Limb Segment Load Inhibits the Recovery of Soleus H-Reflex After Segmental Vibration in Humans

We investigated the effects of vertical vibration and compressive load on soleus H-reflex amplitude and postactivation depression. We hypothesized that, in the presence of a compressive load, limb vibration induces a longer suppression of soleus H-reflex. Eleven healthy adults received vibratory stimulation at a fixed frequency (30 Hz) over two loading conditions (0% and 50% of individual's body weight). H-reflex amplitude was depressed ～88% in both conditions during vibration. Cyclic application of compression after cessation of the vibration caused a persistent reduction in H-reflex excitability and postactivation depression for > 2.5 min. A combination of limb segment vibration and compression may offer a nonpharmacologic method to modulate spinal reflex excitability in people after CNS injury.     

Social comparison,coping and depression in people with spinal cord injury

The present study among 70 people with spinal cord injury examined the prevalence and correlates of identification (seeing others as a potential future) and contrast (seeing others in competitive terms) in social comparison as related to coping and depression. The most prevalent social comparison strategy was downward contrast (a positive response to seeing others who were worse-off), followed by upward identification (a positive response to perceiving better-off others as a potential future), downward identification (a negative response to perceiving worse-off others as a potential future), and upward contrast (a negative response to seeing others who were better-off). Those with less severe lesions reported the highest levels of upward contrast, coping through blaming others, and depression. Downward contrast was particularly related to constructive coping, and upward identification to wishful thinking. The less adaptive social comparison strategies, i.e., upward contrast and downward identification, were quite strongly related to wishful thinking and blaming others. Particularly upward contrast, i.e., feeling bad as response to seeing that others are better-off, was related to depression.     

The impact of assuming the primary caregiver role following traumatic spinal cord injury: An interpretative phenomenological analysis of the spouse's experience

This study aimed to explore the lived experience of assuming the primary caregiver role in a group of spouses of individuals living with a traumatic spinal cord injury (SCI) (injuries ranged from paraplegia to quadriplegia). Individual in-depth interviews were conducted with 11 participants who were both the spouse and primary caregiver of an individual with a SCI; of these, 10 were female and 1 was male. All interviews were transcribed verbatim and were subjected to interpretative phenomenological analysis (IPA). Here we present three inter-related master themes: ‘The emotional impact of SCI’; ‘Post-injury shift in relationship dynamics’ and ‘Impact of caregiving on identity’. Regarding the emotional impact of spinal injury, participants reported an almost instantaneous sense of loss, emptiness and grief during the injured person's rehabilitative period and feelings of anxiety were reported in anticipation of their return to the family home. A distinct change in role from spouse and lover to care provider was reported and this ultimately contributed to relationship change and a loss of former identity. The findings are discussed in relation to extant caregiver literature and recommendations for future caregiver support are highlighted.     

Women's experience of brain injury: An interpretative phenomenological analysis

Acquired traumatic brain injury (TBI) can leave the survivor with a complex range of psychological sequalae. This study aims to investigate the experience from the perspective of women with acquired TBI. Using a qualitative research method, six women with a TBI were interviewed about their experience, and the interviews were transcribed verbatim and analysed according to Interpretative Phenomenological Analysis (IPA). The major themes that emerged were: awareness of change; the emotional reaction; struggling to make sense; adaptation and acceptance. This article describes the process of adaptation, and the implications for rehabilitation are discussed. It is suggested that an intervention based on these themes might be an effective tool in rehabilitation.     

Neurodevelopmental Disorders Across the Lifespan: A Neuroconstructivist Approach.

Objectives. To investigate neuropsychological and neurobehavioral outcome in children with arterial ischemic stroke (AIS).

Background. Childhood stroke can have consequences on motor, cognitive, and behavioral development. We present a cross-sectional study of neuropsychological and neurobehavioral outcome at least one year poststroke in a uniquely homogeneous sample of children who had experienced AIS.

Method. Forty-nine children with AIS aged 6 to 18 years were recruited from a specialist clinic. Neuropsychological measures of intelligence, reading comprehension, attention, and executive function were administered. A triangulation of data collection included questionnaires completed by the children, their parents, and teachers, rating behavior, executive functions, and emotions.

Key Findings. Focal neuropsychological vulnerabilities in attention (response inhibition and dual attention) and executive function were found, beyond general intellectual functioning, irrespective of hemispheric side of stroke. Difficulties with emotional and behavioral regulation were also found. Consistent with an “early plasticity” hypothesis, earlier age of stroke was associated with better performance on measures of executive function.

Conclusions. A significant proportion of children poststroke are at long-term risk of difficulties with emotional regulation, executive function, and attention. Data also suggest that executive functions are represented in widespread networks in the developing brain and are vulnerable to unilateral injury.     

Executive function outcomes of children with traumatic brain injury sustained before three years

Traumatic brain injury (TBI) is a common cause of disability in childhood. While the outcomes of TBI sustained in school years has been heavily researched, very little is known about the impact of TBI in infants and young children. The aim of this study was to investigate the impact of TBI on executive function (EF) in children who sustained a TBI before 3 years of age. A group of 55 children, 19 with a mild TBI, 16 children with a moderate-severe TBI, and 20 uninjured comparison children participated. The EF of children aged 3 to 6 years were compared using child-based measures of attentional control and information processing. Parents completed questionnaires rating their child's EF. Severity groups differed on the child-based EF measure of attentional control with children with TBI performing below the control group. There were no significant group differences for information processing or parent-rated EF. It appears that children who sustain a TBI before the age of 3 years display impairments in some areas of attentional control 3–4 years postinjury. The findings fit with the existing EF literature for older children.     

The Illness/Injury Sensitivity Index: Validation of a German Version of the ISI-R

Three fundamental fears—anxiety sensitivity, fear of negative evaluation, and illness/injury sensitivity—are considered integral components of anxiety-related psychopathology and also bear connections with chronic pain. Scales measuring the first two fears, the Anxiety Sensitivity Index and the Fear of Negative Evaluation Scale, have been translated into German; however, the nine-item Illness/Injury Sensitivity Index-Revised (ISI-R) that measures fears of injury and illness has not been available in German language yet. The aim of this study therefore was a translation of the ISI-R into German language and an initial validation of the translated scale in two different samples. The German ISI-R was translated by both professionals and laypersons, and a final version was decided on by consensus. In Study 1, participants included 96 undergraduate students (85% women) who completed the German version of the ISI as part of a larger study. An exploratory factor analysis with oblique rotation was conducted and suggested a two-factor-solution with one factor representing fears of illness and the other fears of injury. This factor structure was confirmed via a confirmatory factor analysis (CFA) in Study 2. Participants included 117 community members (79% women). Convergent validity was supported using a visual analogue scale for fear of illness in both samples and the German translation of the Whiteley Index in Study. Overall, the results supported the German translation of the ISI-R. Comprehensive results, limitations, and directions for future research are discussed.     

Sport,moral interpretivism,and football's voluntary suspension of play norm

In recent years it has become increasingly the norm in football1 1. For North American readers, football here equals soccer. to kick the ball out of play when a player is, or appears to be, inadvertently injured. Kicking the ball out of play in football represents a particular instantiation of a generally understood fair play norm, the voluntary suspension of play (VSP). In the philosophical literature, support for the VSP norm is provided by John Russell (2007 Russell, J. S. 2007. “Broad internalism and the moral foundations of sport”. In Ethics in Sport, 2nd edn, Edited by: Morgan, W. J. Champaign, IL: Human Kinetics.  [Google Scholar]) who claims that his interpretivist account of sport is helpful for evaluating complex moral issues in sport in general and issues related to injury in football in particular. This paper examines whether Russell's interpretivist-backed account of autonomy can adequately inform football players as to the nuanced and ambiguous moral considerations that arise in relation to the VSP norm. The paper goes on to identify the highly complex dynamic circumstances football players need to consider in order to better discharge their moral responsibilities when faced with inadvertent injuries.     

Personality Disorders and Spinal Cord Injury: A Pilot Study

A substantial body of research has found that spinal cord injury (SCI) patients have relatively high degrees of energy, impulsivity, and risk-taking (W. Fordyce, 1964; G. P. Taylor, 1970; B. Woodbury, 1978). The present study endeavors to extend our knowledge to the personality disorder (PD) domain. Forty SCI participants and 40 matched controls were given a semistructured diagnostic interview and a self-report personality disorder instrument. Findings indicated that 27.5% of SCI patients, and a similar number of controls, have PDs. Unexpectedly, impulsive/externalizing disorders (histrionic, narcissistic, antisocial, and borderline) were not unusually high in SCI patients, and were not higher than controls. Avoidant and depressive disorders were unexpectedly high.     

Crisis Support and Coping as Mediators of Well-Being in Persons with Spinal Cord Lesion

This study aims to investigate whether crisis support and coping mediate symptoms of posttraumatic stress disorder (PTSD) in individuals with spinal cord lesions (SCL). PTSD, crisis support, and coping were assessed an average of 83 days after the injury (T1), at discharge from the rehabilitation center (T2), and an average of 121 days following discharge (T3). Sixty-nine newly injured paraplegics and tetraplegics completed the questionnaire at T1, 40 (58%) at T2, and 38 (55%) at T3. Individuals with PTSD experienced significantly lower levels of social support, and used more emotional coping than did those without PTSD. On the basis of logistic regression analyses, emotional coping and the interaction between negative response and emotional coping predicted PTSD. Emotional coping is a strong predictor of PTSD in persons with new SCL.