Neuropathic pain post spinal cord injury part 1: systematic review of physical and behavioral treatment. Functional electrical stimulation therapy for grasping in traumatic incomplete spinal cord injury: randomized control trial. Lipid profile in spinal cord-injured women with different injury levels. Spinal Cord Injury Rehabilitation Evidence: Methods of the SCIRE Systematic Review. Sexuality and sexual life in women with spinal cord injury: a controlled study. Client-Centered Occupational Therapy for Individuals with Spinal Cord Injury Application of functional neuromuscular stimulation to children with spinal cord injuries: candidate selection for upper and lower extremity research
BACKGROUND Neuropathic pain has various physiologic and psychosocial aspects . Hence , there is a growing use of adjunct nonpharmacological therapy with traditional pharmacotherapy to reduce neuropathic pain post spinal cord injury ( SCI ) . OBJECTIVE The purpose of this study was to conduct a systematic review of published research on nonpharmacological treatment of neuropathic pain after SCI . METHODS MEDLINE , CINAHL , EMBASE , and PsycINFO data bases were search ed for articles addressing nonpharmacological treatment of pain post SCI . Articles were restricted to the English language . Article selection was conducted by 2 independent review ers with the following inclusion criteria : the subjects participated in a treatment or intervention for neuropathic pain ; at least 50 % of the subjects had an SCI ; at least 3 subjects had an SCI ; and a definable intervention was being studied . Data extracted included study design , study type , subject demographics , inclusion and exclusion criteria , sample size , outcome measures , and study results . R and omized controlled trials ( RCTs ) were assessed for quality using the Physiotherapy Evidence Data base ( PEDro ) assessment scale . Levels of evidence were assigned to each intervention using a modified Sackett scale . RESULTS The 16 articles selected for this review fell into 1 of 2 categories of nonpharmacological management of pain after SCI : physical and behavioral treatments . The pooled sample size of all studies included 433 participants . Of the 16 studies included , 7 were level 1 , 3 were level 2 , and 6 were level 4 studies . CONCLUSIONS Physical interventions demonstrated the strongest evidence based on quality of studies and numbers of RCTs in the nonpharmacological treatment of post-SCI pain . Of these interventions , transcranial electrical stimulation had the strongest evidence of reducing pain . Despite a growing body of literature , there is still a significant lack of research on the use of nonpharmacological therapies for SCI pain The purpose of this single-site r and omized control trial was to assess the short-term and long-term efficacy of functional electrical stimulation ( FES ) therapy over conventional occupational therapy in improving voluntary h and function in incomplete C4-C7 spinal cord injury individuals . All 22 participants recruited in this r and omized control trial received treatment for both the left and right upper extremities . Every participant , irrespective of group allocation , received one dose ( 60 min per day , 5 days per week for the duration of 8 weeks ) of conventional occupational therapy for h and function . Of the 22 participants , 12 individuals received an additional dose of conventional occupational therapy , while the remaining 10 participants received a dose of FES h and therapy . The primary outcome measure was Functional Independence Measure ( FIM ) self-care subscore . The secondary outcome measures were Spinal Cord Independence Measure ( SCIM ) self-care subscore and Toronto Rehabilitation Institute H and Function Test ( TRI-HFT ) . The participants who received FES therapy showed significantly greater improvements in h and function at discharge , and were able to maintain their gains at long-term follow-up as assessed using FIM self-care subscore , SCIM self-care subscore , and TRI-HFT . The FES therapy effectively increased independence and thereby improved quality of life of individuals with tetraplegia when compared with conventional occupational therapy Background . In dependence on their injury level , male subjects with spinal cord injury ( SCI ) exhibit a less favorable lipoprotein profile than control persons . The impairment of the sympathetic nervous system and the fact that persons with spinal cord injury are subject to extreme physical inactivity may have an influence on their lipid profile and lipoprotein(a ) concentration . It has been shown that sex-specific differences in hormonal regulation are responsible for differences in lipoprotein levels between nondisabled men and women . However , the role of hormones on lipoprotein levels has not been investigated in female subjects with spinal cord injury . Methods . Therefore , we performed a detailed investigation regarding the lipid profile in 32 premenopausal women with spinal cord injury ranging from tetraplegia to low paraplegia and in 36 control subjects .  VO(2max ) was determined by a wheelchair ergometry with stepwise increase in work load . Result . VO(2max ) was significantly higher in paraplegics than in tetraplegics but significantly lower than in control subjects . Paraplegics had significantly higher low-density lipoprotein levels than both tetraplegics and control persons . The lipid profile of female tetraplegics was characterized by elevated triglycerides . An association between high-density lipoprotein levels and spinal cord injury or the level of the injury was not observed . No significant difference in lipoprotein(a ) was found within SCI individuals as well as between SCI individuals and control persons indicating the predominant genetic determination of lipoprotein(a ) and the thus related cardiovascular risk . Conclusion . Despite the extreme reduction of VO(2max ) , the assumed physical inactivity and low serum catecholamine levels due to the impairment of the sympathetic nervous system , female tetraplegic persons did not show an adverse lipoprotein profile with respect to high-density lipoprotein cholesterol levels . If the higher low-density lipoprotein cholesterol concentrations in female with spinal cord injury with low lesion levels or the elevated TG levels in female tetraplegics bare relevance with respect to an increased cardiovascular risk in this population needs to be clarified in further longitudinal investigations The Spinal Cord Injury Rehabilitation Evidence ( SCIRE ) is a synthesis of the research evidence underlying rehabilitation interventions to improve the health of people living with SCI . SCIRE covers a comprehensive set of topics and in this issue we present six papers relevant to SCI rehabilitation clinicians ( SCI inpatient rehabilitation practice s , gait strategies , upper extremity reconstructive surgery , spasticity treatments , cardiovascular health and bone health ) . The SCIRE used a systematic and well-defined protocol to assess and synthesize the evidence . Each article was scored for its method ological quality using either the Physiotherapy Evidence Data base ( PEDro ) Score for r and omized controlled trials or the Downs and Black Tool for other types of studies . Following the individual study assessment , conclusions were drawn about the accumulated studies for each topic of interest based on the levels of evidence , quality of studies and concurring evidence . The SCIRE project was design ed for health professionals to inform them of best practice OBJECTIVE To describe sexual life in women with spinal cord injury . DESIGN Controlled cross-sectional , question naire . PARTICIPANTS AND METHODS Women , 18 - 65 years , treated at spinal cord centres in Sweden , Denmark , Norway , Finl and and Icel and . 545 women ( 57 % ) completed the question naires . The age-matched control group consisted of 507 women . The 104-item Spinal Cord Injury Women Question naire , was design ed to assess different dimensions of sexuality . RESULTS 80 % of the women with spinal cord injury had engaged in sex after the injury . Reasons for not wanting or not having the courage to be intimate and sexual were physical problems , low sexual desire , low self-esteem and feelings of being unattractive . The motivations of both the women with spinal cord injury and controls to engage in sexual activity were intimacy-based rather than primarily sexual . Being in the right mood both before and during sex to become receptive to sexual stimulation was important . CONCLUSION For women who are able to overcome the physical restrictions and mental obstacles due to injury , it is possible to regain an active and positive sexual life together with a partner . Sexual information and counselling should be available both during initial rehabilitation and later when the women have returned to their homes A r and omized controlled trial investigated the effect of client-centered Occupational Therapy on individuals with spinal cord injuries ( SCI ) . Twenty-one subjects , 4 to 6 months post acute rehabilitation , received eight in-home , client-centered Occupational Therapy sessions or eight visits from social visitors . The Functional Independence Measure ( FIM ) , the Craig H and icap Reporting and Assessment Technique ( CHART ) , the Role Checklist and the Life Satisfaction Inventory-A ( LSIA )  were administered pre and post interventions . Analyses showed no differences between groups on the CHART and the FIM ; the Role Checklist showed the Occupational Therapy group took on a limited number of new life roles ; however , a statistically significant difference was found between groups post intervention for LSIA ( p < 0.05 ) This paper summarizes the results of screening for participation in research programs involving functional neuromuscular stimulation ( FNS ) . It examines the characteristics of a group of children and teenagers with spinal cord injuries ( SCI ) identified as potential c and i date s for FNS  as defined by the rigorous inclusion criteria of the research studies . One hundred and thirteen children and teenagers under the age of 20 with cervical , thoracic or lumbar level spinal cord injuries were examined for inclusion in an experimental program of FNS to provide st and ing , walking , or prehension . Although biased towards adolescents with complete midthoracic and midcervical injuries , the age , sex , injury level , etiology , and neurological status of the sample coincided with previously published reports and consisted predominantly of teenage males injured in motor vehicle or sports related accidents . Approximately half of the individuals examined were physically appropriate for research participation without preparatory intervention . Treatment options to prepare individuals for FNS were identified in 25 % of those considered inappropriate at the initial evaluation , indicating that the potential user population of clinical systems may be larger than estimates obtained from research applications . Peripheral denervation was the single most prevalent physical impediment to the application of FNS . Although the incidence of lower motor neuron ( LMN ) involvement was similar in subjects with tetraplegia and paraplegia , those with cervical lesions more frequently exhibited other medical complications that interfered with the application of FNS .  Surgical procedures involving transfer of paralyzed but excitable muscles were identified in almost one third of the c and i date s with tetraplegia who were excluded due to denervation . Of those physically appropriate , psychological factors eliminated several c and i date s from consideration . Such concerns may also be addressed with suitable intervention in preparation for the clinical application of FNS . Almost 50 % of those appropriate for FNS research elected to participate in the programs , with those declining citing the hospitalization , time and travel commitments as the primary factors influencing their decisions . Results suggest that FNS for st and ing , walking and h and grasp may be an option for a significant percentage of the pediatric SCI population
Although there was a lack of consensus among the selected studies , the majority of them presented a strong correlation between physical activity and variables of quality of life and /or functional independence .
Thus , physical activity appears to have an important influence on social relationships , functional independence , psychological factors , and physical aspects , which can enhance quality of life and independence in the performance of daily activities
This study aim ed to perform a systematic review of studies that address the influence of physical activity on the quality of life and functional independence of adult individuals with spinal cord injury .