Topics in spinal cord injury rehabilitation
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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.
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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
Cardiovascular function in individuals with incomplete spinal cord injury: a systematic review.
There is a clear relationship between the neurological level of spinal cord injury (SCI) and cardiovascular function; however, the relationship between completeness of injury and cardiovascular function is less straightforward. Traditionally completeness of injury has referred to neurological (motor/sensory) completeness. Recently, a number of studies have started to investigate autonomic completeness of injury. ⋯ For acute SCI, there is no clear consensus whether cardiovascular function differs between complete and incomplete. For chronic SCI, the studies to date suggest that autonomic completeness of SCI is more strongly related to cardiovascular function than neurological completeness of injury. Thus, clinicians and scientists should account for autonomic completeness of injury when assessing cardiovascular function in SCI.
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Nociceptive and neuropathic pain (NP) are common consequences following spinal cord injury (SCI), with large impact on sleep, mood, work, and quality of life. NP affects 40% to 50% of individuals with SCI and is sometimes considered the major problem following SCI. Current treatment recommendations for SCI-NP primarily focus on pharmacological strategies suggesting the use of anticonvulsant and antidepressant drugs, followed by tramadol and opioid medications. ⋯ They express a desire to improve communication with their physicians and learn about reliable alternative sources for obtaining information about their pain and pain management. The discrepancy between treatment algorithms and patient expectations is significant. Clinicians will benefit from hearing the patient´s voice.
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Top Spinal Cord Inj Rehabil · Jan 2012
Motor and gait improvement in patients with incomplete spinal cord injury induced by high-frequency repetitive transcranial magnetic stimulation.
To assess the effect of high-frequency repetitive transcranial magnetic stimulation (rTMS) on lower extremities motor score (LEMS) and gait in patients with motor incomplete spinal cord injury (SCI). ⋯ High-frequency rTMS over the leg motor area can improve LEMS, spasticity, and gait in patients with motor incomplete SCI.