OBJECTIVE: To evaluate the usefulness of plain abdominal radiography as an evaluation method for bowel dysfunction in patients with spinal cord injury (SCI). METHODS: Forty-four patients with SCI were recruited. Patients were interviewed about their clinical symptoms, and the constipation score and Bristol stool form scale were assessed. The colon transit time (CTT) was measured by using radio-opaque markers (Kolomark). The degree of stool retention and the presence of megacolon or megarectum were evaluated using plain abdominal radiographs. We examined the relationship between clinical aspects and CTT and plain abdominal radiography. RESULTS: The constipation scores ranged from 1 to 13, and the average was 4.19+/-3.11, and the Bristol stool form scale ranged from 1 to 6, with an average of 4.13+/-1.45. CTTs were 19.3+/-16.17, 19.3+/-13.45, 15.32+/-13.15, and 52.42+/-19.14 in the right, left, rectosigmoid, and total colon. Starreveld scores were 3.4+/-0.7, 1.8+/-0.86, 2.83+/-0.82, 2.14+/-1, and 10.19+/-2.45 in the ascending, transverse, descending, rectosigmoid, and total colon. Leech scores were 3.28+/-0.7, 2.8+/-0.8, 2.35+/-0.85, and 8.45+/-1.83 in the right, left, rectosigmoid, and total colon. The number of patients with megacolon and megarectum was 14 (31.8%) and 11 (25%). There were statistically significant correlations between the total CTT and constipation score (p<0.05), and Starreveld and Leech scores (p<0.05). Significant correlations were observed between each segmental CTT and the segmental stool retention score (p<0.05). CONCLUSION: Plain abdominal radiography is useful as a convenient and simple method of evaluation of bowel dysfunction in patients with SCI.
Colon ; Constipation ; Humans ; Megacolon ; Neurogenic Bowel ; Radiography, Abdominal ; Retention (Psychology) ; Spinal Cord ; Spinal Cord Injuries

The purposes of this study were to identify sexual interest and adjustment in patients with spinal cord injury and to determine the factors that relate to sexual adjustment. A total of 134 persons included in this study was the members of spinal cord injury organization and the impatients in rehabilitation unit between February and June 1999. Five questionnaires were answered concerning importance of life events, sexual concern, sexual adjustment, relationship with a sex partner, and depression. The collected data were analyzed by Frequency, t-test, ANOVA and pearson correlation. The results were as follows: 1) Considering the importance among 11 areas of life, economic status occupied the top, sex life held the sixth rank, and the mean rating for social life being 3.78 was the lowest of all. 2) As regard to 7 topics related to sexuality, the most attention was drawn to methods and techniques achieving sexual satisfaction, and the next interest was for helping partners cope emotionally with sexual dysfunction. 3) The mean for sexual adjustment and depression was average, and the mean for sex partner relationship was high. 4) Sexual adjustment in spinal cord injury patients correlated with economic status and sex partner relationship. While it was inversely correlated with age and depression. It was found that lower age and less depression play a positive role on sexual adjustment by SCI people. Also, higher economic status and favorable sex partner relationship increase sexual adjustment. In conclusion, a sex partner relationship, depression, economic status, and age seemed to influence on their sexual adjustment after SCI. Also, psychosocial factors would be more important for satisfying sexual life and relationship rather than physical factors.
Depression ; Economic Recession ; Humans ; Psychology ; Surveys and Questionnaires ; Rehabilitation ; Sexuality ; Spinal Cord Injuries* ; Spinal Cord*

OBJECTIVE: To verify the safety and clinical utility of noninvasive respiratory management as an alternative method of invasive respiratory management for the patients with cervical spinal cord injury (CSCI) who often present with ventilatory insufficiency (due to inspiratory muscle paralysis) or difficulty in removing airway secretions (because of expiratory muscle weakness). METHOD: Nineteen patients with CSCI (male: 15, female: 4, mean age: 45.6) were recruited. All of the patients were in need of mechanical ventilation due to ventilatory failure or indwelling tracheostomy tube for secretion management. In order to switch from invasive to noninvasive means of respiratory management, expiratory muscle aids such as manual assist or CoughAassist(R) and inspiratory muscle aids such as noninvasive ventilatory support were applied to all candidates. RESULTS: Fifteen out of the 19 patients had indwelling tracheostomy tubes, and the remaining 4 patients were intubated via endotracheal tubes at admission. Through the noninvasive respiratory management, we were able to remove intubation or traheostomy tubes for all of the patients. Eleven patients were able to maintain normal ventilation status without ventilatory support, as time went on. The rest 8 patients were continuously in need of ventilatory support, but they could maintain normal ventilation status by noninvasive method. CONCLUSION: Noninvasive respiratory management is safe and equally effective in treating ventilatory insufficiency or removing airway secretions for patients with CSCI. In cases of long-term ventilator dependency or chronic tracheostomy state, it can be replaced as a creditable alternative to invasive respiratory management.
Dependency (Psychology) ; Humans ; Intubation ; Muscles ; Respiration, Artificial ; Spinal Cord ; Spinal Cord Injuries ; Tracheostomy ; Ventilation ; Ventilators, Mechanical

Spinal cord injury often leads to central neuropathic pain syndromes, such as allodynic and hyperalgesic behaviors. Electrophysiologically, spinal dorsal horn neurons show enhanced activity to non-noxious and noxious stimuli as well as increased spontaneous activity following spinal cord injury, which often called hyperexcitability or central sensitization. Under hyperexcitable states, spinal neurons lose their ability of discrimination and encoding somatosensory information followed by abnormal somatosensory recognition to non-noxious and noxious stimuli. In the present review, we summarize a variety of pathophysiological mechanisms of neuronal hyperexcitability for treating or preventing central neuropathic pain syndrome following spinal cord injury.
Animals ; Central Nervous System Sensitization ; Discrimination (Psychology) ; Neuralgia ; Neurons ; Posterior Horn Cells ; Rats ; Spinal Cord ; Spinal Cord Injuries

PURPOSE: We aimed to assess the efficacy of biofeedback therapy for patients with fecal incontinence (FI) according to the etiology. METHODS: Twenty-nine patients with fecal incontinence were treated with biofeedback therapy using a EMG-based system. The efficacy was assessed by using changes in the FI score (Cleveland Clinic, Florida: 0~20) and satisfaction based on a subjective evaluation score from 0 to 100. The median follow up duration was 12 (3~25) months. RESULTS: Ten patients had idiopathic fecal incontinence. Fourteen patients had fecal incontinence due to a sphincter saving operation for rectal cancer. Four cases had spinal cord injury and one patient had a major external sphincter tearing due to trauma. The mean age was 52 (16~78) years. The median number of biofeedback sessions was 10 (3~15) overall. The mean efficacy was 42.8%, and the mean satisfaction score was 56.6. Improvements in the FI score and in the patients' satisfaction varied according to the etiology, 69.5% and 71.5 in the idiopathic group, 28.5% and 49.3 in the postoperative group, and 35% and 24 in the spinal cord injury group. In the idiopathic group, 50% of the patients showed an improvement in the FI score of more than 75%, and 90% of the patients showed an improvement of more than 50%. The number of liquid incontinence episodes was improved 78.3% later in the biofeedback group, and this result was much better than in the postoperative incontinence group (31.8%, p=0.03). CONCLUSIONS: The success rate of the biofeedback therapy for fecal incontinence is acceptable. Subjective satisfaction is relatively higher than the improvement in the ecal incontinence score. Idiopathic fecal incontinence may be the best indication for biofeedback therapy.
Biofeedback, Psychology* ; Fecal Incontinence* ; Florida ; Follow-Up Studies ; Humans ; Rectal Neoplasms ; Spinal Cord Injuries

Advances in medical and rehabilitative care have increased interest in studying how different factors may affect the health-related quality of life (HRQOL) of individuals with spinal cord injury (SCI). There has been a large increase in the number of studies assessing HRQOL among persons with SCI. However, despite these advances, numerous issues remain unanswered because these studies have used a variety of methodologic approaches and assessment tools to examine how different factors have a role in predicting HRQOL in SCI populations. Therefore, standardized instruments should be used as part of this process. The Medical Outcomes Study Short Form (SF-36) was developed in order to survey health status of the general population. However, the available data on the HRQOL of individuals with SCI are currently limited. In addition, there is little information currently available on the factors that are associated with HRQOL in the SCI population and this issue remains controversial. The findings from several individual studies that used the SF-36 to assess the HRQOL of patients suffering from SCI were reviewed, and the results were interpreted with disability in mind. This review article aims to summarize the data regarding the HRQOL of individuals with SCI by using the SF-36.
Health Surveys ; Humans ; *Quality of Life ; *Questionnaires ; Spinal Cord Injuries/physiopathology/*psychology

Advances in medical and rehabilitative care have increased interest in studying how different factors may affect the health-related quality of life (HRQOL) of individuals with spinal cord injury (SCI). There has been a large increase in the number of studies assessing HRQOL among persons with SCI. However, despite these advances, numerous issues remain unanswered because these studies have used a variety of methodologic approaches and assessment tools to examine how different factors have a role in predicting HRQOL in SCI populations. Therefore, standardized instruments should be used as part of this process. The Medical Outcomes Study Short Form (SF-36) was developed in order to survey health status of the general population. However, the available data on the HRQOL of individuals with SCI are currently limited. In addition, there is little information currently available on the factors that are associated with HRQOL in the SCI population and this issue remains controversial. The findings from several individual studies that used the SF-36 to assess the HRQOL of patients suffering from SCI were reviewed, and the results were interpreted with disability in mind. This review article aims to summarize the data regarding the HRQOL of individuals with SCI by using the SF-36.
Health Surveys ; Humans ; *Quality of Life ; *Questionnaires ; Spinal Cord Injuries/physiopathology/*psychology

STUDY DESIGN: A retrospective study OBJECTIVES: To study the socio-psychological adaptation through the psychoanalysis in the patients with spinal cord injury. MATERIALS AND METHODS: From May 1998 to Aug. 2003 we chose the 15 patients who have been undergone surgery for spinal cord injury after spinal fracture. Psycological analysis were based on the Korean version of Beck Depression Index(K-BDI), Hamilton Anxiety Scale, and the Minnesota Multiphasic Personality Inventory(MMPI), and valuation of quality of life. RESULTS: K-BDI applied results showed an average of 33.5+/-10.3, having a higher average than normal. Hamilton Anxiety Scale resulted with an average of 32.4+/-9.4. 4 patients were taken intensive care psychologically beause of depression. The Lie score out of the MMPI`s suitability scale showed 43.3+/-9.7, Validity score as 75.4+/-23.6, and Defensiveness score with 47.7+/-10.6 as average and standard deviation, resulting a higher as to normal. Further more, clinical scales of Hypochondriasis scale was 69.9+/-12.6, Depression as 65.5+/-15.3, Hysteria scale as 67.9+/-11.5, Psychopathic deviate as 65.6+/-12.1, Paranonia as 71.9+/-17.6, Psychasthenia scale as 67.9+/-12.3, Schizophrenia as 70.4+/-17.8, Hypomania scale as 54.0+/-11.3, and social introversion scale as much as 60.1+/-15.0 higher than normal. In evaluation the quality of life, there was a prominent issue in the occupation(0.1) and economic independence(0.5) out of the total 6 items, difference was 0.6, social adaptation was 0.8, physical independence was 0.7 and orientation(1.6) was similar to normal person. CONCLUSION: As the physical and the psychological changes abrupt at the same time with the spinal cord injury, it is important to encourage the patients to have a strong ego to have an optimistic confidence of recuperation.
Anxiety ; Depression ; Ego ; Humans ; Hypochondriasis ; Hysteria ; Critical Care ; Introversion (Psychology) ; Minnesota ; Psychoanalysis ; Quality of Life* ; Retrospective Studies ; Schizophrenia ; Spinal Cord Injuries* ; Spinal Cord* ; Spinal Fractures* ; Weights and Measures

STUDY DESIGN: A retrospective study OBJECTIVES: To study the socio-psychological adaptation through the psychoanalysis in the patients with spinal cord injury. MATERIALS AND METHODS: From May 1998 to Aug. 2003 we chose the 15 patients who have been undergone surgery for spinal cord injury after spinal fracture. Psycological analysis were based on the Korean version of Beck Depression Index(K-BDI), Hamilton Anxiety Scale, and the Minnesota Multiphasic Personality Inventory(MMPI), and valuation of quality of life. RESULTS: K-BDI applied results showed an average of 33.5+/-10.3, having a higher average than normal. Hamilton Anxiety Scale resulted with an average of 32.4+/-9.4. 4 patients were taken intensive care psychologically beause of depression. The Lie score out of the MMPI`s suitability scale showed 43.3+/-9.7, Validity score as 75.4+/-23.6, and Defensiveness score with 47.7+/-10.6 as average and standard deviation, resulting a higher as to normal. Further more, clinical scales of Hypochondriasis scale was 69.9+/-12.6, Depression as 65.5+/-15.3, Hysteria scale as 67.9+/-11.5, Psychopathic deviate as 65.6+/-12.1, Paranonia as 71.9+/-17.6, Psychasthenia scale as 67.9+/-12.3, Schizophrenia as 70.4+/-17.8, Hypomania scale as 54.0+/-11.3, and social introversion scale as much as 60.1+/-15.0 higher than normal. In evaluation the quality of life, there was a prominent issue in the occupation(0.1) and economic independence(0.5) out of the total 6 items, difference was 0.6, social adaptation was 0.8, physical independence was 0.7 and orientation(1.6) was similar to normal person. CONCLUSION: As the physical and the psychological changes abrupt at the same time with the spinal cord injury, it is important to encourage the patients to have a strong ego to have an optimistic confidence of recuperation.
Anxiety ; Depression ; Ego ; Humans ; Hypochondriasis ; Hysteria ; Critical Care ; Introversion (Psychology) ; Minnesota ; Psychoanalysis ; Quality of Life* ; Retrospective Studies ; Schizophrenia ; Spinal Cord Injuries* ; Spinal Cord* ; Spinal Fractures* ; Weights and Measures

Objective To explore the relationship among post-traumatic stress disorder(PTSD),social support and quality of life in patients with spinal cord injury(SCI)after a long recovery in China and investigate the factors influencing the quality of life. Methods In this cross-sectional study,206 SCI patients who were hospitalized in 9 hospitals were enrolled.Data collection was performed using general information,the Post-Traumatic Stress Disorder Checklist-Civilian version,the social support scales,and the World Health Organization Quality of Life-Abbreviated version.The data were statistically analyzed using
China/epidemiology* ; Cross-Sectional Studies ; Humans ; Quality of Life ; Social Support ; Spinal Cord Injuries/psychology* ; Stress Disorders, Post-Traumatic/epidemiology*