A composição corporal em indivíduos com lesão medular praticantes de basquetebol em cadeira de rodas / The body composition of wheelchair basketball individuals with spinal cord injury

Os sujeitos com lesão medular podem sofrer inúmeras alterações fisiológicas como, por exemplo, atrofia muscular e, como destacado na literatura, o aumento do percentual de gordura (KOCINA, 1997). Este estudo teve como objetivo determinar o Percentual de Gordura (% G) de Lesados Medulares, praticantes de Basquetebol em Cadeira de Rodas. O estudo foi realizado com 22 sujeitos do sexo masculino com Lesão Medular, na faixa entre 18 e 32 anos, divididos em dois grupos (11 sujeitos cada) segundo o nível de lesão: G I - Lesão Superior e G II - Lesão Inferior, sendo o ponto de corte o nível T-7 (Sétima Vértebra Torácica). Na avaliação foi utilizada a técnica antropométrica. Para determinar a densidade corporal foi utilizada uma equação de Bulbulian et al. (1987). Para o calculo de % G foi utilizada a equação de Siri (1961). Na análise dos dados foi aplicado o Teste 't' de student e o pos hoc de Kruskal-Wallis, através do software Minitab 14. Os sujeitos do G I apresentaram valores mais altos de % G: (23,44 contra 19,42 %), o que sugere que estes tenham um maior gasto energético, não tendo sido encontradas diferenças estatisticamente significativas entre as médias. Todos os sujeitos apresentaram percentual de gordura acima dos níveis normais, estabelecidos na literatura para sujeitos não deficientes na faixa etária estudada, o que está de acordo com a afirmação da autora citada. Entretanto, há evidências de que os lesados possuam alta demanda energética, o que pode minimizar o acúmulo de gordura.

Individuals with spinal cord injury may suffer innumerable physiological alterations such as muscular atrophy and, as detached in literature, the increase of the percentage of body fat (KOCINA, 1997). This study aimed at determining the Percentage of BodyFat (% G) of wheelchair basketball individuals with Spinal Cord Injury. The study was carried out with 22 male subjects with Spinal Cord Injury, 18-32 yr, divided in two groups (11 subjects) according to injury level: GI - High Injury and GII - Low Injury. The cutoff score was T7 (Spinal Cord Segment). Anthropometric technique was used for the assessment. An equation of Bulbulian et. al. (1987) to determine the body density was used. the equation of Siri (1961) was used to calculate the %G . Test “t” of student and the Kruskal-Wallis pos hoc – through software Minitab 14 – was applied fot the data analysis. The individuals from GI presented higher %G-values (23.44 against 19.42%), suggesting their higher energy expenditure. Signifi cant differences between the means were not found through the statistical procedures. All the subjects presented percentage of fat above normal levels – values found in the literature for non-injured with the same age –in accordance with the affirmation of the cited author. However, there are evidences that the injured have high energy demand, what may minimize the accumulation of fat.

Effect of sustained spinal cord compression on spinal cord injury / 中国康复理论与实践

@#ObjectiveTo explore the effect of sustained spinal cord compression on spinal cord injury (SCI).MethodsTwenty four dogs underwent sustained spinal cord compression for 30 minutes (group A), 90 minutes (group B) and 180 min (group C) with a device designed by the authors for weight loading spinal compression, and anthor four dogs as the control group (group D) only underwent surgical operation without SCI. Cortex somatosensory evoked potentials (CSEP) were monitored during all the procedure of making model. The changes of pathologic histology, imaging and behavior examination of all animals were observed.ResultsThe lesion degrees gradually increased from group A to group C (P<0.01), and there was similar outcome in MRI imaging. The behavior improvement in group A was more significantly than that in groups B and C (P<0.05).ConclusionSustained spinal cord compression aggravates the extent of SCI process, and the decompression must be taken as soon as possible.

Risk Factors for Urinary Tract Infection in Chronic Spinal Cord Injured Patients

OBJECTIVE: To survey the method of bladder management and to evaluate the risk factor for urinary tract infection in chronic spinal cord injured patients. METHOD: We retrospectively reviewed the medical records and interviewed 129 spinal cord injured patients who have been for at least 2 years. We obtained demographic characteristics, associated factors, methods of bladder management and frequency of urinary tract infections. Logistic regression analysis and analysis of variance were done to evaluate the risk factor for urinary tract infection. RESULTS: The mean duration since spinal cord injury was 10.14 years. The method of bladder management was as follows: percussion and crede, valsalva maneuver (42.1%), clean intermittent catheterization (37.3%), combination of above 2 methods (9.4%), suprapubic catheter (4.7%), condom catheter (3.1%) and indwelling urethral catheter (2.3%). The overall incidence and frequency of urinary tract infection was 67.5%, 3.7 times/year respectively and was highest in indwelling urethral catheter group. The risk factors for urinary tract infection were age over 60, complete spinal cord injury (p <0.05). CONCLUSION: Complete spinal cord injury and old age are risk factors for urinary tract infection in chronic spinal cord injured patients. Incidence and frequency of urinary tract infection was affected by the method of bladder management.

Retrospective analysis of bladder management of spinal cord injured patients using Alfuzosin / 中国康复理论与实践

@#ObjectiveTo explore the effect and limitation of α1 adrenergic recepter blockers used in bladder management of spinal cord injured patients.Methods70 patients were divided into two groups who received intermittent catheterization and intermittent catheterization combined with Alfuzosin respectively. After 4 months of treatment, the residual urine and the time to reduce the residual urine were compared.ResultsThere was no differences in deducing the residual urine and the time to reduce the residual urine between the two groups.ConclusionAlfuzosin has limited effect in reducing the residual urine in bladder management.

Evaluation of the function of afferent neuronal pathways of the lower urinary tract in patients with spinal cord injury by using sympathetic skin response / 中华物理医学与康复杂志

Objective To evaluate the function of afferent neuronal pathways (ANP) from the lower urinary tract (LUT) in patients with spinal cord injury (SCI) by use of sympathetic skin response (SSR). Methods Twenty-one patients with SCI (13 cases of incomplete injury, and 8 cases of complete injury) were recruited as a SIC group and 8 healthy volunteers as a control group. SSRs of all subjects were evoked by means of electrical stimulation (ES) of the median nerve and perineal region,as well as bladder filling (BF), while SSRs of the right palm and sole were recorded using surface electrodes. Results SSRs induced by ES of the median nerve and perineal region, and also by BF in the control group were recorded. SSRs of palms and soles could be recorded by using ES of the median nerve in patients with incomplete SCI, who had desire to void. However, SSRs could not be evoked in 3 of 13 patients with incomplete SCI but without sensation of perineal skin. In 8 patients with complete SCI but without sensation of trunk skin and bladder, SSRs of palms and soles could not be induced during ES of the median nerve if injuries were located over T_3, and SSRs of palms were recorded when the injuries were located between T_(4~9), while SSRs of palms and soles were evoked if injuries were located under T_(10). However, SSRs of palms and soles could not be evoked by ES of perineal region and BF in all patients. Conclusion SSRs, evoked by BF, could concord with the subjective sensation of the subjects from the LUT, and reflect the integrity of ANP from LUT. There is difference between somatosensory and viscerosensory ANP.

Semen parameters retrieved by electroejaculation in spinal cord injured Thai men: Preliminary report.

Semen characteristics from seven spinal injured Thai men retrieved by electroejaculation were studied at Spinal cord injury unit and Infertility unit, Siriraj hospital. The mean age of the subjects was 24.7 years. Three cases had sperm count within normal limit ( > 20x106/c.c. ) and oligospermia in three cases. One case had azoospermia. All had low motility or no motility at all. All had leukospermia ( > 1x106/c.c. ) except one case. This study shows the change in semen parameters and may help for planning the management of spinal cord injured men.

Clinical Utility of a Special Mattress in the Prevention of Pressure Ulcers

We studied a group of spinal cord injured patients, using two different mattresses, to analyze statistically the pressure measured over sacral area and skin changes developed on the dorsal skin surface of patients for pat ients for specific duration of time. Local pressure measured sacral area and skin change score were lower on a Bazooka system than common hospital mattress. And the weight. BMI(Body Mass Index) and % IBW(Ideal Body Weight) of patients significantly correlated with the skin changes developed on the dorsal skin surface after lying on common hospital mattress for 2 hours. But skin changes developed after lying on a Bazooka system for 8 hours didn't correlated with these variables. Therefore a Bazooka system may be effective in the prevention of pressure ulcers for spinal cord injured patients.

Effect of Postures on Residual Urine Following Catheterization in Spinal Cord Injured Patients

Intermittent catheterization has reduced the frequency of urinary tract infection(UTI), calculus formation and vesicourethral reflux in spinal cord injured(SCI) patients. Still the residual urine (RU) following catheterization has been suggested as one of the possible causes of UTI. The purpose of this study was to identify the effect of postures on RU following catheterization, for the rehabilitation of neurogenic bladder in SCI patients. The inclusion criteria were: SCI patients with neurogenic bladder; completion of bladder rehabilitation program; good sitting balance and intact hand function. twelve SCI patients fulfilled the criteria and completed ultrasonographic RU measurement in sitting and supine posture following catherterization, respectively. We also studied the frequency of UTI, the functional type of neurogenic bladder and the postures during bladder evacuation at home. All patients had ultrasonographical evidence of RU following catheterizations both in sitting and supine postures. Residual urine volume following catheterization was significantly smaller in sitting posture than in supine posture(p<0.05). Frequency of UTI was significantly lower in the patients who performed catheterizations in sitting posture than in supine posture(p<0.05). In conclusion, bladder training in sitting posture would be better than in supine posture to minimize RU in SCI patients with good sitting balance and intact hand function.