Paraplegia
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Some studies have suggested that nondisabled people follow the dictates of a 'kindness norm' when reacting to those who are disabled. Spinal cord injured substance abusers have sometimes used the kindness of others to help maintain their addictive behavior. A special unit for such substance abusers in a Veterans Affairs hospital has used group psychotherapy as one of the principal methods for moving beyond the kindness norm and challenging its patients to struggle with their substance abuse. Therapists in this group have had to become aware of the special content of denial in this population, of the role of physical problems specific to spinal cord injury, and of the need to set aside clinical issues at times in order to make on the spot responses to practical problems associated with the injury.
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This study evaluated the aerobic capacity and anaerobic threshold of national level Israeli wheelchair basketball players. Subjects were tested working on a wheelchair rolling on a motor driven treadmill and on an arm cycle ergometer. Metabolic and cardiopulmonary parameters were measured during graded maximal exercise tests. ⋯ Low correlations were obtained between peak exercise VO2 and VE measured while working on the wheelchair and those measured with arm cycle ergometer (r = 0.57 p = 0.137 and r = 0.4 p = 0.233 respectively). As athletes, subjects in the present study may be classified as having a low aerobic capacity and anaerobic threshold. It is also concluded that the ergometer type may have an important influence on test results.
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We surveyed 35 patients who had been admitted to the Hakone National Hospital with a traumatic spinal cord injury (SCI) resulting from sports accidents, from 1975 to 1991. There were 32 males and three females. Thirty-one patients (88.6%) under the age of 30 had been injured. ⋯ Paralysis at the sixth cervical level occurred in 15 cases. Regarding the mechanism of injury, impact on the ground due to misjudgment in the depth of water was the most frequent in swimming; and failure in a somersault the most frequent in gymnastics. The most important point raised in the prevention of SCI sport was education about the dangers during elementary schooling.
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Two commonly-used methods of weaning individuals with quadriplegia from mechanical ventilators were compared. The medical records were reviewed of 52 patients who were injured at the C3 or C4 levels, were ventilator dependent following their injury, and were treated at the participating facilities. ⋯ Comparing the two weaning methods, progressive ventilator-free breathing was found to be successful more often than intermittent mandatory ventilation (67.6% compared to 34.6%). In addition, progressive ventilator-free breathing appeared superior in its ability to provide a more functional alternative to individuals unable to wean completely.