RESUMEN

CONTEXT/OBJECTIVE: To compare the beliefs and practices of individuals with spinal cord injury (SCI), their friends and family members (F&F SCI), and healthcare professionals (HCP) regarding complementary alternative medicine (CAM). DESIGN: A questionnaire regarding CAM practices and beliefs was administered to participants on paper or online. SETTING: An academic rehabilitation hospital. PARTICIPANTS: Ninety-six individuals voluntarily participated in the study. Participants included 28 patients with SCI, 36 F&F SCI, and 32 HCP. INTERVENTIONS: Not applicable Outcome Measures: The questionnaire assessed participants' prior or current use of 14 CAM modalities, their willingness to use CAM in the future or recommend its use, and their beliefs and opinions of CAM. RESULTS: Participants with SCI and their family and friends, were more likely than HCP to have used CAM (P ≤ 0.01 and P ≤ 0.03, respectively) and recommend its use (P ≤ 0.04 and P ≤ 0.03, respectively). All three groups showed statistical significance in their willingness to ever use certain CAM modalities (P ≤ 0.03 for SCI, P ≤ 0.04 for F&F SCI, and P ≤ 0.02 for HCP). SCI, F&F SCI, and HCP groups had similar beliefs and opinions regarding CAM. CONCLUSION: Patients with SCI as well as their friends and family, have significantly more experience with CAM and are more likely to recommend its use than HCP, suggesting that they are interested and find benefit in alternative healthcare. This warrants further investigation of the integration of CAM into general health practices for those with SCI.

Asunto(s)

Actitud , Terapias Complementarias/psicología , Traumatismos de la Médula Espinal/rehabilitación , Adolescente , Adulto , Cuidadores/psicología , Terapia Combinada , Terapias Complementarias/métodos , Femenino , Personal de Salud/psicología , Humanos , Masculino , Persona de Mediana Edad , Encuestas y Cuestionarios

RESUMEN

Autonomic dysreflexia (AD) following spinal cord injury can lead to a physiologic state where there is unopposed sympathetic tone and subsequent hypertension, bradycardia, hyperhidrosis and anxiety. It is known to be triggered by nociceptive stimuli below the level of injury-most commonly constipation and bladder retention. We present a case of a C6-7 tetraplegic who developed AD 20 years after his injury with the unusual trigger of positional spinal instability due to osteomyelitis and discitis. The patient's clinical course began when he was diagnosed with L2-3 and L3-4 osteomyelitis, discitis and myositis of the bilateral paraspinous muscles. The infection did not respond well to an attempted course of medical management and degenerated into an unstable spinal segment. This instability in the vertebral column led to positional AD with symptom onset in extension (lying supine) and relieved with flexion (patient sitting up and bending forward). Once the trigger for his AD was determined, he was successfully treated with spinal fusion to stabilize the mobile segment and further antibiotic treatment. He had complete resolution of his AD after surgery and eradication of his infection.