Grace Leong - Academia.edu (original) (raw)

Papers by Grace Leong

Research paper thumbnail of Age, gender, and side differences of cutaneous electrical perceptual threshold testing in an able-bodied population

The Journal of Spinal Cord Medicine, 2010

Objective:To investigate age, gender, and left-right differences in cutaneous electrical perceptu... more Objective:To investigate age, gender, and left-right differences in cutaneous electrical perceptual threshold (EPT) testing in an able-bodied, Australian sample.Study Design:Prospective experimental.Setting:Hospital-based spinal cord injuries unit.Methods:Cutaneous electrical stimulation of the 28 dermatomes at ASIA sensory key points (C2-S4/S5) was performed on 29 female and 16 male healthy volunteers aged 21 to 76 years. Mean EPTs for each dermatome were compared (repeated measures ANOVA) for left-right, gender-related, and age-related (</>50 years of age) differences.Results:There was no group difference between sides (repeated measures ANOVA, P = 0.934). Women across all ages had lower group mean EPTs than men (P < 0.0001). Women younger than age 50 years had lower mean EPTs than those older than age 50 years (P = 0.008). There was no group difference between younger and older men (P = 0.371). Analysis of individual dermatomes revealed no significant differences in thoracic dermatomes between genders or age groups, contrary to the limb dermatomes.Conclusion:There were gender differences in EPT values across all ages. Women had higher EPTs as they advanced in age, but this was less clear in men. There was considerable somatotopic variability in EPTs, especially in the lower limbs. If EPT testing is to be applied to detect subclinical changes within a dermatome, establishment of age- and gender-specific somatotopic normograms is a prerequisite.

Research paper thumbnail of For Fit's Sake: A Norms-Based Approach to Healthy Behaviors Through Influence of Presumed Media Influence

Health communication, Jan 22, 2016

Based on the influence of presumed media influence (IPMI) model as the theoretical framework, thi... more Based on the influence of presumed media influence (IPMI) model as the theoretical framework, this study examines how injunctive norms and personal norms mediate the influence of healthy lifestyle media messages on public intentions to engage in two types of healthy lifestyle behaviors-physical activity and healthy diet. Nationally representative data collected from 1,055 adults in Singapore demonstrate partial support for the key hypotheses that make up the extended IPMI model, highlighting the importance of a norms-based approach in health communication. Our results indicate that perceived media influence on others indirectly shaped public intentions to engage in healthy lifestyle behaviors through personal norms and attitude, providing partial theoretical support for the extended IPMI model. Practical implications for health communicators in designing health campaigns media messages to motivate the public to engage in healthy lifestyle are discussed.

Research paper thumbnail of 51.: Subacute delayed ascending myelopathy: A rare early neurological complication of spinal cord injury

Journal of Clinical Neuroscience, Nov 30, 2014

Research paper thumbnail of Management of spinal cord injury in general practice - part 2

Australian Family Physician, May 1, 2008

BACKGROUND: People with spinal cord injury (SCI) are at risk of developing complications specific... more BACKGROUND: People with spinal cord injury (SCI) are at risk of developing complications specific to the condition. As the incidence of SCI is low, general practitioners may not be familiar with these complications.OBJECTIVE: This article completes the overview of common problems associated with SCI, highlighting specific points to be aware of when managing pressure areas, pain, spasticity, musculoskeletal disorders, neurological complications, sexual dysfunction, fertility, and psychological wellbeing. It aims to give readers a broad understanding of SCI issues, thereby increasing their confidence and ability to provide first line assessment and management.DISCUSSION: General practitioners are well placed to recognise and manage some conditions associated with SCI. Systematically addressing the issues can also serve as the springboard for health promotion, thus pre-empting and potentially avoiding morbidity for the patient with SCI.

Research paper thumbnail of Fitting disability into practice--focus on spinal cord injury

Australian family physician, 2007

People with specialised needs such as spinal cord injury (SCI) may not feature prominently in the... more People with specialised needs such as spinal cord injury (SCI) may not feature prominently in the caseload of the general practitioner. However, when people with chronic disabilities are aggregated, they constitute a reasonable percentage of consultations. It may be difficult to deliver high quality health care for such complex patients. We propose a method for integration of health care and prevention activities for patients with SCI in general practice, using tools such as a structured questionnaire, general practice management plans and team care arrangements. Practice structures can efficiently and effectively accommodate people with disabilities. Tools can serve as clinical prompts, help with planning, save time, and be financially rewarding. Importantly, they can anchor a 12 month cycle of preventive health care, allowing systematic monitoring and increasing intensity/coordination of professional input for those identified with greatest needs.

Research paper thumbnail of Management of spinal cord injury in general practice - part 2

Australian family physician, 2008

People with spinal cord injury (SCI) are at risk of developing complications specific to the cond... more People with spinal cord injury (SCI) are at risk of developing complications specific to the condition. As the incidence of SCI is low, general practitioners may not be familiar with these complications. This article completes the overview of common problems associated with SCI, highlighting specific points to be aware of when managing pressure areas, pain, spasticity, musculoskeletal disorders, neurological complications, sexual dysfunction, fertility, and psychological wellbeing. It aims to give readers a broad understanding of SCI issues, thereby increasing their confidence and ability to provide first line assessment and management. General practitioners are well placed to recognise and manage some conditions associated with SCI. Systematically addressing the issues can also serve as the springboard for health promotion, thus pre-empting and potentially avoiding morbidity for the patient with SCI.

Research paper thumbnail of Age, gender, and side differences of cutaneous electrical perceptual threshold testing in an able-bodied population

The journal of spinal cord medicine, 2010

To investigate age, gender, and left-right differences in cutaneous electrical perceptual thresho... more To investigate age, gender, and left-right differences in cutaneous electrical perceptual threshold (EPT) testing in an able-bodied, Australian sample. Prospective experimental. Hospital-based spinal cord injuries unit. Cutaneous electrical stimulation of the 28 dermatomes at ASIA sensory key points (C2-S4/S5) was performed on 29 female and 16 male healthy volunteers aged 21 to 76 years. Mean EPTs for each dermatome were compared (repeated measures ANOVA) for left-right, gender-related, and age-related (</ >50 years of age) differences. There was no group difference between sides (repeated measures ANOVA, P = 0.934). Women across all ages had lower group mean EPTs than men (P < 0.0001). Women younger than age 50 years had lower mean EPTs than those older than age 50 years (P = 0.008). There was no group difference between younger and older men (P = 0.371). Analysis of individual dermatomes revealed no significant differences in thoracic dermatomes between genders or age gro...

Research paper thumbnail of Electrical perceptual threshold testing: a validation study

The journal of spinal cord medicine, 2009

To investigate inter-rater and intra-rater reliability of electrical perceptual threshold (EPT) t... more To investigate inter-rater and intra-rater reliability of electrical perceptual threshold (EPT) testing in assessing somatosensory function in healthy volunteers. Prospective experimental. Hospital-based spinal cord injuries unit. Cutaneous electrical stimulation of 4 dermatomes at ASIA sensory key points (C3, T1, L3, and S2) was performed on 40 control subjects. The lowest ascending stimulus intensity at which sensation was perceived was recorded as the EPT. Mean EPT values for each dermatome, as determined by 2 testers at 2 time points, were examined and plotted against a normative template. Differences and associations between intra- and inter-rater measurements and left-right measurements were studied. EPT results for 2 people with spinal cord injuries were also examined. EPT measurements from left and right sides, obtained from the 2 time points and 2 testers, were found to be strongly associated, with the exception of left and right side measurements at the S2 dermatome. No si...

Research paper thumbnail of Development of a Checklist to Support Health Monitoring and Prevention Activities of Persons with SCI in General Practice

Research paper thumbnail of Changes in electrical perceptual threshold in the first 6 months following spinal cord injury

The Journal of Spinal Cord Medicine, 2011

Objectives: To investigate the use of electrical perceptual threshold (EPT) testing to follow the... more Objectives: To investigate the use of electrical perceptual threshold (EPT) testing to follow the natural history of sensory progression after complete and incomplete acute spinal cord injury (SCI) and to compare EPT changes with the American Spinal Injuries Association (ASIA) Impairment Scale (AIS). Study Design: Prospective descriptive study. Methods: ASIA examination and EPT testing was performed on 17 patients (7 AIS A, 10 AIS B-D), within 1, 3, and 6 months after acute SCI. EPT assessment was carried out bilaterally at ASIA sensory points from 2 levels above the neurological level to all levels below, including the sacral segments. Comparisons of EPT values above, at, and below the SCI were made at the three time points as well as comparisons of EPT data to ASIA assessment. Results: There was poor agreement between lowest normal level on EPT and ASIA assessment. Over time, EPTs tended to deteriorate above and at the ASIA level in AIS A patients with modest changes below the neurological level of injury (NLI), mainly where EPTs correlated with the zone of partial preservation. Sacral sparing was detected in one patient with EPT testing, but not with ASIA assessment. AIS B-D patients showed improvement at the ASIA level and extensive changes, both improvement and deterioration, below the NLI. Conclusion: EPT testing has sufficient sensitivity to detect subclinical changes in sensory function as early as the first month post-SCI, which is not apparent in ASIA examination. In particular, the testing is able to show abnormalities at and around the injury site for both complete and incomplete SCI. In addition, EPT allows for the detection and monitoring of alterations, both improvements and deterioration, in the abnormal range of sensation.

Research paper thumbnail of Organization of the neuroepithelial actin cytoskeleton is regulated by heparan sulfation during neurulation

Neuroscience Letters, 2013

Research paper thumbnail of Performing tip-enhanced Raman spectroscopy in liquids

Journal of Raman Spectroscopy, 2009

Many outstanding questions in biology and medicine require analytical tools that provide imaging ... more Many outstanding questions in biology and medicine require analytical tools that provide imaging and chemical information with high spatial resolution. Tip-enhanced Raman spectroscopy (TERS) has been shown to allow both topographic and label-free chemical information to be obtained with a lateral resolution of approximately 20-50 nm, but has been performed only in air or ultrahigh vacuum until now. Since most biological samples such as cells and tissues can only be studied in their active state if they are kept in aqueous buffers, TERS in liquids would be a crucial step towards nanoscale chemical analysis of living biological entities. For the first time, we introduce TERS experiments that have been performed with both the tip and sample completely immersed in water. We demonstrate that SiO x /Ag-coated AFM tips provide enhancement factors of >10 4 with visible light irradiation and are robust enough to be used in water. Furthermore, the tips have been protected from contaminants by adsorbing a self-assembled monolayer (SAM) of ethanethiolate on their Ag surfaces. The protection layer caused the enhancement to drop by a factor of approximately 5, but successfully prevented the adsorption of analyte molecules, carbon, and other contamination to the tip. Furthermore, our experiments have shown that the formation of carbonaceous contamination by laser irradiation on the tip is dramatically slowed down when TERS experiments are performed in water. Finally, a proof-of-principle study on SAMs of thiophenolate on Au surfaces demonstrates the feasibility of performing TERS in liquids.

Research paper thumbnail of Role of glycosaminoglycans in murine primary spinal neurulation

Developmental Biology, 2011

Research paper thumbnail of Life expectancy after spinal cord injury: a 50-year study

Spinal Cord, 2012

Cohort of incident cases from 1955 to 2006. To analyse acute and long-term mortality, estimate li... more Cohort of incident cases from 1955 to 2006. To analyse acute and long-term mortality, estimate life expectancy and identify survival patterns of individuals experiencing traumatic spinal cord injury (SCI). Specialised SCI unit in Australia. Data for patients with traumatic SCI admitted to a spinal unit in Sydney, Australia between January 1955 and June 2006 were collated and deaths confirmed. Cumulative survival probability was estimated using life-table techniques and mortality rates were calculated from the number of deaths and aggregate years of exposure. Standardised mortality ratios (SMRs) were estimated from the ratio of observed to expected number of deaths. Life expectancy was then estimated using adjusted attained age-specific mortality rates. From 2014 persons, 88 persons with tetraplegia (8.2%) and 38 persons with paraplegia (4.1%) died within 12 months of injury, most often with complete C1-4 tetraplegia. Among first-year survivors, overall 40-year survival rates were 47 and 62% for persons with tetraplegia and paraplegia, respectively. The most significant increases in mortality were seen in those with tetraplegia and American Spinal Injury Association Impairment Scale (AIS) grades A-C lesions, with SMRs between 5.4 and 9.0 for people &lt;50 years, reducing with advancing attained age. Estimated life expectancies from 25 to 65 years ranged between 69-64%, 74-65%, 88-91% and 97-96% for C1-4 AIS A-C, C5-8 A-C, T1-S5 A-C and all AIS D lesions, respectively. Survival related strongly to extent of neurological impairment. Future research should focus on identifying contextual factors, personal or environmental, that may contribute to the reduced life expectancy after SCI.

Research paper thumbnail of Age, gender, and side differences of cutaneous electrical perceptual threshold testing in an able-bodied population

The Journal of Spinal Cord Medicine, 2010

Objective:To investigate age, gender, and left-right differences in cutaneous electrical perceptu... more Objective:To investigate age, gender, and left-right differences in cutaneous electrical perceptual threshold (EPT) testing in an able-bodied, Australian sample.Study Design:Prospective experimental.Setting:Hospital-based spinal cord injuries unit.Methods:Cutaneous electrical stimulation of the 28 dermatomes at ASIA sensory key points (C2-S4/S5) was performed on 29 female and 16 male healthy volunteers aged 21 to 76 years. Mean EPTs for each dermatome were compared (repeated measures ANOVA) for left-right, gender-related, and age-related (</>50 years of age) differences.Results:There was no group difference between sides (repeated measures ANOVA, P = 0.934). Women across all ages had lower group mean EPTs than men (P < 0.0001). Women younger than age 50 years had lower mean EPTs than those older than age 50 years (P = 0.008). There was no group difference between younger and older men (P = 0.371). Analysis of individual dermatomes revealed no significant differences in thoracic dermatomes between genders or age groups, contrary to the limb dermatomes.Conclusion:There were gender differences in EPT values across all ages. Women had higher EPTs as they advanced in age, but this was less clear in men. There was considerable somatotopic variability in EPTs, especially in the lower limbs. If EPT testing is to be applied to detect subclinical changes within a dermatome, establishment of age- and gender-specific somatotopic normograms is a prerequisite.

Research paper thumbnail of For Fit's Sake: A Norms-Based Approach to Healthy Behaviors Through Influence of Presumed Media Influence

Health communication, Jan 22, 2016

Based on the influence of presumed media influence (IPMI) model as the theoretical framework, thi... more Based on the influence of presumed media influence (IPMI) model as the theoretical framework, this study examines how injunctive norms and personal norms mediate the influence of healthy lifestyle media messages on public intentions to engage in two types of healthy lifestyle behaviors-physical activity and healthy diet. Nationally representative data collected from 1,055 adults in Singapore demonstrate partial support for the key hypotheses that make up the extended IPMI model, highlighting the importance of a norms-based approach in health communication. Our results indicate that perceived media influence on others indirectly shaped public intentions to engage in healthy lifestyle behaviors through personal norms and attitude, providing partial theoretical support for the extended IPMI model. Practical implications for health communicators in designing health campaigns media messages to motivate the public to engage in healthy lifestyle are discussed.

Research paper thumbnail of 51.: Subacute delayed ascending myelopathy: A rare early neurological complication of spinal cord injury

Journal of Clinical Neuroscience, Nov 30, 2014

Research paper thumbnail of Management of spinal cord injury in general practice - part 2

Australian Family Physician, May 1, 2008

BACKGROUND: People with spinal cord injury (SCI) are at risk of developing complications specific... more BACKGROUND: People with spinal cord injury (SCI) are at risk of developing complications specific to the condition. As the incidence of SCI is low, general practitioners may not be familiar with these complications.OBJECTIVE: This article completes the overview of common problems associated with SCI, highlighting specific points to be aware of when managing pressure areas, pain, spasticity, musculoskeletal disorders, neurological complications, sexual dysfunction, fertility, and psychological wellbeing. It aims to give readers a broad understanding of SCI issues, thereby increasing their confidence and ability to provide first line assessment and management.DISCUSSION: General practitioners are well placed to recognise and manage some conditions associated with SCI. Systematically addressing the issues can also serve as the springboard for health promotion, thus pre-empting and potentially avoiding morbidity for the patient with SCI.

Research paper thumbnail of Fitting disability into practice--focus on spinal cord injury

Australian family physician, 2007

People with specialised needs such as spinal cord injury (SCI) may not feature prominently in the... more People with specialised needs such as spinal cord injury (SCI) may not feature prominently in the caseload of the general practitioner. However, when people with chronic disabilities are aggregated, they constitute a reasonable percentage of consultations. It may be difficult to deliver high quality health care for such complex patients. We propose a method for integration of health care and prevention activities for patients with SCI in general practice, using tools such as a structured questionnaire, general practice management plans and team care arrangements. Practice structures can efficiently and effectively accommodate people with disabilities. Tools can serve as clinical prompts, help with planning, save time, and be financially rewarding. Importantly, they can anchor a 12 month cycle of preventive health care, allowing systematic monitoring and increasing intensity/coordination of professional input for those identified with greatest needs.

Research paper thumbnail of Management of spinal cord injury in general practice - part 2

Australian family physician, 2008

People with spinal cord injury (SCI) are at risk of developing complications specific to the cond... more People with spinal cord injury (SCI) are at risk of developing complications specific to the condition. As the incidence of SCI is low, general practitioners may not be familiar with these complications. This article completes the overview of common problems associated with SCI, highlighting specific points to be aware of when managing pressure areas, pain, spasticity, musculoskeletal disorders, neurological complications, sexual dysfunction, fertility, and psychological wellbeing. It aims to give readers a broad understanding of SCI issues, thereby increasing their confidence and ability to provide first line assessment and management. General practitioners are well placed to recognise and manage some conditions associated with SCI. Systematically addressing the issues can also serve as the springboard for health promotion, thus pre-empting and potentially avoiding morbidity for the patient with SCI.

Research paper thumbnail of Age, gender, and side differences of cutaneous electrical perceptual threshold testing in an able-bodied population

The journal of spinal cord medicine, 2010

To investigate age, gender, and left-right differences in cutaneous electrical perceptual thresho... more To investigate age, gender, and left-right differences in cutaneous electrical perceptual threshold (EPT) testing in an able-bodied, Australian sample. Prospective experimental. Hospital-based spinal cord injuries unit. Cutaneous electrical stimulation of the 28 dermatomes at ASIA sensory key points (C2-S4/S5) was performed on 29 female and 16 male healthy volunteers aged 21 to 76 years. Mean EPTs for each dermatome were compared (repeated measures ANOVA) for left-right, gender-related, and age-related (</ >50 years of age) differences. There was no group difference between sides (repeated measures ANOVA, P = 0.934). Women across all ages had lower group mean EPTs than men (P < 0.0001). Women younger than age 50 years had lower mean EPTs than those older than age 50 years (P = 0.008). There was no group difference between younger and older men (P = 0.371). Analysis of individual dermatomes revealed no significant differences in thoracic dermatomes between genders or age gro...

Research paper thumbnail of Electrical perceptual threshold testing: a validation study

The journal of spinal cord medicine, 2009

To investigate inter-rater and intra-rater reliability of electrical perceptual threshold (EPT) t... more To investigate inter-rater and intra-rater reliability of electrical perceptual threshold (EPT) testing in assessing somatosensory function in healthy volunteers. Prospective experimental. Hospital-based spinal cord injuries unit. Cutaneous electrical stimulation of 4 dermatomes at ASIA sensory key points (C3, T1, L3, and S2) was performed on 40 control subjects. The lowest ascending stimulus intensity at which sensation was perceived was recorded as the EPT. Mean EPT values for each dermatome, as determined by 2 testers at 2 time points, were examined and plotted against a normative template. Differences and associations between intra- and inter-rater measurements and left-right measurements were studied. EPT results for 2 people with spinal cord injuries were also examined. EPT measurements from left and right sides, obtained from the 2 time points and 2 testers, were found to be strongly associated, with the exception of left and right side measurements at the S2 dermatome. No si...

Research paper thumbnail of Development of a Checklist to Support Health Monitoring and Prevention Activities of Persons with SCI in General Practice

Research paper thumbnail of Changes in electrical perceptual threshold in the first 6 months following spinal cord injury

The Journal of Spinal Cord Medicine, 2011

Objectives: To investigate the use of electrical perceptual threshold (EPT) testing to follow the... more Objectives: To investigate the use of electrical perceptual threshold (EPT) testing to follow the natural history of sensory progression after complete and incomplete acute spinal cord injury (SCI) and to compare EPT changes with the American Spinal Injuries Association (ASIA) Impairment Scale (AIS). Study Design: Prospective descriptive study. Methods: ASIA examination and EPT testing was performed on 17 patients (7 AIS A, 10 AIS B-D), within 1, 3, and 6 months after acute SCI. EPT assessment was carried out bilaterally at ASIA sensory points from 2 levels above the neurological level to all levels below, including the sacral segments. Comparisons of EPT values above, at, and below the SCI were made at the three time points as well as comparisons of EPT data to ASIA assessment. Results: There was poor agreement between lowest normal level on EPT and ASIA assessment. Over time, EPTs tended to deteriorate above and at the ASIA level in AIS A patients with modest changes below the neurological level of injury (NLI), mainly where EPTs correlated with the zone of partial preservation. Sacral sparing was detected in one patient with EPT testing, but not with ASIA assessment. AIS B-D patients showed improvement at the ASIA level and extensive changes, both improvement and deterioration, below the NLI. Conclusion: EPT testing has sufficient sensitivity to detect subclinical changes in sensory function as early as the first month post-SCI, which is not apparent in ASIA examination. In particular, the testing is able to show abnormalities at and around the injury site for both complete and incomplete SCI. In addition, EPT allows for the detection and monitoring of alterations, both improvements and deterioration, in the abnormal range of sensation.

Research paper thumbnail of Organization of the neuroepithelial actin cytoskeleton is regulated by heparan sulfation during neurulation

Neuroscience Letters, 2013

Research paper thumbnail of Performing tip-enhanced Raman spectroscopy in liquids

Journal of Raman Spectroscopy, 2009

Many outstanding questions in biology and medicine require analytical tools that provide imaging ... more Many outstanding questions in biology and medicine require analytical tools that provide imaging and chemical information with high spatial resolution. Tip-enhanced Raman spectroscopy (TERS) has been shown to allow both topographic and label-free chemical information to be obtained with a lateral resolution of approximately 20-50 nm, but has been performed only in air or ultrahigh vacuum until now. Since most biological samples such as cells and tissues can only be studied in their active state if they are kept in aqueous buffers, TERS in liquids would be a crucial step towards nanoscale chemical analysis of living biological entities. For the first time, we introduce TERS experiments that have been performed with both the tip and sample completely immersed in water. We demonstrate that SiO x /Ag-coated AFM tips provide enhancement factors of >10 4 with visible light irradiation and are robust enough to be used in water. Furthermore, the tips have been protected from contaminants by adsorbing a self-assembled monolayer (SAM) of ethanethiolate on their Ag surfaces. The protection layer caused the enhancement to drop by a factor of approximately 5, but successfully prevented the adsorption of analyte molecules, carbon, and other contamination to the tip. Furthermore, our experiments have shown that the formation of carbonaceous contamination by laser irradiation on the tip is dramatically slowed down when TERS experiments are performed in water. Finally, a proof-of-principle study on SAMs of thiophenolate on Au surfaces demonstrates the feasibility of performing TERS in liquids.

Research paper thumbnail of Role of glycosaminoglycans in murine primary spinal neurulation

Developmental Biology, 2011

Research paper thumbnail of Life expectancy after spinal cord injury: a 50-year study

Spinal Cord, 2012

Cohort of incident cases from 1955 to 2006. To analyse acute and long-term mortality, estimate li... more Cohort of incident cases from 1955 to 2006. To analyse acute and long-term mortality, estimate life expectancy and identify survival patterns of individuals experiencing traumatic spinal cord injury (SCI). Specialised SCI unit in Australia. Data for patients with traumatic SCI admitted to a spinal unit in Sydney, Australia between January 1955 and June 2006 were collated and deaths confirmed. Cumulative survival probability was estimated using life-table techniques and mortality rates were calculated from the number of deaths and aggregate years of exposure. Standardised mortality ratios (SMRs) were estimated from the ratio of observed to expected number of deaths. Life expectancy was then estimated using adjusted attained age-specific mortality rates. From 2014 persons, 88 persons with tetraplegia (8.2%) and 38 persons with paraplegia (4.1%) died within 12 months of injury, most often with complete C1-4 tetraplegia. Among first-year survivors, overall 40-year survival rates were 47 and 62% for persons with tetraplegia and paraplegia, respectively. The most significant increases in mortality were seen in those with tetraplegia and American Spinal Injury Association Impairment Scale (AIS) grades A-C lesions, with SMRs between 5.4 and 9.0 for people &lt;50 years, reducing with advancing attained age. Estimated life expectancies from 25 to 65 years ranged between 69-64%, 74-65%, 88-91% and 97-96% for C1-4 AIS A-C, C5-8 A-C, T1-S5 A-C and all AIS D lesions, respectively. Survival related strongly to extent of neurological impairment. Future research should focus on identifying contextual factors, personal or environmental, that may contribute to the reduced life expectancy after SCI.