Does consumption of polyunsaturated fatty acids influence on neurorehabilitation in traumatic spinal cord-injured individuals? a double-blinded clinical trial A comparison of posttraumatic stress disorder in veterans with and without spinal cord injury. A randomized trial of functional electrical stimulation for walking in incomplete spinal cord injury: Effects on walking competency Phenotypes and predictors of pain following traumatic spinal cord injury: a prospective study. A longitudinal study of the prevalence and characteristics of pain in the first 5 years following spinal cord injury Pain following spinal cord injury
Study design : A double-blinded r and omized clinical trial . Objectives : The anti-inflammatory and neuroprotective effect of omega-3 fatty acids have been shown so far , but still its influence on clinical measures in spinal cord-injured human models were not known . We tried to investigate changes in disability and dependency scores in chronic traumatic spinal cord-injured patients after 14 months of ω-3 fatty-acid consumption . Methods : Main inclusion criteria were : traumatic spinal cord injury ( SCI ) and post injury duration longer than 1 year .  Disability and dependency was assessed using UK Functional Independence Measure and Functional Assessment Measure ( FIM+FAM ) scale . MorDHA capsules ( 435 mg of docosahexaenoic acid and 65 mg of eicosapentaenoic acid ) were administered in treatment group , whereas control group received placebo capsules for 14 months . UK FIM+FAM scale were estimated before intervention and at the end of the trial . Results : Fifty-four patients in treatment group and 50 patients in placebo group completed the trial . Highest scores were detected in cognitive domain in both groups before and after intervention . Most dependency was observed in locomotion subscale and secondly in sphincter control . Scores of none of these components were changed by ω-3 fatty-acid consumption . Conclusion : Although omega-3 fatty acids have been shown to have neuroprotective effect in acute phase of SCI , it seems that they have no significant influence in chronic inflammatory state of SCI . The positive effect of ω-3 fatty acid in chronic neurorecovery process , if exists , is weaker to exert any significant improvement in UK FIM+FAM scores in spinal cord-injured individuals The authors assessed effects of  paraplegic and quadriplegic spinal cord injuries ( SCIs )  on posttraumatic stress disorder ( PTSD ) by comparing severity and prevalence of PTSD in these groups to a sample of controls who experienced traumatic injuries other than SCI . The authors found that veterans with quadriplegia reported significantly less severe current PTSD symptoms than controls who were not significantly different from veterans with paraplegia . These results suggest that sustaining a quadriplegic SCI decreases risk of current PTSD , whereas sustaining a paraplegic SCI is associated with greater risk of PTSD , although the risk is no greater than that incurred from experiencing the trauma itself Abstract Background Multi-channel surface functional electrical stimulation ( FES ) for walking has been used to improve voluntary walking and balance in individuals with spinal cord injury ( SCI ) . Objective To investigate short- and long-term benefits of 16 weeks of thrice-weekly FES-assisted walking program , while ambulating on a body weight support treadmill and harness system , versus a non-FES exercise program , on improvements in gait and balance in individuals with chronic incomplete traumatic SCI , in a r and omized controlled trial design . Methods Individuals with traumatic and chronic ( ≥18 months ) motor incomplete SCI ( level C2 to T12 , American Spinal Cord Injury Association Impairment Scale C or D ) were recruited from an outpatient SCI rehabilitation hospital , and r and omized to FES-assisted walking therapy ( intervention group ) or aerobic and resistance training program ( control group ) . Outcomes were assessed at baseline , and after 4 , 6 , and 12 months . Gait , balance , spasticity , and functional measures were collected . Results Spinal cord independence measure ( SCIM ) mobility sub-score improved over time in the intervention group compared with the control group ( baseline/12 months : 17.27/21.33 vs. 19.09/17.36 , respectively ) . On all other outcome measures the intervention and control groups had similar improvements . Irrespective of group allocation walking speed , endurance , and balance during ambulation all improved upon completion of therapy , and majority of participants retained these gains at long-term follow-ups . Conclusions Task-oriented training improves walking ability in individuals with incomplete SCI , even in the chronic stage . Further r and omized controlled trials , involving a large number of participants are needed , to verify if FES-assisted treadmill training is superior to aerobic and strength training UNLABELLED Pain is a serious consequence of spinal cord injury ( SCI ) . Our aim was to investigate the temporal aspects of different types of pain following traumatic SCI and to determine possible predictors of neuropathic pain . Prospect i ve data on 90 patients were collected at 1 , 6 , and 12 months after traumatic SCI . The patients completed question naires on pain severity , descriptors , and impact and underwent clinical examination with bedside sensory testing .  Eighty-eight patients completed the 12-month follow-up . Approximately 80 % of patients reported any type of pain at all 3 time points . Neuropathic pain related to SCI increased over time , and musculoskeletal pain decreased slightly , with both being present in 59 % of patients at 12 months ; other neuropathic pain not related to SCI and visceral pain were present in 1 to 3 % . At-level neuropathic pain present at 1 month resolved in 45 % and below-level pain resolved in 33 % . Early ( 1 month ) sensory hypersensitivity ( particularly cold-evoked dysesthesia ) was a predictor for the development of below-level , but not at-level , SCI pain at 12 months . In conclusion , the present study demonstrates phenotypical differences between at-level and below-level SCI pain , which is important for future studies aim ing to uncover underlying pain mechanisms . PERSPECTIVE The finding that early sensory hypersensitivity predicts later onset of below-level central neuropathic pain may help to identify patients at risk of developing neuropathic pain conditions after traumatic spinal cord injury . Information about onset of pain may help to identify different phenotypes in neuropathic pain conditions & NA ; A longitudinal cohort study of 100 people with traumatic spinal cord injury ( SCI ) was performed to determine the prevalence and severity of different types of pain ( musculoskeletal , visceral , neuropathic at‐level , neuropathic below‐level ) at 5 years following SCI . Prospect i ve data on the characteristics of pain up to 6 months following injury had been collected previously and allowed comparisons between the presence of pain at different time points . In addition , we sought to determine the relationship between the presence of pain and physical factors related to the injury such as level of lesion , completeness and clinical SCI syndrome . We also obtained information regarding mood , global self‐rated health and the impact of pain on function . Of the 100 subjects in the original cohort , 73 were available for follow up . When all types of pain were included , 59 of the 73 subjects ( 81 % ) reported the presence of pain . Musculoskeletal pain was the most common type of pain experienced and was present in 43 subjects ( 59 % ) , at‐level neuropathic pain was present in 30 subjects ( 41 % ) , below‐level neuropathic pain was present in 25 subjects ( 34 % ) and visceral pain was present in four subjects ( 5 % ) . Overall , 58 % reported their pain as severe or excruciating and those with visceral pain were most likely to rate their pain in these categories . There was no relationship between the presence of pain overall and level or completeness of lesion , or type of injury . However , tetraplegics were more likely to report below‐level neuropathic pain . This study prospect ively demonstrates the differing time courses of different types of pain over the first 5 years following SCI . There was a strong correlation between the presence of both types of neuropathic pain at 5 years and earlier time points but both visceral pain and musculoskeletal pain demonstrated a poor correlation between time points . Chronic visceral pain occurs in a small percentage of patients and does not correlate with the presence of visceral pain early following injury . Those with neuropathic pain early following their injury are likely to continue to experience ongoing pain and the pain is likely to be severe . In contrast , chronic musculoskeletal pain is more common but less likely to be severe and can not be predicted by the presence of pain in the first 6 months following injury Some patients with spinal cord injury ( SCI ) complain of severe pain . The purpose of this study was to investigate the prevalence and classification of SCI-related pain , in terms of severity , location , aggravating and alleviating factors . 47 SCI individuals were studied between 15 and 67 years of age . Sixty-one percent of subjects experienced pain of moderate to severe intensity . 32 subjects complained of pain in the lower limbs , five patients had pain in the visceral region , eight in the pelvic and perineal areas . The pain duration was for a median of 5 weeks . The patients with pain were older ( median 41 years ) than those without pain ( median 23 years ) .  Pain was reported to be more intense in the evening and at night . The incidence of pain was higher in patients with thoracolumbar and incomplete spinal cord lesions .  Inactivity , stress , weather change , overactivity were identified as aggravating factors . Sleep and rest were demonstrated as alleviating factors
The reported rate did not appear to be related to study quality .
Pain prevalence in the combined sample s did not appreciably differ between males and females , those with complete versus incomplete SCI , and those with paraplegia versus tetraplegia .
We conclude that too much heterogeneity was present in the reports to calculate a post-SCI pain prevalence rate using meta-analytic methods .
Published studies have reported widely divergent estimates of the prevalence of chronic pain among individuals with ( traumatic ) spinal cord injury ( SCI ) .