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NeuroRehabilitation, an international, interdisciplinary, peer-reviewed journal, publishes manuscripts focused on scientifically based, practical information relevant to all aspects of neurologic rehabilitation. We publish unsolicited papers detailing original work/research that covers the full life span and range of neurological disabilities including stroke, spinal cord injury, traumatic brain injury, neuromuscular disease and other neurological disorders.
We also publish thematically organized issues that focus on specific clinical disorders, types of therapy and age groups. Proposals for thematic issues and suggestions for issue editors are welcomed.
Authors: Sipski, Marcalee
Article Type: Introduction
DOI: 10.3233/NRE-2000-15201
Citation: NeuroRehabilitation, vol. 15, no. 2, pp. 87-87, 2000
Authors: Brackett, Nancy L. | Lynne, Charles M.
Article Type: Research Article
Abstract: The methods of penile vibratory stimulation (PVS) and rectal probe electroejaculation (EEJ) are widely used to obtain semen from anejaculatory men with spinal cord injury. This paper reviews evidence that the semen quality resulting from PVS versus EEJ is different, and these methods should be used as variables in studies of men with spinal cord injury. The following evidence is reviewed. PVS and EEJ stimulate ejaculation by different mechanisms. In humans and monkeys, semen quality is different when obtained by PVS versus EEJ of the same group of subjects. In neurologically intact men, EEJ results in low sperm motility. Markers …of accessory gland function are different in ejaculates obtained by PVS versus EEJ. For scientific studies, it is recommended that whenever possible, antegrade specimens obtained by PVS be used. For clinical applications, such as obtaining sperm for assisted reproductive procedures, the choice is less critical, however, PVS offers advantages over EEJ. Show more
Keywords: spinal cord injuries, spermatozoa, semen, ejaculation, infertility
DOI: 10.3233/NRE-2000-15202
Citation: NeuroRehabilitation, vol. 15, no. 2, pp. 89-100, 2000
Authors: Green, Bruce G. | Martin, Sherri
Article Type: Research Article
Abstract: Objective: To evaluate the efficacy and safety of sildenafil over a two-year period in patients with erectile dysfunction caused by spinal cord injury and multiple sclerosis in a clinical practice following FDA approval and release of the medication to the general healthcare community. Study design: 40 patients including 33 SCI (13 quadriplegics, 20 paraplegics; 14 complete, 19 incomplete) and 7 MS patients were prescribed sildenafil in varying dosages. The patients were asked to return to the clinic for additional prescriptions so that we could assess their clinical response and their incidence of side effects. They were then followed …for a period of up to two years either by follow up clinic visits or telephone interviews to determine whether they continued to use sildenafil as an ongoing solution to their erectile dysfunction. Results: Mean erectile response went from 4.9 to 7.8 (scale 1–10). Non-responders went from 9 to 4. 36 of the 40 were able to achieve erections sufficient for sexual intercourse. At the 2-year interval 13 of the 40 were no longer using sildenafil but only six discontinued due to lack of response. Adverse effects were minimal and mimicked those seen in the able-bodied studies. Conclusion: Sildenafil is a safe and effective first line treatment for the treatment of male neurogenic erectile dysfunction. However close clinical surveillance is necessary so that patients can avail themselves of other options should sildenafil not be effective. Show more
DOI: 10.3233/NRE-2000-15203
Citation: NeuroRehabilitation, vol. 15, no. 2, pp. 101-105, 2000
Authors: Hibbard, Mary R. | Gordon, Wayne A. | Flanagan, Steven | Haddad, Lisa | Labinsky, Ellen
Article Type: Research Article
Abstract: Objective: The frequency of self reported sexual difficulties was examined in a group of 322 individuals with traumatic brain injury (TBI) (N = 193 men; 129 women) and contrasted with reports of sexual difficulties in 264 individuals without disability (152 men; 112 women) residing in the community. Physiological, physical, and body images problems impacting sexual functioning were examined individually and then summed into a sexual dysfunction score. Mood, quality of life, health status and presence of an endocrine disorder were examined as predictors of sexual difficulties post TBI. Study design: In this retrospective study, data about sexual …difficulties were analyzed separately for men and women with TBI and without disability. ANOVAs with post hoc analysis for continuous variables, chi-square analyses for categorical variables, and ANCOVAs for predictors of sexual difficulties were utilized. Results: When contrasted to individuals without disability, individuals with TBI reported more frequent: (1) physiological difficulties influencing their energy for sex, sex drive, ability to initiate sexual activities and achieve orgasm; (2) physical difficulties influencing body positioning, body movement and sensation, and (3) body image difficulties influencing feelings of attractive and comfort with having a partner view one’s body during sexual activity. Additional gender specific TBI findings were observed. In comparison to gender matched groups without disability, men with TBI reported less frequent involvement in sexual activity and relationships, and more frequent difficulties in sustaining an erection; women with TBI reported more frequent difficulties in sexual arousal, pain with sex, masturbation and vaginal lubrication. While groups differed in core demographic variables, age was the only demographic variable that was related to reports of sexual difficulties in individuals with TBI and men without disability. Age at onset and severity of injury were negatively related to reports of sexual difficulties in individuals with TBI. In men with TBI and without disability, the most sensitive predictor of sexual dysfunction was level of depression. For women without disability, an endocrine disorder was the most sensitive predictor of sexual dysfunction. For women with TBI, an endocrine disorder and level depression combined were the most sensitive predictors of sexual difficulties. Conclusion: Individuals post TBI report frequent physiological, physical and body images difficulties which negatively impact sexual activity and interest. For men post TBI, predictors of sexual difficulties included age at interview, age at injury, and having milder injuries, however, depression was the most sensitive predictor of sexual dysfunctions. For women post TBI, predictors of their sexual difficulties included age at injury and having milder injuries, however, depression and an endocrine disorder combined were the most sensitive predictors of sexual dysfunction. Implications of this study include the need for broad-based assessment of sexual dysfunction, and the implementation of treatment studies to enhance sexual functioning post TBI. Show more
Keywords: traumatic brain injury, sexual dysfunction
DOI: 10.3233/NRE-2000-15204
Citation: NeuroRehabilitation, vol. 15, no. 2, pp. 107-120, 2000
Authors: Mona, Linda R. | Krause, James S. | Norris, Fran H. | Cameron, Rebecca P. | Kalichman, Seth C. | Lesondak, Linda M.
Article Type: Research Article
Abstract: Sexual adjustment, defined within this study as post-injury sexual views of the self, among 109 men and 86 women with spinal cord injury (SCI) was explored through cognitive adaptation theory [30]. It was predicted that cognitive adaptation constructs (i.e., personal control, optimism, meaning, and self-esteem) and sexual self-esteem would be predictive of sexual adjustment. It was also hypothesized that sexual self-esteem would be predictive of sexual adjustment over and above cognitive adaptation constructs. A series of hierarchical regression models were performed with results being consistent with proposed hypotheses. Implications for rehabilitation professionals are discussed and clinical suggestions are provided.
Keywords: disability, spinal cord injury, sexual self-esteem, sexuality, rehabilitation
DOI: 10.3233/NRE-2000-15205
Citation: NeuroRehabilitation, vol. 15, no. 2, pp. 121-131, 2000
Authors: McKenna, Kevin E.
Article Type: Research Article
Abstract: Recent basic research on the neural control of female sexual function is reviewed with an emphasis on the pathways controlling the genitalia. Sexual responses require the coordination of sympathetic, parasympathetic and somatic nervous system. This coordination is performed by interneuronal systems within the lower spinal cord. Sexual responses can be reflexively elicited by genital stimulation. The excitability of the spinal cord can be positively or negatively modulated by descending pathways from supraspinal sites. These supraspinal areas are extensively interconnected and also receive pelvic sensory information. Several of them are modulated by gonadal hormones, allowing for a hormonal control of sexual …behavior. Successful restoration of function following neural injury requires an understanding of these neural pathways. Show more
DOI: 10.3233/NRE-2000-15206
Citation: NeuroRehabilitation, vol. 15, no. 2, pp. 133-143, 2000
Authors: Sipski, Marca L. | Rosen, Raymond | Alexander, Craig J. | Hamer, Robert
Article Type: Research Article
DOI: 10.3233/NRE-2000-15207
Citation: NeuroRehabilitation, vol. 15, no. 2, pp. 145-153, 2000
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