Ryan Solinsky

• MD
• Medical Doctor at Mayo Clinic

Background Individuals with spinal cord injury (SCI) commonly have autonomic dysreflexia (AD) with increased sympathetic activity. After SCI, individuals have decreased baroreflex sensitivity and increased vascular responsiveness. Objective To evaluate the relationship between baroreflex and blood vessel sensitivity with AD symptoms. Design Case...

Over the last decade, clinical trials have shown that spinal cord stimulation can restore motor functions that were thought to be permanently impaired in persons with spinal cord injury. However, the off-target effects of delivering electrical impulses to intertwined spinal networks remain largely unknown. This generates safety concerns for this ot...

This work’s purpose was to quantify rapid sympathetic activation in individuals with spinal cord injury (SCI), and to identify associated correlations with symptoms of orthostatic hypotension and common autonomically mediated secondary medical complications. This work was a cross-sectional study of individuals with SCI and uninjured individuals. Sy...

Autonomic dysfunction is common after spinal cord injury, though differing from motor and sensory function, there are currently no established batteries of tests to comprehensively characterize these deficits. Further, while individual established autonomic tests have a long history and sound scientific background, translating these autonomic testi...

Introduction: Individuals with spinal cord injury (SCI) commonly have autonomic dysreflexia (AD) with increased sympathetic activity. After SCI, individuals have decreased baroreflex sensitivity and increased vascular responsiveness. Objective: To evalate relationship between baroreflex and blood vessel sensitivity with autonomic dysreflexia sympto...

Study design: Cross-sectional study. Objectives: Determine how well common clinical assessments of level and completeness of injury are correlated with symptoms of autonomic blood pressure instability and secondary medical complications after spinal cord injury (SCI). Setting: Academic medical center, United States. Methods: Eighty-two indiv...

Study Design: Secondary outcome measures analysis of a randomized, controlled study. Objectives: To assess the effects of hybrid-functional electrical stimulation (FES) rowing, arms only (AO) rowing and waitlist (WL) controls on pain, pain interference, and depression in individuals with spinal cord injury (SCI). Setting: Outpatient rehabilitation...

Objectives: To investigate the effectiveness of health care team communication regarding cardiometabolic disease (CMD) risk factors with patients with subacute spinal cord injury (SCI). Design: Multi-site prospective cross-sectional study. Setting: Five National Institute on Disability, Independent Living, and Rehabilitation Research Model SCI Re...

Individuals with spinal cord injury (SCI) have significant dysfunction in cardiovascular autonomic regulation. While recent findings postulate that spinal cord stimulation improves autonomic regulation, limited scope of past methods have tested only above level sympathetic activation, leaving significant uncertainty. To identify whether transcutane...

Study design: Cross-sectional study Objectives: Determine how well common clinical assessments of level and completeness of injury are correlated with symptoms of autonomic blood pressure instability and secondary medical complications after spinal cord injury (SCI). Setting: Academic medical center, United States Methods: Eighty-two individuals wi...

Introduction: Autonomic dysreflexia (AD) is a frequent complication of spinal cord injury (SCI), though current clinical practice patterns for medication management of this condition are unknown. Correspondingly, it is unclear if national differences in practice patterns exist. Objective: Determine trends in current pharmacologic management of A...

Context: Cardiometabolic disease (CMD) frequently occurs in individuals with spinal cord injury (SCI), with growing awareness surrounding the expansive scope of this problem. As CMD has significant morbidity and mortality, early guidelines-based screening and management have been established. However, the extent to which these guidelines have been...

Importance: Individuals with spinal cord injury (SCI) have significant autonomic nervous system dysfunction. However, despite recent findings postulated to support that spinal cord stimulation improves dynamic autonomic regulation, limited scope of previous testing means the true effects remain unknown. Objective: To determine whether transcutaneou...

Objective: Compare ability of renal ultrasound and Tc-99m mercaptoacetyltriglycine (MAG3) renal scan to identify upper urinary tract stasis. Design: Retrospective chart review. Setting: Outpatient Neuro-urology clinic serving a large SCI population. Participants: One hundred and sixty-five individuals with spinal cord injury, presenting for...

Physical deconditioning commonly occurs following spinal cord injury (SCI) due to loss of voluntary functional movement and resultant increased sedentary behavior. This lesser energy expenditure leads to increased fat mass, decreased lean tissue mass, increased body mass index, declines in cardiac structure and function, reduced insulin sensitivity...

Context/objectives: Cardiometabolic disease (CMD) is increased after spinal cord injury (SCI), with an increased number of CMD risk factors that relate to higher mortality. The study objective was to characterize the relationship of age and injury duration with CMD. Design: Retrospective cohort assessment of CMD risks using unbiased recursive pa...

The purpose of the present investigation was to assess the effects of whole-body exercise on anaerobic threshold in individuals with spinal cord injury (SCI). Maximal oxygen uptake (VO2max) and oxygen uptake at anaerobic threshold (AT) were measured before and after 6 months of hybrid functional electrical stimulation row training in 47 participant...

Introduction: Heart rate variability is a measure of autonomic activity which is growing in popularity as a research outcome. However, despite its increased use, the known effects of respiration on heart rate variability measures are rarely accounted for in rehabilitation medicine research, leading to potential misinterpretation. Objective: Desc...

Black Panther presents an African cultural tapestry. The wide breadth of the African elements fit Black Panther well within Afrofuturism, a genre defined by its use and placement of people of African descent in the past, present, and future of society. Beyond these cultural elements, Black Panther 's Afrofuturism employs water imagery and spinal co...

High-level spinal cord injury commonly leads to blood pressure instability. This manifests clinically as orthostatic hypotension (OH), where blood pressure can drop to the point of loss of consciousness, and autonomic dysreflexia (AD), where systolic blood pressure can climb to over 300 mmHg in response to an unperceived noxious stimulus. These blo...

Objectives (1) Describe the prevalence cardiometabolic disease (CMD) at spinal cord injury (SCI) rehabilitation discharge; (2) compare this with non-SCI controls; (3) identify factors associated with increased CMD. Design Multicenter, prospective observational study. Setting Five NIDILRR Model SCI Rehabilitation Centers. Participants SCI; n=95 a...

Blood pressure regulation following spinal cord injury (SCI) is often compromised due to impaired vascular sympathetic control, leading to increased reliance on cardiovagal baroreflex sensitivity to maintain pressure. Whole-body exercise improves cardiovagal baroreflex sensitivity in uninjured individuals, though has not been explored in those with...

After complete spinal cord injuries (SCI), spinal segments below the lesion maintain inter-segmental communication via the intraspinal propriospinal network. However, it is unknown whether selective manipulation of these circuits can restore locomotor function in the absence of brain-derived inputs. By taking advantage of the compromised blood-spin...

Retrospective analysis of treated inpatients compared to expected neurorecovery from a propensity score-matched national database cohort. Evaluate the effectiveness of buspirone on clinical neurorecovery following traumatic SCI when started during acute inpatient rehabilitation. University-based hospital in Boston, USA. Chart review yielded thirty-...

Purpose of Review The purpose of this article is to update health care providers on recommended identification and management strategies for autonomic dysreflexia (AD), as well as an in-depth discussion of pharmacological management of AD. In addition, this article will focus on prevention strategies and less commonly recognized causes of AD. Rece...

Racial health disparities continue to disproportionately affect Black persons in the United States (US). Black individuals also have increased risk of worse outcomesassociated with social determinants of health including socioeconomic factors such as income, education and employment. This narrative review included studies originally spanning a peri...

Introduction The prevalence of cardiometabolic disease following spinal cord injury is known to be high. However, it is unknown whether engaging in high‐intensity exercise, which is advocated by recent guidelines, is beneficial or feasible for these individuals. Objective To assess the effects of high‐intensity, whole‐body exercise on the prevalen...

Objective: The current diagnostic criteria of autonomic dysreflexia (AD) is based solely on systolic blood pressure (SBP) increases from baseline without regard to changes in diastolic blood pressure (DBP). During urodynamics in persons with SCI at or above the sixth thoracic level (T6), we evaluated diastolic blood pressure (DBP) changes related w...

People with tetraplegia resulting from spinal cord injury experience debilitating hand impairments that may lead to lifelong dependence on others to perform activities of daily living. Wearable robotic devices that actively support hand function during daily living tasks could bring great benefits to this population. In this work, the performance o...

Bone is a highly vascularized organ with an extensive network of arteries, arterioles, and capillaries that is critical for bone development, maintenance, and repair. Despite the importance of bone circulation to bone health, the regulation of blood flow to bone is not well understood in humans. One of the potential factors controlling bone blood f...

PurposeTo define differences in heart rate and blood pressure variability (HRV/BPV) after spinal cord injury (SCI) compared with uninjured controls, and to determine whether variabilities are impacted by whole-body exercise after SCI.Methods Individuals with SCI (n = 40), aged 18–40, and uninjured age/sex-matched controls (n = 22) had HRV and BPV d...

Secondary outcome measures analysis of a randomized, controlled study. To assess the effects of hybrid-functional electrical stimulation (FES) rowing on motor and sensory recovery in individuals with spinal cord injury (SCI) 6–18 months post injury. Outpatient rehabilitation network. 25 participants 6–12 months after SCI were randomly assigned to h...

Aims: To obtain objective evidence for the time to onset of action for intravesical lidocaine utilizing exaggerated sympathetic blood-pressure responsiveness in patients with spinal cord injuries (SCI). Methods: This prospective observational cohort study analyzed blood pressure responses in individuals with SCI at or above T6 who did (lidocaine...

Context/objective: To determine current barriers for clinical implementation of epidural stimulation for functional improvement after spinal cord injury and highlight applicable ethical constructs to approach future research. Design: Survey of spinal cord injury medicine physicians, January 2019. Setting: Spinal cord injury model systems hospital s...

Background: Botulinum toxin injections are effective in relieving focal spasticity resulting from upper motor neuron injuries. Doses approved in the United States for onabotulinumtoxinA and incobotulinumtoxinA are up to 400 units, yet higher doses are often used. Objective: To determine differences in risk of adverse events when using higher (>6...

Study design: Analysis of published cases OBJECTIVES: To identify and describe symptoms, radiologic findings, treatment strategies, and reoccurrence of Charcot spine in individuals with spinal cord injury (SCI). Methods: This analysis included all English articles published prior to October 2017, describing Charcot spine after SCI as identified...

Context: Autonomic dysreflexia (AD) is characterized by a sudden onset of hypertension in those with spinal cord injuries (SCI) at T6 or above. Prompt recognition and treatment of AD is important. Herein are two individuals with SCI and acute hypertension due to anxiety that may easily have been confused for AD. Findings: Case 1: A 77-year-old male...

Objective: To evaluate the role of intravesical lidocaine in preventing autonomic dysreflexia (AD) during routine catheter changes in individuals with spinal cord injury (SCI) at T6 or above. Design: Prospective observational cohort study. Setting: Outpatient urology clinic. Participants: Fifty consecutive individuals with SCI at or above T6 and a...

One innovation currently influencing physical medicine and rehabilitation is brain-computer interface (BCI) technology. BCI systems used for motor control record neural activity associated with thoughts, perceptions, and motor intent, decode brain signals into commands for output devices, and perform the user’s intended action through an output dev...

Background: Retained botulinum toxin solution may be visible in vials and syringe tips after mixing and presumed complete injections, leaving patients without the full prescribed dose. Objective: To quantify the mean amount of retained toxin within vials, syringes, and needles following spasticity injections (phase 1), and to design/test a targe...

Objective/Context To highlight questions with regards to the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) and provide historical perspectives to help SCI professionals gain fuller insights into the classification system. Methods Frequently asked questions to the ISNCSCI were collected and a review of lite...

Objectives: Identify clinical and pathophysiologic insights into autonomic dysreflexia (AD) in patients with spinal cord injury (SCI). Study Design: Analysis of prospectively gathered AD dataset. Setting: Inpatient Veterans Affairs SCI unit. Participants: 78 male patients with SCI who experienced AD. Methods: Statistical methods were utilized to id...

Study design: Secondary analysis of prospectively collected observational data assessing the safety of an autonomic dysreflexia (AD) management protocol. Objectives: To estimate the time to onset of action, time to full clinical effect (sustained systolic blood pressure (SBP) <160 mm Hg) and effectiveness of nitroglycerin ointment at lowering bl...

Objective/Background: Autonomic dysreflexia is a potentially life-threatening condition which afflicts a significant proportion of individuals with spinal cord injuries (SCI). To date, the safety and efficacy of several commonly used interventions for this condition have not been studied. Design: A retrospective chart review of the safety of a prev...

We report on one patient with Bickerstaff’s brainstem encephalitis (BBE) and associated flaccid weakness. Counter to previous studies with BBE which indicate weakness due to Guillain–Barre syndrome, our patient’s presentation of paraplegia following BBE is consistent with concomitant acute transverse myelitis. Her findings of BBE largely resolved,...

Objective/Background: Autonomic dysreflexia is a potentially life-threatening condition which afflicts a significant proportion of individuals with spinal cord injuries (SCI). To date, the safety and efficacy of several commonly used interventions for this condition have not been studied. Design: A retrospective chart review of the safety of a prev...

To determine if bracing frequency, geographical region, clinical specialty, or percentage of practice devoted to knee pain influences the criteria used by sports medicine professionals to determine if a brace should be prescribed for treating patients with nontraumatic patellofemoral pain syndrome. Cross-sectional study SETTING: United States sport...

Visually-impaired people have difficulty detecting objects beyond the reach of a cane. We functionally coupled a far-infrared camera to a linear array of tactile elements to create a thermal tactile viewer that enhances environmental awareness. Users may scan such a device across a scene to spatially locate people. We observed in a series of acuity...