Spinal Cord Injury Rehabilitation
Foreword Spinal Cord Injury Rehabilitation
Gregory T. Carter, MD, MS Consulting Editor
As someone who has spent the vast majority of his career in the Pacific Northwest, when we decided to do an updated issue on spinal cord injury (SCI) rehabilitation, I immediately thought of my friend and colleague, Dr Diana Cardenas. When Dr Cardenas was here at the University of Washington, she developed and directed a nationally recognized SCI Center of Excellence. This was the “go to” place for all of us to refer our SCI patients for their annual complete evaluation and checkup. For many years now, Dr Cardenas has served as Professor and Chair, Department of Rehabilitation Medicine and Chief of Service and Medical Director, Department of Rehabilitation Medicine at the University of Miami Miller School of Medicine. She is also part of the Miami Project to Cure Paralysis (the Buoniconti Fund). As I suspected she would, Dr Cardenas recruited a list of “who’s who” in spinal cord medicine to author the articles within this issue. This issue starts with an excellent article entitled, “Updates for the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI),” by Drs Kirshblum and Waring. This is a great overview and provides an excellent treatise on how to use these standards to improve care. Drs Goetz and Klausner authored, “Strategies for Prevention of Urinary Tract Infections in Neurogenic Bladder Dysfunction,” which provides up-to-date strategies on how to approach and treat this significant problem seen in the vast majority of patients of SCI and neurogenic bladder. Moving into a more experimental topic, Drs Sherman and Wang present, “Hypothermia as a Clinical Neuroprotectant.” As they point out, there is now a very robust body of experimental evidence that hypothermia is beneficial in the treatment of acute SCI. The potential benefits of hypothermia in preventing or limiting SCI following trauma are discussed in detail along with an overview of the potential use of hypothermia after SCI.
Phys Med Rehabil Clin N Am 25 (2014) xiii–xiv http://dx.doi.org/10.1016/j.pmr.2014.07.001 1047-9651/14/$ – see front matter Ó 2014 Elsevier Inc. All rights reserved.
pmr.theclinics.com
xiv
Foreword
Dr Dalal offers an excellent overview of “Diaphragmatic Pacing in Spinal Cord Injury.” In this article, there is first-rate coverage of the problem of chronic hypoventilation that can be seen in higher injury level quadriplegics. Diaphragm pacing through electrical stimulation of the phrenic nerve can be a very effective treatment for central hypoventilation syndrome in patients with SCI, and the article by Dr Dalal discusses the use of phrenic nerve stimulation for diaphragm pacing to address this. Drs Kushner and Alvarez have co-authored, “Dual Diagnosis: Traumatic Brain Injury with Spinal Cord Injury.” This exceptional article overviews and interprets the research into the problems encountered by people with SCI and coexistent or traumatic brain injury, which may often be overlooked. Patients with concomitant SCI and traumatic brain injury often present unique challenges and this article fully explores that. Drs Kressler, Cowen, Bigford, and Nash present an excellent treatise on “Reducing Cardiometabolic Disease in Spinal Cord Injury,” which is a major secondary cause of comorbidity given the impaired ability to exercise for patients with SCI. “Chronic Neuropathic Pain in SCI: Evaluation and Treatment” is authored by Dr Felix, a noted expert in this area. Neuropathic pain is a known consequence of SCI and may persist for years after the inciting injury. Dr Felix gives recommendations for diagnostic and treatment strategies for this problem, including a discussion of the use of anticonvulsant agents, tricyclic antidepressants, and other strategies. An outstanding discussion on “Spasticity and the Use of Intrathecal Baclofen in Patients with Spinal Cord Injury” is provided by Drs Khurana and Garg, followed by a very thorough article authored by Drs Irwin and Wolff, entitled, “Assessment of Neuromuscular Conditions Using Ultrasound.” This issue concludes with an article entitled, “Functional Electrical Stimulation and Spinal Cord Injury,” by Drs Ho, Triolo, Elias, Kilgore, DiMarco, Bogie, Vette, Audu, Kobetic, Chang, Chan, Dukelow, Bourbeau, Brose, Gustafson, Kiss, and Mushawar, and an article entitled, “Spinal Cord Injury Pressure Ulcer Treatment: An Evidencebased Approach,” by Dr Sunn. These are both outstanding articles. I want to thank all of these distinguished authors, and in particular, our editors, Drs Cardenas and Dalal, for giving us such a wonderful, up-to-date, and remarkably thorough issue on SCI rehabilitation. These authors have given us a directly useful and highly valuable addition to the Physical Medicine and Rehabilitation Clinics of North America series. Gregory T. Carter, MD, MS St Luke’s Rehabilitation Institute 711 South Cowley Street Spokane, WA 99202, USA E-mail address: [email protected]
Foreword Spinal Cord Injury Rehabilitation
Gregory T. Carter, MD, MS Consulting Editor
As someone who has spent the vast majority of his career in the Pacific Northwest, when we decided to do an updated issue on spinal cord injury (SCI) rehabilitation, I immediately thought of my friend and colleague, Dr Diana Cardenas. When Dr Cardenas was here at the University of Washington, she developed and directed a nationally recognized SCI Center of Excellence. This was the “go to” place for all of us to refer our SCI patients for their annual complete evaluation and checkup. For many years now, Dr Cardenas has served as Professor and Chair, Department of Rehabilitation Medicine and Chief of Service and Medical Director, Department of Rehabilitation Medicine at the University of Miami Miller School of Medicine. She is also part of the Miami Project to Cure Paralysis (the Buoniconti Fund). As I suspected she would, Dr Cardenas recruited a list of “who’s who” in spinal cord medicine to author the articles within this issue. This issue starts with an excellent article entitled, “Updates for the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI),” by Drs Kirshblum and Waring. This is a great overview and provides an excellent treatise on how to use these standards to improve care. Drs Goetz and Klausner authored, “Strategies for Prevention of Urinary Tract Infections in Neurogenic Bladder Dysfunction,” which provides up-to-date strategies on how to approach and treat this significant problem seen in the vast majority of patients of SCI and neurogenic bladder. Moving into a more experimental topic, Drs Sherman and Wang present, “Hypothermia as a Clinical Neuroprotectant.” As they point out, there is now a very robust body of experimental evidence that hypothermia is beneficial in the treatment of acute SCI. The potential benefits of hypothermia in preventing or limiting SCI following trauma are discussed in detail along with an overview of the potential use of hypothermia after SCI.
Phys Med Rehabil Clin N Am 25 (2014) xiii–xiv http://dx.doi.org/10.1016/j.pmr.2014.07.001 1047-9651/14/$ – see front matter Ó 2014 Elsevier Inc. All rights reserved.
pmr.theclinics.com
xiv
Foreword
Dr Dalal offers an excellent overview of “Diaphragmatic Pacing in Spinal Cord Injury.” In this article, there is first-rate coverage of the problem of chronic hypoventilation that can be seen in higher injury level quadriplegics. Diaphragm pacing through electrical stimulation of the phrenic nerve can be a very effective treatment for central hypoventilation syndrome in patients with SCI, and the article by Dr Dalal discusses the use of phrenic nerve stimulation for diaphragm pacing to address this. Drs Kushner and Alvarez have co-authored, “Dual Diagnosis: Traumatic Brain Injury with Spinal Cord Injury.” This exceptional article overviews and interprets the research into the problems encountered by people with SCI and coexistent or traumatic brain injury, which may often be overlooked. Patients with concomitant SCI and traumatic brain injury often present unique challenges and this article fully explores that. Drs Kressler, Cowen, Bigford, and Nash present an excellent treatise on “Reducing Cardiometabolic Disease in Spinal Cord Injury,” which is a major secondary cause of comorbidity given the impaired ability to exercise for patients with SCI. “Chronic Neuropathic Pain in SCI: Evaluation and Treatment” is authored by Dr Felix, a noted expert in this area. Neuropathic pain is a known consequence of SCI and may persist for years after the inciting injury. Dr Felix gives recommendations for diagnostic and treatment strategies for this problem, including a discussion of the use of anticonvulsant agents, tricyclic antidepressants, and other strategies. An outstanding discussion on “Spasticity and the Use of Intrathecal Baclofen in Patients with Spinal Cord Injury” is provided by Drs Khurana and Garg, followed by a very thorough article authored by Drs Irwin and Wolff, entitled, “Assessment of Neuromuscular Conditions Using Ultrasound.” This issue concludes with an article entitled, “Functional Electrical Stimulation and Spinal Cord Injury,” by Drs Ho, Triolo, Elias, Kilgore, DiMarco, Bogie, Vette, Audu, Kobetic, Chang, Chan, Dukelow, Bourbeau, Brose, Gustafson, Kiss, and Mushawar, and an article entitled, “Spinal Cord Injury Pressure Ulcer Treatment: An Evidencebased Approach,” by Dr Sunn. These are both outstanding articles. I want to thank all of these distinguished authors, and in particular, our editors, Drs Cardenas and Dalal, for giving us such a wonderful, up-to-date, and remarkably thorough issue on SCI rehabilitation. These authors have given us a directly useful and highly valuable addition to the Physical Medicine and Rehabilitation Clinics of North America series. Gregory T. Carter, MD, MS St Luke’s Rehabilitation Institute 711 South Cowley Street Spokane, WA 99202, USA E-mail address: [email protected]
