An examination of post-traumatic growth in Canadian and American ParaSport athletes with acquired spinal cord injury

ObjectivesThe study was guided by two research questions: (1) Does participation in ParaSport following acquired spinal cord injury (SCI) influence people's perceptions of post traumatic growth (PTG)? (2) What specific dimensions of PTG, if any, do ParaSport athletes report experiencing?DesignA phenomenological approach was adopted to understand ParaSport athletes' perceptions and experiences of PTG and sport participation following acquired SCI.MethodTwelve participants with acquired SCI who integrated, reintegrated, or attempted to integrate into sport completed a survey and participated in a semi-structured interview to assess their perceptions of acquired SCI, involvement in ParaSport, and PTG.ResultsFive general dimensions of growth emerged from the data including: (a) injury relevant processing; (b) appreciation for life; (c) reactive behavior as a result of attempted integration into ParaSport; (d) relating to others and (e) health and well-being. Participants reported increased physical functioning and independence related to their involvement in sport. Emotional and psychological gains were also associated with ParaSport including re-establishment of self-identity, improved clarity and perception of life, changed priorities, greater confidence, and enhanced social relationships.ConclusionsParticipation in ParaSport following acquired SCI may provide physical, emotional, and psychological health benefits, which should be considered in the development and implementation of sport related interventions to encourage PTG. Clinicians and rehabilitation specialists may use information from the present study to help individuals improve their identity, build relationships, and develop an appreciation for life after incurring a SCI.     

Stories that move? Peer athlete mentors' responses to mentee disability and sport narratives

BackgroundHow people respond to the stories people tell matters. Past research demonstrates that there are varied responses to the narratives individuals with spinal cord injury (SCI) use. Yet, no research has explored how peer athlete mentors with SCI respond to their mentees' stories about sport participation that are framed in different disability narratives.PurposeTo explore how peer athlete mentors respond to four mentees' vignettes representing various attitudes towards adapted sport.MethodsThirteen peer athlete mentors discussed these vignettes in hour-long interviews; their responses were analysed using a dual narrative analysis.ResultsPeer athlete mentors tailored their responses to each individual vignette. Specifically, responses to the most open vignettes were tailored to the mentees' disability narratives and provided a variety of resources and sport information. This type of response to mentees' stories can support and validate these mentees' experiences and increase the likelihood that mentees will try sport. In contrast, peer athlete mentors' responses to the heavily resistant vignettes contained limited information about sport. These responses also challenged the mentees' disability narratives. These types of responses may be counter-productive as they invalidate the mentees' experiences with sport and SCI and may further deter sport participation.ConclusionWhile peer athlete mentors tailored the information they would provide to mentees who use different disability narratives, they expressed difficulties responding to the heavily resistant narrative. Future peer athlete mentor training should address this difficulty by providing practice around how to communicate with individuals expressing resistant narratives.     

Problematic donation procedures vs. futuristic research and treatment applications: A dichotomous social representation of stem cells in Italy

IntroductionCurrently, stem cells (SC) are one of the most studied issues of medical research as well as a widespread, complex, socially and ethically relevant issue.ObjectiveThe general aim of the present study is to explore how social representations (SR) of SC is different for people more or less willing to donate SC, also comparing bone marrow SC (BMSC) donation and umbilical cord blood SC (UCBSC) donation.MethodA paper-and-pencil survey was administrated to 78 Italian respondents. A structural analysis of SC-SRs (prototypical and co-occurrence analysis) was conducted comparing people with a high/low intention to donate UCBSC/BMSC.ResultsSimilarly to other bioethically relevant issues, SR of SC seems to be ambivalent and dichotomously organized, with the donation procedure been a barrier.ConclusionThese results are in line with studies finding two sets of dichotomies: on the one hand, a gift-of-life/replacement-of-body-parts dichotomy coexisting within people's SR of organ donation; on the other hand, a help/pain and needle dichotomy within blood donation's SR. Directions for future research are suggested.     

脊髓损伤者生育困难与服务需求调查

对63名18岁以上未婚或已婚未生育子女的脊髓损伤者进行问卷调查,并对其中17人进行了深入访谈,了解其生育愿望、影响因素与生育服务现状,探讨解决脊髓损伤者生育困难的方法和措施.调查发现,脊髓损伤者生育愿望普遍而迫切,受到经济水平、教育背景、生活环境、其他脊髓损伤者生育经历等多方面因素影响;同时发现社会对此问题关注不够、认识不足、服务缺失.建议从改善环境、提高认识、普及知识、专业培训、建立制度等方面对脊髓损伤者提供专业化服务,解决生育困难,保障生育权力.     

Using Corticomuscular and Intermuscular Coherence to Assess Cortical Contribution to Ankle Plantar Flexor Activity During Gait

The present study used coherence and directionality analyses to explore whether the motor cortex contributes to plantar flexor muscle activity during the stance phase and push-off phase during gait. Subjects walked on a treadmill, while EEG over the leg motorcortex area and EMG from the medial gastrocnemius and soleus muscles was recorded. Corticomuscular and intermuscular coherence were calculated from pair-wise recordings. Significant EEG–EMG and EMG–EMG coherence in the beta and gamma frequency bands was found throughout the stance phase with the largest coherence towards push-off. Analysis of directionality revealed that EEG activity preceded EMG activity throughout the stance phase until the time of push-off. These findings suggest that the motor cortex contributes to ankle plantar flexor muscle activity and forward propulsion during gait.     

Interlimb Coordination During Step-to-Step Transition and Gait Performance

Most energy spent in walking is due to step-to-step transitions. During this phase, the interlimb coordination assumes a crucial role to meet the demands of postural and movement control. The authors review studies that have been carried out regarding the interlimb coordination during gait, as well as the basic biomechanical and neurophysiological principles of interlimb coordination. The knowledge gathered from these studies is useful for understanding step-to-step transition during gait from a motor control perspective and for interpreting walking impairments and inefficiency related to pathologies, such as stroke. This review shows that unimpaired walking is characterized by a consistent and reciprocal interlimb influence that is supported by biomechanical models, and spinal and supraspinal mechanisms. This interlimb coordination is perturbed in subjects with stroke.     

椎体后凸成形术治疗骨质疏松性椎体压缩骨折的随访分析

对我院应用椎体后凸成形术治疗的65例骨质疏松性椎体压缩骨折患者进行平均长达2年的随访,对随访结果进行综合分析,以初步探讨椎体后凸成形术治疗骨质疏松性椎体压缩骨折的长期疗效及安全性。结果显示随访期间疗效得到很好的维持和肯定。因此认为椎体后凸成形术的长期疗效满意,安全性好,可作为骨质疏松性椎体压缩骨折的临床干预措施继续进一步的推广和应用。     

When good pain turns bad

Classically, pain is viewed as being mediated solely by neurons. However, recent research has shown that activated glial cells (astrocytes and microglia) within the spinal cord amplify pain. These nonneuronal cells play a major role in the creation and maintenance of pathological pain. Glia become activated by immune challenges (viral or bacterial infection) and by substances released by neurons within the pain pathway. Activated glia amplify pain by releasing proinflammatory cytokines. Taken together, research findings suggest a novel approach to human pain control that targets glia. In addition, it is likely that such glial-neuronal interactions are not unique to pain, but rather reflect a general rule of sensory processing.     

DNA methylation and behavioral changes induced by neonatal spinal transection

Although the importance of epigenetic mechanisms in behavioral development has been gaining attention in recent years, research has largely focused on the brain. To our knowledge, no studies to date have investigated epigenetic changes in the developing spinal cord to determine the dynamic manner in which the spinal epigenome may respond to environmental input during behavioral development. Animal studies demonstrate that spinal cord plasticity is heightened during early development, is somewhat preserved following neonatal transection, and that spinal injured animals are responsive to sensory feedback. Because epigenetic alterations have been implicated in brain plasticity and are highly responsive to experience, these alterations are promising candidates for molecular substrates of spinal plasticity as well. Thus, the current study investigated behavioral changes in the development of weight-bearing locomotion and epigenetic modifications in the spinal cord of infant rats following a neonatal low-thoracic spinal transection or sham surgery on postnatal day (P)1. Specifically, global levels of methylation and methylation status of the brain-derived neurotrophic factor (Bdnf) gene, a neurotrophin heavily involved in both CNS and behavioral plasticity, particularly in development, were examined in lumbar tissue harvested on P10 from sham and spinal-transected subjects. Behavioral results demonstrate that compared to shams, spinal-transected subjects exhibit significantly reduced partial-weight bearing hindlimb activity. Molecular data demonstrate group differences in global lumbar methylation levels as well as exon-specific group differences in Bdnf methylation. This study represents an initial step toward understanding the relationship between epigenetic mechanisms and plasticity associated with spinal cord and locomotor development.     

Synergistic influences of sensory and central stimuli on non-voluntary rhythmic arm movements

In recent years, neuromodulation of the cervical spinal circuitry has become an area of interest for investigating rhythmogenesis of the human spinal cord and interaction between cervical and lumbosacral circuitries, given the involvement of rhythmic arm muscle activity in many locomotor tasks. We have previously shown that arm muscle vibrostimulation can elicit non-voluntary upper limb oscillations in unloading body conditions. Here we investigated the excitability of the cervical spinal circuitry by applying different peripheral and central stimuli in healthy humans. The rationale for applying combined stimuli is that the efficiency of only one stimulus is generally limited. We found that low-intensity electrical stimulation of the superficial arm median nerve can evoke rhythmic arm movements. Furthermore, the movements were enhanced by additional peripheral stimuli (e.g., arm muscle vibration, head turns or passive rhythmic leg movements). Finally, low-frequency transcranial magnetic stimulation of the motor cortex significantly facilitated rhythmogenesis. The findings are discussed in the general framework of a brain-spinal interface for developing adaptive central pattern generator-modulating therapies.