esign: A cross-sectional study. Objective: To assess the effects of pain on quality of life (QoL), functional independence and depression in patients with spinal cord injury (SCI). Setting: An inpatient rehabilitation center.
Methods:A total of 140 patients (104 M, 36 F) with SCI who underwent inpatient rehabilitation treatment were examined. A questionnaire including clinical variables was applied. Motor score of Functional Independence Measure was used to assess dailylife activities, the 36-Item Medical Outcomes Short-Form Health (SF-36) for QoL and Beck Depression Inventory (BDI) for depression. Patients were then divided into those having chronic pain (Group I) and those without any pain (Group II), and groups were compared according to demographic and clinical variables. Results: The most common causes of SCI were falls (35.0%) and motor vehicle accidents (34.2%). Chronic pain was present in 78% of patients. Patients employed before injury and patients who had complete injury had lower Numerical Rating Scale scores (Po0.05). SCI patients with chronic pain had higher depression ratings and their BDI scores were correlated with some of the SF-36 domains (general health, vitality, social functioning and mental health). Only bodily pain and social functioning (Po0.05) scores were found to be lower in Group I (Po0.05) when compared with Group II. Conclusion: As mood and QoL are negatively affected with pain in SCI patients, we suggest that chronic pain should always be treated in a multidisciplinary setting where pharmacological, physical and psychological therapies are combined.
Study design: Multi-center, cross-sectional study. Objectives: To investigate the effects of different bladder management methods on the quality of life (QoL) in patients with spinal cord injury (SCI). Setting: Turkey. Methods: Consecutive SCI patients (n ¼ 195, 74.4% males), for whom at least 6 months had elapsed since the injury, were included and evaluated in five groups: normal spontaneous micturition (NSM), micturition with assisted maneuvers (MAM), aseptic intermittent catheterization by patient (IC-P), aseptic IC by an attendant/caregiver (IC-A) and indwelling catheterization. The King's Health Questionnaire was used to evaluate the patients' QoL. Results: The bladder management groups were similar regarding age, time elapsed since injury, education level, marital and occupational status. There was no difference among the groups in general health perception, personal relationships and sleep/energy domain scores. While the NSM group had generally the lowest scores, that is, better QoL, the IC-A group had the highest scores, that is, poorer QoL, in most of the domains. When the patients were grouped according to the frequency of urinary incontinence or American Spinal Injury Association Impairment Scale grades, no difference was found in the domain scores of the groups except the symptom severity domain scores. No significant difference was found between paraplegic and tetraplegic patients in the King's Health Questionnaire domains. Conclusion: The QoL was notably affected in SCI patients in IC-A group and negative effects on emotional status, physical and social activity limitations were observed, as well.
Presence of bladder-filling sensation in many of the SCI patients observed in this study revealed the potential for sensation-dependent bladder emptying in SCI patients, especially in the ones with complete lesions below T10 and the ones with incomplete lesions. This method may prevent early emptying attempts, unnecessary catheterisations and overdistension episodes and may improve the patient's self-esteem and quality of life. However, further studies on clinical experience and patient compliance for this method are needed.
These results have shown that cross-sectional area of both the agonist and antagonist muscles increased after 20 sessions of neuromuscular electrical stimulation treatment. Future studies with larger samples and longer follow-up are definitely awaited for better evaluation of neuromuscular electrical stimulation application on muscle architecture and its possible correlates in clinical/functional outcome.
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