Spinal cord injury

Top 10 priorities

1. Does activity based rehabilitation, including functional electrical stimulation coupled with physical activity and hydrotherapy, improve outcomes such as muscle function and neuroplasticity after spinal cord injury?
2. Does stem cell therapy result in better outcomes after spinal cord injury and does this depend on the type of injury (e.g. acute or chronic; complete or incomplete)?
3. Does the provision of care packages in the community, including physiotherapy, after discharge from hospital improve the health and wellbeing of people living with spinal cord injury?
4. Which bladder management strategy is most effective in reducing the number of urinary tract infections and secondary complications that may result from these after spinal cord injury?
5. Does early mobilisation or a period of 4-6 weeks of physically active bed rest result in improved patient outcomes after surgical spinal column stabilisation?
6. Does discharge from a hospital to a physically enabling environment, including people and facilities which enable a person to become physically active, improve the quality of life of spinal cord injury patients?
7. Does the provision of specialist rehabilitation services, which includes multidisciplinary team planning, improve the health and wellbeing of spinal cord injury patients?
8. Do interventions including controlled fibre and fluid intake after spinal cord injury improve individuals' bowel function and quality of life?
9. What are the effects of ageing after spinal cord injury on the development of complications, including spasticity and bladder and bowel incontinence, and need for home-based support?
10. Does early diagnosis and treatment lead to improved outcomes for people with (a) cauda equina syndrome and (b) transverse myelitis (including relapses)?

The following questions were also discussed and put in order of priority at the workshop:

11. Does chondroitinase administration after spinal cord injury result in improved repair or recovery outcomes, including improved muscle function and sensation?
12. Do allied health therapies, which include physiotherapy and occupational therapy, provided early or later following spinal cord injury improve outcomes such as quality of life?
13. Are compensatory techniques or techniques based on neuroplasticity more effective in improving health and wellbeing outcomes following spinal cord injury?
14. What is the optimum amount of time spent per day for occupational therapy, physiotherapy and patient education for optimal outcomes after spinal cord injury?
15. Does physiotherapy after spinal cord injury improve functional outcomes, including neuroplasticity?
16. Does the timing in which corticosteroids are administered following a spinal cord injury have an effect on outcomes and recovery?
17. Are baclofen or gabapentin in comparison to other drug treatments more effective in reducing spasticity and stiffening of limbs (after spinal cord injury)?
18. What effect does age at the onset of spinal cord injury have on the occurrence of complications that arise later in life and does this depend on the type of injury (e.g. tetraplegia or paraplegia)?
19. Which wheelchair cushions are most effective in prevention of pressure ulcers in wheelchair users?
20. What are the long-term effects on internal organs for those who cannot stand?
21. Is a magnetic resonance imaging (MRI) scan the most accurate method in detecting transverse myelitis compared to other methods of detection?
22. What is the psychological impact of ageing in spinal cord injured patients who have decreasing mobility?