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Mental Health After SCI

Miscellaneous Interventions for Anxiety

Discussion

In a randomized controlled trial, Feng et al. (2017) evaluated the effectiveness of hyperbaric oxygen compared to psychotherapy or standard rehabilitation on anxiety symptoms. The study found significant difference in levels of anxiety among those that received HBO compared to standard rehabilitation group. No significant difference was seen among HBO and psychotherapy.

Conclusion

There is level 1b evidence that hyperbaric oxygen may improve symptoms of anxiety post SCI.

Author Year
Country
Research Design
PEDro Score
Total Sample Size
Methods Outcome
Feng et al. (2017)
China
RCT
PEDro=6
N=60
Population: HBO group (n=20): Mean
age=36.1±5.2 yr; Gender: males=14,
females=6; Level of injury: C=7, T=8,
L=5; Severity of injury: AIS A=0, B=12,
C=5, D=3.
Psychotherapy group (n=20): Mean
age=34.8±4.7 yr; Gender: males=15,
females=5; Level of injury: C=8, T=6,
L=6; Severity of injury: AIS A=0, B=10,
C=8, D=2. Conventional rehabilitation
group (n=20):Mean age=33.1±4.6 yr;
Level of injury: C=7, T=9, L=4; Severity
of injury: AIS A=0, B=10, C=7, D=3.
Intervention: Participants were
randomly allocated to either a
hyperbaric oxygen group (HBO), a
psychotherapy group or a conventional
rehabilitation group for an 8-wk
intervention in which all three groups
received routine rehabilitation on top of
their intervention. Therapy sessions
occurred once a day, 6 days a wk for 8
wk.
Outcome Measures: Hamilton
depression scale (HAMD), Hamilton
anxiety scale (HAMA), American spinal
injury association score (AISA) and
functional independence measure
(FIM).
1. HAMD score was significantly lower
in both the HBO and psychotherapy
groups compared to the control group
at the end of 8 wk (p<0.05 for both)
with no significant difference between
HAMD score for HBO and
psychotherapy groups from baseline
to 8 wk (p>0.05).
2. HAMA score was significantly lower
for the HBO group than for the
control group (p<0.05) with no
significant difference in HAMA score
between the HBO and psychotherapy
groups (p>0.05).

Discussion

Federici and colleagues (2019) provided participants with a sexual health psychoeducation program over 12 session. The program found no significant improvements in level of anxiety post intervention.

Conclusion

There is level 4 evidence that sexual health may not improve anxiety post SCI.

Author Year
Country
Research Design
PEDro Score
Total Sample Size
Methods Outcome
Federici et al., (2019)
Italy
Pre-Post
N=11
Population: Mean age:
males=50.4±7.3 yr,
females=41.5±11.26 yr; Gender:
males=5, females=6; Time since
injury=30.1±9.4 yr; Level of injury:
tetraplegia=3, paraplegia=4, no
paraplegia/tetraplegia=4; Severity of
injury: complete=5, incomplete=2,
none=4.
Intervention: Participants were 4
couples (one with SCI and one without)
and 3 singles with SCI who took part in
a sexual health psychoeducational
intervention in which 4 couples and 3
singles met every two weeks for 12
meetings of a growth group and
reported the results of their love lives
and persona lives.
Outcome Measures: Sexual interest
and satisfaction scale (SIS), Beck
depression inventory – II (BDI-II) and
Beck anxiety inventory (BAI).
1. All participants improved significantly
on item 5 of the SIS scale “How are
your opportunity and your ability to
enjoy sexuality yourself?” (p<0.01),
SIS scale total score (p<0.05) and
BAI scores (p<0.05).
2. No difference was found for SIS
scale’s general satisfaction after
injury, BDI, or BAI (p>0.05).
3. Significant effect found on item 5 of
the SIS scale “How are your
opportunity and your ability to enjoy
sexuality yourself?” for both
individuals and partners (p<0.05 for
both).
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