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1
Leeds, Marilyn June. "You're pretending, you don't need a wheelchair' - children and adolescents with spinal cord injury." Thesis, The University of Sydney, 2001. http://hdl.handle.net/2123/803.
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This thesis examines the requirements of children and adolescents with severe spinal cord injuries. The requirements are expressed by the parents of the children and by adolescents and are in contrast to official views of their 'needs'. There is no literature on the needs of these children and adolescents. The thesis thus begins with a examination of the literature on the needs of people with disabilities and people with spinal cord injury. Proponents of the social model of disability, which is based on the experiences of people with disabilities, contend that the main requirements of people with disabilities is ending their social marginalisation, and it is hypothesised that the requirements of the children and adolescents will be related to ending social marginalisation. Open-ended unstructured interviews with parents, parents and adolescents and adolescents alone ( a total of 20 interviews) provided data for analysis. Analysis of the data shows that the requirements of the children and adolescents, like adults with spinal cord injuries, differ from those of people with disabilities in that there are important concerns in addition to marginalisation.
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Leeds, Marilyn June. "You're pretending, you don't need a wheelchair' - children and adolescents with spinal cord injury." University of Sydney. Social Work, 2001. http://hdl.handle.net/2123/803.
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This thesis examines the requirements of children and adolescents with severe spinal cord injuries. The requirements are expressed by the parents of the children and by adolescents and are in contrast to official views of their 'needs'. There is no literature on the needs of these children and adolescents. The thesis thus begins with a examination of the literature on the needs of people with disabilities and people with spinal cord injury. Proponents of the social model of disability, which is based on the experiences of people with disabilities, contend that the main requirements of people with disabilities is ending their social marginalisation, and it is hypothesised that the requirements of the children and adolescents will be related to ending social marginalisation. Open-ended unstructured interviews with parents, parents and adolescents and adolescents alone ( a total of 20 interviews) provided data for analysis. Analysis of the data shows that the requirements of the children and adolescents, like adults with spinal cord injuries, differ from those of people with disabilities in that there are important concerns in addition to marginalisation.
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Al'joboori, Yazi Dhahia. "Maximising recovery of function after severe spinal cord injury by combining electrical epidural stimulation, locomotor training and intraspinal lentiviral-mediated chondroitinase-ABC delivery." Thesis, University of Leeds, 2016. http://etheses.whiterose.ac.uk/16263/.
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Electrical epidural stimulation (ES) of the lumbar spinal cord (L2 to S1) has previously been shown to improve locomotor function in complete transection models of rat spinal cord injury (SCI) (Ichiyama et al., 2005), and is facilitated by pharmacological treatment and daily bipedal locomotor training (TR) (Ichiyama et al., 2008b; Ichiyama et al., 2008a; Van den Brand et al., 2012). Whilst, bipedal treadmill stepping is improved, this functional recovery does not translate into un-assisted overground stepping. We have also recently demonstrated that exercise up-regulates inhibitory chondroitin sulphate proteoglycans (CSPGs) in the lumbar spinal cord in intact animals (Smith et al., 2015). This is potentially restricting synaptic plasticity and therefore further functional recover. Previous evidence has demonstrated functional improvements when combining rehabilitation of forelimb function and application of Chondroitinase-ABC (ChABC) following SCI (Garcia-Alias et al., 2009; Wang et al., 2011a). The premise for this thesis therefore, is that addition of lentiviral Chondroitinase (LV-ChABC) locally after injury would greatly enhance synaptic plasticity; thus, enabling ES and TR to drive functional recovery. Adult Sprague-Dawley rats received a severe spinal contusion injury (T9/10), epidural implantation at segmental levels L2 and S1 and intra-spinal injections of LV-ChABC or saline (control) ~1mm above and below the level of the lesion. Rats were then randomly assigned to one of four groups: cage control, training only, ES only (40 Hz; L2) or Combination (ES+TR). Rats in trained groups stepped bipedal-to-quadrupedally on a body weight supported treadmill (5-16 cm/s) (5 days/week, 20 mins/day) for 8 weeks. By the end of the 8-week period rats in the Saline-Combination group showed improvements not only in supported treadmill stepping ability but also in open field locomotion (BBB), with combination Saline/LV-ChABC treated animals achieving the highest overall increase in mean BBB score compared to Saline/LV-ChABC controls. Furthermore, kinematics analysis also revealed differences in stepping characteristics and pattern following 8 weeks of training. We did not observe any electromyography (EMG) responses in hindlimb muscles following cortical stimulation in any animal from any group, and no increased sensitivity to mechanical pain stimulation. Therefore, our results suggest that a combination of step training and epidural stimulation in an incomplete model of SCI successfully improved locomotor function further than either therapy administered alone. Combination treatment animals not only improved in treadmill step performance but were also able to transfer this skill to an open field task without the presence of stimulation. Interestingly, addition of LV ChABC produced differences in both kinematic profiles and withdrawal responses to mechanical paw pressure. These promising results indicate that the combination of ES, locomotor training and LV-ChABC is a viable treatment for functional recovery after severe SCI.
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Dorsett, Patricia Ann. "Spinal cord injury." Access full text, 2001. http://www.health.qld.gov.au/qscis/PDF/QSCIS_Information/Spinal_Cord_Injury_How_Do_People_Cope.pdf.
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Augutis, Marika. "Pediatric spinal cord injury /." Stockholm, 2007. http://diss.kib.ki.se/2007/978-91-7357-129-6/.
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Norrbrink, Budh Cecilia. "Pain following spinal cord injury /." Stockholm, 2004. http://diss.kib.ki.se/2004/91-7349-995-1/.
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Altas, Melanie. "Spinal cord transplants in a rat model of spinal cord injury." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1999. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape7/PQDD_0021/MQ49305.pdf.
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Surey, Sarina. "Understanding the molecular mechanisms of spinal cord cavitation after spinal cord injury." Thesis, University of Birmingham, 2015. http://etheses.bham.ac.uk//id/eprint/5721/.
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Spinal cord injury (SCI) is a neurodegenerative disease with research centered on axon regeneration and preservation to cure paralysis. Mice and rats are widely studied and experienced models used to imitate SCI due to differences in vascular disruption, blood vessel loss and cavitation at SCI epicenters. This study investigates sub-acute SCI responses, documenting angiogenic/inflammatory factors and matrix deposition in both species. Although cavitation was absent in mice, the lesion site in rats was larger at 8 and 15 days post lesion (dpl). Absence of cavitation in mice correlated with increased levels of pro-angiogenic/wound healing factors within the wound compared to rats at 8 dpl, coinciding with microarray analysis along with increased axonal sparing at T7 and T9 spinal segments. Despite similar deficits in thermal sensitivity 2 hours after injury, by 7 days the responses were comparable to controls in both species. Furthermore, inducing inflammation directly after injury using zymosan resulted in inflammatory-induced angiogenic responses between both species at 8 dpl, contributing to tissue damage and micro-cavities in the CNS. In conclusion angiogenic responses in mice attenuates wound cavitation, reducing secondary axon damage and thus induces axon sprouting/regeneration. These results suggest potential therapeutic utility of manipulating angiogenic/inflammatory responses after human SCI.
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Boulton, Holly. "Chronic Pain after Spinal Cord Injury." Thesis, University of Southampton, 2007. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.484857.
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Chronic pain is a common and problematic issue for many individuals with spinal cord injury (SCI; Kennedy, Lude, & Taylor, 2006). Whilst understanding of chronic pain in the general population is increasing, understanding of such pain after SCI remains limited. The literature review explores the issue ofchronic pain after SCI and considers how two dominant models of pain may be applied to chronic pain after SCI. Three pertinent psychological issues are discussed that may play an important role in the maintenance and exacerbation of chronic pain in individuals with SCI; attention, depression, and PTSD. The review stresses that further research into these factors is vital in order to further understanding ofchronic pain in individuals with SCI. The empirical paper focuses of one of the main psychological factors highlighted in the literature review: attentional bias. The study explores whether individuals with SCI and chronic pain possess an attentional bias for pain-related words. Three groups were recruited: chronic pain and SCI (n =14), SCI (n = 15), and healthy controls (n = 15). All participants completed a dot probe computer task that presented pain-related words, pertaining to sensory and affective characteristics ofchronic pain, and neutral words. Words were presented at two exposure durations, 500ms and 1250 ms. Results showed that individuals with chronic pain and SCI possessed an overall attentional bias towards pain related information, in comparison with the other two groups. This difference in attentional bias between the groups was not significantly affected by exposure duration (500ms vs. 1250 ms) or type ofpain words (affective vs. sensory pain words). The general theoretical and clinical implications are discussed, and some suggestions are made for future research
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Hunter, Susan M. "Living with traumatic spinal cord injury /." View online ; access limited to URI, 2007. http://0-digitalcommons.uri.edu.helin.uri.edu/dissertations/AAI3276966.
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Mann, Cody Mandeep. "Pharmacological neuroprotection for spinal cord injury." Thesis, University of British Columbia, 2008. http://hdl.handle.net/2429/2758.
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Spinal cord injuries can cause the catastrophic loss of motor and sensory function. The neurological deficits that result are the consequence of not only the primary injury to the spinal cord, but also a complex milieu of secondary pathological processes that are now beginning to be understood. The major mechanisms that underlie this secondary pathology include vascular disruption, ischemia, oxidative stress, excitotoxicity, and inflammation. In light of this, the fact that this secondary pathology occurs after the initial impact makes it potentially amenable to therapeutic intervention. Pharmacotherapies may attenuate some of these processes and minimize secondary damage.
Some of the promising treatments that are emerging for acute spinal cord injury are drugs that are already used by physicians for the treatment of unrelated diseases. These drugs, which have already been established to be safe for humans, offer the unique advantage over other novel therapeutic interventions that have yet to be tested in humans. This would save a tremendous amount of time and money needed for human safety studies, if considered as a treatment for spinal cord injury. Examples of such drugs include minocycline (an antibiotic), erythropoietin (a recombinant hormone used to treat anemia), and statins (a popular class of blood cholesterol reducers), all of which have demonstrated the ability to attenuate the various pathophysiological processes initiated after trauma to the central nervous system.
In a series of studies, erythropoietin, darbepoetin, atorvastatin, simvastatin, and minocycline were all evaluated for their ability to improve neurologic recovery in a clinically relevant model of spinal cord injury. My experiments revealed that erythropoietin, darbepoetin, atorvastatin and minocycline did not significantly improve neurological recovery. These negative results were in stark contrast to the positive findings which had been published in the literature suggesting that differences in experimental models and methodology influence the neuroprotective efficacy of these drugs. Simvastatin, on the other hand, demonstrated significant improvements in locomotor and histological outcomes. Although this is indeed exciting, the results were modest at best. My results highlight the need for further preclinical work on the above treatments to refine and optimize them prior to proposing them for human testing.
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Plemel, Jason Ryan. "Remyelination strategies following spinal cord injury." Thesis, University of British Columbia, 2012. http://hdl.handle.net/2429/42886.
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Peter, Claudio. "Adjustment to spinal cord injury (SCI)." Diss., Ludwig-Maximilians-Universität München, 2013. http://nbn-resolving.de/urn:nbn:de:bvb:19-162256.
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Tripathi, Richa Balmiki. "Oligodendrogenesis Following Experimental Spinal Cord Injury." The Ohio State University, 2008. http://rave.ohiolink.edu/etdc/view?acc_num=osu1206114626.
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Lim, Siew-Na. "Development of novel therapeutic strategies in spinal cord injury using rodent models of spinal cord compression injury." Thesis, Queen Mary, University of London, 2011. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.538663.
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Ghosh, Arko. "A cortical perspective on spinal cord injury /." [S.l.] : [s.n.], 2009. http://e-collection.ethbib.ethz.ch/show?type=diss&nr=18202.
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Sliedrecht, Susan. "Counselling Patients with a Spinal Cord Injury." The University of Waikato, 2007. http://hdl.handle.net/10289/2426.
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The aim of this study was to improve current counselling services at the Auckland Spinal Unit. This purpose was achieved by co-researching the topic with people who have extensive experience of living in the community with a spinal cord injury to reveal what they believe was helpful, or believe would have been helpful, in terms of the counselling, when they were newly injured. Listening to the stories of the research participants, through supervision of my own practice, doing a literature review and writing a journal became sources that provided rich knowledges to reflect on my current counselling practice. A qualitative study was conducted using aspects of action research, feminist research and post-structuralist methods. In November 2005, an information pack was mailed to the sixteen patients who had been discharged from the Auckland Spinal Unit between June 2002 and June 2004, who were under the age of sixty -five and lived in the Auckland area, inviting them to participate in this research. Seven people agreed and were available to participate. I interviewed these seven participants, using unstructured interviews. All the interviews were audio-taped and then transcribed verbatim. These verbatim transcripts were then sent back to the participants for any additions/deletions/alterations they chose to make. To initiate the reflecting process, I then went through all the interviews and identified common themes. I understand that if the research participants had been involved in this process, other themes might have emerged for them. The themes identified were loss and grief as a result of a spinal cord injury, sexuality, family (whanau) involvement and how counselling services should be positioned in a setting such as the Auckland Spinal Unit. These themes formed the iii foci of the chapters, with an additional chapter on weaving cultural threads into counselling. The main findings of the study centre on the very important role of counselling at the Auckland Spinal Unit. In particular, the study highlighted the importance of counselling as a place for conversations that make room for multiple positionings and multiple versions of events, a space that respects a patient's hopes, beliefs and dreams for his/her life (which often does not include wheelchairs, catheters and caregivers) but that also supports the patient to make meaning of living life with a spinal cord injury. The study also identified the importance of sexuality counselling. Not including sexuality as a topic in the rehabilitation services provided perpetuates dominant discourses that a person with a spinal cord injury does not want sexual intimacy or cannot be sexually intimate and cannot have children. Family (whanau) involvement in and family's becoming part of the rehabilitation team was very important to most participants. This study looks at how this involvement can be achieved and explores some of the structures currently in place at the Auckland Spinal Unit to facilitate this involvement. Participants in this study expressed a desire for counselling to be highly accessible to both themselves and their families (whanau). They would prefer the counsellors to get to know the patients in their own environment first (in their rooms), so that the patients are positioned to have agency to make choices about how they would like to use the available counselling services. The study concludes with my personal journey of working as a counsellor at the Auckland Spinal Unit and how this research has shaped and fine-tuned my practice.
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Wilsmore, Bradley R. "Thermoregulation in people with spinal cord injury." School of Health Sciences - Faculty of Health and Behavioural Sciences, 2007. http://ro.uow.edu.au/theses/85.
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Thermoafferent information is integrated at multiple levels within the central nervous system. However, due to the difficulty in differentiating thermoregulatory functions of the spinal cord from those of higher centres in humans, the role of the spinal cord in certain aspects of thermoregulation remains unclear. Subjects with spinal cord injury have unique neural changes providing an opportunity to evaluate the role of the spinal cord, independently of higher thermoregulatory centres. Subjects with (N=11) and without (N=11) spinal cord injury were studied in a series of experiments, in which a wide range of local and whole-body temperature changes and postural manipulations were imposed. During these trials, various physiological (skin temperature, core temperature, local sweat rate and sweat expulsion frequency - a measure of central sympathetic drive), and psychophysical variables (thermal sensation and discomfort) were investigated. Six key observations arose from these experiments: (i) Subjects with spinal cord injury had a lower thermoafferent capacity (secondary to neural damage) and a corresponding reduction in thermoefferent drive (sudomotor sensitivity of 4.2 versus 8.8 expulsions•min-1•C-1 in able-bodied; P=0.03). (ii) Equations used to approximate thermoafferent drive in able-bodied subjects, overestimated thermal feedback in subjects with spinal cord injury. However, this could be corrected by modifying the skin area weightings to include only the sensate areas. (iii) No subjects with physiologically-confirmed thermoefferent spinal cord injury displayed sweating from insensate skin sites, indicating that a spinal cord that has been isolated from higher centres cannot induce thermal sweating. (iv) Subjects with spinal cord injury had higher forehead sweat rates (0.77 versus 0.52 mg•cm-2•min-1; P=0.03), but an equivalent sweat sensitivity (1.24 versus 1.27 mg•cm-2•min-1•°C-1; P=0.94), indicating the presence of a peripheral adaptation to sustain thermal homeostasis, and secondary to reduced thermal afferent and efferent flow. (v) Respiratory frequency increased more for a given increase in body temperature in subjects with spinal cord injury (2.4 versus 1.1 breaths•min-1•°C-1; P=0.042), but this did not provide a thermoregulatory benefit. (vi) Subjects with spinal cord injury demonstrated greater changes in behavioural thermoregulatory indicators (thermal sensation and discomfort) in response to standardised local and whole-body thermal loads. Collectively, these observations indicate the unique nature of thermoregulation in people with spinal cord injury and the adaptive ability of the human thermoregulatory system.
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Josephson, Anna. "Spinal cord injury: mechanical and molecular aspects /." Stockholm, 2002. http://diss.kib.ki.se/2002/91-7349-235-3/.
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Lee, Jae Ho. "Pharmacological neuroprotection in cervical spinal cord injury." Thesis, University of British Columbia, 2010. http://hdl.handle.net/2429/27239.
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Spinal cord injury (SCI) is a devastating condition that causes paralysis below the level of the injury. To date, there is no convincingly effective treatment. An enormous preclinical and clinical effort is underway to find a treatment, and one approach is to search for pharmacological agents that are already in clinical use (albeit for different indications), but that may also have neuroprotective properties. Examples of such drugs are magnesium, Riluzole (sodium channel blocker), minocycline and statins.
While the majority of human SCI occur in the cervical spinal cord, the vast majority of laboratory SCI research employs animal models of thoracic SCI. An important step, therefore, in the preclinical evaluation of novel treatments is to assess their efficacy in a model of cervical SCI. First, I describe the development of a novel unilateral contusive model of cervical SCI with refined biomechanical, functional, and histological parameters using the Infinite Horizon spinal cord injury device. I conducted a series of experiments in which the spinal cord was injured using various impact forces, impact trajectories, and impact locations off the midline. Behavioral deficits were assessed using a variety of forelimb function tests, after which the cords were evaluated histologically. From these series of experiments, I established a new cervical unilateral spinal cord injury contusion model.
Next, I evaluated the neuroprotective effects of minocycline and simvastatin in the clinically relevant unilateral cervical contusion model. Minocycline is a commonly prescribed tetracycline antibiotic that is prescribed for acne. Simvastatin is one of many hydroxymethylglutaryl-coenzyme-A reductase inhibitors that lower cholesterol. As both drugs have translational potential and have been reported to have neuroprotective properties in various neurological diseases, I assessed the neuroprotective effects of these drugs using a host of functional and histological assessments. In the end, there were no neurological improvements with minocycline or simvastatin treatment after a cervical contusion injury.
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Kramer, John L. K. "Neurological outcomes after cervical spinal cord injury." Thesis, University of British Columbia, 2011. http://hdl.handle.net/2429/37312.
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In addition to overcoming biological barriers that limit regeneration and repair in the central nervous system after spinal cord injury, clinicians and researchers are faced with the daunting task of assessing the safety and efficacy of therapeutics proposed to ameliorate neurological deficits in humans. While the selection of an appropriate clinical endpoint will depend on a number of factors, including the phase of study and the underlying biological activity, the estimated effect size based on preclinical studies in animal models of spinal cord injury of most therapeutics are expectedly small. A potential promising strategy to detect subtle but clinically meaningful changes in humans is to focus on individual spinal segments partially damaged adjacent to the level of injury.
The primary aim of this thesis was to evaluate the validity of segmental sensorimotor outcomes for the purpose of devising clinical trial endpoints for spinal cord injury. In Chapters Two through Five, I focus this investigation on evaluating sensory outcomes. Chapter Two is chiefly intended to introduce clinical sensory testing methods (i.e. light touch and pinprick) and provide a better understanding of the relationship between the neuropathology of spinal cord injury and afferent anatomy and physiology. In order to address limitations of clinical sensory testing methods, the subsequent three chapters are focused on the application of segmental neurophysiological approaches. More specifically, this involves a series of studies in individuals with spinal cord injury aimed at objectively measuring conduction deficits in the dorsal column and spinothalamic tract based on outcomes from sensory evoked potentials. The thesis then shifts to the segmental assessment of motor function. In Chapter Six, changes in muscle strength are examined in the first year after cervical spinal cord injury, with a specific interest in documenting the relationship between improvements in motor scores in the upper extremities and the recovery of motor levels. This chapter concludes by linking functional independence and neurological outcomes. The discussion that follows is intended to provide an outline of how the knowledge acquired during the course of this doctoral thesis could be translated into phases of a clinical trial program.
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Tegg, Sophie Louise. "Psychological adjustment to traumatic spinal cord injury." Thesis, University of Southampton, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.327331.
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Wang, Difei. "Chondroitinase ABC in chronic spinal cord injury." Thesis, University of Cambridge, 2011. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.609828.
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Hillyer, Jessica Erin. "Enhancing Locomotor Recovery after Spinal Cord Injury." Kent State University / OhioLINK, 2008. http://rave.ohiolink.edu/etdc/view?acc_num=kent1216910376.
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Mohrman, Ashley E. "Regenerative Medicine Approaches to Spinal Cord Injury." University of Akron / OhioLINK, 2017. http://rave.ohiolink.edu/etdc/view?acc_num=akron1491495476427594.
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Carpenter, Randall Scott. "The Neuroimmunological Consequences of Spinal Cord Injury." The Ohio State University, 2019. http://rave.ohiolink.edu/etdc/view?acc_num=osu1562674460866325.
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Phang, Isaac Sng Khai. "Management of acute traumatic spinal cord injury." Thesis, St George's, University of London, 2016. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.703277.
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Traumatic spinal cord injury (TSCI) is a devastating condition. Most patients remain paralysed or wheelchair bound. After TSCI the injured cord swells and is compressed against the dura. My supervisors showed that, after TSCI, intraspinal pressure (ISP) rises and spinal cord perfusion pressure (SCPP) falls, leading to decreased spinal cord blood flow at the injury site. ISP can be monitored, but this is an invasive procedure that requires inserting a pressure probe at the injury site. My supervisors also showed that monitoring ISP and SCPP is feasible and helps guide management of TSCI patients in the intensive care unit. The thesis has five parts: 1) Study of the safety of ISP monitoring in TSCI patients. The data show that ISP monitoring is safe [42 patients]. 2) Study of the safety of performing magnetic resonance imaging (MRI) during ISP monitoring. The data show that MRI is safe with the ISP probe in situ [gel phantoms, 1 patient]. 3) Study of the pressure in and around the injured spinal cord. The data show that three intradural compartments form after TSCI, each with a different pressure profile. The data also show that subdural ISP is the same as intraparenchymal ISP at the injury site [1 patient]. 4) Study of whether laminectomy plus expansion duroplasty decompresses the injured spinal cord more effectively than laminectomy. The data show that laminectomy plus expansion duroplasty lowers ISP, increases SCPP and improves spinal pressure reactivity more than laminectomy [21 patients]. 5) Microdialysis monitoring from the injury site. The data show that increased SCPP is associated with improved metabolic profile at the injury site and that worse neurological status at presentation is associated with worse metabolic profile at the injury site. The data also suggest that the optimum SCPP is around 90 mmHg. Increasing SCPP improves the entry of intravenously administered drugs into the injury site [14 patients). The findings have important implications for the management of TSCI patients and the design of drug trials for TSCI.
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Wirth, Brigitte Susanne. "Cortico-spinal tract function in incomplete human spinal cord injury." Zürich : ETH, 2008. http://e-collection.ethbib.ethz.ch/show?type=diss&nr=17602.
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Carter, Jarrod W. "Compressive cervical spine injury : the effect of injury mechanism on structural injury pattern and neurologic injury potential /." Thesis, Connect to this title online; UW restricted, 2002. http://hdl.handle.net/1773/8010.
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Divanoglou, Anestis. "The Stockholm - Thessaloniki acute traumatic spinal cord injury study." Stockholm, 2010. http://diss.kib.ki.se/2010/978-91-7409-779-5/.
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Rigby, Sally. "An exploration of appraisals following spinal cord injury." Thesis, University of Oxford, 2006. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.437394.
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Zbogar, Dominik. "Physical activity during inpatient spinal cord injury rehabilitation." Thesis, University of British Columbia, 2015. http://hdl.handle.net/2429/55204.
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Introduction
Rehabilitation activities of a sufficient intensity are necessary for optimal recovery in individuals with spinal cord injury (SCI). Optimizing rehabilitation and activity prescription requires quantification of physical activity and its predictors during this time.
Purpose
To determine, during inpatient rehabilitation, the:
1) reliability and validity of measures of physical activity.
2) level of physical activity using objective and self-report measures.
3) level of cardiovascular stress experienced during physical therapy (PT) and occupational therapy (OT).
4) variables associated with greater time spent at higher heart rate during PT.
5) number of active movement repetitions occurring during PT and OT.
Methods
Design: A test retest design was used to determine the reliability of physical activity measures. A longitudinal observation design was used to determine movement repetitions and physical activity levels. A cross-sectional observational design was used to determine the level of cardiovascular stress.
Subjects: Participants (n=108) were recruited from consecutive admissions to rehabilitation.
Results
Good reliability for accelerometry and step counts, and moderate reliability for self-report, was demonstrated. Validity was demonstrated for wrist accelerometry and step counts but not self-report physical activity.
For most groups and variables, no changes occurred during therapy time from admission to discharge. Outside of therapy all groups increased from admission to discharge in accelerometer measured activity kilocounts but not self-report minutes, where the majority of time was spent in leisure time sedentary activity (~4.5 hours).
The average time spent at a heart rate within the cardiovascular training zone was 6.0±9.0 minutes in PT and lower in OT. Lower spasticity, higher exercise self-efficacy, and better orthostatic tolerance correlated with a greater amount of time within a cardiovascular training zone.
Average repetitions for PT and OT combined did not exceed 300 for the upper or lower extremity. Most repetition variables remained unchanged over the inpatient rehabilitation stay while clinical outcomes improved significantly.
Conclusions
Individuals report that a large amount of time is spent engaged in higher intensity activities. Measurement of heart rate during therapy sessions shows little time is spent at intensities sufficient to accrue cardiovascular benefits. Repetitions in therapy are low compared to the motor learning literature.Medicine, Faculty of
Graduate
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Assinck, Peggy Lee. "Myelinating cells in repair of spinal cord injury." Thesis, University of British Columbia, 2017. http://hdl.handle.net/2429/62788.
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Santiago, Raquel Vanessa. "Electromyographic indicators of recovery from spinal cord injury." Connect to resource, 2007. http://hdl.handle.net/1811/28354.
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Thesis (Honors)--Ohio State University, 2007.Title from first page of PDF file. Document formatted into pages: contains 58 p.; also includes graphics. Includes bibliographical references (p. 57-58). Available online via Ohio State University's Knowledge Bank.
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Sköld, Camilla. "Spasticity : an elusive problem after spinal cord injury /." Stockholm, 2001. http://diss.kib.ki.se/2001/91-628-4607-8/.
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Sardella, Thomas Christian Peter. "Promoting bridging axonal regeneration after spinal cord injury." Thesis, University of Glasgow, 2010. http://theses.gla.ac.uk/1420/.
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Olfactory ensheathing cells (OECs) are amongst the best candidates for cell transplantation into lesions of the central nervous system. These specialised glial cells are found in the olfactory system and are associated with the physiological restoration of neuronal circuitry in the first cranial nerve of the adult. There is conflicting evidence on the extent to which OECs promote long distance axonal regeneration when transplanted into spinal cord lesions. In the first chapter of Results (chapter 3) we aimed to determine the potential of OEC transplantation in promoting axonal regeneration beyond the injury. This was investigated by producing a transection of the dorsal columns at the lumbar 3-lumbar 4 (L3-L4) border using a wire knife device that cut ascending primary sensory afferents and immediately after, transplanting olfactory bulb derived OECs into the lesion. Regeneration was assessed in these fibres by injecting the neurotracer biotin dextran amine (BDA) into the left L4 and L5 spinal roots and sacrificing the animals 6 weeks after the lesion. We detected axonal labelling in the lumbar and thoracic cord rostral to the dorsal column lesion; but the labelled axons included spared fibres. For this reason it was necessary to develop a quantification method that included only convincing regeneration and excluded sparing or potential sprouting. With care it was possible to detect convincing axonal regeneration of dorsal root ganglia (DRG) neurons across the lesion in animals transplanted with OECs. Although there have been several claims of axonal regeneration following OEC transplantation in spinal cord pathways information is still lacking on the spatial relationship between regenerating axons and transplanted OECs. To understand this, OECs were transduced before transplantation with a lentiviral vector to express green fluorescent protein (GFP). With this technique it was possible to detect the OECs in the transplanted spinal cord and determine that tract traced axons preferentially regenerated though continuous tracts of GFP labelled OECs in continuity with the transplanted lesion, while they did not normally regenerate through the host spinal cord in areas devoid of OECs. Regeneration beyond the lesion in OEC transplanted animals was very limited in terms of both distance and numbers of axons. The conditioning lesion of the sciatic nerve is a procedure which appears to prime DRG neurons for growth. We next asked whether the regeneration observed after an OEC transplant alone could be maximised by a combined treatment paradigm that included OEC transplantation and conditioning lesions. Conditioning lesions were performed by transecting the left sciatic nerve at mid thigh level and the spinal cord was lesioned at the L3-L4 level. Long distance bridging axonal regeneration was strongly potentiated (58 fold). As seen in OEC transplanted animals, axons in the distal spinal cord were located preferentially in areas where OECs were also present. Regeneration was also studied at earlier and later time points. The number of regenerating axons was significantly greater if survival time was of 2 weeks from the lesion/transplantation compared to the 6 week survival, while it did not vary significantly between 6 weeks and 17 weeks survival. Direct comparison of the growth promoting effects exerted by OECs and Schwann cells have not so far been performed on transection type lesions, but only on other lesion models where sparing cannot be ruled out. To understand if these two cell types share similar properties with reference to promoting long distance axonal regeneration, in the second chapter of Results (chapter 4) we consider sciatic nerve derived Schwann cell transplantation alone or in combination with conditioning lesions following the same lesion paradigm in which OECs were transplanted. Interestingly, no significant difference was found between the growth promoting properties of the two glial cells. Furthermore, with Schwann cells as with OECs, regenerating axons in the distal spinal cord were associated mostly with the transplanted cells. To understand whether the long distance axonal regeneration observed was occurring irrespective of the cell type injected, we transplanted sciatic nerve derived fibroblasts in combination with conditioning lesions. With this lesion paradigm significantly less regeneration was detected indicating that fibroblasts are less effective than OECs and Schwann cells in terms of their regeneration promoting properties. On the other hand we determined that OECs, Schwann cells and fibroblasts all preserved the lesion integrity by preventing the lesion from dilating. Importantly, rats are now being used as a model of study for syringomyelia, a pathology that leads to progressive central canal cavitation. We have found that dilation of the central canal normally develops also in the wire knife dorsal column lesion model; however transplantation of OECs or Schwann cells significantly reduced the central canal dilation compared to non-transplanted animals. Any clinical use of cell transplantation will likely involve a delay between injury and treatment, and since a glial scar will develop and the regenerative response of the axotomised fibres may subside, it is not clear to what extent regeneration will occur. In the third chapter of results (chapter 5) we have therefore investigated whether delayed OEC transplantation might promote a significant level of regeneration. Surprisingly, the distribution of OECs following delayed transplantation was similar to that after an acute transplant and OECs formed tracts that were in continuity with the lesion transplant. The presence of these OEC tracts allowed regenerating axons to bridge the lesion and grow for relatively long distances on the other side. Delayed conditioning lesions were combined with delayed OEC transplantation and boosted axonal growth 9 times compared to delayed OEC transplanted animals.
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NAPHADE, SWATI B. "Progranulin Function in Spinal Cord Injury and Neuroinflammation." The Ohio State University, 2011. http://rave.ohiolink.edu/etdc/view?acc_num=osu1309888495.
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Khalifa, Mohammed Fadhil. "Learned response to long-term spinal cord injury." Diss., The University of Arizona, 1992. http://hdl.handle.net/10150/185761.
Full textAbstract:
Spinal cord injury is one of the most catastrophic events that may befall a human being. As greater numbers of disabled young adults survive for longer periods, the need for long-term care at home increases. However, self-satisfaction and perceived quality of their care at home are thus important of study. The study had two purposes which included: (1) to describe what factors influence self-satisfaction and perceived quality of care provided for individuals who have had spinal cord injury, and (2) to generate the Learned Response Model that describes the relationships among factors essential for self-satisfaction and perceived quality of care provided for persons with spinal cord injury in the home. A correlation design with a causal modeling methodology was used. Eighty spinal cord injured persons were obtained from six rehabilitation sites in Arizona. Six instruments were utilized to collect data: (1) Knowledge of Disability Questionnaire (KDQ), (2) Stressful Life Events Questionnaire (SLEQ), (3) Activities of Daily Living Scale (ADLS), (4) Involvement of Significant Others Questionnaire (ISOQ), (5) Self-Satisfaction Questionnaire (SSQ), and (6) Perceived Quality of Care Scale (PQCS). Data analysis included use of descriptive statistics to summarize the sample in terms of demographic variables and theoretical and empirical model testing using multiple regression techniques and residual analysis. The study findings indicated that stressful life events was found to have direct negative impact upon perceived quality of care. Activities of daily living and involvement of significant others were found to be moderators relative to self-satisfaction. These variables also interacted together relative to self-satisfaction and perceived quality of care. Involvement of significant others was found to have a significant, but weak, moderation effect relative to the relationship of stressful life events with perceived quality of care.
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Britten, Laura Elizabeth. "Bimanual coordination after incomplete cervical spinal cord injury." Thesis, University of Leeds, 2015. http://etheses.whiterose.ac.uk/12152/.
Full textAbstract:
This thesis examines unimanual and bimanual prehension in people with an incomplete cervical Spinal Cord Injury (icSCI) when compared to non-injured younger adults (YA) and older adults (OA). Quantifying control changes following icSCI will help to guide rehabilitation to improve arm and hand function, which is the main priority for rehabilitation following injury to the cervical spinal cord. Using 3D kinematic and surface EMG analysis, eighteen participants with an icSCI, sixteen YA and sixteen OA were examined, in three studies, when reaching and grasping objects, varying in distance and size, in unimanual and bimanual conditions. Kinematic data showed that participants with an icSCI produced unimanual and bimanual movements of a longer duration and lower peak velocity, with an increased reliance on the deceleration and final adjustment phase when compared to non-injured participants. With regards to the grasp phase, participants with an icSCI produced maximum grasp aperture earlier in the movement and with temporal dissociation between the transport and grasp phases. Participants with an icSCI also showed novel muscle activity patterns when compared to non-injured participants, suggesting that neuroplasticity of spared fibres had occurred in the acute stages of the injury. Object distance and object size influenced both the transport and grasp phases of unimanual and bimanual prehension, resulting in control differences between participants with an icSCI and non-injured participants e.g. longer movement time and increased reliance on the final adjustment phase when reaching to large objects. Despite bilateral deficits of the arms and hands, participants with an icSCI showed evidence for retaining a level of bimanual coordination, such as using the final adjustment phase to improve synchrony between the limbs. This supports the integration of bimanual movements into rehabilitation in order to improve arm and hand function, as well as the performance of activities of daily living, which are often bimanual in nature.
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Chan, Wing-han Esther. "Road to recovery : adjustment and services needed for those suffering from spinal cord injury /." Hong Kong : University of Hong Kong, 1998. http://sunzi.lib.hku.hk/hkuto/record.jsp?B20131835.
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Lord, Tyler M. "EFFECTS OF SPINAL CORD INJURY ON ACTIVATION OF THE SPINAL EJACULATION GENERATOR." Kent State University / OhioLINK, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=kent1589565574775045.
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Kraemer, Marina. "Novel scaffolds for spinal cord repair." Thesis, University of Bath, 2013. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.591041.
Full textAbstract:
Injuries to the central nervous system (CNS) have traumatic consequences such as irreparable disability due to the inability of the CNS to regenerate injured nerve fibres. The aim of the work presented here was to develop a scaffold which potentially provides guidance to axons in the injured spinal cord thus facilitating signal transduction. A poly-(lactic-co-glycolic acid) (PLGA, PLA:PGA ratio of 75:25) flat sheet membrane scaffold was created using phase inversion with N-methyl pyrrolidinone (NMP) as the solvent and water as the non-solvent for immersion precipitation. PLGA flat sheet membranes were exposed to surface treatments including aminolysis, peptide immobilisation and ozonation in order to achieve higher cell attachment of PC12 cells, a cell line which was cloned from a solid pheochromocytoma tumour of white rats, and used as a tool for measurement of regeneration. Cell attachment studies revealed no significant difference in cell attachment between modified and not-modified PLGA flat sheet membranes. However, the absence of foetal calf serum (FCS) resulted in fivefold higher cell attachment compared to medium supplemented with 10% FCS. A second scaffold was produced by electrospinning 10% (w/w) PLGA in a chloroform:methanol (CHCl3:MeOH) mixture in ratio of 3:1 resulting in a nanofibrous scaffold. Optimum settings for electrospinning were found to be 3 ml/h feeding rate, 15kV applied voltage and 11cm collector-to-needle distance. Random and aligned PLGA nanofibres were produced, with a fibre diameter of 530±140nm. PC12 cells attached and differentiated to the nanofibrous scaffold. When exposed to NGF these cells stopped dividing and extended neurites. On random fibres, neurite orientation was random, whereas on aligned fibres 63% of neurites grew with the fibre orientation ±15��ᵒ. After 7 days of exposure to NGF, cells had 1-4 neurites on random fibres, reaching a maximum length of 188μm, whereas on aligned fibres, cells had 1-2 neurites, reaching a maximum length of 400μm. PLGA nanofibres were also investigated as a delivery vehicle for bioactive molecules. For this, poly-L-lysine (PLL) was incorporated into electrospun PLGA nanofibres via emulsion electrospinning. PLGA-PLL nanofibres were significantly larger than PLGA nanofibres having a diameter of 830±190nm. In order to visualise the incorporation of PLL, FITC-PLL was electrospun und the resulting nanofibres fluoresced greed. Attachment of PC12s to PLGA-PLL nanofibres was not significantly different compared to PLGA nanofibres. Aligned PLGA-PLL nanofibres were shown to promote neurite outgrowth of PC12s with resulting neurites of up to twice the length compared to aligned PLGA nanofibres. The results suggest that PLGA nanofibres strongly influences neurite organisation, which is potentially useful for future therapeutic approaches. The work in this thesis has shown that electrospun PLGA nanofibre mats have the potential to be used as scaffolds for spinal cord repair addressing topographical guidance and delivery of bioactive molecules to the site of injury.
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White, Brian Dale Driver Simon. "Identifying changes in resilience during rehabilitation from a spinal cord injury." [Denton, Tex.] : University of North Texas, 2008. http://digital.library.unt.edu/permalink/meta-dc-6039.
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Ryge, Jesper. "Gene expression in rodent spinal neuronal populations and their response to injury." Stockholm : Department of Neuroscience, Karolinska Institutet, 2009. http://diss.kib.ki.se/2009/978-91-7409-712-2/.
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Amo, Aparicio Jesús. "Modulation of the inflammatory response after spinal cord injury." Doctoral thesis, Universitat Autònoma de Barcelona, 2019. http://hdl.handle.net/10803/668008.
Full textAbstract:
La lesión de médula espinal (LME) consiste en la disrupción de la vías ascendentes y/o
descendentes de información debido a un daño del tejido nervioso. Puesto que los axones del
sistema nervioso central no regeneran, el daño conduce a una falta de comunicación
permanente entre el cerebro y las regiones del cuerpo que están por debajo de la zona de
lesión. Esta falta de comunicación se traduce en pérdida de movimiento, pérdida de sensación,
déficits autonómicos y dolor. La magnitud final de estos déficits se define en base al nivel, la
severidad y el tipo de lesión. Sin embargo, hay muchos procesos secundarios degenerativos
que ocurren en la médula espinal después del daño primario y que contribuyen a los déficits
finales. Entre estos procesos, la respuesta inflamatoria es uno de los más importantes.
La LME activa una respuesta inflamatoria producida principalmente por macrófagos y
microglía. Todo el proceso está dirigido por citoquinas. Estas células y mediadores son
fundamentales para la limpieza de los restos celulares y la recuperación del tejido dañado. Sin
embargo, a diferencia de otros tejidos, la respuesta inflamatoria del sistema nervioso central
no se resuelve adecuadamente. Una respuesta inflamatoria exacerbada puede producir daños
en el tejido vecino sano, incrementando el tamaño de la lesión y empeorando los déficits
finales. El objetivo principal de esta tesis es la modulación de la respuesta inflamatoria después
de la LME, manteniendo los beneficios esenciales de la respuesta inflamatoria pero evitando
los daños atribuidos a una respuesta exacerbada. Según nuestra hipótesis, esta modulación
resultará en una mejora de la preservación del tejido y de la recuperación funcional en un
modelo murino de LME.
Las primeras dos estrategias de esta tesis están basadas en la supresión del ambiente
proinflamatorio actuando sobre IL-1a e IL-1b, citoquinas principales en las primeras fases de
la respuesta inflamatoria. La actuación sobre IL-1a se realizó mediante MABp1, un anticuerpo
monoclonal recientemente aprobado para su uso clínico. Este anticuerpo neutraliza la forma
soluble de la IL-1a e inhibe su unión a los receptores. A pesar de los hallazgos prometedores
en otras enfermedades mediadas por la respuesta inflamatoria, MABp1 no promovió
protección después de una LME. La actuación sobre IL-1b se realizó mediante OLT1177, un
inhibidor del inflamasoma NLRP3 necesario para el procesamiento y la liberación de IL-1b e IL-
18. OLT1177 promovió de manera exitosa la preservación del tejido y la mejora funcional
cuando se inyectó intraperitonealmente después de una LME. Puesto que OLT1177 es seguro
en humanos, es un candidato prometedor para el tratamiento de la LME.
Las últimas dos estrategias de esta tesis están basadas en la potenciación del ambiente
antiinflamatorio mediante IL-37 en IL-13. Resultados previos de nuestro grupo mostraron que
incrementar los niveles de IL-37 promovía un efecto protector después de una LME. En esta
tesis estudiamos la contribución de la rutas nucleares y extracelulares en el papel de la IL-37.
Demostramos que, aunque las dos rutas promueven efectos protectores, los efectos
beneficios después de una LME eran atribuidos principalmente a una señalización extracelular.
Incrementar los niveles de IL-13 promovió un ambiente antiinflamatorio después de una LME,
como había sido previamente demostrado por nuestro grupo con IL-4. Sin embargo, a
diferencia de IL-4, IL-13 no proporcionó mejora funcional. Para determinar las diferencias
- 12 -
entre estas dos citoquinas, realizamos la primera secuenciación de ARN de las poblaciones de
macrófagos y microglía después de una LME. Observamos que, aunque ambas citoquinas
tienen el mismo efecto en la modulación del ambiente inflamatorio, inducen diferencias en el
metabolismo de macrófagos y microglía. El metabolismo inducido por IL-4 era más oxidativo
mientras que el metabolismo inducido por IL-13 era más glucolítico. Puesto que la respuesta
inflamatoria es un proceso muy exigente, la forma en la que las células obtienen energía puede
ser crucial para el desarrollo de la respuesta inmune y podría explicar las diferencias
observadas a nivel funcional.
El futuro de la LME es multidisciplinar. A través de esta tesis, proporcionamos evidencias para
apoyar que la modulación trófica del ambiente inflamatoria es un componente fundamental
de las nuevas estrategias terapéuticas para tratar la LME.Spinal cord injury (SCI) consists in the disruption of the ascending and/or descending information pathways due to the death of nervous tissue. Since axons from the central nervous system do not regenerate, injury results in a permanent lack of communication between the brain and the regions of the body below the lesion site. This lack of communication translates into loss of movement, loss of sensation, autonomic deficits, and pain. The final magnitude of these dysfunctions is defined by the level, the severity, and the type of injury. However, there are many secondary degenerative processes that take place in the spinal cord after primary injury and that contribute to the final dysfunctions. Among these processes, inflammatory response is one of the most important. Spinal cord injury elicits an inflammatory response produced mainly by macrophages and microglia. All the process is orchestrated by cytokines. These cells and mediators are fundamental for the clearance of cellular debris and the healing of damaged tissue. However, in contrast to other tissues, inflammatory response in the central nervous system is not properly resolved. Exacerbated and uncontrolled inflammatory response produces damage to healthy neighboring tissue, increasing the lesion size and worsening the final deficits. The main objective of this thesis is the modulation of the inflammatory response after SCI, maintaining the essential benefits of an immune response but avoiding dangers of exacerbated immunity. We hypothesize that this modulation will result in improvement of tissue preservation and functional recovery in a murine model of SCI. First two strategies of this thesis are based on the suppression of pro-inflammatory environment targeting IL-1a and IL-1b, main cytokines in the first stages of the inflammatory response. Targeting of IL-1a was performed by MABp1, a monoclonal antibody recently approved for clinical use. This antibody neutralizes the soluble form of IL-1a and inhibits its binding to receptors. Besides promising findings in other inflammatory-mediated diseases, MABp1 failed to promote protection after SCI. Targeting of IL-1b was performed by OLT1177, an inhibitor of the NLRP3 inflammasome needed for the processing and release of IL-1b and IL-18. OLT1177 successfully promoted tissue protection and locomotor improvement when injected intraperitoneally after SCI. Since OLT1177 is safe in humans, it is a promising candidate for the treatment of SCI. Last two strategies of this thesis are based on the potentiation of the anti-inflammatory environment by IL-37 and IL-13. Previous result from our group showed that increasing IL-37 levels promoted a protective effect after SCI. Here we studied the contribution of the nuclear and extracellular pathways to the role of IL-37. We demonstrated that, although both pathways promote protective effects, benefits after SCI were attributed mainly to extracellular signaling. Increasing levels of IL-13 promoted anti-inflammatory environment after SCI, as previously reported by our group with IL-4. However, in contrast to IL-4, IL-13 failed to confer functional - 10 - improvement. To determine differences between these two cytokines, we performed the first cell-specific RNA sequencing of macrophages and microglia after SCI. We observed that, although both cytokines have the same effect on the modulation of the injury environment, they induce differences in the metabolism of macrophages and microglia. Metabolism induced by IL-4 was more oxidative whereas metabolism induced by IL-13 was more glycolytic. Since inflammatory response is a very demanding process, how cell obtain energy may be crucial for the development of the immune response and may explain differences observed at functional level. Future of SCI is multidisciplinary. Through this thesis we provide evidences to support that trophic modulation of the injury environment is a fundamental component of novel therapeutic approaches to treat SCI.
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Carpenter, Christine. "The experience of spinal cord injury as transformative learning." Thesis, University of British Columbia, 1991. http://hdl.handle.net/2429/30422.
Full textAbstract:
The purpose of this study is to explore individual conceptions of the experience of traumatic spinal cord injury from the perspective of adult learning. A qualitative research approach was chosen as the most appropriate to explore these meanings. The methodology for this study was both descriptive and interpretive. Data collection took the form of semi-structured in-depth interviews. The research was essentially exploratory. Commonalities of meaning attributed to the injury were revealed through analysis of the data and grouped into three thematic categories; rediscovery of self, redefining disability and establishing a new identity.
These themes, whilst representing commonalities, revealed the complex and multidimensional nature of each individual's experience. The disability and overall sense of loss were initially symbolized by the physical changes or the external experience of disability. These are separate from the internal concept of 'self ' which was perceived by the individuals as being the same as pre-injury. The findings suggest that an inner conflict between the external or public 'self ' and the internal or private 'self ' develops which can best be described as an experiential split.
The theme of rediscovering self is concerned with those components of the post-injury experience which inhibit or facilitate a reintegration of the internal and external selves. The inhibiting factors identified included the loss of control over physical functioning and capabilities, alienation from the 'real world,' the restrictive environment and instructional limitations of the rehabilitation facility and the attitudes of health professionals. The process was found to be facilitated
by the continuity of their sense of self, a gradual build-up of a new framework of experience and personal resources accrued from their pre-injury history and social context.
The theme of redefining disability was achieved by challenging the attitudes and stereotypes espoused by health professionals and society, and an assimilation of a new sense of coherence. The latter was seen as occurring through attributing meaning to the cause of the injury, expanding the range of available options and developing new value priorities.
The third theme of the establishment of a new identity was found to be associated with making comparisons with others by which self-esteem can be enhanced, by association and dialogue with a peer minority, by creating intimacy with significant others and new ways of interacting with society.
These themes bear little relationship to the instructional content of current rehabilitation programs, and defy explanation through the traditional learning perspective of skill acquisition and behavioral change which has dominated rehabilitation practice, and to which research is primarily directed. The data yielded a way of understanding the experience of spinal cord injury which is not adequately expressed in the literature. It became apparent that these individuals were engaged upon a complex learning process.
A theory of transformative learning proposed by Mezirow was introduced as a possible alternative, or adjunct to, the educational model of rehabilitation service provision. Central to this theory are two dimensions of meaning described as meaning schemes and meaning perspectives and the unique adult characteristic of critical reflection.
The subjects in this study recognized the learning involved in questioning old meaning perspectives and creating new ones. By reflecting and acting on these new meaning perspectives the facts and implications of disability became integrated into a chosen lifestyle.
Implications for rehabilitation practice are that the target of an educational intervention may not, in fact, be the clients but the health professionals involved in providing instruction and care. A greater understanding of the experience of traumatic spinal cord injury over time, and the uniquely individual learning process involved, would facilitate a more client centred and relevant approach to instruction.Education, Faculty of
Educational Studies (EDST), Department of
Graduate
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Qiao, Juan. "Neurophysiological effects of 4-aminopyridine in spinal cord injury." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1997. http://www.collectionscanada.ca/obj/s4/f2/dsk3/ftp04/nq28515.pdf.
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Gensel, John Carib. "Modeling and treatment of rat cervical spinal cord injury." Columbus, Ohio : Ohio State University, 2007. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=osu1167753874.
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Bloemen-Vrencken, Josephine Huguette Anna. "Health problems after spinal cord injury rehabilitation: who cares?" Maastricht : Maastricht : Universitaire Pers Maastricht ; University Library, Universiteit Maastricht [host], 2006. http://arno.unimaas.nl/show.cgi?fid=5660.
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Taylor, Laura Anne. "Neurotrophin gradients and axon growth after spinal cord injury." Connect to a 24 p. preview or request complete full text in PDF format. Access restricted to UC campuses, 2007. http://wwwlib.umi.com/cr/ucsd/fullcit?p3278318.
Full textAbstract:
Thesis (Ph. D.)--University of California, San Diego, 2007.Title from first page of PDF file (viewed November 7, 2007). Available via ProQuest Digital Dissertations. Vita. Includes bibliographical references.