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M - Cardiovascular Integrity

REPORT CARD: Cardiovascular Integrity KNOWLEDGE GENERATION CLINICAL APPLICATION POLICY CHANGE Innovaon/Discovery Integrave Care Environmental Shi Emerging Evidence Outcome Measures Resource Capacity Take Home Mesage: The prevention and rehabilitation of CVD, for individuals with SCI, is a major challenge due to the complexities of the added risk factors that SCI brings. The field is moving forward with SCI-specific research, but the practice, prevention and policy development lags behind. The immediate adoption of existing protocols for OH and AD testing, in all SCI rehabilitation sites, should be mandatory. The “customization” of care in cardiometabolic syndrome after spinal cord injury that has been suggested by Nash et al is embraced.9 A well-constructed, integrated approach (including the creation of a national, interprofessional SCI CVD Working Group to deliver a strategic plan for the management of CVD, utilizing a concerted research-to-practice approach), is obligatory, if CVD-related morbidity and mortality, among Canadians with SCI, are to be reduced. Resources Effecve Pracce (Evidence and Outcomes) Equity Pracce Capacity Change Agents Societal Awareness Community Capacity 2020 PRIORITY 3 2020 PRIORITY 1 2020 PRIORITY 2 1. Bauman WA, Spungen AM. Coronary heart disease in individuals with spinal cord injury: assessment of risk factors. Spinal Cord. 2008;46(7):466-76. 2. Myers J, Lee M, Kiratli J. Cardiovascular disease in spinal cord injury: an overview of prevalence, risk, evaluation, and management. Am J Phys Med Rehabil. 2007;86(2):142-52. 3. Warburton DER, Sproule S, Krassioukov A, Eng JJ. Cardiovascular health and exercise following spinal cord injury. In: Eng JJ, Teasell RW, Miller WC, et al., eds. Spinal Cord Injury Rehabilitation Evidence. Version 4.0. Vancouver, BC; 2012:1-43.  4. Krassioukov A, Blackmer J, Teasell RW, Eng JJ. Autonomic dysreflexia following spinal cord injury. In: Eng JJ, Teasell RW, Miller WC, et al., eds. Spinal Cord Injury Rehabilitation Evidence. Version 4.0. Vancouver, BC; 2012:1-31. 5. Krassioukov A, Wecht JM, Teasell RW, Eng JJ. Orthostatic hypotension following spinal cord injury. In: Eng JJ, Teasell RW, Miller WC, et al., eds. Spinal Cord Injury Rehabilitation Evidence. Version 4.0. Vancouver, BC;2012:1-21. 6. Sampson EE, Burnham RS, Andrews BJ. Functional electrical stimulation effect on orthostatic hypotension after spinal cord injury. Arch Phys Med Rehabil. 2000;81(2):139-43. 7. Finnie AK, Buchholz AC, Martin Ginis KA, and the SHAPESCI Research Group. Current coronary heart disease risk assessment tools may underestimate risk in community- dwelling persons with chronic spinal cord injury. Spinal Cord. 2008;46:608-15. 8. Pearson TA, Mensah GA, Alexander RW, et al. Markers of inflammation and cardiovascular disease. Application to clinical and public health practice: a statement for healthcare professionals from the Centers of Disease Control and Prevention and the American Heart Association. Circulation. 2003;107:499-511. 9. Nash MS, Cowan RE, Kressler J. Evidence-based and heuristic approaches for customization of care in cardiometabolic syndrome after spinal cord injury. J Spinal Cord Med. 2012;35(5):278-92. 136 CAPTURING CAPACITY IN CANADIAN SCI REHABILITATION


M - Cardiovascular Integrity
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