BACKGROUND AND OBJECTIVESThe main objectives of this cross-sectional study were (1) to examine chronic pain using the Multidimensional Pain Inventory-Spinal Cord Injury (MPI-SCI) version and (2) to assess the relationship between chronic pain and functional status, depression, and sleep quality among patients with SCI.DESIGN AND SETTINGSThis was a cross-sectional study of all eligible patients admitted to the Ministry of Health Ankara Diskapi Yildirim Beyazit Education and Research Hospital Physical Therapy and Rehabilitation Clinic between January 2007 and July 2010.METHODSForty-four patients (33 male, 11 female) with traumatic SCI, aged ≥18 years, who had pain continuing for ≥6 months and were hospitalized in the physical therapy and rehabilitation clinic were included in this cross-sectional study. Chronic pain intensity, functional status, depression, and sleep quality were assessed according to the MPI-SCI, Functional Independence Measure (FIM), Hamilton Rating Scale for Depression (HAM-D), and Pittsburg Sleep Quality Index (PSQI), respectively.RESULTSA positive correlation was observed between “Pain Severity” (one of the subscales of the MPI-SCI) and HAM-D (r=0.487, P=.001) and PSQI (r=0.312, P=.039). “Pain Severity” was significantly higher in the “impaired sleep” group (P<.05) than in the “normal sleep” group and in the “depression” group (P<.05) than in the “no depression” group.CONCLUSIONWe identified a strong interrelationship between SCI-related “Pain Severity” and both depression and sleep quality. Hence, a comprehensive pain examination and management strategies including psychosocial interventions should be given particular consideration to address the critical issue of chronic pain in individuals with SCI.

The factors that may cause poststroke depression were investigated in the literature focusing on lesion localization, age, stroke severity, and impairments in physical and cognitive function. The aim of this study was to examine the risk factors influencing the development of poststroke depression and to determine the effect of depression on the patients' functional improvement after rehabilitation. Patients in the first 6-month period after stroke who were hospitalized in the Physical Medicine and Rehabilitation Clinic were included in this study. Patients who were admitted to the hospital within 0-30 and 30-120 days from the date of stroke were considered early and late rehabilitation entrants, respectively. The sample of this study included 93 patients. Patients' demographic and clinical characteristics, complications, and medical history were recorded. Upper extremity motor function, ambulation, and mood were evaluated according to the Frenchay Arm Test, the Functional Ambulation Scale, and the Beck Depression Inventory, respectively. The Functional Independence Measure (FIM) was applied to patients at admission to the hospital, at discharge, and 1 month after discharge (follow-up). The mean age of the patients was 58 years and the mean disease duration was 53 days. Depression was diagnosed in 49 (53%) patients. Except for age and disease duration, none of the factors of sex, hemiplegic side, stroke severity, stroke etiology, neglect, spasticity, sedentary lifestyle, poststroke immobility, and early-onset or late-onset to rehabilitation was found to induce statistically significant differences in the development of depression. Statistically significant changes occurred in total FIM levels between the groups with and without depression between admission and discharge, admission and follow-up, and discharge and follow-up. The levels were significantly higher in patients without depression than in patients with depression. Depression was found in a high frequency in stroke patients. Younger age and long disease duration were found to be factors affecting the development of depression. FIM scores were observed to be lower in stroke patients with depression.

Aim of this study was to examine relationship between Limited Joint Mobility syndrome (LJM) in patients with type-1 and type-2 diabetes and duration, metabolic control and other complications of diabetes, and to assess effects of the syndrome on hand functions and quality of life. Demographic characteristics, and micro-macrovascular and hand complications were recorded. Level of fasting blood sugar and HbA1c, superficial, pain, temperature, vibration and cortical senses, and deep tendon reflexes were measured. Hand dexterity was evaluated with nine-hole peg test. Grip and pinch strengths were recorded. Functionality of the hand with Hand Functional Index (HFI) and quality of life were evaluated with Short Form 36. Group 1 included 37.8% (n= 130) of 344 hands of 172 patients with LJM according to Rosenbloom classification, group 2 included 44.8% (n= 154) according to the same, and group 3 included 17.4% (n=60). In the comparison between groups, deterioration correlating with the increase in LJM stage was found in terms of duration of disease, level of fasting blood sugar and HbA1c, frequency of retinopathy and nephropathy, diabetic foot involvement, Dupuytren contracture, presence of CTS, superficial, pain, temperature and cortical senses, DTR, hand dexterity, grip strengths and function of the hand and quality of life except pain. In patients with long-term DM with poor metabolic control, presence of LJM can make contribution to prevent morbidity, mortality and functional disabilities of these patients.

Objective: The primary aim of this study was to assess chronic pain in patients with traumatic spinal cord injury (SCI) using the West Haven Yale Multidimensional Pain Inventory Spinal Cord Injury (WHYMPI-SCI) version pain inventory. Moreover, we examined the effects of sociodemographic and clinical characteristics on chronic pain. Material and Methods: Forty-four inpatient traumatic SCI patients aged ≥18 years and with pain continuing for ≥6 months were included in this cross-sectional study. Pain was assessed using the two parts: "pain impact" and "responses by significant others" of the WHYMPI-SCI version. Results: 'Support' scores were shown to increase with increasing age of patients and age at the time of traumatic SCI (p=0.038, p=0.004, respectively). Tetraplegic patients showed higher scores compared to paraplegic patients for 'affective distress' and 'negative responses' from caregivers (p=0.047, p=0.013, respectively). 'Support' and 'distracting responses' values were higher in incomplete patients (p=0.014, p=0.007, respectively). Conclusion: This study details the assessment of chronic pain multidimensionally and reveals that it affects daily living activities negatively. In particular, determining the characteristics of pain in older and more functionally dependent patients with SCI may guide the design of multidisciplinary treatment approaches and facilitate an early transition into social life.