This issue, which wraps up 41 years of consecutive publication for the Journal of Spinal Cord Medicine (JSCM), contains a range of topics that reflect new avenues of research and extensions of longstanding areas of interest to professionals involved in the care and research of individuals with injuries and dysfunction of the spinal cord.
Fundamental to our global progress in clinical research is adherence to the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI). Experts expand our understanding of this important tool in ‘Challenging questions regarding the International Standards’ by Drs. Solinsky and Kirshblum, based on nine frequently asked questions by SCI professionals. In a related article, Andrade and Soares, colleagues from Portugal, emphasize the importance of testing the integrity of the sacral segments as part of the neurological examination, and present four cases in which this additional testing provided conclusive evidence for the underlying cause of bladder dysfunction.
The dual diagnosis of brain and spinal cord damage has emerged as an important issue, given that each injury can reciprocally affect rehabilitation outcomes, health behavior and quality of life. The findings of experts at Baylor University suggest that a greater focus must be placed on cognitive assessment in newly injured individuals in order to see improvements. There is also an uptick in interest in vocational rehabilitation among researchers, who are achieving some success with multi-faceted approaches. Along those lines, Dorstyn et al piloted the online program ‘Work and SCI’, a 4-week e-mail-based information package, among job seekers in Australia, and determined that improving participation and engagement would require added supports.
The consequences of secondary complications remain a focus of investigation, with authors addressing the impact of urological complications, fractures, respiratory dysfunction, and hormonal deficits. Stampas et al, for example, explore how intercurrent urinary tract infections compromise rehabilitation outcomes. This retrospective study cannot cast light on causality or pathomechanism, but it is important to note that infections of any type can upregulate cytokines that interfere with recovery of neural function. A review by VA researchers highlights hypogonadism, an underrecognized secondary complication of SCI, which adversely affects body composition, bone mineral density, sexual function, mood, erythropoiesis, cognition and quality of life. Weighing the risks and benefits of testosterone replacement therapy may play a role in the long-term care of men with SCI, but the risks and benefits must be carefully weighed.
We remind you that members of the Academy of SCI Professionals receive access to JSCM as a member benefit, including our decades of archived content, as well as our ‘latest articles’ – articles that have been published online in advance of print publication. Each new article is announced via Twitter @JSpinalCordMed, and posted on JSCM’s Facebook page.
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