We're entering the homestretch ahead of Working 2 Walk 2018 in Vancouver - just under 2 weeks left to register online. The excitement continues to build as the pieces fall into place: from our first-class line-up of presenters to our interactive agenda that will allow more time for critical engagement, to the formal and organic connections that are made within the SCI Community.
Each year our conference surveys reflect again and again how necessary and satisfying Working 2 Walk is for our Community. As one respondent put it last year:
It is rare to get so many individuals who are passionate about any topic in the same room, and it is amazing to have this for the SCI Community!
Don't miss out on this great opportunity to be privy to cutting-edge scientific knowledge and the empowerment and energy that comes from connecting with the SCI Community - Register Now!
The Breadcrumb Path from Bench to Bedside
Lyn Jakeman, PhD | Program Director, Repair and Plasticity, National Institute of Neurological Disorders and Stroke
Drugs, cells, gene therapies, and devices are under investigation around the world with hopes of determining safety and effectiveness to improve or enhance recovery after injury. Meanwhile, advances in tools and technology in biology, engineering and communications have vastly accelerated neuroscience discoveries. Yet, many basic research studies end with some new knowledge and scientific publications, but no product has been found, no treatment identified. Early stage clinical trials also often end with no definitive answers, or do not finish at all. Why does this happen? Is it inevitable? Are there exceptions? How do we ensure that investments in research will benefit patients and consumers? These are questions that funding agencies grapple with all of the time. In this presentation, I will discuss the often spotted and twisted path from fundamental research to translation of ideas into therapies, and I will outline some of the existing programs targeted at helping projects get to the next step. In closing, I will present some ideas for how diverse stakeholders can work together to identify and respond to potential research advances that are poised at the intersection of scientific, technological and community readiness. I hope to encourage discussion of the approaches and language that can can be employed to foster cooperative efforts across the translational spectrum.
Sexual and Fertility Rehabilitation After Spinal Cord Injury
Stacy Elliott, MD | Medical Director, BC Centre for Sexual Medicine and Vancouver General Hospital; Professor, University of BC
Sexual function is a huge priority for persons with spinal cord injury (SCI), ranked either first or second in terms of importance in quality of life after SCI. This relatively neglected area of rehabilitation has been highlighted with the advent of Viagra and the rise of social media. For men, the use of PDE5i and penile injections has mainly resolved the issue of unreliable erectile function, but ejaculation and orgasm still remain elusive to more than 75% and 50%, respectively. For women, there is no specific medication for arousal disorders or orgasmic dysfunction after SCI. Experience over time, having an intimate partner, and having an incomplete injury versus complete injury bode better for orgasmic release for both sexes. Some persons experience autonomic dysreflexia with sexual practices (particularly with ejaculation and orgasm) which may require prophylactic medications, while others experience mild to moderate dysreflexia which over time can be morphed into more erotic feelings. Ejaculation has been utilized not only for sexual and fertility purposes, but anecdotally has improved bladder and bowel control. While not formally studied, improved walking skills with Exoskeleton and pelvic floor strengthening, may enhance sexual function in some. Fertility is most affected in men after SCI with the ejaculatory difficulties, of which sperm retrieval methodology exists. However, semen quality is invariably affected by the cytokines found in seminal fluid, significantly altering sperm quality. Women’s fertility is not affected after SCI, but contraception may need to be modified. Women with SCI can safely carry a pregnancy and most deliver vaginally. A multidisciplinary team must be in place for women to assist with pregnancy, labour, delivery and postpartum issues (including breastfeeding). A positive outlook and interest toward sexual and fertility rehabilitation is finally here!