Background: Burnout is an emerging critical issue facing specialists and trainees in all disciplines and not particularly studied among physiatry specialists and trainees in Saudi Arabia during the COVID-19 pandemic. Objective: To assess physiatrist burnout, depression, anxiety, and stress during the current COVID-19 pandemic crisis in Saudi Arabia. Design: Cross-sectional study. Setting: By distributing an electronic survey, the researcher assessed burnout using the Maslach Burnout Inventory (MBI) Human Services Survey (HSS) in the midst of the curfew that Saudi authorities imposed. Participants: One hundred one participating trainees, specialists, and consultants. Results: Of the 101 study participants, the majority (73.3%) were between the ages of 24 and 34 years old, with the rest distributed within the age group ranging from 35 to 65 years old. Junior residents represented 34.7%, senior residents 22.8%, physiatrist specialists 26.7%, and consultants 15.8%. The sample included 55.4% males and 44.6% females; 64.4% of the participants were married, 29.7% were still single, and 5.9% were divorced. Among the total group participating, 25.7% were handling COVID-19 patients. In the total participant sample, 80.2% reported experiencing burnout, 10.9% experienced stress, and 22.8% and 6.9% experienced anxiety and depression, respectively. Conclusion: Burnout in Saudi Arabia exists among more than two-thirds of practicing physiatrists in Physical Medicine & Rehabilitation (PM&R), and that did not appear to have a statistically significant influence on stress, anxiety, or depression (p > 0.05). The current COVID-19 global pandemic might escalate burnout and influence mental health outcomes. The healthcare authority and administration should take the lead in identifying the challenges, overcoming the obstacles, and optimizing clinician well-being, delivering up-to-date solutions, and promptly checking their effectiveness.

Background: Motor vehicle accidents are the most common cause of spinal cord injury (SCI) in Saudi Arabia, mainly involving young adults. Much attention has been dedicated to obtaining work after SCI during the past decades because of the psychological, social, financial, and political implications. Since high unemployment rates pose a significant social burden due to the increase in the expenditures associated with benefits, it remains an important consideration in individuals with activity limitation after spinal cord injury. There are no current data or guidelines for community reintegration or employment rates in the spinal cord injury population in Saudi Arabia.Objective: The objective of our study was to identify the awareness of vocational rehabilitation in individuals with spinal cord injury in Saudi Arabia.Design and methods: This cross-sectional study was conducted in the outpatient department of the largest tertiary care rehabilitation hospital in Saudi Arabia. After obtaining informed consent, structured interviews were conducted from March 2018 through July 2018 (five months) by the primary investigator and a rehabilitation nurse The interviews were administered in a one-to-one format.Results: One hundred and twenty-one male patients with SCI were included in the study with mean age of 35.6 ± 13.9 years. Seventy (57.9) were employed at the time of injury. The employment rate decreased significantly after injury; only 20 (16.5%) were employed, 38 (31.4%) had retired, and 11 (9.1%) patients resumed their studies.One hundred and five (86.8%) patients received rehabilitation treatment as an inpatient. Ninety-four (77.7%) reported that they had no idea about vocational rehabilitation. Only five patients (4.1%) received services of vocational rehabilitation.Conclusion: Vocational rehabilitation awareness among spinal cord injury male patients in Saudi Arabia is lacking. This needs to be addressed to overcome unemployment and improve the quality of life which in turn may reduce the economic burden and costs among spinal cord injury patients in Saudi Arabia.

Background: Residents in training must employ a variety of study strategies, as they not only participate in academic studies but also interact with patients. This study aimed to evaluate the study practices and factors affecting those practices among Saudi Arabian physical medicine and rehabilitation residents during their residency program. Methods: In this cross-sectional study, a previously used questionnaire was distributed to Saudi Arabian physiatry residents from July 1 to August 15, 2022, via a social media platform and completed using a Google Forms survey. A Microsoft Excel spreadsheet was used to collect, clean, and import the data before IBM SPSS Statistics for Windows, version 22.0 was utilized for statistical analysis. Results:The data of 94.91% of respondents were included in the analysis. Individuals who were female, unmarried or divorced, and without children predominated. Only 17.9% (n = 10) of the residents believed that their training program effectively prepared them to pass the board examination, which was the most strongly motivating factor for studying for 85.7% of respondents. Over two-thirds of the residents mentioned that they regularly exercise. Residents who studied more than 11 hours per week had a significantly lower score in the category of factors that negatively affect examination performance (M = 12.33 ± 2.82, F = 2.794, P < 0.05). Females, finalyear residents, and Riyadh residents studied more than their counterparts. Conclusion:Our study is the first to investigate how Saudi physiatrists study, with the finding that current physiatry residents employ a combination of traditional and contemporary learning strategies. This information can help stakeholders to understand current training challenges, improve the quality of training for physiatry residents, and create an ideal learning environment.

Return to work is a challenging aspect of community integration for individuals with disabilities. The reintegration of individuals with spinal cord injury (SCI) is multifactorial; hence, regional challenges need to be investigated in the context of their clinical attributes and perceptions. A total of 121 male participants above 18 years of age with diagnosis of SCI and living at home were included in this cross-sectional survey. The study was conducted at a tertiary care rehabilitation facility in Saudi Arabia. The most common reported clinical barriers to employment were mobility, bladder incontinence, spasticity, musculoskeletal pain, and neuropathic pain. Bladder incontinence and musculoskeletal pain were the most common perceived clinical barriers for individuals with paraplegia and tetraplegia, respectively. A significant difference was observed for bowel incontinence as a reported barrier (p = 0.024) among adults less than thirty years of age in comparison with those older than thirty years. Spasticity as a barrier was reported more among patients who were older than thirty years (54.0%) compared to those younger than thirty years of age (37.9%) (p = 0.077). Twenty-two (23.7%) participants with paraplegia reported transfers as a perceived barrier to employment, which was significant (p = 0.014), and it was also reported as a significant barrier (p = 0.001) in individuals with tetraplegia (56%). This study shows that clinical conditions associated with SCI are considered potential barriers to employment by individuals with SCI. In terms of priority, the perceived barriers between individuals with tetraplegia and paraplegia were mostly different. This shows the need to consider relevant secondary health care conditions in goal setting while planning for employment in individuals with SCI.

Autonomic dysreflexia (AD) is a life-threatening condition that affects patients with spinal cord injuries (SCI) at the sixth thoracic vertebrae (T6) and above due to a noxious stimulus below the level of spinal cord injury. This is a case report of a 48-year-old man with a history of paraplegia T1 (American Spinal Injury Association Impairment Scale -ASIA A) spinal cord injury due to a road traffic accident 16 years ago who presented with recurrent episodes of hypertension, sweating, bradycardia, and hypothermia. Previous hospitalizations suggested that his symptoms were caused by sepsis from a urinary tract infection; however, further assessment revealed that his symptoms were consistent with untreated and undiagnosed autonomic dysreflexia. This case report provides an overview of AD, including its distinctive presentation, etiology, pathophysiology, and management. Autonomic dysreflexia can be a life-threatening condition associated with spinal cord injury patients at the T6 level and above due to various noxious stimuli below the neurological level of injury. Bladder distension appears to be the trigger in most of the cases reported. AD can be easily missed by medical staff unfamiliar with this condition. Patient and healthcare provider education and a thorough evaluation are essential for diagnosis and management.