"What should a rehabilitation hospital be like?" Priorities and expectations of people with spinal cord injury in Türkiye.

In the rehabilitation of patients with spinal cord injuries, sexual rehabilitation is a pertinent issue that should not be ignored. Although they may not openly discuss sexual issues with their doctor at first, patients consider these issues to be very important. Therefore, doctors should ask their patients about their sexual problems in order to provide them with consultation and treatment. For males with spinal cord injuries, erectile dysfunction is the most significant problem. Patients are looking for a doctor who can help them to solve their problem of erectile dysfunction. Fortunately, there are a variety of effective methods that can help with erectile dysfunction in patients with spinal cord injuries. Oral medications, such as sildenafil, are very effective. However, if medications prove ineffective, intracavernosal injections may be considered. Couples with spinal cord injury are, of course, still capable of sexual intercourse. A couple in which the patient is a male may use the woman-on-top position. If the aim is conception, women with spinal cord injuries should be informed that their fertility is likely unaffected. Doctors may recommend that males with spinal cord injuries be treated in a fertility clinic. Hospitals with full-time sexual rehabilitation personnel and sexual rehabilitation programs can be of great help to patients with spinal cord injuries. The scope of such sexual rehabilitation should include not only medical help but also strategies for restoring sexual life, eliminating conflicts, and ensuring the happiness of couples.

Cortex is believed to have the necessary substrate to manifest plasticity following manipulations of sensorimotor experience, peripheral or spinal cord injury (SCI). One common model for studying SCI is a complete low thoracic transection in rats resulting in total paraplegia. Complete thoracic SCI induces significant cortical reorganization, such as expansion of forelimb sensory map into the deafferented cortex and expansion of motor representation of hand and proximal muscles. Trunk motor control is crucial after SCI and several rehabilitative strategies are aimed at enhancing trunk stabilization and postural control. How the trunk motor cortex reorganizes after SCI is not clear. Recently using trunk based robot rehabilitation we showed that SCI rats can significantly improve function. Underlying cortical mechanisms associated with successful recovery of function with robot rehabilitation are not completely understood. To this end, we used intracortical microstimulation to examine motor representations in the cortex of SCI rats. We first examined plasticity of trunk motor cortex after chronic adult SCI. We next investigated the effects of robot rehabilitation training on the plasticity of trunk motor cortex in adult SCI rats and adult rats with neonatal SCI. Lastly, we investigated the importance of trunk sensorimotor cortex in mediating recovery of function with robot rehabilitation in adult rats with neonatal SCI through cortical lesion studies. Our results suggest that chronic adult SCI induces significant reorganization of trunk motor cortex. This results in formation of novel synergies between trunk and forelimb and between different trunk segments. Passive (non-stepping) rehabilitation training of adult SCI rats does not induce any measurable plastic changes in trunk motor cortex. Successful robot rehabilitation training of adult rats with neonatal SCI induces significant reorganization of the trunk motor cortex including fractionation and emergence of novel complex muscle synergies within trunk motor cortex. Bilateral lesions to the trunk sensorimotor cortex in adult rats with neonatal SCI disrupts the sensorimotor integration associated with robot training resulting in lack of improvement over the duration of training along with no measurable plastic changes in the cortex. Taken together our findings imply significant reorganization of trunk motor cortex with SCI and successful rehabilitation training.

Background: About 1.5 million individuals with spinal cord injuries (SCIs) reside in India. Sixty to seventy percent of the 20,000 new cases of SCI that is added each year are from impoverished, illiterate people. SCI leads to life-altering experiences, encompassing physical, physiological, psychological, and social changes. The sexual orientation of an individual with SCI may directly impact their self-assurance and vice versa. Aims and Objectives: Patients with SCI may have physical, physiological, psychological, and social changes, including changes in their sexuality. After a SCI, individuals’ sexual health is a crucial topic that is rarely addressed. The purpose of this study was to learn about the patients’ experiences and feelings regarding sexual activity after a SCI. Materials and Methods: Patients with SCI were given a questionnaire. This study covered all male SCI patients between the ages of 18 and 50 who were married at the time of the injury and were followed up until December 2023. The purpose of this study was to talk about different facets of sexual activity and the issues that came with it. Second, these data will support SCI sufferer’s sexual rehabilitation. Results: Of the 231 patients, 72.3% had erections but only 32% had ejaculations. 55.8% of patients experienced difficulties with sexual function as a result of other SCI sequelae, such as flexor spasm, bladder, and bowel dysfunction, among others. In response, almost 90% of patients said that they had never received sexual rehabilitation or advice on their sexuality. Conclusion: Health-care providers and clinicians do not frequently bring up sexuality with patients who have SCI. Patients who frequently inquire about sexual activity following SCI yet are seldom helped. Since there is stigma associated with the topic, every SCI clinic needs to have a specialized sexual rehabilitation staff.

Background: About 1.5 million individuals with spinal cord injuries (SCIs) reside in India. Sixty to seventy percent of the 20,000 new cases of SCI that is added each year are from impoverished, illiterate people. SCI leads to life-altering experiences, encompassing physical, physiological, psychological, and social changes. The sexual orientation of an individual with SCI may directly impact their self-assurance and vice versa. Aims and Objectives: Patients with SCI may have physical, physiological, psychological, and social changes, including changes in their sexuality. After a SCI, individuals’ sexual health is a crucial topic that is rarely addressed. The purpose of this study was to learn about the patients’ experiences and feelings regarding sexual activity after a SCI. Materials and Methods: Patients with SCI were given a questionnaire. This study covered all male SCI patients between the ages of 18 and 50 who were married at the time of the injury and were followed up until December 2023. The purpose of this study was to talk about different facets of sexual activity and the issues that came with it. Second, these data will support SCI sufferer’s sexual rehabilitation. Results: Of the 231 patients, 72.3% had erections but only 32% had ejaculations. 55.8% of patients experienced difficulties with sexual function as a result of other SCI sequelae, such as flexor spasm, bladder, and bowel dysfunction, among others. In response, almost 90% of patients said that they had never received sexual rehabilitation or advice on their sexuality. Conclusion: Health-care providers and clinicians do not frequently bring up sexuality with patients who have SCI. Patients who frequently inquire about sexual activity following SCI yet are seldom helped. Since there is stigma associated with the topic, every SCI clinic needs to have a specialized sexual rehabilitation staff.

This special issue is dedicated to the Borneo International Spinal Cord Injury (SCI) Rehabilitation Conference (BISCIR) which was held on 30th July – 1st August 2021 through a virtual platform. It was co-organized by the Department of Rehabilitation Medicine, Queen Elizabeth Hospital, and Rehabilitation Medicine Unit, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah in partnership with Docquity and Kelab Perubatan Rehabilitasi Sabah. Attended by almost 500 delegates from Southeast Asian countries including the hosting country of Malaysia, the conference served its purpose as a global sharing platform by having invited local and international experts from Thailand, the Philippines, India, South Korea, and Australia. With the theme “SCI Rehabilitation: Basics and Beyond”, there was a great opportunity for participating delegates to submit their abstracts for oral and poster competition on spinal cord-related disorders and their rehabilitation. The covered areas include but are not exhaustive to the spinal cord pathophysiology, disease presentations, complications, and management, as well as rehabilitation interventions. Each submitted abstract was double-blinded peer-reviewed by two external reviewers. A total of 15 abstracts were accepted after rigorous review based on objective judging criteria, with seven and eight abstracts as oral and poster submissions respectively. Most of them were case reports with four cross-sectional studies and one review article. “Managing Tetraplegia with Blindness: Rehabilitation Approach” presented the improvement in mobility and daily living skills through orientation and mobility training with sensory education and repeated verbal instructions for compensating the loss of visual and sensory feedback. The “International Lower Urinary Tract Function Data Set: A Study in SCI Population in HRC” reviews the epidemiology of spinal cord injury patients with the neurogenic bladder in the largest rehabilitation hospital in Malaysia. “Navigating Neurological Recovery with NeuroAiD in Severe Spinal Cord Injury: A Noteworthy Novelty?” reported a case of complete tetraplegia who regained some neurological recovery following NeuroAiD supplementation. “A Case of Incomplete Spinal Cord Injury Associated with Brown Sequard Syndrome After Cervical Blunt Trauma with Atlanto-Axial Rotatory Subluxation in a Paediatric Patient” exhibited a case of a paediatric patient with high cervical spinal cord injury secondary to blunt trauma that has resulted in atlantoaxial rotatory subluxation. The “Long Cervicothoracolumbal Rigid Bracing Stabilization on Incomplete Spinal Cord Injury of Post-Operated Multi-Focal Upper Cervical-Thoracic Spinal Tuberculosis: A Unique Case Report” showed that the use of long CTLSO rigid external stabilization justifies the reason to boost protection while recovering from spinal tuberculosis despite receiving stable internal stabilization. “Orthotic Intervention for Ageing Individuals with Spinal Cord Injury: A Brief Review” explored the use of orthotic intervention among the elderly with SCI in 25 published articles. The “Demographic Characteristic of Spinal Cord Injury Patients Referred for Rehabilitation in Miri Hospital” aimed to explore the demographic characteristics among the referrals for rehabilitation among spinal cord injury populations in that tertiary hospital. The “Autonomic Dysreflexia with Concurrent Orthostatic Hypotension: A Clinical Approach Dilemma” highlighted the complicated conditions of managing concurrent Autonomic dysreflexia and orthostatic hypotension in a patient with high cervical spinal cord injury. “A Pinch of Salt Won’t Kill: The Role of Salt Tablets in Reversing Intractable Orthostatic Hypotension in an Incomplete Tetraplegic Patient” presented a case of intractable orthostatic hypotension in incomplete tetraplegia, which resolved after the initiation of salt tablets. The “Marching Forward with Mirabegron: A Novel Treatment Option for Neurogenic Detrusor Overactivity in Traumatic Spinal Cord Injury” showcased a case of young traumatic paraplegia who has been successfully treated with Mirabegron as an alternative to anticholinergics in treating overactive bladder for its better tolerability and comparable efficacy. “A Retrospective Pilot Study on the Prevalence of Acceptability for Teleconsultation among Spinal Cord Injury Patients” observed the acceptability of teleconsultation among SCI patients in a major tertiary rehabilitation hospital with a description of their clinical and demographic features. “Performing Solat in Spinal Cord Injury Patients: Challenges and Solutions” emphasized the importance to educate healthcare workers for identifying the limitations and leniency in Islam related to performing prayer (solah) and understand the conditions of the validity of the performed prayer as means to equip patients with the right knowledge and method. The ”Sharing of Experience of Teleconsultation with Spinal Cord Injury Patients” proven that the use of teleconsultation is a beneficial service among SCI patients during the COVID-19 pandemic. “Fleet Enema-Induced Autonomic Dysreflexia in Spinal Cord Injured Patient” reported the use of fleet enema in spinal cord injured patients that can cause autonomic response leading to severe complication of a generalized tonic-clonic seizure. The “An Uncommon Case Post-traumatic Syringobulbia: A Case Report” showed that the formation of syringobulbia, although rare, is one of the causes of the delayed-onset neurological deterioration in spinal cord injured patients. The accepted abstracts are presented in the following sections of this issue. Readers are welcome to contact us for any comments or queries.

This special issue is dedicated to the Borneo International Spinal Cord Injury (SCI) Rehabilitation Conference (BISCIR) which was held on 30th July – 1st August 2021 through a virtual platform. It was co-organized by the Department of Rehabilitation Medicine, Queen Elizabeth Hospital, and Rehabilitation Medicine Unit, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah in partnership with Docquity and Kelab Perubatan Rehabilitasi Sabah. Attended by almost 500 delegates from Southeast Asian countries including the hosting country of Malaysia, the conference served its purpose as a global sharing platform by having invited local and international experts from Thailand, the Philippines, India, South Korea, and Australia. With the theme “SCI Rehabilitation: Basics and Beyond”, there was a great opportunity for participating delegates to submit their abstracts for oral and poster competition on spinal cord-related disorders and their rehabilitation. The covered areas include but are not exhaustive to the spinal cord pathophysiology, disease presentations, complications, and management, as well as rehabilitation interventions. Each submitted abstract was double-blinded peer-reviewed by two external reviewers. A total of 15 abstracts were accepted after rigorous review based on objective judging criteria, with seven and eight abstracts as oral and poster submissions respectively. Most of them were case reports with four cross-sectional studies and one review article. “Managing Tetraplegia with Blindness: Rehabilitation Approach” presented the improvement in mobility and daily living skills through orientation and mobility training with sensory education and repeated verbal instructions for compensating the loss of visual and sensory feedback. The “International Lower Urinary Tract Function Data Set: A Study in SCI Population in HRC” reviews the epidemiology of spinal cord injury patients with the neurogenic bladder in the largest rehabilitation hospital in Malaysia. “Navigating Neurological Recovery with NeuroAiD in Severe Spinal Cord Injury: A Noteworthy Novelty?” reported a case of complete tetraplegia who regained some neurological recovery following NeuroAiD supplementation. “A Case of Incomplete Spinal Cord Injury Associated with Brown Sequard Syndrome After Cervical Blunt Trauma with Atlanto-Axial Rotatory Subluxation in a Paediatric Patient” exhibited a case of a paediatric patient with high cervical spinal cord injury secondary to blunt trauma that has resulted in atlantoaxial rotatory subluxation. The “Long Cervicothoracolumbal Rigid Bracing Stabilization on Incomplete Spinal Cord Injury of Post-Operated Multi-Focal Upper Cervical-Thoracic Spinal Tuberculosis: A Unique Case Report” showed that the use of long CTLSO rigid external stabilization justifies the reason to boost protection while recovering from spinal tuberculosis despite receiving stable internal stabilization. “Orthotic Intervention for Ageing Individuals with Spinal Cord Injury: A Brief Review” explored the use of orthotic intervention among the elderly with SCI in 25 published articles. The “Demographic Characteristic of Spinal Cord Injury Patients Referred for Rehabilitation in Miri Hospital” aimed to explore the demographic characteristics among the referrals for rehabilitation among spinal cord injury populations in that tertiary hospital. The “Autonomic Dysreflexia with Concurrent Orthostatic Hypotension: A Clinical Approach Dilemma” highlighted the complicated conditions of managing concurrent Autonomic dysreflexia and orthostatic hypotension in a patient with high cervical spinal cord injury. “A Pinch of Salt Won’t Kill: The Role of Salt Tablets in Reversing Intractable Orthostatic Hypotension in an Incomplete Tetraplegic Patient” presented a case of intractable orthostatic hypotension in incomplete tetraplegia, which resolved after the initiation of salt tablets. The “Marching Forward with Mirabegron: A Novel Treatment Option for Neurogenic Detrusor Overactivity in Traumatic Spinal Cord Injury” showcased a case of young traumatic paraplegia who has been successfully treated with Mirabegron as an alternative to anticholinergics in treating overactive bladder for its better tolerability and comparable efficacy. “A Retrospective Pilot Study on the Prevalence of Acceptability for Teleconsultation among Spinal Cord Injury Patients” observed the acceptability of teleconsultation among SCI patients in a major tertiary rehabilitation hospital with a description of their clinical and demographic features. “Performing Solat in Spinal Cord Injury Patients: Challenges and Solutions” emphasized the importance to educate healthcare workers for identifying the limitations and leniency in Islam related to performing prayer (solah) and understand the conditions of the validity of the performed prayer as means to equip patients with the right knowledge and method. The ”Sharing of Experience of Teleconsultation with Spinal Cord Injury Patients” proven that the use of teleconsultation is a beneficial service among SCI patients during the COVID-19 pandemic. “Fleet Enema-Induced Autonomic Dysreflexia in Spinal Cord Injured Patient” reported the use of fleet enema in spinal cord injured patients that can cause autonomic response leading to severe complication of a generalized tonic-clonic seizure. The “An Uncommon Case Post-traumatic Syringobulbia: A Case Report” showed that the formation of syringobulbia, although rare, is one of the causes of the delayed-onset neurological deterioration in spinal cord injured patients. The accepted abstracts are presented in the following sections of this issue. Readers are welcome to contact us for any comments or queries.

This paper reports a study which explored family carers' experiences of taking care of a relative who has a spinal cord injury. Spinal cord injury is one of the most disastrous injuries a person may experience. Although one family member experiences the injury, the entire family is affected. In Taiwan, family carers carry the primary responsibility of providing care on a 24-hour basis during the rehabilitation hospitalisation. However, very limited research exists regarding their experiences. This qualitative study has a cross-sectional and descriptive-explorative design. Grounded theory was used to explore the psychosocial implications for family carer who has a relative with spinal cord injury. Data collection and analysis. Data were collected through in-depth, tape-recorded, semi-structured interviews and observation of a group discussion and two religious activities in a rehabilitation hospital in Taiwan. Fifteen family carers participated in this study comprising eight individual interviews and seven participating in the group discussion. Data collection and analysis occurred concurrently. The findings resulted in the core category 'living with a relative who has a spinal cord injury' and identified the experience of taking care of a relative who has a spinal cord injury. Three stages, including four categories: stage 1 'A catastrophic life event'; stage 2 'Confronting challenges'; and stage 3 'Family resilience' or 'Family breakdown'. This study shows that family carers experience a catastrophic life event, they have to confront challenges and the positive consequence is family resilience, the negative consequence is family breakdown. Relevance to clinical practice. Knowing how prospective family carers view their own situation and what they need is essential to provide effective nursing care for the family that has been changed dramatically by a spinal cord injury.

Review article. Critical review of literature on the multiple aspects of sexual rehabilitation in women with spinal cord injury (SCI) from initial recovery to long-term follow-up. Neuro-urology Department. Studies on sexuality selected from PubMed from 1993 to 2009. Literature supported by significant statistical analyses reports that females with complete tetraglegia deserved special attention immediately at initial recovery; sexual intercourse is much more difficult for them (as compared with other women with SCI) mainly because of autonomic dysreflexia and urinary incontinence. There are sparse data on predictable factors favoring sexual rehabilitation such as the age SCI was incurred, the importance of one's sexual orientation, and the SCI etiology. Information after initial discharge is based chiefly on questionnaires, which report that as more time passes since the injury, patients attain more sexual satisfaction compared with recently injured women. Studies on neurological changes after SCI, and their effect on sexual response, are supported by a significant statistical analysis, but with few SCI patients. One topic reported the effect of sildenafil on sexuality, without benefit. No paper offers any detailed analysis on the sexual impact of medical and psychological treatments related to SCI. Literature reports that some co-morbidities are more prevalent in women with SCI compared with able-bodied women but data on sexual functioning are missing. To improve sexual rehabilitation services, sexual issues and response require evaluation during periodical check-ups using validated questionnaires administered by a physician 'guide' who coordinates professional operators thus providing personalized programmable interventions.

Descriptive cross-sectional and retrospective study. To gain more insight into the long-term health status in persons with traumatic spinal cord injury (SCI), especially perceived psychological distress as well as self-reports of utilization of healthcare services. Sunnaas Rehabilitation Hospital, Norway. In total, 147 persons with SCI were examined for more than 20 years and interviewed (in 2004/2005) using a self-administrated questionnaire and General Health Questionnaire (GHQ-20). Descriptive statistics and a logistic regression analysis were conducted to identify variables associated with psychological distress. Most participants had received SCI follow-up health services at least once after initial rehabilitation; 34% were satisfied, 51% neutral and 18% unsatisfied with the health services provided. Concerning psychological distress, 34 persons were cases according to the GHQ-20. The cases did not differ from non-cases concerning demography, time since injury, injury aetiology, injury severity, marital status or employment status. The regression analysis revealed that cases were associated (P<0.05) with more use of SCI-specific follow-ups. In a 20+ years' post-injury SCI population, psychological distress is common and associated with the use of follow-up services. The varying satisfaction of people with SCI about healthcare services is notable, as is the finding that 20% of people with paraplegia did not use specific SCI follow-up services. The experiences of people with SCI with healthcare services need further investigation, and there is also a need for studies that examine the effects of interventions aimed at improving services and patient satisfaction.

The purpose of this study was to determine sleep quality and presence of sleep disorders in participants with spinal cord injury (SCI). A web-based survey, available online from February 2011 to July 2013, using validated sleep questionnaires, advertised via the internet and locally through SCI consumer organizations in the United States, Australia, New Zealand, and Canada, was designed to evaluate sleep in adults with self-reported SCI. Demographic characteristics and medical history were obtained from participant self-report. In our study population, 70% of the 304 participants were male with a mean age of 45 ± 13 years. The mean duration of injury was 16 ± 12 years. Cervical injuries were reported by 49% and thoracic injuries noted in 40% of participants. Increased sleep apnea risk was noted in 31% of participants, with 66% reporting snoring. Insomnia symptoms were reported by 54% of the respondents. Almost 40% of participants ranked their sleep quality as "fairly bad" to "very bad" in the previous month, 29% reported "often" or "almost always" waking up because of pain, and 22% had difficulty falling asleep because of leg cramps. In the past year, 27% of the respondents reported daily uncomfortable leg sensations and 28% found these leg symptoms to be "moderately to extremely distressing." This study increases the awareness that insomnia, sleep apnea, and poor sleep quality are common in individuals with chronic SCI; often coexisting. There is a need for increased screening for sleep problems by healthcare providers taking care of individuals living with SCI.

Motor Recovery after Spinal Cord Injury Enhanced by Strengthening Corticospinal Synaptic Transmission

Spinal cord injuries are a global health problem, which strikes millions of people worldwide, and causing either a lifetime severs disability or death. Objectives To assess spinal cord injured persons quality of life. Methodology A descriptive quantitative study is carried out at Ibn AL-Kuff Hospital for spinal cord injuries, started from December 20th, 2009 to July 20th, 2010. A non-probability (Purposive sample) of (100) spinal cord injured persons, who were clients of Ibn AL-Kuff hospital for spinal cord injuries/ outpatient clinic after at least 6 months after their discharged from the hospital for medical follow-up and rehabilitation, within 16 years old or more. The data are collected through the use of semi-constructed questionnaire, which consists of three parts (1) Socio-demographic data form that consist 9-items (2) clinical characteristics form that consist of 10-items and (3) Main domains of the quality of life, which consist of six main domains: physical, psychological, level of independence, social, environmental, and spiritual domain, by means of direct interview technique with the spinal cord injured persons. Reliability of the questionnaire is determined through a pilot study and the validity through a panel of (15) experts. The data were described statistically and analyzed through use of the descriptive and inferential statistical analysis procedures. Results The findings of the present study indicate that the spinal cord injury affect the quality of life domains. The maximal affect presented by the social domain, followed by the level of independence domain, the psychological domain, then the physical domain. While the minimal effect, presented by spiritual domain, followed by the environmental domain. There is a significant relationship between gender, age, marital status after injury, level of education, occupational status after the injury, levels of injury, types of injury, duration of injury, associated diseases, follow-up and physiotherapist visits, use of assistive aids, and the possible complications after injury and quality of life domains. There is a non-significant relationship between residence, marital status before injury, occupational status before injury, socio-economic status, and causes of injury and quality of life domains.Conclusion The study concludes that the spinal cord injury most common occurs among persons in urban residential area than in those in rural. Spinal cord injury most occurs in male than in females. Spinal cord injury does not affect the continuity of the person's marital relationships. Also the study confirmed that the spinal cord injury affects negatively on the continuity of the persons jobs. In addition, the study indicates that the external trauma is the most common cause of the spinal cord injury. Moreover, paraplegic injury is the most common level in spinal cord injuries than tetraplegics injury. Also the incomplete injury is the most common type of spinal cord injuries. And, the spinal cord injury associated with many complications involves all the body systems.  Recommendations The study recommends that an intensive comprehensive wide population-based studies be conducted to assess the spinal cord injured persons, quality of life. Also, an intensive comprehensive wide population-based education programs be conducted to support the nurses' knowledge and practice toward spinal cord injury management and rehabilitation. And health oriented mass media approach should be employed by the Ministry of Health to increase population knowledge and awareness of spinal cord injury. Health oriented mass media approach should be employed by the Ministry of Health to increase population knowledge and awareness of spinal cord injury.Key wards: assessment, spinal cord injuries, quality of life

Spinal cord injury (SCI) is one of the most devastating physical disabilities. It leads to varying degrees of loss in sensations and mobility below the level of injury and causes loss in autonomic functions, such as bladder/bowel control, and sexual impairments. Research, mostly conducted in the developed western nations, reveals that coming to terms with one’s sexuality after SCI is most crucial for early reintegration in the society and quality of life for persons with SCI. Thus, experts advocate that the sexual rehabilitation of persons with SCI is an integral component of comprehensive rehabilitation. In the Indian context, however, the sexuality of persons with SCI, particularly women, has been largely overlooked by the disability rights movement, and discourses on gender, sexuality and rehabilitation. This article is based on an in-depth study of the experiences of sexuality and intimate relationships of 24 women with SCI in India. It demonstrates that sexuality and intimate relationships are integral aspects of health and well-being for women. But there are wide gaps in the sexual rehabilitation and support needs for women with SCI in India, making their sexual adjustment extremely challenging. By analysing women’s journeys of sexual adjustment and rediscovery of sexual pleasure that echo their voices as sexual beings, this article argues for the development of evidence-based and gender-sensitive sexual rehabilitation services for women with SCI in India.

Undocumented Patients and Rehabilitation Services

IntroductionTraumatic brain injury (TBI) and spinal cord injury (SCI) are both major contributors to permanent disability globally, with an estimated 27 million new cases of TBI and 0.93 million new...