RESUMEN
BACKGROUND: The prevalence of obesity is increasing in the United States. A common concern among health care providers is that prescribing a power mobility device (PMD) may decrease physical activity and lead to obesity and increasing morbidity. This study analyzes the effect of PMD prescriptions over a 2-year period on body mass index (BMI) and body weight in a population of veterans both as a whole and in BMI/age subgroups. METHODS: Prosthetics department medical records of veterans who received PMDs for the first time between January 1, 2011 and June 30, 2012 were reviewed. Of 399 records reviewed, 185 veterans met criteria for data analysis. The primary outcome measure was the change in BMI and body weight from time 1 (date of PMD prescription) to time 2 (2 years later). RESULTS: There was a significant decrease in BMI and weight in the first 2 years after receiving a PMD prescription. However, age moderated the relationship between BMI and time. CONCLUSIONS: PMD use does not seem to be associated with significant weight change. Further studies using control groups and assessing comorbidities are needed.
RESUMEN
INTRODUCTION: Dual lesion spinal cord injury (SCI) is the presence of two distinct regions of injury to the spinal cord, which can occur simultaneously or as a sequela of initial injury. Dual lesion SCI appears to be a rather rare occurrence with a paucity of cases described. As such, there is limited information available regarding presentation, evaluation, long-term rehabilitation management, and prognostication of these patients. CASE PRESENTATION: Presented is a case of a 25-year-old woman with a gunshot wound injury to the T5 vertebra with associated cord damage, initially classified as T6 ASIA Impairment Scale (AIS) B. A subsequent cervical spinal stroke, in the setting of cord edema, resulted in a motor incomplete cervical SCI. As such, she underwent additional functional decline. DISCUSSION: Patients with dual lesion SCI present with unique challenges in evaluation and management. This case highlights key factors for the acute care and rehabilitation teams to consider when addressing these challenges.