Objective To evaluate the effectiveness and safety of Botulinum toxin-A (BTX-A) injection into detrusor to treat neurogenic detrusor overactivity in patients with spinal cord injury (SCI).Methods A total of 78 patients with SCI were treated with transurethral injection of BTX-A (300 IU dissolved in 15 ml of saline) into 30 different points of detrusor with 15 ml in every patients. Urodynamic parameters and voiding diary were assessed at baseline and 3 weeks and 3 months after the injections. Adverse events were recorded after the injection if present.Results After the first injection, 78 patients showed that the mean frequencies of incontinence decreased from 13.5 to 2.7 times per day, the mean volume of intermittent catheterization (IC) increased from 131 ml to 389 ml per time, the mean volume of incontinence decreased from 1 690 ml to 281 ml per day, the mean getting effect time was 7.6 days. 10 patients received second injection at 8.9 months after first injection, the results showed that the mean frequencies of incontinence decreased from 9.7 to 3.7 times per day, the mean IC volume increased from 108 ml to 387 ml. 6 patients received third injection at 5.8 months after second injection, the results showed that the mean frequencies of incontinence decreased from 9.2 to 3.9 times per day, the mean IC volume increased from 116 ml to 364 ml. No side effects were observed during the follow-up.Conclusion BTX-A injection into detrusor to treat neurogenic detrusor overactivity in patients with SCI seems to be an effective, safe and miniinvasive solution.

The goals of videofluoroscopy are visualization of oropharyngeal swallow physiology in the lateral and anterior/posterior plane, visualization of symptoms of swallowing disorders and assessment of efficacy of various selected treatment strategies.Analyzing videofluoroscopic evaluation results can provide the foundation for treatment planning. The session will include: Overview of normal anatomy and physiology, X-ray landmarks of structures involved in oropharyngeal swallowing, videofluorographic view of normal swallow physiology, identification of symptoms and disorders representing swallowing problems, and overview of treatment planning.

Objective To improve communication between patients with communication disorders and their health care providers. Methods A communication training session and a communication toolkit for health care workers in long-term care facilities (L-TCFs) were used before. A control group and experimental group were used to assess the effectiveness of the communication training and a toolkit. Results and Conclusion There was little benefit to the training and toolkit. However, anecdotal observations showed there were some benefits, especially with the increased use of amplifiers for patients with hearing impairment. In addition, the L-TCF is inherent with structural obstacles to successful communication that need to be taken into account when interpreting the results. More research is needed in this area.

Autism is a perplexing developmental disorder that presents itself in a variety of behavioral disorders. Research indicates that through early intervention and appropriate treatment these behaviors can be improved. This article reviews and critiques several of the current treatment programs for children with autism. These include Applied Behavioral Analysis (ABA), TEACCH,Sign Language, Facilitated Communication, Piture Exchange Comminication System (PECS), Object Exchange, Auditory Integration Therapy (AIT), and augmentative communication. When appropriate, the treatments were reviewed for their abilities to increase attention, imitation and initiation, social interaction and intentional communication, language development, and emotional regulation. The article, hopefully, provides parents and professionals a clearer choice as to what treatment is most appropriate for which child and when to use them.

In this article, I will discuss disability issues as a second and a half generation American of Chinese descent who has worked with persons with disabilities, has taught rehabilitation counseling as well as having been a rehabilitation psychologist for more than 35 years in the U.S. and Australia. I am pleased to be able to share some of my thoughts and experiences in this article that is a bit less formal than what you may expect in a professional journal. Though I hope that what I share will provoke some thinking and action from those who read these words.

The article is intended to introduce the readers to the concept and background of Web accessibility in the United States. I will first discuss different definitions of Web accessibility. The beneficiaries of accessible Web or the sufferers from inaccessible Web will be discussed based on the type of disability. The importance of Web accessibility will be introduced from the perspectives of ethical, demographic, legal, and financial importance. Web accessibility related standards and legislations will be discussed in great detail. Previous research on evaluating Web accessibility will be presented. Lastly, a system for automated Web accessibility transformation will be introduced as an alternative approach for enhancing Web accessibility.

Despite years of interventions in the United States, substance abuse continues to be a major national problem in our society. For individuals affected, it can constitute a major disability and a decrease in quality of life. Current American societal expectations are that individuals who identify they are involved in substance abuse will go to treatment, eventually recover, get off public assistance straightaway, and return to work. Most rehabilitation professionals also maintain the same expectations. The reality is that efforts of prevention do not appear to diminish the number of people with substance abuse. Traditional treatment appears to have minimal, if any, influence upon the cessation of substance abuse, and traditional vocational rehabilitation practices appear unsuited for the unique problems and types of symptoms experienced by substance abusers. Creative, yet sound, alternatives that combine effective treatment strategies and non-traditional vocational rehabilitation methods need to be explored and tested for effectiveness, and applied.

Objective To study the activity and participation status of patients with spinal cord injury or traumatic brain injury. Methods From 2013 to 2016, 60 patients with spinal cord injury and 38 patients with traumatic brain injury were assessed with WHO Disability As-sessment Schedule 2.0 (WHO-DAS 2.0) (International Chinese Version of fully structured interviewer administered 36 questions). Results The patients with traumatic brain injury had moderate dysfunction in domains of cognition and getting along with people, and severe dys-function in other domains. The patients with spinal cord injury had mild dysfunction in domain of cognition, moderate dysfunction in do-mains of self-care and getting along with people, and severe dysfunction in other domains. The dysfunction was severer in domains of cogni-tion and self-care in the patients with traumatic brain injury than in the patients with spinal cord injury (t>2.140, P<0.05). Conclusion The inpatients with spinal cord injury and traumatic brain injury are difficult in mobility, self-care, getting along with people, life activities and participation.

Objective To evaluate the effects of Achilles tendon lengthening on talipes equinus in children with spastic cerebral palsy. Methods From December, 2013 to June, 2014, seventeen spastic cerebral palsy children with talipes equinus (34 feet) received Achilles ten-don lengthening. Ankle dorsiflexion range of motion (ROM) and surface electromyography from tibialis anterior and medial head of gastroc-nemius were measured before and 8 to 12 months after operation, respectively. ROM of passive and active dorsiflexion, root mean square (RMS) of tibia muscle group and co-contraction ratio (CR) when standing were compared. Results The ROM of ankle passive and active dorsiflexion increased (Z>4.867, P<0.001), while the RMS of gastrocnemius muscle decreased when ankle passively dorsiflex (t=4.31, P<0.001). RMS of tibialis anterior and gastrocnemius muscle changed little when standing (Z<1.291, P>0.05), while CR reduced (t=2.38, P<0.05). Conclusion Achilles tendon lengthening can improve the coordination of tibia muscle group to increase the ROM of ankle for chil-dren with talipes equinus after spastic cerebral palsy.

Objective To investigate the situation of family intimacy and adaptability, and social avoidance and distress in severe burn patients, and explore the correlation between them, so as to provide basis for intervention. Methods From January, 2013 to June, 2015, 289 patients with severe burn were surveyed with self-designed general condition questionnaire, Family Adaptability and Cohesion Evaluation Scale (FACES Ⅱ) and Social Avoidance and Distress Scale (SADS), and analyed with Pearson correlation analysis. Results The real family intimacy and adaptability were lower in the severe burn patients than in national norm (t>3.830, P<0.01), and the ideal family intimacy, dis-satisfied intimacy level, ideal adaptability and dissatisfied adaptability level were higher in the severe burn patients than in national norm (t>3.857, P<0.01). The SADS score was higher in the severe burn patients than in national norm. The real intimacy, real adaptability and the to-tal score of FACES II negatively correlated with the scores of SADS (P<0.05), while the levels of dissatisfied intimacy and adaptability posi-tively correlated (P<0.05). Conclusion The social avoidance and distress exist in severe burn patients, which may associated with the family intimacy and adaptability, that some interventions may target to.