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1 Introduction
Pages 13-29

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From page 13...
... This report highlights the current status of spinal cord injury research, examines the research and infrastructure needs, and provides recommendations for advancing and accelerating progress in the treatment of spinal cord injuries. The ancient Egyptians declared spinal cord injury as a condition "not to be treated." Early efforts to treat spinal cord injuries began to be developed by the Greek physician Hippocrates, who constructed several rudimentary forms of traction using a board or ladder to immobilize the patient's back (Eltorai, 2002)
From page 14...
... On the basis of reports to the National Spinal Cord Injury Statistical Center (NSCISC) , the major causes of spinal cord injuries in the United States are motor vehicle crashes and traffic accidents (50.4 percent)
From page 15...
... Caucasian 76.8 62.2 African American 14.9 23.7 Hispanic 6.2 10.9 Asian American 0.8 2.2 Native American 1.3 0.3 Other Race 0.0 0.7 NOTE: The NSCISC database includes data from an estimated 13 percent of new spinal cord injury cases in the United States. As of July 2004, the database contained information on 22,992 individuals who had sustained traumatic spinal cord injuries.
From page 16...
... 16 clear to assist assist assist equipment assist total total total assist to to to with 6 total endurance require to Cervical Low May secretions · · Independent Some Independent Independent Independent Independent eating setup, assist with for 5 secretions endurance require assist assist assist assist assist clear independent equipment Cervical Low May to · · Total Total Some Total Independent equipment Total then with Injury Cord be breathe to may with Spinal 4 able ventilator of be assist assist assist assist assist; assist Cervical May without Total Total Total Total Total independent equipment Total Level by be Living, dependent may with to Injury 1-3 secretions of assist assist assist assist assist; assist Daily of Ventilator Inability clear Level Cervical · · Total Total Total Total Total independent equipment Total Activities and 1-2 of control wheelchair relief control Living mobility and TABLE Activities Daily Respiratory control Bowel Bladder Bed Bed transfers Pressure positioning Eating
From page 17...
... 17 total to Continued independent assist independent assist hours/day to 4 total total independent extremity: to extremity: body: to extremity: independent care: assist assist care: Lower some Upper independent Lower some Upper Manual: assist Power: hours/day · · Some · · · · Total Independent Independent Home Personal 6 some assist hours/day to to 6 independent assist extremity: extremity: total independent care: assist assist to assist assist assist care: some hours/day Lower total Upper some Manual: to Power: · · Some Total · · Total Independent assist Total independent Home Personal 10 assist to total independent care assist assist assist assist assist assist Manual: Power: Total Total Total · · Total Total independent Total 24-hour assist to total independent care assist assist assist equipment assist assist assist Manual: Power: with Total Total Total · · Total Total independent Total 24-hour propulsion assistance and of Dressing Grooming Bathing Wheelchair Standing ambulation Communication Transportation Amount required
From page 18...
... 18 5 2-Sacral function Lumbar Intact Independent Independent Independent Independent Independent Independent Independent 1 10-Lumbar function Thoracic Intact Independent Independent Independent Independent Independent Independent Independent 1-9 endurance Thoracic Low Independent Independent Independent Independent Independent Independent Independent some assist assist to to to secretions independent Injury 7-8 total extremity: endurance require to extremity: of to assist assist assist clear Low May to Lower assist Upper independent Level Cervical · · Some Independent some Independent some Independent some Independent Independent · · Continued and control 1-2 of control wheelchair relief control Living mobility and TABLE Activities Daily Respiratory Bowel Bladder Bed Bed transfers Pressure positioning Eating Dressing
From page 19...
... 19 hour/day Independent Independent Independent Independent Independent Independent Homemaking: 0-1 Publishing. Medical Demos hours/day by Independent Independent Independent Independent Independent Independent Homemaking: 2 2002 Copyright 2002.
From page 20...
... Individuals with spinal cord injuries also incur significant costs for home and vehicle modifications, equipment purchase, medications, and personal assistance services (Table 1-4) , with an estimate of $244,000 for each individual's first-year medical and home modification costs (Berkowitz et al., 1998)
From page 21...
... 67.83 Wheelchairs 235.60 Personal assistance 2,068.10 Total annual costs 4,548.42 Indirect Costs 2,591.11 Total Costs 9,727.68 SOURCE: Reprinted with permission, from Berkowitz et al., 1998. Copyright 1998 by Demos Medical Publishing.
From page 22...
... To have limited or no ability to walk, pick up a coffee cup, or write with a pencil or pen and to face daily routines that take many times longer than before the injury are a fraction of the hardships and challenges that individuals living with spinal cord injuries continually encounter. With tenacity, creativity, and compassion, these challenges have been and continue to be overcome by individuals living with spinal cord injuries and their families.
From page 23...
... Once the patient is stabilized, there are opportunities for a range of therapeutic interventions to improve or restore the lost function. Developing acute and chronic care interventions is the challenge facing the spinal cord injury research community.
From page 24...
... By setting forth a set of goals for spinal cord injury research, the committee wishes to emphasize the different stages of the injury during which interventions are needed and the multiple health impairments that affect an individual's daily quality of life and that require the development of effective therapeutic interventions (Figure 1-1)
From page 25...
... Other recent advances -- including the ongoing elucidation of the biological blockers and promoters of nerve regeneration -- have continued to accelerate research progress and move research closer toward clinical therapies · Emergency medical treatment. Emergency care for individuals with spinal cord injuries has only recently reached a point at which rapid response, standardized protocols for the immobilization and treatment of neck injuries, and the training of emergency medical technicians have led to increased survival rates and decreases in the number of complete spinal cord injuries.
From page 26...
... SCOPE AND ORGANIZATION OF THIS REPORT In 1998 the state of New York established the New York State Spinal Cord Injury Research Trust to focus on funding and coordinating research on therapeutic interventions for spinal cord injuries (see Chapter 8)
From page 27...
... The committee will provide recommendations that consider the distinctive contribution that can be made by New York's Spinal Cord Injury Research Board and Trust Fund to complement the efforts of other state, federal, and private supporters of research aimed at stimulating the search for cures for spinal cord injuries. individuals with spinal cord injuries, advocates, policy makers, researchers, and clinicians, the report provides both broad overviews of the issues as well as specific details on the science of spinal cord injury.
From page 28...
... In Chapter 7, the committee examines the research infrastructure and proposes recommendations for accelerating progress in spinal cord injury research. Chapter 8 highlights the state programs in spinal cord injury research and provides recommendations to the New York State Spinal Cord Injury Research Board, the sponsor of this study.
From page 29...
... . NSCISC (National Spinal Cord Injury Statistical Center)


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