Study design: Multi-center, cross-sectional study. Objectives: To investigate the effects of different bladder management methods on the quality of life (QoL) in patients with spinal cord injury (SCI). Setting: Turkey. Methods: Consecutive SCI patients (n ¼ 195, 74.4% males), for whom at least 6 months had elapsed since the injury, were included and evaluated in five groups: normal spontaneous micturition (NSM), micturition with assisted maneuvers (MAM), aseptic intermittent catheterization by patient (IC-P), aseptic IC by an attendant/caregiver (IC-A) and indwelling catheterization. The King's Health Questionnaire was used to evaluate the patients' QoL. Results: The bladder management groups were similar regarding age, time elapsed since injury, education level, marital and occupational status. There was no difference among the groups in general health perception, personal relationships and sleep/energy domain scores. While the NSM group had generally the lowest scores, that is, better QoL, the IC-A group had the highest scores, that is, poorer QoL, in most of the domains. When the patients were grouped according to the frequency of urinary incontinence or American Spinal Injury Association Impairment Scale grades, no difference was found in the domain scores of the groups except the symptom severity domain scores. No significant difference was found between paraplegic and tetraplegic patients in the King's Health Questionnaire domains. Conclusion: The QoL was notably affected in SCI patients in IC-A group and negative effects on emotional status, physical and social activity limitations were observed, as well.

The aim of this study was to determine the causes of rehospitalization in patients with spinal cord injury (SCI) treated in Istanbul Physical Medicine and Rehabilitation Centre and to compare the data with previous studies. Patients who were rehospitalized after an initial phase of rehabilitation between 1 January 1996 and 31 December 2001 were enrolled into the study. SCI patients aged 17 years or over at the time of injury were included. This retrospective study was designed using our medical records. In 5 years, 733 SCI patients were treated and 56 of them experienced rehospitalization. We examined the demographic and injury characteristics of rehospitalized patients with SCI. The SPSS computer programme was used for statistical analysis. We found that the rate of rehospitalization was 7.6%, the length of stay (LOS) was 72.21 days and the average age was 34.25 years. The reasons for rehospitalization were, in descending order, spasticity 25%, additional rehabilitation 21.4%, pressure sores 17.9%, urinary infection 16.1%, spinal surgery 8.9%, urinary system surgery 5.4% and pain 5.4%. Statistical significance was found between mean age and causes. The patients who were rehospitalized because of spinal surgery had a lower mean age than those rehospitalized because of pain (P=0.04, F=2.4). The most frequent reasons for rehospitalization of patients over 25 years old were spasticity and pressure sores. In conclusion, SCI patients' LOS was longer than found in previous studies because of a lack of efficient home rehabilitation. The most frequent cause of rehospitalization was spasticity, because of uncontrolled medical therapy. The study demonstrates how education of the patients and their families is important, and that home-based rehabilitation services must be established and supported by government.

In the intermediate stage of CTS, SCT was an effective treatment to improve symptoms and functional status. Tendon and nerve gliding exercises alone were inferior to either SCT alone or SCT in combination with gliding exercises.

Objectives: The aim of this study is to examine the obstacles in people with traumatic spinal cord injury (SCI) face performing intermittent catheterization (IC), also their worries and level of satisfaction. Methods: Two hundred sixty-nine patients performing IC for at least 3 months were asked to fill-out a questionnaire about their opinions on IC. Results: In total, 69.5% of patients performed IC themselves, 10.4% had performed by their mothers, 7.8% by another caregiver and 7.4% by their spouse. For the 72 (26%) patients unable to apply IC, reasons were insufficient hand function (56.1%), being unable to sit appropriately (35.4%) and spasticity (8.5%). In all, 70% of male patients had insufficient hand function, 20% could not sit and 10% had spasticity while 56.3% of female patients could not sit, 37.5% had insufficient hand function and 63% had spasticity. Difference between sexes was found to be statistically significant (Po0.05). Worries patients had when starting IC were fear of being dependent on IC (50.2%), accidentally injuring self (43.8%), embarrassment (43.2%), causing an infection (40.2%), bleeding (32.7%), fear of feeling pain (30.2%) and hygiene (24.7%). More women felt embarrassment; other items were similar in both sexes. In all, 46.9% of patients had urinary incontinence in intervals. Conclusion: In total, 69.5% of patients performed IC themselves. Men's most common obstacle was insufficient hand function while women's was being unable to sit appropriately. Patients' most common worries were being dependent on IC for life. In all, 46.9% had incontinence in intervals; 47.9% said IC improved their life quality; and 97.4% preferred IC over continuous catheterization.

Low back pain is common among caregivers of patients with spinal cord injury and is associated with duration of injury, level of injury, severity of injury, and functional level of the patient.