance they attributed to commonly measured outcomes, the most highly rated outcome identified by both groups was “distance traveled.” There were significant differences between the groups’ perspectives in rating and ranking the importance of “pressure-relief activities”, “seat pressure” and “acceleration.” In terms of challenges or barriers associated with the use of data loggers for monitoring manual wheelchair use, it appears that researchers and clinicians have relatively similar needs and preferences. However, only clinicians reported that the time they wanted to, or could, allocate to review recorded information was a potential hardship. Our hope is that these results will help further development and increase the functionality and applicability of data loggers for manual wheelchairs in research and clinical contexts.

Validity of the Elite HRV Smart Phone Application for Examining Heart Rate Variability in a Field Based Setting

Authors: Perrotta AS, Jeklin A, Hives BA, Meanwell LE, Warburton DE.
Published in: J Strength Cond Res. 2017 Feb 8. doi: 10.1519/JSC.0000000000001841. [Epub ahead of print]
About: The introduction of smart phone applications has allowed athletes and practitioners to record and store R-R intervals on smart phones for immediate heart rate variability (HRV) analysis. This user-friendly option should be validated in the effort to provide practitioners confidence when monitoring their athletes before implementing such equipment.The objective of this investigation was to examine the relationship between a vagal related HRV index, rMSSD when derived from a smart phone application accessible with most smart phone operating systems against Kubios HRV 2.2R-R intervals were recorded immediately upon awakening over 14 consecutive days using the Elite HRV smartphone application. R-R recordings were then exported into Kubios HRV 2.2 for analysis. The relationship between rMSSDln derived from Elite HRV and Kubios HRV 2.2 was examined using a Pearson Product Moment Correlation and a Bland-Altman Plot.An extremely large relationship was identified (r = 0.92; p < 0.0001; CI 95% = 0.90;0.93). A total of 6.4% of the residuals fell outside of the 1.96 ±SD (CI 95% = -12.0%; 7.0%) limits of agreement. A negative bias was observed (mean: -2.7%; CI 95% = -3.10%;-2.30%) whose CI 95% failed to fall within the line of equality.Our observations suggest Elite HRV as a non-valid smart phone application for examining rMSDDLn when compared to Kubios HRV 2.2. We propose further research is warranted to confirm our observations and to identify if this smart phone application may be reliable rather than valid when assessing parasympathetic modulation.

Distinct eye movement patterns enhance dynamic visual acuity

Authors: Palidis DJ, Wyder-Hodge PA, Fooken J, Spering M.
Published in: PLoS One. 2017 Feb 10;12(2):e0172061. doi: 10.1371/journal.pone.0172061. eCollection 2017.
About: Dynamic visual acuity (DVA) is the ability to resolve fine spatial detail in dynamic objects during head fixation, or in static objects during head or body rotation. This ability is important for many activities such as ball sports, and a close relation has been shown between DVA and sports expertise. DVA tasks involve eye movements, yet, it is unclear which aspects of eye movements contribute to successful performance. Here we examined the relation between DVA and the kinematics of smooth pursuit and saccadic eye movements in a cohort of 23 varsity baseball players. In a computerized dynamic-object DVA test, observers reported the location of the gap in a small Landolt-C ring moving at various speeds while eye movements were recorded. Smooth pursuit kinematics-eye latency, acceleration, velocity gain, position error-and the direction and amplitude of saccadic eye movements were linked to perceptual performance. Results reveal that distinct eye movement patterns-minimizing eye position error, tracking smoothly, and inhibiting reverse saccades-were related to dynamic visual acuity. The close link between eye movement quality and DVA performance has important implications for the development of perceptual training programs to improve DVA.

Measurement properties of the Wheelchair Skills Test for scooters among experienced users

AuthorsMortenson WB, Hurd Clarke L, Goldsmith CH, Jang S, Kirby RL.
Published inDisabil Rehabil Assist Technol. 2017 Feb 5:1-6. doi: 10.1080/17483107.2017.1280546. [Epub ahead of print]
About: The purpose of this study is to investigate the score distribution, reliability, and validity of the objective Wheelchair Skills Test (WST) for scooter user.

Effects of early and delayed initiation of exercise training on cardiac and haemodynamic function after spinal cord injury

Authors: Popok DW, West CR, McCracken L, Krassioukov AV.
Published in: Exp Physiol. 2017 Feb 1;102(2):154-163. doi: 10.1113/EP085978.
About: Spinal cord injury (SCI) reduces physical activity and alters descending supraspinal cardiovascular control, predisposing this population to early onset of cardiovascular disease. We used a T3 SCI rodent model to investigate the effect of early versus delayed passive hindlimb cycling (PHLC), as well as the effect of detraining on cardiac dysfunction and blood pressure control, including autonomic dysreflexia (AD).

2015 ParaPan American Games: Autonomic Function, But Not Physical Activity, Is Associated with Vascular-Cognitive Impairment in Spinal Cord Injury

Authors: Phillips AA, Squair JR, Currie KD, Tzeng YC, Ainslie PN, Krassioukov AV.
Published in: J Neurotrauma. 2017 Jan 27. doi: 10.1089/neu.2016.4751. [Epub ahead of print]
About: The optimization and maintenance of mean arterial blood pressure (MAP) and the general avoidance of systemic hypotension for the first 5-7 days following acute traumatic spinal cord injury (tSCI) is considered to be important for minimizing secondary spinal cord ischemic damage. The characterization of hemodynamic parameters in the immediate post-injury stage prior to admission to a specialized spine unit has not been previously reported. Here we describe the blood pressure management of 40 acute tSCI patients in the early post-injury phases of care prior to their arrival in a specialized spinal injury high dependency unit (HDU), intensive care unit (ICU), or operating room (OR). This study found that a significant proportion of these patients experience periods of relative hypotension prior to their admission to a specialized spinal unit. In particular, the mean calculated MAP was 78.8 mm Hg, with 52% of MAP measurements <80 mm Hg at primary receiving hospitals. Despite having a mean calculated MAP of 83.3 mm Hg in the emergency room of the tertiary hospital, 40% of the MAP measurements were <80 mm Hg. Although stringent monitoring and management of MAP may be facilitated and adhered to in a spinal HDU, ICU, or OR, it is important to recognize that acute traumatic SCI patients may experience many periods of relative hypotension prior to their arrival in such specialized units. This study highlights the need for education and awareness to optimize the hemodynamic management of acute SCI patients during the immediate post-injury period.

MR measurement of luminal water in prostate gland: Quantitative correlation between MRI and histology

Authors: Sabouri S, Fazli L, Chang SD, Savdie R, Jones EC, Goldenberg SL, Black PC, Kozlowski P.
Published in: J Magn Reson Imaging. 2017 Jan 27. doi: 10.1002/jmri.25624. [Epub ahead of print]
About: The purpose of this study is to determine the relationship between parameters measured from luminal water imaging (LWI), a new magnetic resonance imaging (MRI) T2 mapping technique, and the corresponding tissue composition in prostate.

Effects of weld damage on the dynamics of energy absorbing lanyards

Authors: Katona DN, Bennett CR, McKoryk M, Brisson AL, Sparrey CJ.
Published in: Int J Occup Saf Ergon. 2017 Jan 26:1-24. doi: 10.1080/10803548.2017.1282236. [Epub ahead of print]
About: Manufacturers recommend removing fall protection system components from service for any indication of weld spatter or tool damage; however, little is known about the specific effects of lanyard damage on fall arrest dynamics. Thirty-two energy absorbing lanyards were drop tested after being damaged with weld spatter, plasma torches and cutting tools and compared with new, undamaged lanyards. Two lanyards damaged with a plasma torch failed completely without deploying the energy absorber while weld spatter damage and tool cuts, up to 2/3 through the width of the webbing, had no effect on fall arrest dynamics. The results highlight the catastrophic implications of high temperature damage to lanyard webbing resulting from plasma torches – which require immediate removal from service. In addition, the integrated energy absorber design in bungee style lanyards makes them more susceptible to damage anywhere along its length. We therefore recommended against bungee lanyards for ironworkers and welders.

Paralympic Medicine: The Road to Rio

Authors: Phillips AA, Squair JW, Krassioukov AV.
Published in: J Neurotrauma. 2017 Jan 24. doi: 10.1089/neu.2016.4715. [Epub ahead of print]
About: The optimization and maintenance of mean arterial blood pressure (MAP) and the general avoidance of systemic hypotension for the first 5-7 days following acute traumatic spinal cord injury (tSCI) is considered to be important for minimizing secondary spinal cord ischemic damage. The characterization of hemodynamic parameters in the immediate post-injury stage prior to admission to a specialized spine unit has not been previously reported. Here we describe the blood pressure management of 40 acute tSCI patients in the early post-injury phases of care prior to their arrival in a specialized spinal injury high dependency unit (HDU), intensive care unit (ICU), or operating room (OR). This study found that a significant proportion of these patients experience periods of relative hypotension prior to their admission to a specialized spinal unit. In particular, the mean calculated MAP was 78.8 mm Hg, with 52% of MAP measurements <80 mm Hg at primary receiving hospitals. Despite having a mean calculated MAP of 83.3 mm Hg in the emergency room of the tertiary hospital, 40% of the MAP measurements were <80 mm Hg. Although stringent monitoring and management of MAP may be facilitated and adhered to in a spinal HDU, ICU, or OR, it is important to recognize that acute traumatic SCI patients may experience many periods of relative hypotension prior to their arrival in such specialized units. This study highlights the need for education and awareness to optimize the hemodynamic management of acute SCI patients during the immediate post-injury period.

Exercise and the Multidisciplinary Holistic Approach to Adolescent Dysautonomia

Authors: Armstrong K, De Souza AM, Sneddon P, Potts JE, Claydon VE, Sanatani S.
Published in: Acta Paediatr. 2017 Jan 23. doi: 10.1111/apa.13750. [Epub ahead of print]
About: The purpose of this study is to determine if an 8-week strength training program as part of a multidisciplinary approach would minimize symptoms and improve quality of life in patients with dysautonomia.

Interrater and intrarater reliability of the wheelchair skills test version 4.2 for power wheelchair users

Authors: Smith EM, Low K, Miller WC.
Published inDisabil Rehabil. 2017 Jan 23:1-9. doi: 10.1080/09638288.2016.1271464. [Epub ahead of print]
About: The purpose of this study is to estimate the interrater and intrarater reliability of the Wheelchair Skills Test (WST) Version 4.2 for powered wheelchairs operated by adult users.

Mean Arterial Blood Pressure Management of Acute Traumatic Spinal Cord Injured Patients during the Pre-Hospital and Early Admission Period

Authors: Tee JW, Altaf F, Belanger L, Ailon T, Street J, Paquette S, Boyd M, Fisher CG, Dvorak MFKwon BK.
Published in: J Neurotrauma. 2017 Jan 13. doi: 10.1089/neu.2016.4689. [Epub ahead of print]
About: The optimization and maintenance of mean arterial blood pressure (MAP) and the general avoidance of systemic hypotension for the first 5-7 days following acute traumatic spinal cord injury (tSCI) is considered to be important for minimizing secondary spinal cord ischemic damage. The characterization of hemodynamic parameters in the immediate post-injury stage prior to admission to a specialized spine unit has not been previously reported. Here we describe the blood pressure management of 40 acute tSCI patients in the early post-injury phases of care prior to their arrival in a specialized spinal injury high dependency unit (HDU), intensive care unit (ICU), or operating room (OR). This study found that a significant proportion of these patients experience periods of relative hypotension prior to their admission to a specialized spinal unit. In particular, the mean calculated MAP was 78.8 mm Hg, with 52% of MAP measurements <80 mm Hg at primary receiving hospitals. Despite having a mean calculated MAP of 83.3 mm Hg in the emergency room of the tertiary hospital, 40% of the MAP measurements were <80 mm Hg. Although stringent monitoring and management of MAP may be facilitated and adhered to in a spinal HDU, ICU, or OR, it is important to recognize that acute traumatic SCI patients may experience many periods of relative hypotension prior to their arrival in such specialized units. This study highlights the need for education and awareness to optimize the hemodynamic management of acute SCI patients during the immediate post-injury period.

Thermal grill conditioning: Effect on contact heat evoked potentials

Authors: Jutzeler CR, Warner FM, Wanek J, Curt A, Kramer JL.
Published in: Sci Rep. 2017 Jan 12;7:40007. doi: 10.1038/srep40007.
About: The ‘thermal grill illusion’ (TGI) is a unique cutaneous sensation of unpleasantness, induced through the application of interlacing warm and cool stimuli. While previous studies have investigated optimal parameters and subject characteristics to evoke the illusion, our aim was to examine the modulating effect as a conditioning stimulus. A total of 28 healthy control individuals underwent three testing sessions on separate days. Briefly, 15 contact heat stimuli were delivered to the right hand dorsum, while the left palmar side of the hand was being conditioned with either neutral (32 °C), cool (20 °C), warm (40 °C), or TGI (20/40 °C). Rating of perception (numeric rating scale: 0-10) and evoked potentials (i.e., N1 and N2P2 potentials) to noxious contact heat stimuli were assessed. While cool and warm conditioning decreased cortical responses to noxious heat, TGI conditioning increased evoked potential amplitude (N1 and N2P2). In line with other modalities of unpleasant conditioning (e.g., sound, visual, and olfactory stimulation), cortical and possibly sub-cortical modulation may underlie the facilitation of contact heat evoked potentials.

Fibrin hydrogels induce mixed dorsal/ventral spinal neuron identities during differentiation of human induced pluripotent stem cells

Authors: Edgar JM, Robinson M, Willerth SM.
Published in: Acta Biomater. 2017 Jan 11. pii: S1742-7061(17)30040-5. doi: 10.1016/j.actbio.2017.01.040. [Epub ahead of print].
About: We hypothesized that generating spinal motor neurons (sMNs) from human induced pluripotent stem cell (hiPSC)-derived neural aggregates (NAs) using a chemically-defined differentiation protocol would be more effective inside of 3D fibrin hydrogels compared to 2D poly-L-ornithine(PLO)/laminin-coated tissue culture plastic surfaces. We performed targeted RNA-Seq using next generation sequencing to determine the substrate-specific differences in gene expression that regulate cell phenotype. Cells cultured on both substrates expressed sMN genes CHAT and MNX1, though persistent WNT signaling contributed to a higher expression of genes associated with interneurons in NAs cultured in 3D fibrin scaffolds. Cells in fibrin also expressed lower levels of astrocyte progenitor genes and higher levels of the neuronal-specific gene TUBB3, suggesting a purer population of neurons compared to 2D cultures.

Optimizing Clinical Decision Making in Acute Traumatic Spinal Cord Injury

Authors: Fehlings M, Noonan V, Atkins D, Burns AS, Cheng CL, Singh A, Dvorak MF.
Published in: J Neurotrauma. 2017 Jan 5. doi: 10.1089/neu.2016.4926. [Epub ahead of print]

Patterns of community participation across the seasons: A year-long case study of three Canadian wheelchair users

Authors: Ripat J, Borisoff JF, Grant LE, Chan FH.
Published inDisabil Rehabil. 2017 Jan 5:1-10. doi: 10.1080/09638288.2016.1271463. [Epub ahead of print]
About: The aim of this study was to explore the patterns of wheelchair users’ community participation across a one-year period, including periods with substantial differences in weather conditions. We sought to develop a detailed understanding of the patterns of, and influences on, wheelchair use and participation within wheelchair users’ own communities.

Journal Club: Pregnancy outcome following maternal exposure to pregabalin may call for concern

Authors: Jutzeler CR, Cragg JJ, Warner FM, Archibald J, Thomas CP, Elliott S, Kramer JL.
Published in: Neurology. 2017 Jan 3;88(1):e5-e7. doi: 10.1212/WNL.0000000000003458.
About: Evidence from animal studies implicates pregabalin as a potential teratogen. Although human data are scarce, pregabalin is a Category C drug: risks cannot be ruled out, but potential benefits may justify the risks of pregabalin during pregnancy. Suggested teratogenic mechanisms include reproductive toxicity, skeletal malformation, neural deficits, spontaneous abortions, growth retardation, and behavioral abnormalities. To shed light on this issue, Winterfeld et al. recently investigated adverse pregnancy outcomes following maternal exposure to pregabalin. Considering the high prevalence of women of childbearing age with neuropathic pain and epilepsy, it is important to explore potential teratogenic effects of first-line treatments. Moreover, as pregnant women are considered vulnerable, it is difficult to assess risks during the drug development process. This study provides an elegant example of an observational study used to assess fetal risks resulting from exposure to pregabalin. This work has important implications for clinical practice guidelines for a range of neurologic disorders.

Coordinated Control of Three-Dimensional Components of Smooth Pursuit to Rotating and Translating Textures

Authors: Edinger J, Pai DK, Spering M.
Published in: Invest Ophthalmol Vis Sci. 2017 Jan 1;58(1):698-707. doi: 10.1167/iovs.16-21038.
About:The neural control of pursuit eye movements to visual textures that simultaneously translate and rotate has largely been neglected. Here we propose that pursuit of such targets-texture pursuit-is a fully three-dimensional task that utilizes all three degrees of freedom of the eye, including torsion.

Open Access Platforms in Spinal Cord Injury

AuthorsKramer JL, Geisler F, Ramer L, Plunet W, Cragg JJ.
Published in: Neurorehabil Neural Repair. 2017 Jan 1:1545968316688801. doi: 10.1177/1545968316688801. [Epub ahead of print]
About: Recovery from acute spinal cord injury (SCI) is characterized by extensive heterogeneity, resulting in uncertain prognosis. Reliable prediction of recovery in the acute phase benefits patients and their families directly, as well as improves the likelihood of detecting efficacy in clinical trials. This issue of heterogeneity is not unique to SCI. In fields such as traumatic brain injury, Parkinson’s disease, and amyotrophic lateral sclerosis, one approach to understand variability in recovery has been to make clinical trial data widely available to the greater research community. We contend that the SCI community should adopt a similar approach in providing open access clinical trial data.

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