Topics in spinal cord injury rehabilitation
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Top Spinal Cord Inj Rehabil · Jan 2013
Cerebral activation during the test of spinal cord injury severity in children: an FMRI methodological study.
The International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) are internationally accepted to determine and classify the extent of motor and sensory impairment along with severity (ASIA Impairment Scale [AIS]) following spinal cord injury (SCI). The anorectal examination is a component of the ISNCSCI that determines injury severity. There is a void in the health care literature on the validity of the anorectal examination as an indication of SCI severity. ⋯ Preliminary findings indicate that fMRI is a useful tool in evaluating the validity of the anorectal examination in determining SCI severity. Assessment of which cortical regions are activated during the testing procedure provides an indication of which pathways are transmitting information to the brain.
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Top Spinal Cord Inj Rehabil · Jan 2013
Restoring voluntary grasping function in individuals with incomplete chronic spinal cord injury: pilot study.
Functional electrical stimulation (FES) therapy has been shown to be one of the most promising approaches for improving voluntary grasping function in individuals with subacute cervical spinal cord injury (SCI). ⋯ The results of the pilot data justify a clinical trial to compare FES therapy and COT alone to improve voluntary hand function in individuals with chronic incomplete tetraplegia.
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Top Spinal Cord Inj Rehabil · Jan 2013
Neuropathic pain post spinal cord injury part 1: systematic review of physical and behavioral treatment.
Neuropathic pain has various physiologic and psychosocial aspects. Hence, there is a growing use of adjunct nonpharmacological therapy with traditional pharmacotherapy to reduce neuropathic pain post spinal cord injury (SCI). ⋯ Physical interventions demonstrated the strongest evidence based on quality of studies and numbers of RCTs in the nonpharmacological treatment of post-SCI pain. Of these interventions, transcranial electrical stimulation had the strongest evidence of reducing pain. Despite a growing body of literature, there is still a significant lack of research on the use of nonpharmacological therapies for SCI pain.
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Top Spinal Cord Inj Rehabil · Jan 2013
Which pain coping strategies and cognitions are associated with outcomes of a cognitive behavioral intervention for neuropathic pain after spinal cord injury?
Chronic neuropathic pain is one of the most difficult problems to manage after spinal cord injury (SCI). Pain coping and pain cognitions are known to be associated with the patient's experience of neuropathic pain, but they have not been studied in the context of a cognitive behavioral treatment program for coping with neuropathic pain after SCI. ⋯ Our findings suggest that modifying pain coping strategies and cognitions by a cognitive behavioral intervention for chronic neuropathic pain after SCI may have some beneficial effects on pain intensity and pain-related disability. Further research should show how dysfunctional pain coping strategies and cognitions can be most effectively modified.
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Top Spinal Cord Inj Rehabil · Jan 2013
Neuropathic pain post spinal cord injury part 2: systematic review of dorsal root entry zone procedure.
Pharmacotherapy may not sufficiently reduce neuropathic pain in many individuals post spinal cord injury (SCI). The use of alternative therapies such as surgery may be effective in reducing neuropathic pain in these individuals. However, because of the invasive nature of surgery, it is important to examine the evidence for use of this treatment. ⋯ The studies demonstrated that the DREZ procedure may be effective in reducing segmental pain. Hence, DREZ may be important in treatment of neuropathic pain in individuals resistant to less invasive treatments. Because the studies lacked control conditions and examination of long-term effects, there is a need for larger trials with more stringent conditions.