AWARD-WINNING POSTER ABSTRACTS Categories: Student, Education, Research, Patient Care
Research Award Winner – First Place
A RANDOMIZED CONTROLLED TRIAL TO TEST THE EFFECTS OF THE SCI GET FIT TOOLKIT ON PHYSICAL ACTIVITY BEHAVIOR AND COGNITIONS IN ADULTS WITH SPINAL CORD INJURY: A PRELIMINARY ANALYSIS Kelly Arbour-Nicitopoulos 1,2, Shane Sweet3, Marie-Eve Lamontagne 4, Amy Latimer-Cheung 2,5 1
University of Toronto, 2SCI Action Canada, 3McGill University, 4CIRRIS-IRDPQ, 5Queen’s University
Background/Objective: SCI Action Canada has developed a SCI Get Fit Toolkit, an evidence-informed physical activity (PA) resource for Canadian adults with spinal cord injury (SCI). The purpose of this study was to evaluate the effects of the toolkit on self-efficacy, intentions, planning, and PA behavior in a sample of Canadian adults with SCI. Methods/Overview: Participants were randomized to one of the two conditions: experimental (n = 19) or control (n = 20). Participants with both conditions completed online social-cognitive (i.e. self-efficacy, intentions, and planning) and PA behavior questionnaires at four timepoints (i.e. baseline, 24 hours post-baseline, 1 week post-baseline, 1 month post-baseline). At 24 hours post, exposure to either the toolkit (experimental condition) or the SCI Physical Activity Guidelines (control condition) occurred. Preliminary analyses were conducted using the baseline to 1-week post-timepoint to determine the effects of the experimental manipulation on the measured outcomes: a 2 (condition) × 3 (time: baseline, 24-hour post, and 1-week post) analysis of variance for self-efficacy and intentions; a 2 (condition) × 2 (time: baseline, 1-week post) for planning; a one-way analysis of covariance on PA, controlling for between-condition differences on baseline values. Due to the small sample, effect sizes (i.e. partial η 2 (η)) were reported and emphasized. Three separate 2 (condition) × 2 (time (e.g. 24-hour post, 1-week post)), post hoc analyses were conducted where necessary. Results: Of the 39 participants recruited, 20 (M age = 48.50 years ± 9.26; 60% quadriplegia; 80% male; 60% French-speaking) completed all three assessment periods. Analyses indicated moderate- to large-sized effects for the time × condition interaction of planning (P = 0.09, η = 0.16) and self-efficacy (P = 0.15, η = 0.10), respectively. In comparison to the control condition, the experimental condition reported greater PA planning from baseline to 1-week post and greater PA self-efficacy from 24-hour post to 1-week post. After controlling for baseline levels, a medium- to large-sized effect of condition was found for PA behavior (P = 0.18, η = 0.13), indicating that PA behavior was greater at 1-week post for the experimental versus the control condition. No difference over time by condition was found for intentions. Conclusions: Our preliminary analyses suggest that the SCI Get Fit Toolkit appears to be more effective than the guidelines alone for increasing planning, self-efficacy, and PA behavior among a sample of adults with SCI. Acknowledgments: Granting Agency/Funding Source: Ontario Neurotrauma Foundation and the Provincial Rehabilitation Research Network Ontario/Quebec Inter-Provincial Partnership grant.
© The Academy of Spinal Cord Injury Professionals, Inc. 2014 DOI 10.1179/1079026814Z.000000000315
The Journal of Spinal Cord Medicine
Award Winner Research – Second Place
RECOVERY OF TRUNK MUSCLE STRENGTH IN TRAUMATIC AND NONTRAUMATIC SPINAL CORD INJURED INPATIENTS DURING REHABILITATION Sylvie M. Nadeau 1,2,3, Molly C. Verrier 4,5, Cyril Duclos 1,2,3, Dany Gagnon 1,2,3, Sharon Gabison 4,5, Audrey Roy 2 1
Centre de Recherche Interdisciplinaire en Réadaptation (CRIR), 2Institut de Réadaptation Gingras-Lindsay-deMontréal (IRGLM), 3Université de Montréal, 4University of Toronto, 5Toronto Rehabilitation Institute – UHN Background/Objective: Trunk function is important in individuals with spinal cord injury (SCI) whether they are walkers or manual wheelchair users. It is important to document the recovery of the trunk strength muscle in order to inform sensorimotor and mobility rehabilitation. The specific aim of this study was to quantify, for the first time, the natural course of recovery of trunk muscle strength in traumatic (TSCI) and non-traumatic SCI (NTSCI) during inpatient rehabilitation. Methods/Overview: Forty-two individuals (42 years old; SD: 16), including 25 TSCI and 17 NTSCI (American Spinal Injury Association (ASIA) Impairment Scale (AIS) from A to D) were evaluated at rehabilitation admission (T1) and discharge (T2). Maximal isometric muscle strength was measured in the sitting position, in right and left lateral flexion, anterior flexion, and extension of the trunk, using a hand-held dynamometer affixed to a rigid frame. Maximal strength values were normalized to body mass. Statistical analyses (analysis of variances and paired t-tests) were used to assess the effects of time (T1 vs. T2), direction (four), and type of lesion (TSCI vs. NTSCI) on the trunk strength outcome measures, while the level of association between the values for each direction were examined using Pearson’s correlation coefficients. Results: As a group, participants with SCI increased static trunk strength during inpatient rehabilitation in each direction tested except extension. However, differences existed between TSCI and NTSCI with the former showing greatest increases. Static trunk strength (r = 0.57–0.90) upon admission were inter-correlated. Thus, the individuals who are strong in one direction were strong in all directions. Static trunk strength values in extension were nearly double those of the other directions. As expected, for the individuals with a traumatic etiology, the strength results of individuals who walked (ASIA D) were greater than those of the wheelchair users and strength values correlated with the ASIA motor score. Conclusions: Further analysis of the data will determine whether the recovery of trunk muscle strength is a predictor of trunk function and postural control in individuals with SCI. Acknowledgments: Craig H. Neilsen Foundation.
Award Winner Research – Third Place
SPINAL CORD INJURY AND CARDIOVASCULAR DISEASE: A NATIONAL HEALTH STUDY ON RISK AND MECHANISMS Jacquelyn Cragg 1, Vanessa Noonan 2, Andrei Krassioukov 1, G. B. John Mancini 1, Luc Noreau 3, David Patrick 1, Jaimie Borisoff 4 1
University of British Columbia, 2Rick Hansen Institute, 3Université de Laval, 4British Columbia Institute of Technology Background/Objective: Previous evidence demonstrates that individuals with spinal cord injury (SCI) are at a significantly higher risk of heart disease and stroke. In addition to the physical disability caused by SCI, there may be other factors that contribute to this heightened risk. For example, repetitive and significant blood
The Journal of Spinal Cord Medicine
pressure fluctuations from extremely low during episodes of orthostatic hypotension (OH) to extreme elevations due to episodes of autonomic dysreflexia (AD), which are typical and unique to SCI, could contribute to vascular injury, and consequently contribute to this excess risk. However, this hypothesis has never been formally tested. Thus, the primary aim of this study was to examine the relationship between AD and OH with cardiovascular disease (CVD). A secondary aim of the study was to examine the relationship between SCI-specific factors (injury level, completeness of injury, and time since injury) and traditional risk factors (sex, age, and diabetes) with CVD. Methods/Overview: A total of 1109 individuals with chronic traumatic SCI (>1 year post-injury) participated in our self-report cross-sectional Canada-wide survey (mean age: 48.3 ± 13.4 years; 70% male; mean time since injury: 18.5 ± 13.2 years). Results: The adjusted odds of CVD among individuals with frequent OH was 2.79 times those without frequent OH (95% confidence interval: 1.09–6.53). There was no significant relationship between AD and CVD. Diabetes was associated with a significantly increased odds of CVD. Interestingly, sex, age, time since injury, AIS grade, and completeness of injury were not significantly associated with CVD. Conclusions: Some factors that are strong predictors of CVD outcomes in the general population are not associated with CVD outcomes among individuals with SCI; other factors impart similar risk among subjects with SCI compared with non-SCI subjects; others, including OH, impart significantly higher risk for CVD. Overall, these findings suggest that there may be a shift in the relative contribution of traditional risk factors among individuals with SCI. This will be an important consideration for management of CVD risk among these individuals. Acknowledgments: J. Cragg is supported by a University of British Columbia Killam Doctoral Award.
Award Winner Research – Fourth Place
ADULTS WITH SPINAL CORD INJURY WHO REPORT A NEED FOR PEER SUPPORT Shane Sweet 1, Kathleen A. Martin Ginis2, Luc Noreau 3,4, Jean Leblond 4 1
McGill University, 2McMaster University, 3Université Laval, 4CIRRIS
Background/Objective: Peer support programs are widely offered in Canada. However, we still do not know the profiles of adults with spinal cord injury (SCI) who need these programs. The purpose of this study was to identify the characteristics of adults with SCI who reported a peer support need. Methods/Overview: A database of 1549 Canadian adults with SCI allows the analysis of 13 needs for services favoring community integration in relation with socioeconomic and type of lesion variables. In this study, the peer support need was examined according to if it exists or not, and when it exists, whether it is met or unmet. Two recursive partitioning analyses with a classification tree were conducted in R to identify the strongest association between peer support and 11 variables: age, sex, education, marital status, city/urban, severity of injury (ASIA scale), years since injury, event, type of SCI, manual wheelchair use, and number of unmet needs among the 12 other categories. Results: Five groups were differentiated on the peer support need outcome according to the number of unmet needs, education, severity, and type of SCI. Approximately 58% of individuals in Group 1 and 37% in Group 2 reported a need for peer support. The profiles of Groups 1 and 2 are: having 4 unmet needs and, either, a university degree (Group 1, n = 114) or not (Group 2, n = 381). The profiles of the three other groups include having < 4 unmet needs and, either, tetraplegia and ASIA A, B, or C (Group 3, n = 329), paraplegia and ASIA A, B, or C (Group 4, n = 487), or ASIA D (Group 5, n = 238). Approximately 33%, 22%, and 14% of individuals reported a peer support need in Groups 3, 4, and 5, respectively. When the analysis is limited to the 464 adults who reported a peer support need, three groups are differentiated on the basis of the number of unmet needs: