New Peter Wayne, Guilcher Sara J T, Jaglal Susan B, Biering-Sørensen Fin, Noonan Vanessa K, Ho Chester
Spinal Rehabilitation Service, Department of Rehabilitation, Caulfield Hospital, Alfred Health, Caulfield, Victoria, Australia.
Epworth-Monash Rehabilitation Medicine Unit, Southern Medical School, Monash University, Victoria, Australia.
Top Spinal Cord Inj Rehabil. 2017 Fall;23(4):313-323. doi: 10.1310/sci2304-313.
Spinal cord dysfunction (SCDys) is caused by heterogeneous health conditions, and the incidence is increasing. Despite the growing interest in rehabilitation research for SCDys, research into SCDys faces many challenges. The objective of this project was to perform a clinical review of changes in SCDys research over the last 4 decades; identify challenges to conducting research in SCDys; and propose opportunities for improving research in SCDys. A triangulation approach was used for obtaining evidence: literature search (January 2017) using MEDLINE and Embase databases for publications in English (1974-2016) regarding SCDys; workshop discussions at the International Spinal Cord Society annual meeting, September 16, 2016, Vienna, Austria; and our collective expertise in SCDys clinical rehabilitation research. There has been a substantial increase in publications on SCDys over the 4 decades, from 1,825 in 1974-1983 to 11,887 in the decade 2004-2013, along with an improvement in research methodology. Numerous challenges to research in SCDys rehabilitation were grouped into the following themes: (a) identification of cases; (b) study design and data collection; and (c) funding, preclinical, and international research. Opportunities for addressing these were identified. The increase in scientific publications on SCDys highlights the importance of this heterogeneous group among the research community. The overall lack of good quality epidemiological studies regarding incidence, prevalence, and survival in these patients serves as a benchmark for guiding improvements to inform evidence-based care and policy.
脊髓功能障碍（SCDys）由多种健康状况引起，且发病率呈上升趋势。尽管对SCDys康复研究的兴趣日益浓厚，但SCDys研究仍面临诸多挑战。本项目的目的是对过去40年SCDys研究的变化进行临床综述；确定开展SCDys研究的挑战；并提出改善SCDys研究的机会。采用了三角测量法来获取证据：2017年1月使用MEDLINE和Embase数据库进行文献检索，以查找1974 - 2016年期间关于SCDys的英文出版物；2016年9月16日在奥地利维也纳举行的国际脊髓学会年会上进行研讨会讨论；以及我们在SCDys临床康复研究方面的集体专业知识。在这40年里，关于SCDys的出版物大幅增加，从1974 - 1983年的1825篇增加到2004 - 2013年这十年的11887篇，同时研究方法也有所改进。SCDys康复研究面临的众多挑战被归纳为以下几个主题：（a）病例识别；（b）研究设计和数据收集；（c）资金、临床前和国际研究。确定了应对这些挑战的机会。关于SCDys的科学出版物的增加凸显了这一异质性群体在研究界的重要性。总体而言，缺乏关于这些患者发病率、患病率和生存率的高质量流行病学研究，这为指导改进以提供循证护理和政策提供了一个基准。
