Select Papers, Reports & Presentations
RHI is strongly committed to sharing details of the great work that is taking place throughout the SCI field—from promising translational research to inspiring solutions that are improving the quality of life of people with SCI.
We believe strongly in the power of knowledge and are pleased to present a variety of reports and presentations contributed by members of RHI's clinical research network. Also, be sure to check out our Youtube page for interviews with RHI network members.
Many of the papers below are available from the publisher's website. However, some publishers may charge access fees to view the entire article. For tips on how to access and find the research you are looking for, download these fact sheets (finding SCI research news and accessing SCI research articles) to help get you started!
If you would like access to any of the publications below and cannot find the full paper, please contact us for more information.
Peer-Reviewed Scientific Papers
Evaluation of a Clinical Protocol to Assess and Diagnose Neuropathic Pain During Acute Hospital Admission: Results from Traumatic Spinal Cord Injury
Bélanger LMA, Umedaly HS, Noonan VK, Park SE, Prince J, Thorogood NP, Shen T, Townson AF, Street JT, Dvorak MF, Negraeff M.
Clin J Pain. 2017 Jun 12 doi:10.1097/AJP.00000000000 00523. [Epub ahead of print].
Summary: The purpose of this study was to find out how common neuropathic pain is and when it first occurs in patients who have recently sustained a spinal cord injury and are in the hospital. The occurrence of neuropathic pain in the Acute Spine Unit at Vancouver General Hospital was 56% of patients and the onset was first identified an average of 8 days following injury. Patients with incomplete spinal cord injuries were diagnosed with pain earlier than those with complete injuries. A new pain screening method decreased the time it took for patients to be assessed. Neuropathic pain is a secondary complication identified as an area of focus under RHI’s Care Program. This study uses data from the Rick Hansen SCI Registry.
Facilitators and Barriers to International Collaboration in Spinal Cord Injury: Results from a Survey of Clinicians and Researchers
Noonan VK, Chan E, Bassett-Spiers K, Berlowitz DJ, Biering-Sørensen F, Charlifue S, Graco M, Hayes KC, Horsewell J, Joshi P, Markelis D, Smith V, Waheed Z, Brown DJ.
Journal of Neurotrauma. 2017 doi: 10.1089/neu.2017.5036. [Epub ahead of print].
Summary: This paper presents findings from an international survey conducted with SCI clinicians and researchers that identifies barriers and facilitators to international SCI clinical research, potential initiatives for future international collaboration and the use of SCI-specific data sets and standards. The study identified several opportunities for greater collaboration and many of the top barriers (e.g. funding availability, funding timelines, research capacity) can be potentially offset by SCI study initiatives currently underway. One example is the International Spinal Data Network (ISDN) workshop held in 2015 which explored how SCI registries can partner to align data standards and share data.
A priority of RHI’s Care Program is to identify gaps in knowledge and the requirements to fill them. The findings from this survey, as well as its companion survey on the perspectives of people living with SCI and the barriers and facilitators to their participation in clinical studies (Anderson et al., 2016), state the challenges that often prevent progression of important SCI clinical studies and provide insight into how to reduce this gap through international collaboration. Findings from both surveys will also support studies that are part of RHI’s Cure Program by informing the design of SCI clinical trials.
Impact of bladder, bowel and sexual dysfunction on health status of people with thoracolumbar spinal cord injuries living in the community
Park SE, Elliott S, Noonan VK, Thorogood NP, Fallah N, Aludino A, Dvorak MF.
J Spinal Cord Med. 2016 Aug 31:1-12. [Epub ahead of print].
Summary: Bowel, bladder, and sexual problems are common after traumatic SCI and are among the highest priority to improve an individual’s life. We looked at these problems in individuals living with injuries to their thoracolumbar region, as the location of this type of injury corresponds to the nerves that control bowel, bladder and sexual function. Of the 51 individuals who participated in the study, 59% had bladder incontinence, 54% bowel incontinence, and 61% had sexual dysfunction – almost 30% had all three problems. This is the first study looking at the combination of these problems on overall health in this population. Importantly, it showed that these problems often occur together and that care providers need to have standard tests for individuals with SCI to identify these problems in order to help optimize care and improve overall health status. We plan to study these problems in a larger group of people using new standard tests to confirm our results.
Methylprednisolone for the Treatment of Patients with Acute Spinal Cord Injuries: A Propensity Score-Matched Cohort Study from a Canadian Multi-Center Spinal Cord Injury Registry
Evaniew N, Noonan VK, Fallah N, Kwon B, Rivers CS, Ahn H, Bailey CS, Christie SD, Fourney DR, Hurlbert RJ, Linassi AG, Fehlings MG, Dvorak MF, and The RHSCIR Network.
Journal of Neurotrauma. November 1, 2015 doi:10.1089/neu.2015.3963.
Summary: In a matched case-control analysis using national RHSCIR data, no evidence was found that methylprednisolone improves neurologic outcome following traumatic spinal cord injury as found in the controversial and much criticized 1990 NASCIS-II trial. This supports the downgrade of methylprednisolone as a treatment recommendation to a treatment option, and the evidence that it may increase odds of complications.
Effect of older age on treatment decisions and outcomes among patients with traumatic spinal cord injury
Ahn H, Bailey CS, Rivers CS, Noonan VK, Tsai EC, Fourney DR, Attabib N, Kwon BK, Christie SD, Fehlings MG, Finkelstein J, Hurlbert RJ, Townson A, Parent S, Drew B, Chen J, Dvorak MF, and The RHSCIR Network.
Canadian Medical Association Journal. July 6, 2015 cmaj.150085
Summary: More people over the age of 70 are incurring spinal cord injuries given the changing population demographics. It is not clear if there are differences in management of these older patients. We found that older patients with traumatic spinal cord injuries are less likely to receive surgery compared with younger patients and they experience a significant lag between both injury and acute admission to a specialized centre, and between admission and surgery. Future work will look at differences in outcome and advise treatment guidelines.
Minimizing errors in acute traumatic spinal cord injury trials by acknowledging the heterogeneity of spinal cord anatomy and injury severity: an observational Canadian cohort analysis
Dvorak MF, Noonan VK, Fallah N, Fisher CG, Rivers CS, Ahn H, Tsai EC, Linassi AG, Christie SD, Attabib N, Hurlbert RJ, Fourney DR, Johnson MG, Fehlings MG, Drew B, Bailey CS, Paquet J, Parent S, Townson A, Ho C, Craven BC, Gagnon D, Tsui D, Fox R, Mac-Thiong JM, Kwon BK.
J Neurotrauma. 2014 Sep 15;31(18):1540-7.
The Influence of Time from Injury to Surgery on Motor Recovery and Length of Hospital Stay in Acute Traumatic Spinal Cord Injury: An Observational Canadian Cohort Study
Dvorak MF, Noonan VK, Fallah N, Fisher CG, Finkelstein J, Kwon BK, Rivers CS, Ahn H, Paquet J, Tsai EC, Townson A, Attabib N, Bailey CS, Christie SD, Drew B, Fourney DR, Fox R, Hurlbert RJ, Johnson MG, Linassi AG, Parent S, Fehlings MG, and The RHSCIR Network.
J Neurotrauma. doi:10.1089/neu.2014.3632.*
*Named as a High-Impact Article (top-cited) on September 22, 2016.
Community Needs and Outcomes in Long-standing Spinal Cord Injury: Results from the Canadian SCI Community Survey
Noreau L, Noonan VK, Cobb J, Leblond J and Dumont F, Giangregorio L, Craven BC, Jetha A, Sweet S, Park S, Fallah N and Pelletier C.
Topics in SCI Rehabilitation. 2014;20(4): 249-345.
This issue includes a number of articles resulting in the work from the RHI-funded study, the SCI Community Survey - the largest of its kind ever conducted on the needs of Canadians with SCI. Topics include secondary complications, employment, quality of life and health care utilization.
Modeling the Patient Journey from Injury to Community Reintegration for Persons with Acute Traumatic Spinal Cord Injury in a Canadian Centre
Santos S, Gurling J, Dvorak MF, Noonan VK, Fehlings MG, Burns AS, Lewis R, Soril L, Fallah N, Street JT, Bélanger L, Townson A, Liang L, Atkins D.
PLoS ONE. 8(8): e72552. doi:10.1371/journal.pone.0072552.
Incidence, Risk Factors and Impact of Delirium in Patients with Traumatic Spinal Cord Injury
Cheung A, Thorogood NP, Noonan VK, Zhong G, Fisher CG, Dvorak MF, Street JT.
J Neurotrauma. 2013 Nov 1;30(21):1824-9. doi: 10.1089/neu.2013.2975.
The Economic Burden of Traumatic Spinal Cord Injury in Canada
Krueger H, Noonan VK, Trenaman LM, Joshi P, Rivers CS.
Chronic Diseases and Injuries Canada. 33(3), June 2013.
Meeting the Privacy Requirements for the Development of a Multi-Centre Patient Registry in Canada: The Rick Hansen Spinal Cord Injury Registry
Noonan VK, Thorogood NP, Joshi PB, Fehlings MG, Craven BC, Linassi G, Fourney DR, Kwon BK, Bailey CS, Tsai EC, Drew BM, Ahn H, Tsui D, Dvorak MF.
Healthcare Policy. 8(4) May 2013: 87-99.doi:10.12927.hcpol.2013.23397.
The influence of depression on physical complications in spinal cord injury: behavioral mechanisms and health-care implications
Krueger H, Noonan VK, Williams D, Trenaman LM, Rivers CS.
Spinal Cord. (2013) 51, 260–266; doi:10.1038/sc.2013.3; published online 18 February 2013.
The Validity of Administrative Data To Classify Patients with Spinal Column and Cord Injuries
Noonan VK, Thorogood NP, Fingas M, Batke J, Bélanger L, Kwon BK, Dvorak MF.
J Neurotrauma. 30:173–180, February 1, 2013.
Secondary Complications in SCI Across the Continuum: Using Operations Research to Predict the Impact and Optimize Management Strategies
Atkins D, Noonan VK, Santos A, Lewis R, Fehlings MG, Burns AS, Dvorak MF.
Topics in Spinal Cord Injury Rehabilitation. 2012;18(1):57–66, Winter 2012.
The Application of Operations Research Methodologies to the Delivery of Care Model for Traumatic Spinal Cord Injury: The Access to Care and Timing Project
Noonan VK, Soril L, Atkins D, Lewis R, Santos A, Fehlings MG, Burns AS, Singh A, Dvorak MF.
J Neurotrauma. 29:2272–2282, September 1, 2012.
Incidence and Prevalence of Spinal Cord Injury in Canada: A National Perspective
Noonan VK, Fingas M, Farry A, Baxter D, Singh A, Fehlings MG, Dvorak MF.
Neuroepidemiology. 2012;38:219–226, April 27, 2012.
The Rick Hansen Spinal Cord Injury Registry (RHSCIR): a national patient-registry
Noonan VK, Kwon BK, Soril L, Fehlings MG, Hurlbert RJ, Townson A, Johnson M, Dvorak MF, RHSCIR Network.
Spinal Cord. Jan 2012; 50 (1): 1 - 85
Publications and Reports
Health Economics: Agenda for SCI Research in Canada. This RHI report presents a detailed agenda for establishing evidence of the burden of SCI and the costs and consequences of initiatives aimed at mitigating the burden.
RHSCIR Special Report 2011-2013. This first ever report includes data on areas such as demographics, level and severity of injury, length of stay in acute and rehab care and social impacts post-injury such as income, marital status and employment. Also available in French.
SCI Community Survey: Prelimary Results. This participants' report is also the first activity within a comprehensive knowledge translation plan. In addition to academic journal articles, knowledge translation activities include providing data and support to SCI advocacy groups and its Canadian branches to ensure that results from the survey can be used for advocacy, nationally and in provincial jurisdictions.
Rehabilitation Environmental Scan Atlas: Capturing Capacity in Canadian SCI Rehabilitation. This first atlas of Canadian SCI rehabilitation enables rehabilitation providers, people with SCI and their care-givers with evidence-based data to advocate for preventive care, improved clinical care services and a reduction in regional service disparity.
Spinal Cord Injury: Progress in Care & Outcomes in the Last 25 years. This report was commissioned by RHI to review the gains made in SCI care and outcomes over the last 25 years, and in this way help commemorate the historic Man In Motion World Tour that was launched by Rick Hansen in 1985. RHI wishes to thank H. Krueger & Associates Inc., the authors of this report.
The State of Spinal Cord Injury in Canada. This report, jointly released by RHI and Urban Futures, estimates the incidence and prevalence of SCI in Canada and has found that there are close to 86,000 Canadians currently living with SCI and that an estimated 4,300 new cases of SCI occur in Canada each year. This ground-breaking report provides a baseline measurement of the extent of SCI in Canada, a measurement that was previously unknown.
Browse the links below to view a selection of presentations from RHI's research network presented at Interdependence 2012.
- Accreditation Canada - Rick Hansen Institute Partnership, presented by Wendy Nicklin, President & CEO, Accreditation Canada
- Developing a Sexual Rehabilitation Online Education for Health Care Professionals, presented by Kate McBride, RN, BSN, CRRN, GF Strong Rehabilitation Centre
- Feasibility of an Internet Clinic for Treating and Preventing Pressure Ulcers, presented by Dalton Wolfe, PhD, Lawson Health Research Institute
- GRASSP Longitudinal Study, presented by Sukhvinder Kalsi-Ryan, BScPT, MSc, PhD, University of Toronto
- Home Ventilation Guidelines, presented by Jeremy Road, MD FRCPC, University of British Columbia
- Mind the Gap: Standards to Services, co-presented by Catherine Truchon, PhD, MScAdmin, IRDPQ and Jason Knox, BScPT, Foothills Medical Centre
- Physical Activity Guidelines for Adults with SCI & the SCI Get Fit Toolkit, presented by Kathleen Martin Ginis, PhD, SCI Action Canada
- Pregabalin in the Prevention of Neuropathic Pain after SCI, presented by Sean Christie, MD, FRCS, QEII Health Sciences Centre
- The SCI Community Survey: A Survey on Needs, Service Utilizations and Outcomes of People with Spinal Cord Injury, co-presented by Luc Noreau, PhD, Université Laval; Vanessa Noonan, PhD, PT, Rick Hansen Institute; Darren Nickel, PhD, University of Saskatchewan; John Cobb, BSc, OT, Vancouver General Hospital
- SCI Outcome Measures Toolkit, presented by Vanessa Noonan, PhD, PT, Rick Hansen Institute
- Spinal Cord Injury Rehabilitation Evidence (SCIRE), presented by Swati Mehta, HBSc, Parkwood Hospital