Research

The aim of this study is to collect descriptive data on assistive technology (AT) used by individuals with SCI including wheelchair make, model, failures, and repairs, as well as smart-home technology use.

• All participants must be at least 1 year post-injury and have a SCI.
• Study participation consists of completion of an online survey.
• Site Principal Investigator: Elizabeth Felix, Ph.D.

Contact: Mattew DeVlieger, MS 305-243-2694.

Principal Investigator: Elizabeth Felix, Ph.D.

We are interested in studying relationships between body composition (e.g., percent body fat), chronic pain, and measures of inflammation in blood in individuals with chronic spinal cord injury.

Inclusion Criteria

• Individuals who are at least 2 years post-injury may qualify.
• Participation requires between 1 and 3 visits of between 4 and 7 hours each.

Contact: Lais Vidotto at 305-243-3860 or lxv429@miami.edu.

Principal Investigator: Elizabeth Felix, Ph.D.

The South Florida SCIMS, along with 17 other model SCI centers in the US, enrolls newly injured individuals with traumatic SCI and contributes to a national database. This database allows for the evaluation of short-term and long-term rehabilitation outcomes in persons with traumatic SCI. As of September 2019, this database included information from over 34,000 individuals, with some participants being followed for 45 years after their injury.

Contact: Katherine Martinez 305-243-3575 kxm940@miami.edu.

The aim of this study is to assess whether meeting the published physical activity guidelines for people with SCI is related to good health outcomes.

• Participants must already be enrolled in the SCI Model System database, and be at least 1 year post-injury.
• Study participation consists of completion of a ~40 minute phone interview.
• Site Principal Investigator: Elizabeth Felix, Ph.D.

Contact: Katherine Martinez 305-243-3575 kxm940@miami.edu.

We are looking for individuals who:

• Are living with SCI for greater than 1 year
• Are 18 years of age or older

This study involves:

• A one-time phone interview or online survey about physical
• activity after SCI
• The interview lasts ~30 minutes
• Compensation will be provided!

Interested?

Contact: Katherine Martinez
Email: kxm940@miami.edu
Call or Text: 786-540-4104

Schedule Interview

The aims of this study were to replicate findings that a home exercise program intervention improved shoulder pain and function and to assess changes in supraspinatus tendon pathology associated with the home exercise program in persons with chronic spinal cord injury. The study tested groups in an at-home intervention exercise program and an education-only control ground.  The at home exercise group demonstrated improvements in several of the measures of shoulder pain and function after the exercise program intervention. The education-only group showed changes in average unpleasantness after the intervention period. Significant changes in supraspinatus pathology were not detected with quantitative ultrasound metrics.

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Quantitative ultrasound (QUS) is an inexpensive and promising tool for sensitive measurement of tendon pathology. However, few studies have reported the psychometric properties of measurements obtained using this technique for assessments of the supraspinatus tendon. This study was undertaken to determine the variance contributed by several sources of error (participant, ultrasound operator, image analyst, analysis session) to QUS measures of the supraspinatus tendon. We found that the QUS measures of tendon/cartilage thickness, echogenicity, variance, and entropy may be the most promising metrics for use in studies aimed at comparing supraspinatus tendon pathology between subjects. The results suggest variability in QUS measures are higher when they are all taken by one ultrasonographer, but if various image analyst and other specialists analyze the data it can decrease measure variability. Developing valid and reliable measures for the assessment of tendon health with little variability is necessary because of the large impact on clinical decisions regarding interventions aimed at preventing injuries to the rotator cuff. Although traditional US imaging is the standard for diagnosing supraspinatus tears, QUS measures may be useful for diagnosing and tracking tendinosis to prevent the development of shoulder pain and dysfunction in individuals with SCI, who have an increased risk for developing shoulder pain. 

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The aim of this study is to compare the prevalence, intensity ratings, and interference ratings of neuropathic pain (NeuP) and nociceptive pain in people with chronic spinal cord injury (SCI). The study analyzed how pain interfered in the quality of life in individuals with SCI. This is particularly important regarding interference with activities and mostly sleep. This information will help when determining treatment strategies for meeting patient-centered outcome goals.

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The aim of this study was to assess the health consequences associated with poor diet in persons with spinal cord injuries and disorders (SCI/D). The study used a descriptive qualitative design and collected information from in-depth interviews with SCI/D health providers. Participants (n = 12) were from 11 nationwide VA hospitals. Participants were mostly male (75%) and white (67%), between 26-49 years of age, and most were dietitians (75%) and physiatrists (17%). Overall themes identified from the interviews were that several consequences are thought to be associated with poor diet in persons with SCI/D, including: (1) Weight gain and increase in body fat, (2) increased presence of cardiometabolic conditions (e.g., high blood pressure, high cholesterol), (3) bowel dysfunction, (4) increased risk for pressure injuries/wounds, (5) other SCI/D secondary conditions/complications (e.g., renal/kidney problems; immune function/susceptibility to infections; autonomic dysreflexia; bone health/osteoporosis; pain), (6) physical fatigue, and (7) poor mental health.

Efforts to identify nutrition shortcomings and to develop interventions and tailored care plans are needed to improve a myriad of health consequences due to poor diet and nutrition in persons with SCI/D.

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The prevalence of obesity and of neuropathic pain are both estimated at above 50% in the population of people with chronic spinal cord injury (SCI). These secondary consequences of SCI have significant negative impact on physical functioning, activities of daily living, and quality of life. Investigations of relationships between weight or body composition and chronic neuropathic pain in people with SCI are lacking, but investigations in non-SCI cohorts suggest an association between obesity and the presence and severity of neuropathic pain conditions. In the present article, we present a review of the literature linking obesity and neuropathic pain and summarize findings suggesting that metabolic syndrome and chronic, systemic inflammation due to excess adiposity increase the risk for neuropathic pain after an SCI.

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Persons with spinal cord injury (SCI) are at high risk for developing neurogenic obesity due to muscle paralysis and obligatory sarcopenia, sympathetic blunting, anabolic deficiency, and blunted satiety. Persons with SCI are also at high risk for shoulder, elbow, wrist, and hand injuries, including neuromusculoskeletal pathologies and nociceptive pain, as human upper extremities are poorly designed to facilitate chronic weight-bearing activities, including manual wheelchair propulsion, transfers, self-care, and day-to-day activities. This article reviews current literature on the relationship between obesity and increased body weight with upper extremity overuse injuries, detailing pathology at the shoulders, elbows, and wrists that elicit pain and functional decline and stressing the importance of weight management to preserve function.

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The aim of this study was to describe the natural history for development of carpal tunnel syndrome (CTS) in persons with traumatic spinal cord injury (SCI) during the first year after discharge from inpatient rehabilitation after their injury. Measures from ultrasound (US) imaging of the median nerve were taken at the time of discharge from initial inpatient rehabilitation and again 12 months later. Changes in these measures were compared to a group of individuals without SCI across a 12-month period as well. Participants with SCI had greater CTS symptoms at follow-up compared to participants who did not have an SCI, but we observed few differences in US measures of the median nerve between the SCI group and the non-SCI control group. In general, median nerve pathology changes (CTS symptoms and US variables) over 1 year were more common in the nondominant arm and appear to be a function of median nerve pathology at enrollment. Individuals with SCI may experience increased CTS symptoms as soon as 1 year after injury.

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The three aims of this study include describing the prevalence of cardiometabolic disease (CMD) at spinal cord injury (SCI) rehabilitation discharge; (2) compare this with controls without SCI; and (3) identify factors associated with increased CMD. Participants with SCI have significantly higher diastolic blood pressure and triglycerides than those without SCI, with lower fasting glucose and HDL-C. Individuals with SCI have an increased CMD risk compared with the general population; obesity, IR, and low HDL-C are the most common CMD risk determinants; age is significantly associated with early CMD.

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People with spinal cord injuries (SCI) are at higher risk for heart and metabolic problems, including obesity. While general guidelines recommend 150 minutes of moderate exercise per week, research suggests this might not be enough for people with SCI. This paper states that people with SCI need to exercise longer and harder than others to get the same health benefits. Specifically, if possible, they should aim for vigorous exercise (high intensity) for at least 150 minutes per week. If vigorous exercise isn't possible, they should try for 250-300 minutes per week at whatever intensity they can manage comfortably. The evidence shows that the more active they are, the better the results in reducing obesity and other health risks. The key takeaway is that current exercise guidelines might need to be updated for people with SCI to include a larger volume of activity, recommending longer and more intense physical activity to effectively manage their health risks, with the exact amount tailored to each person's abilities.

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When someone has a spinal cord injury (SCI), it doesn't just affect their ability to move - it changes how their entire body works, including how they process and store fat. Thanks to better medical care, people with SCI are living longer, but they're facing new challenges, particularly with obesity. People with SCI tend to develop a specific type of obesity, called neurogenic obesity, that's different from the general population. They gain more fat while losing muscle mass, so much so that doctors and scientists use a lower BMI threshold (22 instead of the usual 30) to diagnose obesity. This happens because the injury disrupts nerve and hormonal pathways that control important body functions like breaking down fat and processing food. What makes this particularly interesting to scientists is that studying obesity in SCI provides a unique window into understanding how our nervous system influences body weight and health. This research could help develop better treatments not just for people with SCI, but potentially for anyone dealing with obesity.

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When someone has a spinal cord injury (SCI), the chances of them developing chronic obesity and metabolic diseases such as diabetes are higher than for the general population without SCI. This is due in part to less energy expenditure (i.e., burning fewer calories) because of a decrease in muscle activity/exercise after their injury. Therefore, they tend to gain unwanted weight after SCI, which then leads to other health issues. However, this may be prevented by adopting a low-energy, nutrient-dense, anti-inflammatory diet that follows recommendations from the Dietary Guidelines for Americans. This article presents information about nutrition in people with SCI and the need for nutrition education.

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The aim of this study was to investigate whether and how physicians, therapists, and nurses educate and discuss cardiometabolic disease (CMD) risk factors with patients who have spinal cord injury (SCI). Because people with SCI are at increased risk for CMD, it is important for the health care team to discuss this with their patients. People with SCI were asked whether they had been informed by their health care providers of any risk factors they may have for CMD (including obesity, high cholesterol, high blood pressure, fasting glucose levels), and whether they had been prescribed any medications to address the CMD risks. This information was compared to actual measures of these risk factors collected by the study team. There was evidence of 197 CMD risk factors across 101 participants in the study, and patients recalled less than 12% of these having been shared with them by their health care team. Pharmacologic management was prescribed to address these risk factors only 7.2% of the time. Based on results from this study, increased education and clinician engagement are needed to best reduce CMD for people with SCI.

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The aim of this study was to assess changes in access to medical and daily living needs, as well as psychological health, before vs. during the COVID-19 pandemic. Phone surveys were conducted between August 3, 2020, and September 21, 2020, in 50 people with SCI living in the South Florida area. Of the individuals interviewed, 78% reported limited access to their regular activities, 40% to healthcare information and services, 38% to personal protective equipment (PPE), 37% to food/groceries, and 34% to medication refills. 16% of the participants had at least moderate levels of depression, and 10% had at least moderate levels of anxiety. Based on depression and resilience scores that had been collected at a time before the pandemic (within two years pre-COVID-19), we found statistically significant increases in depressive symptoms and decreases in resilience scores. Our results show increased levels of psychological distress related to decreased access to goods and services in individuals with SCI due to the COVID-19 pandemic. The results of this study can help the SCI community to target strategies for enhanced access, outreach, shared information, and social support in preparation for future community health or weather emergencies.

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