OBJECTIVE: To observe the clinical effect of acupuncture and moxibustion combined with umbilical therapy on anxiety and depression in patients with neurogenic bladder (NB) after spinal cord injury (SCI). METHODS: Thirty cases of NB after SCI with anxiety and depression were selected and treated with acupuncture and moxibustion combined with umbilical therapy. Acupuncture was applied at Baihui (GV20), Yintang (GV24⁺), Sanyinjiao (SP6), Shenmen (HT7), Hegu (LI4), Taichong (LR3), once a day, continuous treatment for 4 weeks. Ginger moxibustion was applied at the bladder meridian of foot taiyang and governor vessel, once a day, continuous treatment for 4 weeks. In treatment of umbilical therapy, Chaihu (Radix Bupleuri), Yujin (Radix Curcumae), Rougui (Cortex Cinnamomi) were ground and mixed with the same amount of honey, put into the application, and the application was placed on the navel after filling the navel with fine salt, once a day for 4 weeks. Hamilton anxiety scale (HAMA) score, Hamilton depression scale (HAMD) score, urodynamic indexes (maximum urinary flow rate [Qmax], maximum detrusor pressure [Pdet-max], residual urine volume [RUV]), neurogenic bladder symptom score (NBSS), urinary symptom distress scale (USDS) score were compared before and after treatment, and the clinical efficacy was evaluated. RESULTS: After treatment, the scores of HAMA, HAMD, NBSS, USDS and RUVwere lower than those before treatment (P<0.05), and Qmax and Pdet-max were higher than those before treatment (P<0.05). The total effective rate was 93.3 (28/30). CONCLUSION Acupuncture and moxibustion combined with umbilical therapy can effectively relieve anxiety and depression symptoms, improve urination disorders in patients with NB after SCI.
Humans ; Moxibustion ; Male ; Female ; Adult ; Middle Aged ; Acupuncture Therapy ; Spinal Cord Injuries/psychology* ; Depression/etiology* ; Anxiety/etiology* ; Urinary Bladder, Neurogenic/etiology* ; Young Adult ; Aged ; Combined Modality Therapy ; Acupuncture Points

PURPOSE: This study aims to review the literature to explore some factors affecting sexual and partnership adjustment in individuals with spinal cord injury (SCI). METHODS: This study was based on the methodological framework of scoping reviews, including 3 methodological steps: (1) identifying relevant studies (searching for related studies); (2) selecting related studies; (3) collecting key findings, summarizing, and reporting the results. The electronic databases were searched including Medline (PubMed), Scopus, Web of Science, Embase, and Cochrane Library. Studies were included if they reported data about the related factors of sexual and partnership adjustment in individuals with SCI. No limitations were considered in terms of time or methodology of the search. RESULTS: After the full-text screening, 52 studies were included from the year of 1978 - 2019 with various methodologies. The present review demonstrated that proper sexual health among individuals with SCI is related to several factors including the anatomical factor, level of the injury, completeness of the injury, psycho-social factor, socio-economic status, and type of relationship. CONCLUSION With consideration of factors affecting sexual and partnership adjustment in individuals with SCI, a better estimation of sexual health can be achieved in clinical to improve the relationship and quality of life.
Female ; Humans ; Male ; Quality of Life ; Sexual Behavior ; Sexual Health ; Spinal Cord Injuries/psychology*

BACKGROUND: Spinal cord injury (SCI) survivors often experience constipation, which contributes to a reduced sense of well-being and a lower quality of life. Acupressure offers a non-pharmacological and non-invasive alternative therapy for treating constipation. OBJECTIVE: This study examined the effects of home-based acupressure on constipation and subjective well-being among SCI survivors. DESIGN, SETTING, PARTICIPANTS AND INTERVENTIONS: This randomized controlled trial randomly assigned 80 adults from Hong Kong with SCI to two study groups. Using a video demonstration filmed by a registered traditional Chinese medicine practitioner, the intervention group performed home-based acupressure (self-administered or caregiver-assisted) twice daily, 15 min/session, for 10 consecutive days. The control group performed manual light touching of the abdomen with the same frequency and duration as the intervention group. Both groups received defecation education through a structured booklet. MAIN OUTCOMES MEASURES: The primary outcome was constipation severity. Secondary outcomes included bowel habits, psychological well-being, and quality of life. Focus group interviews were conducted after the intervention to collect subjective feedback from participants. RESULTS: Significant group-by-time interaction effects on constipation severity (P = 0.005) and quality of life (P = 0.001) revealed that home-based acupressure produced better results than the control. These treatment effects persisted at the one-month follow-up and continued to have a large effect size (Cohen's d > 0.8). Compared to the control group, the acupressure group also had improvements in anxiety (Cohen's d = 0.69) and depression (Cohen's d = 0.72) at the end of the intervention period. Three qualitative categories were identified from the focus group interviews: improvements in bowel function and management; reduced psychological distress following relief from constipation; and acceptability of home-based acupressure. CONCLUSION: Acupressure effectively relieves constipation, enhances psychological well-being, and improves quality of life in people with SCI. These data provide novel evidence supporting the use of home-based acupressure as an acceptable and effective therapy for treating constipation after SCI. TRIAL REGISTRATION ClinicalTrials.gov (NCT05558657). Please cite this article as: Li MQ, Li Y, Lam W, Yeung WF, Ho YS, Li JY, Sun TC, Yuen S, Hu YL, Yorke J. Home-based acupressure for managing constipation and subjective well-being in spinal cord injury survivors: A randomized controlled trial. J Integr Med. 2025; 23(6):660-669.
Humans ; Acupressure/methods* ; Constipation/psychology* ; Male ; Female ; Spinal Cord Injuries/complications* ; Middle Aged ; Adult ; Quality of Life ; Aged

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*

BACKGROUNDAfter injury, axonal regeneration of the adult central nervous system (CNS) is inhibited by myelin-derived growth-suppressing proteins. These axonal growth inhibitory proteins are mediated via activation of Rho, a small GTP-binding protein. The activated form of Rho, which is bound to GTP, is the direct activator of Rho kinase (ROCK) through serial downstream effector proteins to inhibit axonal regeneration. The objective of this study was to observe the therapeutic effect of inactivation of the Rho-ROCK signaling pathway to promote neurologic recovery after spinal cord injuries in rats.

METHODSOne hundred and twenty adult female Sprague-Dawley rats were randomly divided into three groups. Laminectomies alone were conducted in 40 rats in the sham group. Laminectomies and spinal cord transections were performed in 40 rats in the control group (treated with normal saline administered intraperitoneally). Laminectomies and spinal cord transections were performed in 40 rats in the fasudil-treated group (treated with fasudil administered intraperitoneally). Neurologic recovery was evaluated before surgery and 3 days, and 1, 2, 3, and 4 weeks after surgery using the Basso-Beattie-Bresnahan (BBB) scale of hind limb movement. At the same time, the expression of RhoA mRNA was determined with RT-PCR. Histopathologic examinations and immunofluorescence staining of NF were performed 1 month after surgery.

RESULTSCompared with the control group, the BBB scores of the fasudil-treated group were significantly increased and the expression of RhoA mRNA was significantly decreased. In the fasudil-treated group, a large number of NF-positive regenerating fibers was observed; some fibers crossed the slit of the lesion.

CONCLUSIONInactivation of the Rho-ROCK signaling pathway promotes CNS axonal regeneration and neurologic recovery after spinal cord injuries in rats.

Animals ; Female ; Fluorescent Antibody Technique ; Nerve Regeneration ; Rats ; Rats, Sprague-Dawley ; Signal Transduction ; physiology ; Spinal Cord Injuries ; pathology ; physiopathology ; psychology ; therapy ; rho-Associated Kinases ; antagonists & inhibitors ; physiology ; rhoA GTP-Binding Protein ; antagonists & inhibitors ; physiology

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

PURPOSE: The purpose of the study was to understand and explain the essences and structures of the experience of Korean women who have had a spinal cord injury. METHODS: The data were collected in 2010 through individual in-depth interviews using open-ended questions. A total of 9 women with spinal cord injuries participated in the study. Each interview lasted about 2 hours. Verbatim transcripts were analyzed using phenomenological analysis. RESULTS: Five theme clusters emerged from the analysis using Colaizzi's method: frozen mind with rigid body; shame due to restrictions of physical function and dependency; struggle to go back to the previous normal body; disabilities that are noticeable in everyday family life; rebirth by discarding the obsessions of the past. These theme clusters illustrate that although most participants faced very strange and unbearable situations in most aspects of life after the injury, they were empowered finally by finding their hope and by giving new meanings to the current existence. CONCLUSION: This study provides deep understanding of women with spinal cord injuries who are relatively alienated from society. Based on the results of the study, health professionals could develop effective nursing interventions to improve quality of life of these women.
Adaptation, Psychological ; Adult ; Asian Continental Ancestry Group ; Disabled Persons ; Family ; Female ; Humans ; Interviews as Topic ; Middle Aged ; Qualitative Research ; Quality of Life ; Questionnaires ; Republic of Korea ; Spinal Cord Injuries/*psychology ; Stress, Psychological

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

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

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