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Effect of two different programs of robotic assisted gait training in individuals with chronic motor incomplete spinal cord injury
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Posters (First Part) / Annals of Physical and Rehabilitation Medicine 61S (2018) e103–e308
ISPR8-1379
Effect of two different programs of robotic assisted gait training in individuals with chronic motor incomplete spinal cord injury 1,∗ , L.F. Apodaca-García López 1 , ˜ J. Quinzanos-Fresnedo 2 3, ˜ A.V. Aguirre-Güemez , I. Quinones-Urióstegui A.I. Pérez-Sanpablo 3 , R. Pérez-Zavala 2 1 Instituto Nacional de Rehabilitación, Neurologic Rehabilitation, Mexico city, Mexico 2 Instituto Nacional de Rehabilitación, Spinal Cord Injury, Mexico city, Mexico 3 Instituto Nacional de Rehabilitación, Motion Analysis Laboratory, Mexico city, Mexico ∗ Corresponding author. ˜ E-mail address: [email protected] (J. Quinzanos-Fresnedo)
Introduction/Background Gait training is one of the main objectives in rehabilitation of motor incomplete spinal cord injury (SCI). There are different modalities of locomotion training, being the robotic orthosis among them, and offering until now, positive outcomes. However there is still a lack of evidence of the optimal training characteristics. Objective To determine the effect of two different training programs with robotic gait orthosis for patients with chronic motor incomplete SCI. Material and method Study design: randomized, blinded to the observer, clinical trial. Patients from the National Institute of Rehabilitation (INR) with motor incomplete SCI, with at least 6 months of evolution and who were able to walk, were eligible. Patients were randomly assigned to either one of the two different training groups: 30 minutes or 60 minutes training group. Both groups received a training period of six weeks, five days a week. Assessments of gait pattern analysis with the GaitRite instrument, functional assessment with Spinal Cord Independence measure (SCIM), walking index for spinal cord injury (WISCI) and quality of life with life satisfaction questionnaire (Lisat-9); repeating such evaluations in a 6 and 12 months follow-up. Results In total, 12 participants were studied. After 30 training sessions with the robotic orthosis, both groups had significant improvements in gait as well as in SCIM, LISAT-9 and WISCI. No significant differences between groups were found. Conclusion Robotic orthosis gait training has a positive effect improving gait pattern in incomplete SCI. Until now, there are no significant differences between a 30 minutes and a 60 minutestraining program. Keywords Spinal cord injuries; Gait; Robotic orthosis Disclosure of interest The authors declare that they have no competing interest. https://doi.org/10.1016/j.rehab.2018.05.561 ISPR8-1387
Resilience, coping and spinal cord injury: A pilot study for the validation of a specific scale M. Le Fort 1,∗ , B. Perrouin-Verbe 1 , G. Guihard 2 CHU Nantes, Neurological PMR department, Nantes, France 2 Medicine University, DPHU2 Institut du Thorax et Système Nerveux, Nantes, France ∗ Corresponding author. E-mail address: [email protected] (M. Le Fort)
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Introduction/Background Resilience corresponds to one’s ability to positively outcome while experiencing aversive situation. It may be linked with a disparity of coping strategies after a spinal cordinjury (SCI). After a recent work realized in a population without SCI, suggesting the influence of empathy and alexithymia, the aim
of our work consisted in studying their relative contribution on resilience in a sample of SCI patients. Material and method The survey consisted in the French version of the Connor-Davidson resilience scale (CDRISC10), the interpersonal reactivity index (IRI), the Toronto-alexithymia-scale (TAS20), the Brief-cope scale (b-COPE), the Hospital anxiety-depression scale (HAD) and the sense of coherence scale (SOCS), administered to 17 SCI patients included in the French study QaliPREPS (qualitative analysis of SCI patients’ perception of a systematic medical follow-up). Mean scores for full scales and their respective dimensions were calculated. The correlations between the different constructs were analyzed and the predictors of resilience were highlighted on the basis of multiple linear regression studies. Results Mean scores calculated for anxiety/depression, adaptation, sense of coherence and resilience were comparable to those calculated for a sample of adults with no SCI. Resilience presented significant positive correlation with copying ability and empathy, and significant negative correlation with alexithymia. Our data suggested that two dimensions of alexithymia (i.e., difficulty to describe one’s own emotions and externally oriented thinking) and one dimension of empathy (fantasy ability) are negative predictors of resilience. By contrast, three dimensions of empathy (perspective taking, empathic concern, personal distress) positively influenced the resilience. Conclusion We present the first analysis of resilience predictors in SCI patients. However, our study is limited by the small number of patients included into the survey. It justifies a scaling up in order to increase the strength of our conclusions. Keywords Empathy; Alexithymia; Predictors Disclosure of interest The authors declare that they have no competing interest. https://doi.org/10.1016/j.rehab.2018.05.562 ISPR8-1389
What is the effectiveness of upper limb rehabilitation after tetraplegia: A systematic review and meta-analysis S. Mateo 1,2,3,∗ , J. Di Marco 3 , V. Bergeron 2 , G. Rode 1,3 Hospices civils de Lyon, hôpital Henry-Gabrielle, plateforme mouvement et handicap, Lyon, France 2 École normale supérieure de Lyon, CNRS UMR5672, laboratoire de physique, Lyon, France 3 Université Lyon 1, Inserm U1028, CNRS UMR5292, Lyon Neuroscience Research Center, Impact Team, Lyon, France ∗ Corresponding author. E-mail address: [email protected] (S. Mateo)
1
Introduction/Background Individuals with cervical spinal cord injury experience tetraplegia with dramatic impairment of upper limb (UL) including hand function and decreased autonomy. In absence of very recent evidence and meta-analysis, we addressed UL rehabilitation effectiveness after tetraplegia. Material and method Two independent reviewers performed the systematic review and meta-analysis addressing Pubmed, Pedro, ® Central and Scopus . We considered studies with a randomized controlled trial design, published in English language, which included individuals with tetraplegia and measured UL rehabilitation effect on strength, somesthesia, hand function and autonomy. Results From 573 records identified, 24 studies were included totaling 517 participants with C2 to C7 tetraplegia (ASIA A to D). Interventions lasted from 66 to 3780 minutes. Three different strategies were used i) bottom-up (namely massed practice, Functional Electrical Stimulation – FES, resistance or robotic training), ii) neuromodulation (i.e. electrical nerve, trans-cranial or magnetic stimulations), or iii) top-down (brain computer interfaces with FES or virtual reality). The 17 studies analyzed displayed heterogeneity for all outcomes except for strength. Overall, strength significantly increased with positive but non-significant effect on hand
Posters (First Part) / Annals of Physical and Rehabilitation Medicine 61S (2018) e103–e308
ISPR8-1379
Effect of two different programs of robotic assisted gait training in individuals with chronic motor incomplete spinal cord injury 1,∗ , L.F. Apodaca-García López 1 , ˜ J. Quinzanos-Fresnedo 2 3, ˜ A.V. Aguirre-Güemez , I. Quinones-Urióstegui A.I. Pérez-Sanpablo 3 , R. Pérez-Zavala 2 1 Instituto Nacional de Rehabilitación, Neurologic Rehabilitation, Mexico city, Mexico 2 Instituto Nacional de Rehabilitación, Spinal Cord Injury, Mexico city, Mexico 3 Instituto Nacional de Rehabilitación, Motion Analysis Laboratory, Mexico city, Mexico ∗ Corresponding author. ˜ E-mail address: [email protected] (J. Quinzanos-Fresnedo)
Introduction/Background Gait training is one of the main objectives in rehabilitation of motor incomplete spinal cord injury (SCI). There are different modalities of locomotion training, being the robotic orthosis among them, and offering until now, positive outcomes. However there is still a lack of evidence of the optimal training characteristics. Objective To determine the effect of two different training programs with robotic gait orthosis for patients with chronic motor incomplete SCI. Material and method Study design: randomized, blinded to the observer, clinical trial. Patients from the National Institute of Rehabilitation (INR) with motor incomplete SCI, with at least 6 months of evolution and who were able to walk, were eligible. Patients were randomly assigned to either one of the two different training groups: 30 minutes or 60 minutes training group. Both groups received a training period of six weeks, five days a week. Assessments of gait pattern analysis with the GaitRite instrument, functional assessment with Spinal Cord Independence measure (SCIM), walking index for spinal cord injury (WISCI) and quality of life with life satisfaction questionnaire (Lisat-9); repeating such evaluations in a 6 and 12 months follow-up. Results In total, 12 participants were studied. After 30 training sessions with the robotic orthosis, both groups had significant improvements in gait as well as in SCIM, LISAT-9 and WISCI. No significant differences between groups were found. Conclusion Robotic orthosis gait training has a positive effect improving gait pattern in incomplete SCI. Until now, there are no significant differences between a 30 minutes and a 60 minutestraining program. Keywords Spinal cord injuries; Gait; Robotic orthosis Disclosure of interest The authors declare that they have no competing interest. https://doi.org/10.1016/j.rehab.2018.05.561 ISPR8-1387
Resilience, coping and spinal cord injury: A pilot study for the validation of a specific scale M. Le Fort 1,∗ , B. Perrouin-Verbe 1 , G. Guihard 2 CHU Nantes, Neurological PMR department, Nantes, France 2 Medicine University, DPHU2 Institut du Thorax et Système Nerveux, Nantes, France ∗ Corresponding author. E-mail address: [email protected] (M. Le Fort)
1
Introduction/Background Resilience corresponds to one’s ability to positively outcome while experiencing aversive situation. It may be linked with a disparity of coping strategies after a spinal cordinjury (SCI). After a recent work realized in a population without SCI, suggesting the influence of empathy and alexithymia, the aim
of our work consisted in studying their relative contribution on resilience in a sample of SCI patients. Material and method The survey consisted in the French version of the Connor-Davidson resilience scale (CDRISC10), the interpersonal reactivity index (IRI), the Toronto-alexithymia-scale (TAS20), the Brief-cope scale (b-COPE), the Hospital anxiety-depression scale (HAD) and the sense of coherence scale (SOCS), administered to 17 SCI patients included in the French study QaliPREPS (qualitative analysis of SCI patients’ perception of a systematic medical follow-up). Mean scores for full scales and their respective dimensions were calculated. The correlations between the different constructs were analyzed and the predictors of resilience were highlighted on the basis of multiple linear regression studies. Results Mean scores calculated for anxiety/depression, adaptation, sense of coherence and resilience were comparable to those calculated for a sample of adults with no SCI. Resilience presented significant positive correlation with copying ability and empathy, and significant negative correlation with alexithymia. Our data suggested that two dimensions of alexithymia (i.e., difficulty to describe one’s own emotions and externally oriented thinking) and one dimension of empathy (fantasy ability) are negative predictors of resilience. By contrast, three dimensions of empathy (perspective taking, empathic concern, personal distress) positively influenced the resilience. Conclusion We present the first analysis of resilience predictors in SCI patients. However, our study is limited by the small number of patients included into the survey. It justifies a scaling up in order to increase the strength of our conclusions. Keywords Empathy; Alexithymia; Predictors Disclosure of interest The authors declare that they have no competing interest. https://doi.org/10.1016/j.rehab.2018.05.562 ISPR8-1389
What is the effectiveness of upper limb rehabilitation after tetraplegia: A systematic review and meta-analysis S. Mateo 1,2,3,∗ , J. Di Marco 3 , V. Bergeron 2 , G. Rode 1,3 Hospices civils de Lyon, hôpital Henry-Gabrielle, plateforme mouvement et handicap, Lyon, France 2 École normale supérieure de Lyon, CNRS UMR5672, laboratoire de physique, Lyon, France 3 Université Lyon 1, Inserm U1028, CNRS UMR5292, Lyon Neuroscience Research Center, Impact Team, Lyon, France ∗ Corresponding author. E-mail address: [email protected] (S. Mateo)
1
Introduction/Background Individuals with cervical spinal cord injury experience tetraplegia with dramatic impairment of upper limb (UL) including hand function and decreased autonomy. In absence of very recent evidence and meta-analysis, we addressed UL rehabilitation effectiveness after tetraplegia. Material and method Two independent reviewers performed the systematic review and meta-analysis addressing Pubmed, Pedro, ® Central and Scopus . We considered studies with a randomized controlled trial design, published in English language, which included individuals with tetraplegia and measured UL rehabilitation effect on strength, somesthesia, hand function and autonomy. Results From 573 records identified, 24 studies were included totaling 517 participants with C2 to C7 tetraplegia (ASIA A to D). Interventions lasted from 66 to 3780 minutes. Three different strategies were used i) bottom-up (namely massed practice, Functional Electrical Stimulation – FES, resistance or robotic training), ii) neuromodulation (i.e. electrical nerve, trans-cranial or magnetic stimulations), or iii) top-down (brain computer interfaces with FES or virtual reality). The 17 studies analyzed displayed heterogeneity for all outcomes except for strength. Overall, strength significantly increased with positive but non-significant effect on hand