Evidence map›Paper›PMID 29164029›Full record

ArticleGlobal spine journal2017

A Clinical Practice Guideline for the Management of Patients With Acute Spinal Cord Injury: Recommendations on the Type and Timing of Rehabilitation.

Michael G Fehlings, Lindsay A Tetreault, Bizhan Aarabi, Paul Anderson, Paul M Arnold, Darrel S Brodke, Kazuhiro Chiba, Joseph R Dettori, Julio C Furlan, James S Harrop and 23 more

Registry-linked trialAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Global spine journal, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04316195 (Electromyographic Evaluation of the Bulbocavernosus Reflex After Acute Spinal Cord Injury), which is not on this map. Cited by 43 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
43citing papers in PubMed, 5 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04316195 unknown statusnot on this mapstarted 2020, after this paper: background citation

Electromyographic Evaluation of the Bulbocavernosus Reflex After Acute Spinal Cord Injury: a New Prognostic Concept

Typeobservational_patient_registrySponsorAndréane Richard-DenisRan2020 to 2021Enrolled20ConditionsBulbocavernosus Reflex, Spinal Cord InjuriesArmsAssessment of the bulbocavernosus reflex
3 · Its place in the literature

Who cites it

43 citing papers in PubMed, 5 syntheses or guidelines pooled it.

  1. Pooled it
  2. Exercise therapy can effectively improve trunk performance and sitting balance in spinal cord injury: a systematic review and meta-analysis.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2025
    Pooled it
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  7. Review
  8. Article
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  11. The effect of timing on rehabilitation results in tumor-related spinal cord injuries.Turkish journal of physical medicine and rehabilitation · 2026
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  17. Observational
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

33 authors.

Michael G FehlingsToronto Western Hospital, University Health Network, Toronto, Ontario, Canada.
Lindsay A TetreaultToronto Western Hospital, University Health Network, Toronto, Ontario, Canada.
Bizhan AarabiUniversity of Maryland School of Medicine, Baltimore, MD, USA.
Paul AndersonUniversity of Wisconsin, Madison, WI, USA.
Paul M ArnoldThe University of Kansas, Kansas City, KS, USA.
Darrel S BrodkeUniversity of Utah, Salt Lake City, UT, USA.
Kazuhiro ChibaNational Defense Medical College, Saitama, Japan.
Joseph R DettoriSpectrum Research, Inc, Tacoma, WA, USA.
Julio C FurlanUniversity of Toronto, Toronto, Ontario, Canada.
James S HarropThomas Jefferson University, Philadelphia, PA, USA.
Gregory HawrylukUniversity of Utah, Salt Lake City, UT, USA.
Langston T HollyUniversity of California at Los Angeles, Los Angeles, CA, USA.
Susan HowleyChristopher & Dana Reeve Foundation, Short Hills, NJ, USA.
Tara JejiOntario Neurotrauma Foundation, Toronto, Ontario, Canada.
Sukhvinder Kalsi-RyanToronto Western Hospital, University Health Network, Toronto, Ontario, Canada.
Mark KotterUniversity of Cambridge, Cambridge, England.
Shekar KurpadMedical College of Wisconsin, Milwaukee, WI, USA.
Brian K KwonUniversity of British Columbia, Vancouver, British Columbia, Canada.
Ralph J MarinoThomas Jefferson University Hospital, Philadelphia, PA, USA.
Allan R MartinToronto Western Hospital, University Health Network, Toronto, Ontario, Canada.
Eric MassicotteToronto Western Hospital, University Health Network, Toronto, Ontario, Canada.
Geno MerliSidney Kimmel Medical College, Thomas Jefferson University Hospitals, Philadelphia, PA, USA.
James W MiddletonUniversity of Sydney, Sydney, New South Wales, Australia.
Hiroaki NakashimaNagoya University Graduate School of Medicine, Nagoya, Japan.
Narihito NagoshiToronto Western Hospital, University Health Network, Toronto, Ontario, Canada.
Katherine PalmieriThe University of Kansas, Kansas City, KS, USA.
Anoushka SinghToronto Western Hospital, University Health Network, Toronto, Ontario, Canada.
Andrea C SkellySpectrum Research, Inc, Tacoma, WA, USA.
Eve C TsaiUniversity of Ottawa, Ottawa, Ontario, Canada.
Alexander VaccaroThomas Jefferson University, Philadelphia, PA, USA.
Jefferson R WilsonUniversity of Toronto, Toronto, Ontario, Canada.
Albert YeeSunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
Anthony S BurnsToronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe objective of this study is to develop guidelines that outline the appropriate type and timing of rehabilitation in patients with acute spinal cord injury (SCI).

methodsA systematic review of the literature was conducted to address key questions related to rehabilitation in patients with acute SCI. A multidisciplinary guideline development group used this information, and their clinical expertise, to develop recommendations for the type and timing of rehabilitation. Based on GRADE (Grading of Recommendation, Assessment, Development and Evaluation), a strong recommendation is worded as "we recommend," whereas a weaker recommendation is indicated by "we suggest.

resultsBased on the findings from the systematic review, our recommendations were: (1) We suggest rehabilitation be offered to patients with acute spinal cord injury when they are medically stable and can tolerate required rehabilitation intensity (no included studies; expert opinion); (2) We suggest body weight-supported treadmill training as an option for ambulation training in addition to conventional overground walking, dependent on resource availability, context, and local expertise (low evidence); (3) We suggest that individuals with acute and subacute cervical SCI be offered functional electrical stimulation as an option to improve hand and upper extremity function (low evidence); and (4) Based on the absence of any clear benefit, we suggest not offering additional training in unsupported sitting beyond what is currently incorporated in standard rehabilitation (low evidence).

conclusionsThese guidelines should be implemented into clinical practice to improve outcomes and reduce morbidity in patients with SCI by promoting standardization of care, decreasing the heterogeneity of management strategies and encouraging clinicians to make evidence-informed decisions.

Indexed as

acute spinal cord injuryclinical guidelineguidelinerehabilitationspinal cord injurytraumatic spinal cord injury

Identifiers

PMID29164029
PMCPMC5684839

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.