Community EP062 - Training Balance with Breathing with Kanishka Gambhir

Join us in this episode for a conversation with Kanishka Gambhir, cardiopulmonary physiotherapist and teaching associate at Amity University, Uttar Pradesh, India, to hear about her paper, “Inspiratory Muscle Training Improves Functional Sitting Balance More Than Usual Care in Individuals With Spinal Cord Injury: A Randomized Controlled Trial,” published in Archives of Physical Medicine and Rehabilitation.In this conversation, we explore the implementation of inspiratory muscle training within a tertiary spinal cord injury rehabilitation program. Kanishka discusses participant selection, intervention delivery, outcome assessment, and the primary findings from her randomized controlled trial. We also examine potential mechanisms linking inspiratory muscle performance and balance, and discuss the feasibility of integrating inspiratory muscle training into routine clinical practice.We invite you to listen in as Kanishka discusses the implementation of a co-administered breathing and balance program, future research directions, and the translational implications of this work for SCI rehabilitation.

Join us in this episode for a conversation with Kanishka Gambhir, cardiopulmonary physiotherapist and teaching associate at Amity University, Uttar Pradesh, India, to hear about her paper, “Inspiratory Muscle Training Improves Functional Sitting Balance More Than Usual Care in Individuals With Spinal Cord Injury: A Randomized Controlled Trial,” published in Archives of Physical Medicine and Rehabilitation.In this conversation, we discuss how strengthening the muscles used for breathing may also improve sitting balance after spinal cord injury. Kanishka explains the connection between breathing and postural control, describes what inspiratory muscle training looks like in practice, and shares the main findings from her randomized controlled trial. We also explore what these improvements may mean in everyday life, the feasibility of implementing this approach in rehabilitation settings, and the research questions that remain unanswered. We invite you to listen in as Kanishka shares her perspective on respiratory rehabilitation, spinal cord injury research in India, and the future of inspiratory muscle training after SCI.

Join us in this special combined episode for a roundtable discussion with six physicians who are also living with spinal cord injury: Drs. Hammad Aslam, Lance Goetz, Suzy Kim, Jesse Lieberman, John Lin, and Trevor Dyson-Hudson. Representing a diverse range of clinical practice settings, injury experiences, and career paths, these physicians share perspectives shaped by their dual roles as healthcare providers living with SCI. In this conversation, we explore how spinal cord injury influenced their journeys through medical training, specialty selection, and professional development. Our guests reflect on navigating medical education before, during, and after injury, the challenges and opportunities associated with practicing medicine with varying levels of function, and the ways lived experience has informed their interactions with patients, colleagues, and trainees. They also discuss memorable clinical encounters, evolving perspectives on disability within healthcare, and the unique insights that arise from occupying both sides of the patient-provider relationship. We invite you to listen in as these physicians share lessons learned throughout their careers, discuss what excites them most about the future of spinal cord injury medicine, and offer thoughtful advice for healthcare professionals, trainees, and individuals living with SCI.

Join us in this episode for a conversation with Dr. Hope Jervis‑Rademeyer, physical therapist and Assistant Professor at the University of Saskatchewan, to hear about her paper, “Development of a functional electrical stimulation cycling toolkit for spinal cord injury rehabilitation in acute care hospitals: A participatory action approach,” published in PLOS One. In this conversation, we explore the early application of functional electrical stimulation cycling after spinal cord injury, and the potentially unique benefits of delivering this modality during a critical neuroplastic window in an in-patient hospital settings. Dr. Jervis‑Rademeyer highlights how stakeholder engagement, participatory action research, and iterative design were used to identify key barriers such as workflow constraints, lack of training, and competing clinical priorities, and translate them into actionable resources for both healthcare providers and patients. The resulting toolkit provides structured guidance on patient selection, safety, dosing, setup, and session delivery, alongside accessible information for individuals with spinal cord injury and their caregivers, with the goal of enabling broader adoption without displacing existing services. We invite you to listen in as Dr. Jervis‑Rademeyer discusses the importance of early intervention and the role of local champions in driving adoption.

Join us in this episode for a conversation with Dr. Hope Jervis‑Rademeyer, physical therapist and Assistant Professor at the University of Saskatchewan, to hear about her paper, “Development of a functional electrical stimulation cycling toolkit for spinal cord injury rehabilitation in acute care hospitals: A participatory action approach,” published in PLOS One. In this conversation, we explore the early application of functional electrical stimulation cycling after spinal cord injury, and the potentially unique benefits of delivering this modality during a critical neuroplastic window in an in-patient hospital settings. Dr. Jervis‑Rademeyer highlights how stakeholder engagement, participatory action research, and iterative design were used to identify key barriers such as workflow constraints, lack of training, and competing clinical priorities, and translate them into actionable resources for both healthcare providers and patients. The resulting toolkit provides structured guidance on patient selection, safety, dosing, setup, and session delivery, alongside accessible information for individuals with spinal cord injury and their caregivers, with the goal of enabling broader adoption without displacing existing services. We invite you to listen in as Dr. Jervis‑Rademeyer discusses the importance of early intervention and the role of local champions in driving adoption.

Join us in this episode for a conversation with Aaron Phillips, PhD, scientist and Associate Dean of the Medical School at the University of Calgary. In this conversation we discuss two papers, A neuronal architecture underlying autonomic dysreflexia published in the journal Nature, and An implantable system to restore hemodynamic stability after spinal cord injury published in the journal Nature Medicine. In these papers Dr. Phillips and his team first identify specific neuronal components, and their location, responsible for blood pressure increases due to autonomic dysreflexia. Then an implantable device is demonstrated to help control, via neuromodulation, blood pressure fluctuations in both pre-clinical models and people living with SCI. We invite you to listen in as Dr. Phillips outlines this tour de force in neurologically understanding, and intervening on, hemodynamic instability after SCI.

Join us in this episode for a conversation with Aaron Phillips, PhD, scientist and Associate Dean of the Medical School at the University of Calgary. In this conversation we discuss two papers, A neuronal architecture underlying autonomic dysreflexia published in the journal Nature, and An implantable system to restore hemodynamic stability after spinal cord injury published in the journal Nature Medicine. In these papers Dr. Phillips and his team first identify specific neuronal components, and their location, responsible for blood pressure increases due to autonomic dysreflexia. Then an implantable device is demonstrated to help control, via neuromodulation, blood pressure fluctuations in both pre-clinical models and people living with SCI. We invite you to listen in as Dr. Phillips outlines this tour de force in neurologically understanding, and intervening on, hemodynamic instability after SCI.

Join us in this episode for a conversation with Argyrios “Argy” Stampas, MD, physiatrist, Vice Chair of Research and Innovation and Full Professor in the Department of Physical Medicine and Rehabilitation at UTHealth Houston’s McGovern Medical School, and Director of Spinal Cord Injury Medicine Research at TIRR Memorial Hermann. In this conversation we discuss the paper titled “Reduction of Overactive Bladder Medications in Spinal Cord Injury with Self-Administered Neuromodulation: A randomized Trial" published in The Journal of Urology. In this paper Dr. Stampas discusses self-administered tibial nerve stimulation (TNS) for neurogenic bladder after spinal cord injury (SCI). The discussion highlights how noninvasive neuromodulation can reduce overactive bladder medication use, explores the underlying mechanisms, and considers what these findings mean for daily life and future SCI bladder management. We invite you to listen in as Dr. Stampas describes this device with the potential to reduce drug dependence for overactive bladder, and trust you will enjoy this episode.

Join us in this episode for a conversation with Argyrios “Argy” Stampas, MD, physiatrist, Vice Chair of Research and Innovation and Full Professor in the Department of Physical Medicine and Rehabilitation at UTHealth Houston’s McGovern Medical School, and Director of Spinal Cord Injury Medicine Research at TIRR Memorial Hermann. In this conversation we discuss the paper titled “Reduction of Overactive Bladder Medications in Spinal Cord Injury with Self-Administered Neuromodulation: A randomized Trial" published in The Journal of Urology. In this paper Dr. Stampas discusses self-administered tibial nerve stimulation (TNS) for neurogenic bladder after spinal cord injury (SCI). The discussion highlights how noninvasive neuromodulation can reduce overactive bladder medication use, explores the underlying mechanisms, and considers what these findings mean for daily life and future SCI bladder management. We invite you to listen in as Dr. Stampas describes this device with the potential to reduce drug dependence for overactive bladder, and trust you will enjoy this episode.

Join us this episode for a conversation with Linda Ehrlich-Jones, RN, PhD, Associate Director of the Center for Rehabilitation Outcomes Research at Shirley Ryan AbilityLab and a Research Professor in the Department of Physical Medicine & Rehabilitation at Northwestern University Feinberg School of Medicine. In this conversation we discuss the current state of the art in medicine for chronic pain in people living with spinal cord injury (SCI), with a focus on care that does not require drugs. The paper explaining the process is titled "Behavioral/Physical and Stimulation Interventions for Chronic Pain Following Spinal Cord Injury: A systematic review" published in Topics in Spinal Cord Injury Rehabilitation. In this paper Dr. Ehrlich-Jones compared behavioral and complementary therapies with neuromodulation-based stimulation approaches for managing chronic neuropathic (or "nerve") pain after SCI. We invite you to listen in as Dr. Ehrlich-Jones gives a thorough current update on drug-free pain management, and trust you will enjoy this episode.