Resilience potentially mitigated the negative effects of pain. Moreover, it independently contributed to reduced depression and greater post-traumatic growth. Our findings suggest that resilience might provide a potential target for intervention in SCI individuals.

Gabapentin may be effective in decreasing neuropathic pain refractory to conventional analgesics in some patients with spinal cord injury whose duration of symptoms is less than 6 months, although those with duration of symptoms longer than 6 months showed a significant decrease as well. The drug is unlikely to cause serious adverse effects that limit its use in patients with spinal cord injury.

ObjectiveTo investigate whether higher resilience level predicts low levels of psychological distress in chronic SCI patients living in the community.MethodThirty seven patients (mean age 41.5±10.9, male : female=28 : 9) with chronic spinal cord injury (duration 8.35±7.0 years) living in the community are included, who were hospitalized for annual checkups from November, 2010 to May, 2011. First, their spinal cord injury level, completeness and complications were evaluated. The patients completed questionnaires about their educational status, religion, employment status, marital status, medical and psychological history and also the following questionnaires: Hospital Anxiety and Depression Scale (HADS), Connor-Davidson Resilience Scale (CD-RISC), Alcohol Use Disorders Identification Test-alcohol consumption questions (AUDIT-C) and Health-related quality of life (EQ-5D). The patients were divided into two subgroups: patients with HADS ≥13 are classified as high psychological distress group and others as low psychological distress group. We compared the two groups to find statistically significant differences among the variables.ResultsCD-RISC, EQ-5D and employment status are significantly different between two groups (p<0.05). In a forward stepwise regression, we found that EQ-5D had a greater contribution than CD-RISC to the psychological distress level.ConclusionIn addition to health-related quality of life, resilience can be suggested as a possible predictor of psychological distress in chronic SCI patients.

Income and health are related in a bi-directional manner, whereby level of income affects health and vice versa. People in poorer households tend to experience worse health status and higher mortality rates than people in wealthier households, and, at the same time, having poor health could restrict workability leading to less income. This gap exists in almost every country, and it is more pronounced in more unequal countries and in vulnerable populations, such as people experiencing disability. The goal of this paper is to estimate the health-income gap in people with a Spinal Cord Injury (SCI), which is a chronic health condition often associated with multiple comorbidities that leads to disability. As data on mortality is inexistent, to estimate the health-income gap for persons with SCI, this paper uses two health outcomes: the number of years a person has lived with the injury, and a comorbidity index. Data was obtained from the International Spinal Cord Injury survey (InSCI), which is the first worldwide survey on community-dwelling persons with SCI. To compare across countries, the health outcomes were adjusted through hierarchical models, accounting for country fixed-effects, individual characteristics such as age and gender, and injury characteristics (cause, type and degree). Our results suggest that for the years living with SCI, the gap varies from 1 to 6 years between the lowest and the highest income groups. The main driver of such a difference is the cause of injury, where injuries caused by work accidents showed the biggest gap. Similarly, for the comorbidity index, persons with SCI in poorer deciles reported significantly more comorbidities, forty times more, than people in richer deciles.

Abstract-The wrist-driven flexor hinge orthosis (WDFHO) is a device used to restore hand function in persons with tetraplegic spinal cord injury by furnishing three-point prehension.We assessed the effectiveness and biomechanical properties of the WDFHO in 24 persons with cervical 6 or 7 tetraplegia who have severely impaired hand function. This study introduces a mechanical operating model to assess the efficiency of the WDFHO. Experimental results showed that pinch force increased significantly (p < 0.001) after using the WDFHO and was found to positively correlate with the strength of wrist extensor muscles (r = 0.41, p < 0.001). However, when the strength of the wrist extensors acting on the WDFHO was greater, the reciprocal wrist and finger motion that generates three-point prehension was less effective (r = 0.79, p < 0.001). Reliable and valid biomechanical evaluation of the WDFHO could improve our understanding of its biomechanics.