View Resource

Biblography on Spinal Cord and Assistive Technology Journals

The following is an excellent annotated bibliography on Spinal Cord Injury and Assistive Technology journals:

1. Shieh, Jeng-Hi M.D., Chen, Shee-Uan M.D., Wang, Yen-Ho M.D., Chang, Hong-Chiang M.D., Ho, Hong-Nerng M.D., Yang, Yu-Shih M.D. Ph.D. (2003). A protocol of electorejaculation and systematic assisted reproductive technology achieved high efficiency and efficacy for pregnancy for anejaculatory men with spinal cord injury. Archives of Physical Medicine and Rehabilitation, 84, 535-540. - OBJECTIVE: To help anejaculatory men with spinal cord injury (SCI) to procreate. DESIGN: Prospective, clinical study. SETTING: A team of physiatrists, urologists, and gynecologists at a university hospital in Taiwan. PARTICIPANTS: Ten infertile men with SCI seen at our hospital between 1995 and 2001. INTERVENTIONS: Electroejaculation induced their seminal emission. Depending on semen parameters, the couples were treated with intrauterine insemination (IUI), intracytoplasmic sperm injection (ICSI), surgical retrieval of sperm, cryopreservation of sperm, or donor sperm. MAIN OUTCOME MEASUREMENTS: Fertilization and pregnancy. RESULTS: Ten couples underwent assisted reproductive technology (ART). One couple achieved pregnancy after the second cycle of electroejaculation and IUI. Seven couples underwent 8 cycles of ICSI, 4 cycles with fresh electroejaculates, 2 with cryopreserved samples, and 2 with cryopreserved sample with addition of pentoxifylline. Seven (88%) clinical pregnancies were achieved, 2 of which ended with spontaneous abortion. One couple accomplished pregnancy by ICSI with cryopreserved sperm from vasal aspiration. The percentages of fertilization and pregnancy of ICSI cycles using sperm from men with SCI were comparable to men without SCI. One couple attained pregnancy by using donor sperm. The cumulative successful pregnancy rate per couple was 80% (8/10). CONCLUSION: Electroejaculation and systematic ART are highly efficient for achieving pregnancy with the spouses of men with SCI. The neurologic deficit and electroejaculatory did not affect the outcome of ICSI. Using cryopreserved sperm for ICSI may reduce risk from electroejaculation or surgery.

2. Kittel, Alison, Di Marco, Allie & Stewart, Hugh. (2002). Factors influencing the decision to abandon manual wheelchairs for three individuals with a spinal cord injury. Disability and Rehabilitation, 24 (1/2/3), 106-114. - PURPOSE: This study was conducted to identify factors which influence individuals with a spinal cord injury to abandon their first wheelchair before five years of use. It aims to provide prescribing therapists and manufacturers with insights which may assist in facilitating better outcomes for wheelchair users, Thereby reducing abandonment rates and containing replacement costs. METHOD: A descriptive, qualitative design was used to gather the perceptions of three individuals with a spinal cord injury. RESULTS: Thematic analysis yielded five themes: "Participants" experience of the first prescription"; "The physical issues with the wheelchair have functional implications"; "Gaining experience is so important"; "Participants" experience of the second prescription"; and "Participants" suggestions". CONCLUSIONS: Factors influencing manual wheelchair abandonment for these participants were consistent with findings from the literature concerning dissatisfaction and abandonment of assistive technology. For these three individuals the lack of experience in wheelchair use and selection, the functional limitations encountered with the design of the wheelchair and the manner and timing of the prescription process combined to lead to dissatisfaction and ultimately abandonment. Suggestions for changes to wheelchair prescription practices were made.

3. Scherer, Marcia & Cushman, Laura. (2001). Measuring subjective quality of life following spinal cord injury: a validation study of the assistive technology device predisposition assessment. Disability and Rehabilitation, 23 (9), 387-393. - PURPOSE: Assesses the validity of a subset of items of the Assistive Technology Device Predisposition Assessment (ATDPA) as a measure of quality of life (QOL) for persons with new spinal cord injury. METHOD: Subjects completed the ATD PA QOL subset, Satisfaction with Life Scale (SWLS), and Brief Symptom Inventory (BSI) while in acute rehabilitation. The internal reliability of the QOL subset of the ATD PA was assessed. Concurrent validity with the BSI depression subscale was assessed using Spearman correlations. Subjects were recruited while acute rehabilitation inpatients in a general hospital and consisted of twenty persons with newly acquired SCI (10 males and 10 females). RESULTS: Significant positive correlations between the ATD PA's QOL subset and SWLS (and significant negative correlations with the BSI depression subscale) suggest the QOL subset has concurrent and construct validity. CONCLUSIONS: The ATD PA's QOL subset appears to be a valid measure and, thus, it can be useful both in identifying subjective quality of life and predispositions to AT use early in rehabilitation.

4. Blair, Martin, MS. Assistive technology: what and how for persons with spinal cord injury. SCI Nursing, 17 (3), 110-118. - Assistive Technology (AT) is used to "increase, maintain or improve functional capabilities." (Assistive Technology Act of 1998). This term includes durable medical equipment and rehabilitation technology. More limited definitions of AT sometimes do not consider the broad life areas encountered by people with disabilities. To appropriately assess AT needs, the following questions should be considered: a) what does the patient want to do; b) what are the patient's abilities; and c) what technological features need to be included or provided to enhance the patient's abilities? Each question should be considered in the life areas of home, school, community, and vocation. Agencies and organizations that provide AT information include Assistive Technology Act of 1998 programs in each state and territory, vendors, and local county governments. The overall goal of AT is to help an individual meet independence goals in various life areas affected by disability.

5. Minkel, Jean. (2000). Seating and mobility considerations for people with spinal cord injury. Physical Therapy, 80 (7), 701. - For people with spinal cord injuries, the selection of a wheelchair and seating system involves many factors. This client's perspective describes a model that includes consideration of the person, the wheelchair, the immediate environment of the person and the wheelchair, the intermediate environment of the home and work, and the community environment. The seated posture is examined biomechanically, and the literature is reviewed that highlights the differences in the seated posture of people with spinal cord injuries and people without spinal cord injuries. Reports regarding overuse injuries of the shoulders and wrists are discussed along with methods of relieving pressure at the buttock and seat interface. The impact that researchers findings should have on current clinical practice and the need for more research to provide evidence to either support or change current practice are discussed.

6. Nyland, J., Quigley, P., Huang, C., Lloyd, J., Harrow, J. & Nelson, A. (2000). Preserving transfer independence among individuals with spinal cord injury. Spinal Cord, 38, 649-657. - STUDY DESIGN: Literature review. OBJECTIVES: Upper extremity (UE) joint degeneration, particularly at the shoulder, detrimentally influences functional independence, quality of life, cardiovascular disease risk, and life expectancy of individuals following spinal cord injury (SCI). This review (1) describes UE use for transfers among individuals with SCI; (2) describes contributing factors associated with UE joint degeneration and loss of transfer independence; (3) summarizes and identifies gaps in existing research; and (4) provides suggestions for future research. RESULTS: Investigations of wheelchair transfer related UE joint and function preservation among individuals with SCI should consider factors including age and length of time from SCI onset, interface between subject-wheelchair, pain, shoulder joint range of motion (ROM) and muscle strength deficiencies or imbalances, exercise capacity and tolerance for the physical strain of activities of daily living (ADL), body mass and composition, previous UE injury or disease history, and transfer techniques. Existing studies of transfers among individuals with SCI have relied on small groups of either asymptomatic or non-impaired subjects, with minimal integration of kinematic, kinetic and electromyographic data. Descriptions of UE joint ROM, forces, and moments produced during transfers are lacking. CONCLUSIONS: Biomechanical measurement and computer modeling have provided increasingly accurate tools for acquiring the data needed to guide intervention planning to prevent UE joint degeneration and preserve function among individuals with SCI. The identification of stressful sub-components during transfers will enable intervening clinicians and engineers who design and modify assistive and adaptive devices to better serve individuals with SCI.

7. Scherer, Marcia & Cushman, Laura. (2000). Predicting satisfaction with assistive technology for a sample of adults with new spinal cord injuries. Psychological Reports, 87, 981-987. - To assess the validity of the Assistive Technology Device Predisposition Assessment-Consumer Form for persons with a new spinal cord injury, 10 men and 10 women completed the scale and the Satisfaction with Life Scale and the Brief Symptom Inventory while in acute rehabilitation. One month post-discharge, subjects completed the Perceived Needs Inventory and rated their satisfaction with assistive technology. Significant positive correlations between items of the Assistive Technology Device Predisposition Assessment and Satisfaction with Life Scale (and their significant negative correlations with scores on the Brief Symptom Inventory-Depression) suggest the selected Assistive Technology Device Predisposition Assessment items measure quality of life (concurrent validity). Only Assistive Technology Device Predisposition Assessment scores predicted satisfied use 1-mo. post-discharge as measured by the Perceived Needs Inventory.

8. Melis, E., Torres-Moreno, R., Barbeau, H. & Lemaire, E. (1999). Analysis of assisted-gait characteristics in persons with incomplete spinal cord injury. Spinal Cord, 37, 430-439. - Ambulatory assistive device use can improve functional independence following spinal cord injury and, potentially, quality of life. However, the interaction between aids and user in this population is poorly understood. OBJECTIVES: To determine the influence of walkers, crutches and canes on assisted-gait following incomplete spinal cord injury. STUDY DESIGN/ METHODS: Outcome parameters evaluated in ten individuals included orthogonal forces exerted on instrumental assistive devices, walking speed, cadence, step length, trunk and thigh angles, as well as knee and ankle joint angles. Kinetic data included axial compressive force, and medio/ lateral and antero/ posterior bending forces. SETTING: Canada. RESULTS: Results indicated that walkers (n=5) provided the greatest vertical support (up to 100% body weight), but resulted in slow gait with a forward flexed posture. Elbow crutch users (n=3) walked faster (greater step length and cadence) and had a more upright posture than walker users. Crutches supported up to 50% of the subject's body weight, granted lateral stability and provided restraint in the antero/ posterior direction. Canes (n=2) offered restraining and propulsive assistance, some lateral stability, and the least amount of vertical support. CONCLUSION: Ambulatory devices affected posture and walking speed while fulfilling various assistive functions during locomotion. The conclusion drawn is that rehabilitation specialists are advised to match device characteristics to user needs when prescribing walking aids.

9. Sandford, Paul M.D., Falk-Palec, Deborah & Spears, Katrina. (1999). Return to school after spinal cord injury. Archives of Physical Medicine and Rehabilitation, 80, 885-888. - OBJECTIVE: To determine the typical time elapsed between discharge from and inpatient spinal cord injury (SCI) rehabilitation program and the physical return to school, and to identify barriers faced by patients attempting to return to school. STUDY DESIGN: A retrospective view of all patients ages 18 years or younger who sustained SCI between 1989 and 1995, primary or secondary school, completed their inpatient rehabilitation at our regional SCI center, and were using a wheelchair when discharged from the hospital. RESULTS: Fifteen of 16 eligible patients agreed to participate. The median time for subjects with paraplegia to return to school after hospital discharge was 10 days; subjects with tetraplegia required a median of 62 days. Architectural and transportation barriers that patients encountered were identified. CONCLUSION: Individuals with SCI return to school relatively soon after discharge from the hospital. Barriers do not prohibit a return to school, but they are problematic.

10. Thompson, Lilli PT (1999). Functional changes in persons aging with spinal cord injury. Assistive Technology, 11, 123-129. - Declines in general physical function and the effect of these changes on activities of daily living and needs for assistance were assessed in 150 individuals with spinal cord injury (SCI). The sample consisted of outpatients returning for follow-up at the spinal cord injury clinic at Rancho Los Amigos National Rehabilitation Center in Downey, CA. The average duration of injury of the sample was 13 years (range 1-37), and average age was 38 years (range 18-64). Twenty-four percent of those sampled experienced a decline or change in their physical function within the last 5 years. Individuals experiencing declines were significantly older than those without changes, averaging 45 years versus 36 years. The group with change also had a longer duration of injury, averaging 18 years versus 11 years compared to the group reporting no declines. Fatigue was the most frequently reported problem, followed by pain and weakness. Over half of the group with changes required additional assistance with activities of daily living (ADLs). Family members were the primary helpers for both ADLs and instrumental activities of daily living (IADLs) for those persons experiencing changes. The use of assistive technology, primarily equipment for bathing, toileting and low technology devices, increased with time. The increased vulnerability to loss of function in persons with advancing age and duration of injury in this population with SCI suggests the need for early preventative measures, routine assessments to detect changes, and access to health care and supportive services to alleviate or minimize the effects of these changes.

11. Krause, J. (1998). Changes in adjustment after spinal cord injury: A 20-year longitudinal study. Rehabilitation Psychology, 43 (1), 41-45. - This study assessed the stability of multiple aspects of adaptation after spinal cord injury (SCI). One hundred fourteen participants with SCI completed the Life Situation Questionnaire on 4 separate occasions over a 20-year interval. Changes in the outcomes over time were measured. Time engaged in employment activities, sitting tolerance, and number of years of education increased, and the number of hospitalizations and total days hospitalized decreased. However, self-rated adjustment decreased over the same time period. The results indicate a divergence between changes in objective and subjective aspects of life over the more positive about their lives than they did 20 years prior, despite an increase in employment opportunities and a decrease in hospitalizations.

12. Pell, Stephen, Gillies, Robyn, Gillies & Carss, Marjorie. (1997). Relationship between use of technology and employment rates for people with physical disabilities in Australia: implications for education and training programmes. Disability and Rehabilitation, 19 (8), 332-338. - This study examined the impact of computer and assistive device use on the employment status and vocational modes people with physical disabilities in Australia. A survey was distributed to people over 15 year in age with physical disabilities living in the Brisbane area. Responses were received from 82 people, including those with spinal cord injuries, cerebral palsy and muscular dystrophy. Of respondents, 46 were employed, 22 were unemployed, and 12 were either students or undertaking voluntary work. Three-quarters of respondents used a computer in their occupations, while 15 used assistive devices. Using logistic regression analysis it was found that gender, education, level of computer skill and computer training were significant predictors of employment outcomes. Neither the age of respondent nor use of assistive software ere significant predictors. From information obtained in this study guidelines for a training program designed to maximize the employability of people with physical disabilities were developed.

13. Bain, Beverly, Block, Linda & Strehlow, Anja. (1996). Survey report on the assessment of individuals with spinal cord injuries for assistive technology. Technology and Disability, 5, 289-294. - The purpose of this paper is to identify the current assessment process used by rehabilitation teams in the area of assistive technology for individuals with spinal cord injuries (SCI). Through the use of technology, many individuals with SCI have been able to reach higher levels of independent functioning than ever before possible, including independent living and employment. Many individuals with SCI have a great need for adapted equipment and assistive devices. This paper will suggest recommended areas of assessment for assistive technology, based on both a review of the literature and the results of current research. It is the intent of the authors that the suggestions will be applicable generally and are not limited to individuals with spinal cord injuries.

14. Bell, Paulett & Hinojosa, Jim Ph.D. (1995). Perception of the impact of assistive devices on daily life of three individuals with quadriplegia. Assistive Technology, 7 (2), 87-94. - This qualitative study investigated the perceptions of three men with spinal cord injuries regarding the impact of assistive devices on their daily lives. Data were collected through open-ended face-to-face interviews and observations in the participants' homes. Thematic analysis yielded three recurrent themes: "getting out," "what do I do with all this time," and "I found an easier way." Concerns relating to personal freedom choice, independence, and feelings regarding usefulness and control over daily lives were evident as main issues underlying the three themes. Assistive devices perceived as "advantageous" were simple, appropriate for use in the home, and easy to use in the home. Devices perceived as "complex" were abandoned or modified.

15. Kincaid, Charles & Marge Michael. (1995). Assistive technology and the prevention of secondary disabling conditions among persons with spinal cord injury. Journal of Applied Rehabilitation Counseling, 26 (4), 11-16. - Individuals with spinal cord injury have a high probability of developing secondary disabling conditions. A number of prevention strategies have been implemented. The article explores the application of assistive technology as a method to prevent secondary health conditions from bladder and urinary tract infections, pressure sores, respiratory tract diseases, cardiovascular disorders, neuromuscoloskeletal disorders, psychosocial disorders and to improve quality of life. Recommendations for developing secondary prevention plans in the context of the rehabilitation process are recommended.

16. McColl, M. Ph.D. & Rosenthal, C. Ph.D. (1994). A model of resource needs of aging spinal cord injured men. Paraplegia, 32, 261-270. - It has always been understood that those deal effectively with a disability call upon special resources that members of the able bodied population are not aging outcomes is as yet only superficially understood. The present study provides further information and clarification about the resources needed for aging with a spinal cord injury. The sample consists of 70 individuals who have had a spinal cord injury for at least 15 years, and who are currently over the age of 45, and are therefore either anticipating or experiencing aging. Data from the sample ere examined to produce a model of resources empirically associated with positive outcomes in aging. Emotional support was found to be positively related to the outcomes of life satisfaction, adjustment to disability and the absence of depressive symptomatology. Further, health concerns, financial finding send a clear message to rehabilitation and community service providers to be watchful of survivors with limited social support, concerns about their health and an apparent lack of financial resources. The findings underline the need for better access to health services, and improved knowledge and attitudes of community health care providers working with older disabled individuals.

17. Bates, Pearl, Spencer, Young, Mary, Rintala, Diana. (1993). Assistive technology and the newly disabled adult: adaptation to wheelchair use. American Journal of Occupational Therapy, 47 (11), 1014-1021. - A naturalistic, ethnographic, phenomenological study of adaptation to wheelchair use was conducted with one key informant, a 30-year old white man with acquired paraplegia who was undergoing acute rehabilitation. Primary staff members served as additional informants. It was found that adaptation to wheelchair use had both pragmatic and emotional components. The latter appeared in alternating phases of resistance and neutrality or d├ętente. Therapist and patient had conflicting goals relative to wheelchair use, which occasioned considerable friction. The patient's initial attitudes regarding wheelchairs were prejudicial, which hampered his ability to see the chair as a useful tool for mobility and independence. Successful pragmatic adaptation binged in part on emotional acceptance of the wheelchair.

18. Gerhart, Kenneth, Bergstrom, Ebba, Charlifue, Susan, Menter, Robert M.D., Whiteneck, Gale Ph.D. (1993). Long-term spinal cord injury: functional changes over time. Archives of Physical Medicine and Rehabilitation, 74, 1030-1034. - Functional changes were assessed in a group of 279 individuals with long-term spinal cord injuries. All had sustained their initial injuries 20 to 47 years ago and all had received initial and post-injury follow-up care at one of two British spinal cord injury treatment centers. Twenty-two percent reported that the need for physical assistance from others had increased over the years. Most (45%) needed additional help with transfers; others needed more assistance with dressing, mobility, and toileting. When compared to those whose need for help had not increased, significant differences were found by age: as a group, and when separated by level and severity of injury, those needing more help were older, and those with cervical injuries needed help at younger ages than their counterparts with lower level injuries. Those needing more help also had significantly more reports of shoulder pain, fatigue and weakness, weight gain, and postural changes. They used more attendant care, and perceived their quality of life to be lower than those whose level of function had not changed over time.

19. Platts, R., Fraser, M. (1993). Assistive technology in the rehabilitation of patients with high spinal cord lesions. Paraplegia, 31, 280-287. - The functional requirements for daily living at home are the same for a ventilator dependent quadriplegic person as they are for anyone, whether less severely disabled or able bodied. In persons with high spinal cord lesions, the necessary presence of a carer near to hand should not deter the use of assistive technology to increase independence. Maximized independence is desirable to free the carer from minute by minute tasks such as turning pages, switching lights, TV etc. This not only frees the carer for tasks, making the caring task more bearable (and thus easier to recruit carers) but also vastly improves the morale of the disabled person. Some assistive devices, especially those concerned with mobility and transfer can avoid the need for multiple carers at times such as toileting and going on car journeys. Whichever devices are required by the quadriplegic person, they all clearly need to be worked by a common, carefully selected input interface device matched to his or her preferences and physical abilities for switching. It is vital to ensure a technical integration of the four generic areas of device functionality: those of mobility (wheelchairs, cars), manipulation (page-turners, robotic arms), communication (keyboard emulators, voice processors, artificial speech) and control of the environment. In most countries this integration is poorly addressed owing to the different agencies involved in the provision of devices relating to each of these generic areas - despite the technology being available today. The Keep Able Foundation has developed a semi-modular approach (ability trolleys) which can provide a number of different combination of control methods and of devices to control, integrated across the four generic areas.

20. Garber, Susan, Gregorio, Theresa. (1990). Upper extremity assistive devices: assessment of use by spinal cord-injured patients with quadriplegia. The American Journal of Occupational Therapy, 44 (2), 126-131. - Upper extremity assistive devices prescribed during the rehabilitation of the patient with quadriplegia often are discarded once the patient leaves the hospital. Therefore, we conducted this study to investigate patterns of the prescription and use of such devices and satisfaction with them. An oral questionnaire was administered to 56 spinal cord-injured quadriplegic patients 1 and 2 years after their first rehabilitation experience. Although the patients had discarded 46% of the devices within the 1st year, most of these devices were inexpensive commercially available devices or devices made by occupational therapists. The respondents' most frequently cited reasons for discarding a device were improved physical function" and "alternative solutions found." The devices retained in use most often were the more costly orthotics such as reciprocal orthoses and ball-bearing feeders. Sixty-four percent of the devices used within the 1st year were still being used at the end of the 2nd year. Thirty-five percent of all devices prescribed during rehabilitation were still used at the end of 2 years. The results of this study have heightened therapists' awareness of the efficacy and use of upper extremity assistive devices and have enabled them to eliminate some devices, to modify methods of instructing patients in the use of devices, and to develop alternative products.