Global Research Trends on Gait Rehabilitation in Individuals With Spinal Cord Injury- A Bibliometric Analysis.

STUDY DESIGN: Bibliometric analysis. OBJECTIVE: The study aims to comprehensively assess the literature related to gait rehabilitation for individuals with spinal cord injury (SCI) to identify significant contributors, and to explore the collaborations and emerging themes in the field. METHODS: Original and review articles in English using relevant keywords were searched in the Clarivate Web of Science database. The data from the selected articles were imported into R software. Bibliometric indicators were assessed to determine author contributions, country affiliations, journal sources, and thematic trends. RESULTS: A total of 1313 relevant articles were identified. The USA, followed by Canada and Switzerland were the most prolific countries contributing to gait rehabilitation research in SCI. The most relevant journals were Spinal Cord, Archives of Physical Medicine and Rehabilitation, Journal of Spinal Cord Medicine, Journal of NeuroEngineering, and Journal of Neurotrauma. The highest contributions came from Northwestern University, the University of Miami, and the University of Alberta. The analysis revealed an increase in research interest in gait rehabilitation after 2000, with a focus on interdisciplinary approaches and emerging technologies like robotics, exoskeletons, and neuromodulation. CONCLUSION: The analysis demonstrates the importance of collaborative and interdisciplinary research in gait rehabilitation. The results indicate a shift in research focus from traditional methods to the integration of technology. The impact of publications from the USA and Europe is a notable finding. The study highlights the growth of articles related to technology-driven approaches and understanding neuroplasticity in gait rehabilitation.

Psychophysiological impact of spinal cord injury: Depression, coping and heart rate variability.

Objectives: The aim was to examine the association of post-injury heart rate variability (HRV), coping with injury (fighting-acceptance), and depression symptoms in individuals with spinal cord injury (SCI).Study Design: Cross-sectional study.Setting: Tertiary care spinal cord injury hospital.Participants: Ninety-one individuals with SCI.Methods: All participants were assessed for HRV using polar heart rate monitor RS 800 CX and completed the Patient Health Questionnaire and Spinal Cord Lesion Coping Strategy questionnaire. Participants were grouped based on level of injury (tetraplegic, high paraplegia, and low paraplegia) and injury duration (early vs. late). Odds ratio calculated the risk of depression using HRV and coping as factors for early and late duration groups. Spearman rho estimated the correlation between three ratios: HRV (LF vs. HF), depression (somatic vs. cognitive), and coping (fighting spirit vs. acceptance) for each level of injury group for early and late duration.Results: Individuals with SCI with high HRV had lower odds of depression (OR = 0.14, CI = 0.03-0.78) than individuals with SCI with low HRV in the early duration group. Individuals with SCI with high acceptance had lower odds of depression (OR = 0.19, CI = 0.44-0.79) than individuals with SCI with low acceptance in the later duration group. In the later duration, HRV ratio negatively correlated with coping ratio in individuals with low paraplegia and depression ratio in individuals with high paraplegia.Conclusion: The aftermath of spinal cord injury might reflect a close association between the physiological response of autonomic variability and psychological response of coping and depression with implications for the level of injury and post-injury duration.

Autonomic variability, depression and the disability paradox in spinal cord injury.

STUDY DESIGN: Longitudinal. OBJECTIVE: With an increased risk of depression in spinal cord injury, the study longitudinally examines depression to understand how post-injury autonomic regulation and coping might be related to somatic and cognitive manifestations of depression after 3 years. SETTING: Indian Spinal Injuries Center. METHODS: Twenty-eight spinal cord injury participants completed the follow-up assessment of the Patient Health Questionnaire 3 years post-injury. The participants were grouped based on post-injury autonomic regulation (high and low HRV) and the somatic and cognitive manifestation of depression reflected in a depression ratio. Wilcoxson signed-rank test tested the post-injury (T1) and 3 year follow-up (T2) depression scores. RESULTS: Depression score reduced after 3 years of injury (p ≤ 0.05). Only the high HRV group showed a higher depression ratio (somatic/ cognitive) atfollow-up (T2) (p ≤ 0.05). No difference was observed in post-injury coping between high and low HRV groups. CONCLUSION: The reduced depression score at follow-up (T2) aligns with the 'disability paradox' and mightindicate cognitive adaptation, specifically for those who showed autonomic adaptability in the form of post-injury high autonomic variability.

Effects of glossopharyngeal insufflation on pulmonary function in cervical cord injury patients.

STUDY DESIGN: Quasi experimental. OBJECTIVE: To evaluate the effect of glossopharyngeal insufflation on pulmonary function in cervical cord injury. SETTING: Indian Spinal Injuries Centre, Vasant Kunj, Delhi, India. METHODS: Thirty-one cervical cord injured (ISNCSCI A and B) subjects received respiratory rehabilitation for 4 weeks, with the experimental group performing glossopharyngeal insufflation along with respiratory rehabilitation. The groups were assessed at baseline and after 4 weeks for pulmonary function test, chest expansion, dyspnea, and chest tightness. RESULTS: Significant differences were observed in IVC, IC, FVC, FEV1, MEF 75%, PEF, tidal volume, chest expansion, dyspnea, and chest tightness (p < 0.05). CONCLUSION: Glossopharyngeal insufflation is a technique that can be used to improve the respiratory function after cervical cord injury.