Study DesignPilot randomized controlled trial.PurposeTo compare the efficacy between virtual reality intervention (using Nintendo Wii) along with conventional occupational therapy and conventional occupational therapy alone in improving upper limb function in patients with spinal cord injury (SCI).Overview of LiteratureThe use of virtual reality has gained importance in the rehabilitation sector over the last few years. Nintendo Wii has the potential to encourage upper limb function while engaging in an interesting activity, which is important in long-term interventions, such as the treatment of SCI.MethodsOverall, 22 patients with SCI participated in the study. They were randomly assigned to two groups. Group I received 30 minutes of virtual reality intervention (using Nintendo Wii) and 30 minutes of conventional therapy, whereas group II received conventional therapy only for 30 minutes. Both groups received therapy 3 days a week for 4 weeks. One hand of each patient was identified as the target hand based on the inclusion criteria. All patients were assessed at baseline, 2 weeks and 4 weeks (post-intervention), and 6 weeks (follow-up). The functional ability of the target hand was assessed using the Capabilities of Upper Extremity (CUE) questionnaire. Gross motor dexterity was assessed using the Box and Block Test (BBT). The level of independence in activities of daily living was assessed by the Spinal Cord Independence Measure-Self Report and quality of life by the World Health Organization Quality of Life-BREF.ResultsAfter 4 weeks of intervention, there was no significant difference in improved hand function between the groups. Mean scores were higher for group I than for group II, with a higher percent change (31.5% in CUE questionnaire and 51.7% in BBT) in group I.ConclusionsVirtual reality along with conventional therapy produces similar results in upper limb function as does conventional therapy alone.

Occupational therapy (OT) educators recognize a need to ensure that OT students are culturally competent. The researchers developed the International Collaborative Project on Cultural Competence (ICPCC) to help students understand the impact of cultural context on client care. Entry-level MOT students from a university in the US (N = 18) collaborated with BOT students (N = 4) and advanced MOT students (N = 9) from two universities in India using an online course management system WebCT. The study explored the impact of the ICPCC on OT students' cultural competence and discusses students' perceptions of culture on the OT process. The Inventory for Assessing the Process of Cultural Competence Among Health Care Professionals Revised © measured students' cultural competence at baseline and immediately after participation in the ICPCC. Qualitative data was collected using a Self-Reflection Form. There was an increase in the cultural competence scores among all three groups of students after participating in the ICPCC at p value < .05. Three themes emerged from the qualitative data analysis: meaning of the term culture, impact of cultural on client-centered practice, and impact of cultural on OT outcomes. OT students recognized the role that cultural differences play in OT evaluation and intervention.

Study design: This is a methodological research design. Objectives: Spinal cord injury (SCI) may result in the inability to sit unsupported. This may lead to difficulty performing daily living activities. To make the subjects with SCI independent in their daily living to the maximum possible extent, therapists provide them balance training for which they may require to assess the sitting balance. This study aims to develop an objective measure 'Sitting Balance Measure' (SBM) for the assessment of sitting balance of the subjects with SCI, and to determine its content validity and internal consistency reliability. Setting: This study was conducted in New Delhi, India. Methods: The study was conducted in three phases, namely planning, construction and quantitative evaluation phase. Thirty-six items were generated through the review of literature and semistructured interviews. Qualitative and quantitative content validation through the expert opinion and the content validity ratio (CVR) method resulted in the 24-item scale, which was pilot-tested on a purposive sample of 30 subjects with SCI. Item analysis was conducted to determine internal consistency reliability. Results: CVR method and qualitative review by the experts validated the content of SBM. The SBM has high internal consistency reliability (Cronbach's alpha = 0.96). Conclusion: SBM is a valid scale for the assessment of sitting balance in subjects with SCI. Internal consistency reliability of SBM is high. This may be indicative of item redundancy, which necessitates the need for the second pilot test to refine the scale further.

Study design: Clinimetric study. Objectives: To develop the Perceived Sexual Distress Scale (PSDS) in Hindi language (that is, PSDS-H) for persons with spinal cord injury (SCI), and to establish its content validity, internal consistency and test-retest reliability. Setting: New Delhi, India. Methods: Following a comprehensive literature review and semi-structured interviews, a 43-item questionnaire was drafted. Each item was rated on a 5-point scale. Content validity was established both qualitatively and quantitatively. Inter-item, item total correlations, internal consistency and test-retest reliability were calculated. Results: Expert panel opinion and content validity ratio (CVR) validated the content of the PSDS-H. Five items were dropped because of low CVR, resulting in a 38-item questionnaire. Internal consistency reliability (Cronbach's alpha) was 0.965. The test-retest reliability was 0.647. Conclusion:The PSDS-H is a valid, self/interviewer-rated tool that can help inform the rehabilitation team about the level of an individual's perceived sexual distress post SCI. It also provides an outcome measure to evaluate the efficacy of interventions related to sexuality post injury. Spinal Cord (2014) 52, 712-716; doi:10.1038/sc.2014.83; published online 1 July 2014 INTRODUCTIONThe World Health Organization has described sexual health as 'the integration of the somatic, emotional, intellectual and social aspects of sexual being in ways that are positively enriching and that enhance personality, communication and love' . 1 Spinal cord injury (SCI) frequently concerns women and men in their sexually active and reproductive periods of life. 2 In a study done by Reitz et al. 2 on 120 persons with SCI, 63 reported that the major impact of SCI was on sexual functions. Consequences and complications of SCI, such as inability to move, neurogenic bladder and bowel dysfunction, spasticity and pain, all influence quality of life and sexuality.Sexual readjustment after SCI depends greatly on the particular person's wishes, experiences and sexual habits in their pre-SCI life. It may also, to a great extent, depend on the co-operation and helpfulness of the partner. The psychosexual functioning of persons with paraplegia is not different from quadriplegia. 3 Sexuality and sensuality can be an expression of confidence, validation of the self and one's perceived lovability. A review of the existing literature on sexuality and SCI explains the powerful influence of sexual problems and dysfunctions on psychology of the subjects, including issues of the affected body image, self concept, gender roles, general psychological health and basic sense of self-esteem. 4,5 These problems may give rise to sexuality-related distress in persons with SCI. 6,7 There is little available empirical research on the psychological distress experienced due to sexual dysfunctions post SCI. The available measures primarily examine physical aspects of sexual

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