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2.  Omega-3 fatty acids’ effect on leptin and adiponectin concentrations in patients with spinal cord injury: A double-blinded randomized clinical trial 
Omega-3 fatty acids have been recently proposed to induce neural improvement in patients with spinal cord injury (SCI) while affecting some hormones including leptin and adiponectin.
We tried to evaluate the effect of omega-3 fatty acids on circulatory concentrations of leptin and adiponectin among these patients.
This study is a double-blinded randomized clinical trial with intervention duration of 14 months.
A tertiary rehabilitation center.
Total of 104 patients with SCI who did not meet our exclusion criteria entered the study. Those with history of diabetes, cancer, endocrinology disease, acute infection, and use of special medications were excluded. Patients were divided randomly into the treatment and control group by using permuted balanced block randomization.
The treatment group received two MorDHA® capsules per day (each capsule contain 465 mg of docosahexaenoic acid (DHA) and 63 mg of eicosapentaenoic acid (EPA)) for 14 months while the control group received placebo capsules with similar color, shape, and taste.
Main outcomes measures
Leptin and adiponectin concentrations in plasma were measured at the beginning of trial and then after 6 and 14 months.
Fourteen months of treatment with DHA and EPA did not influence concentrations of leptin but adiponectin level was significantly decreased (P: 0.03). Weight was positively correlated with leptin level at stage 0 of trial (P: 0.008, r = 0.41) while this association was attenuated through stages of trial after intervention.
Our data show that omega-3 fatty acids may not affect plasma concentrations of leptin but adiponectin level is decreased in patients with SCI. Moreover, this intervention influences the linear relationship between weight and leptin after 14 months administration of DHA and EPA.
PMCID: PMC4535802  PMID: 25096818
Omega-3 fatty acid; Leptin; Adiponectin; Spinal cord injury
3.  The correlation between dietary fat intake and blood pressure among people with spinal cord injury 
Iranian Journal of Neurology  2016;15(3):121-127.
Background: Studies have demonstrated the effect of different dietary fats on blood pressure (BP) in general population. However, these associations have not yet been described in people with spinal cord injury (SCI).
Methods: Referred patients to Brain and SCI Research Center between 2011 and 2014 have been invited to participate. Only paraplegic individuals were recruited and patients with injury at cervical or higher thoracic sections were excluded to omit the bias effect of autonomic dysreflexia. Dietary intakes were assessed by recording consumed foods by 24-hour dietary recall interviews using Nutritionist IV 3.5.3 modified for Iranian foods. Systolic BP (SBP) and diastolic BP (DBP) were measured 3 times and the mean values entered analysis.
Results: Higher intakes of cholesterol were related to higher BP (P = 0.010 and 0.011 for SBP and DBP, respectively). Similarly, intake of saturated fat was positively correlated to both SBP (P = 0.016, r = 0.21) and DBP (P = 0.011, r = 0.22). The effect of eicosapentaenoic acid (EPA) on BP was insignificant (P = 0.760 and 0.720 for SBP and DBP, respectively). However, intake of docosahexaenoic acid (DHA) was related to lower BP among people with SCI.
Conclusion: This study has demonstrated that higher intakes of cholesterol and saturated fat are associated with increased BP, whereas DHA is an antihypertensive agent. Dietary modifications with reduction of cholesterol and saturated fat along with intake of additional DHA supplements may help to reduce BP in spinal cord injured-individuals with hypertension.
PMCID: PMC5027146  PMID: 27648172
Hypertension; Spinal Cord Injury; Dietary Fats; Blood Pressure
4.  Effect of 5-HT7 receptor agonist, LP-211, on micturition following spinal cord injury in male rats 
Background and Purpose: Central and peripheral 5-hydroxytryptamine (5-HT) receptors play a critical role in regulation of micturition reflex. The aim of this study was to evaluate effect of a 5-HT7 receptor agonist, LP-211 (N-(4-cyanophenylmethyl)-4-(2-diphenyl)-1-piperazinehexanamide) on micturition reflex in acute spinal cord-injured (SCI) rats during infusion of vehicle into the bladder. Methods: SCI was induced by compressing T10 segment using an aneurysm clip, extradurally in male rats. Following two weeks, LP-211 doses (0.003-0.3 mg/kg) were administered cumulatively (intraperitoneally, i.p.) with 20 min interval. The 5-HT7 antagonist, SB-269970 ((R)-3-[2-[2-(4-Methylpiperidin-1-yl) ethyl] pyrrolidine-1-sulfonyl] phenol hydrochloride), was administered after achievement of LP-211 dose-response. A cystometric study was performed 2 weeks after spinal crushing in all the animals. Cystometric variables consisting of micturition volume (voided volume), residual volume (volume remaining in the bladder after voiding), and bladder capacity (micturition volume plus residual volume). Voiding efficiency was calculated as the percent of micturition volume to bladder capacity. Findings: Intact and sham-operated rats showed few significant changes in micturition reflex. SCI rats responded to LP-211 (0.003-0.3, mg/kg, i.v.) with dose-dependent increases in bladder capacity, and residual volume. In this treatment group, LP-211 induced significant dose-dependent increases in micturition volume, resulting in significant increases in voiding efficiency (P<0.001) compared to intact and sham-operated rats, SB-269970 (0.1 mg/kg, i.v.) completely reversed the LP-211-induced changes on micturition volume and voiding efficiency was decreased significantly. Conclusion: The 5-HT7 receptors activation by LP-211 facilitated the micturition reflex. Furthermore, 5-HT7 receptors do seem to play an important role in physiological regulation of micturition, and as a result, may represent a new strategy to improve voiding efficiency after SCI in patients in the future perspective.
PMCID: PMC4931148  PMID: 27398137
Spinal cord injury; 5-HT7; micturition; LP-211; rat
5.  Efficacy of some non-conventional herbal medications (sulforaphane, tanshinone IIA, and tetramethylpyrazine) in inducing neuroprotection in comparison with interleukin-10 after spinal cord injury: A meta-analysis 
Inflammation after spinal cord injury (SCI) may be responsible for further neural damages and therefore inhibition of inflammatory processes may exert a neuroprotection effect.
To assess the efficacy of some non-conventional herbal medications including sulforaphane, tanshinone IIA, and tetramethylpyrazine in reducing inflammation and compare them with a known effective anti-inflammatory agent (interleukin-10 (IL-10)).
We searched relevant articles in Ovid database, Medline (PubMed) EMBASE, Google Scholar, Cochrane, and Scopus up to June 2013. The efficacy of each treatment and study powers were compared using random effects model of meta-analysis. To our knowledge, no conflict of interest exists.
Eighteen articles entered into the study. The meta-analysis revealed that exogenous IL-10 was more effective in comparison with the mentioned herbal extracts. The proposed pathways for each medication's effect on reducing the inflammation process are complex and many overlaps may exist.
IL-10 has a strong effect in the induction of neuroprotection and neurorecovery after SCI by multiple pathways. Tetramethylpyrazine has an acceptable influence in reducing inflammation through the up-regulation of IL-10. Outcomes of sulforaphane and tanshinone IIA administration are acceptable but still weaker than IL-10.
PMCID: PMC4293529  PMID: 24969510
Cytokines; Spinal cord; Pharmacology; Neuroinflammation
6.  The Effect of Injury-Related Characteristics on Changes in Marital Status after Spinal Cord Injury 
Iranian Journal of Public Health  2015;44(10):1395-1402.
Spinal cord injury (SCI) imposes a significant burden on the social and marital life. Here, we assessed the divorce rate and changes in marital status among a sample of Iranian individuals with SCI.
Referred patients to Brain and Spinal Cord Injury Research Center were invited to participate in this cross-sectional investigation. The Main exclusion criteria were coincidental brain injury, history of chronic diseases before SCI and substance use. Demographic characteristics (including age, gender, educational level, marital status before and after injury and duration of marriage) and Injury characteristics (level of the injury, American spinal injury association (ASIA) scale and Spinal cord independence measure III (SCIM)) were collected.
Total of 241 subjects with SCI participated in this investigation (164 (68%) male and 77 (32%) female). Among men, 16.5% [95% CI: 10.81%–22.18%] and among women 18.2% [95% CI: 9.58%–26.81%] got divorced after injury. Duration of marriage before injury was significantly related to lower divorce rate (P< 0.001 and 0.016 in men and women, respectively). Injury characteristics had no relationship with marital longevity. Age was a protective factor against marital dissolution only in men (P< 0.004).
Our study revealed the divorce rate of 17% [95% CI: 13%–20.9%] after SCI in a sample of Iranian population. The protective influence of age in maintenance of marriage was only detected in men, which proposes existence of a sexual polymorphism in the role of age. Divorce rate was similar between two genders and injury characteristics were not related to divorce rate as well.
PMCID: PMC4644585  PMID: 26576353
Marital status; Spinal cord injury; Divorce; Iran
7.  Serotonin 5-HT7 receptor agonist, LP-211, exacerbates Na+, K+-ATPase/Mg2+-ATPase imbalances in spinal cord-injured male rats 
Diagnostic Pathology  2015;10:157.
The observed controversy that N-(4-cyanophenylmethyl)-4-(2-diphenyl)-1-piperazinehexanamide (LP-211), a selective serotonin (5-HT7) receptor agonist, may either modify or exacerbate imbalances in serum electrolyte concentrations and renal tissue of spinal cord trauma cases has not been reported yet. The aim of this study was to better understand the effects of a new 5-HT7 receptor agonist, LP-211, on serum electrolyte changes in spinal cord injured- (SCI) rats.
Sixty male rats were assigned to the following groups: A) Intact (saline as vehicle, 1 ml/kg, i.p.), B) Intact [LP-211, (0.003–0.3 mg/kg, i.p.)], C) Sham-operated [laminectomy + vehicle (1 ml/kg, i.p.)], D) Sham-operated [laminectomy + LP-211 (0.003–0.3 mg/kg, i.p.)], E) Treatment [laminectomy + spinal trauma (SCI) + vehicle (1 ml/kg, i.p.)], F) Treatment [laminectomy + spinal trauma + LP-211 (0.003–0.3 mg/kg, i.p.)]. SCI was performed by placing an aneurysm clip, extradurally at the level of T10. After two weeks, LP-211 was administered cumulatively and each dose was injected (i.p.) with 20 min interval. At the end of the experiment, blood samples were collected for biochemical evaluations of the electrolytes employing standard commercial kits.
The present results indicate elevated serum levels of Na+, K+, and Mg2+ in SCI rats and significant differences demonstrated between the groups [P < 0.001, F(5, 35) = 23.92], [P < 0.001, F(5, 35) = 67.63], [P < 0.001, F(5, 35) = 71.144], respectively. So that, in groups B, D and F, there was a significant increase in K+ and Mg2+ serum levels compared to the groups A, C, and E (P < 0.001). Furthermore, Na+ serum levels in SCI (LP-211), laminectomy (LP-211), and intact (LP-211) groups tended to be statistically lower than SCI (saline), laminectomy (saline) and intact (saline) groups. Infact, hyponatremia, hyperkalemia and hypermagnesemia was obtained in group F. Nevertheless, in the remaining measured serum electrolytes such as calcium (Ca2+), iron (Fe2+) and phosphorus (P3−), chlorine (Cl−), copper (Cu+), and zinc (Zu+), no significant changes were observed.
It was shown that acute additive LP-211 treatments in the SCI group led to hyponatremia, hyperkalemia and hypermagnesemia, it may be stated that LP-211 treatment as a promising candidate for treating SCI complications in some systems especially urinary tract might take into consideration and further studies would be needed to clarify its benefits or drawbacks. The observed discrepancies, nevertheless; will also pose new questions. Altogether, this will ultimately contribute to further understanding the pathophysiological role regarding 5-HT7 receptor activation.
PMCID: PMC4570585  PMID: 26369408
8.  Injury-related characteristics and quality-of-life among Iranian individuals with spinal cord injury 
Iranian Journal of Neurology  2015;14(3):136-141.
Background: Health-related quality-of-life (HR-QOL) may be affected by various factors including injury-related characteristics among individuals with spinal cord injury (SCI). However, the impact of the influence of these variables has not yet been fully described in Iranian population. Here, we assessed the relationships between injury-related characteristics and HR-QOL among Iranian people with SCI.
Methods: HR-QOL was assessed using short-form health survey (SF-36). Referred patients to Brain and Spinal Injury Research Center between 2010 and 2012 were invited to participate in this investigation. Injury-related characteristics including injury level and completeness, time since injury, plegia type, and American Spinal Injury Association (ASIA) Impairment Scale were evaluated.
Results: Total of 104 patients (85 men and 19 women) entered the study. The majority of patients had a complete injury (77.9%). The most frequent ASIA score was A (75%), and the most common level of injury was at thoracic sections (61.5%). Lower injury levels were associated with higher scores in physical component summary (P = 0.040), mental component summary (P = 0.010) and subsequently total score (P = 0.006). Mean age and time since injury were 52.58 ± 12.69 and 10.88 ± 16.68 years, respectively, and were not related with HR-QOL (P = 0.70 and 0.220, respectively). There was no difference in terms of HR-QOL between patients with complete and incomplete injury. Paraplegic individuals had significantly higher scores in the domain of physical functioning compared to patients with tetraplegia (P = 0.007).
Conclusion: lower injury level is a significant predictor of better QOL among individuals with SCI whereas other injury-related characteristics including completeness, time since injury and plegia type may not influence HR-QOL.
PMCID: PMC4662686  PMID: 26622978
Quality-of-Life; Spinal Cord Injury; Health Survey; Iran
9.  Psychosocial outcomes following spinal cord injury in Iran 
In patients with spinal cord injury (SCI), SCI causes psychosocial complications that vary based on culture, conditions, and the amenities of each community. Health planners and social services should have full knowledge of these issues in order to plan schedules that address them. In this study, we aimed to understand the psychosocial problems of persons with SCI in Iran and to explore the requirements for minimizing these difficulties.
This was a descriptive cross-sectional study.
Brain and Spinal Cord Injury Research (BASIR) Center, Tehran University of Medical Sciences, Tehran, Iran.
One hundred nineteen persons with SCI referred to BASIR clinic to receive outpatient rehabilitation.
In this study, trained interviewers administered a questionnaire to the participants. The questionnaire consisted of socio-demographic variables and psychosocial questions about finances, employment, housing, education, and social communication problems.
Psychosocial problems for persons with SCI are mainly associated with financial hardship due to unemployment and the high cost of living, followed by difficulties with transportation, house modification, education, marriage, social communication, sports, and entertainment. Psychological problems include sadness, depression, irritability/anger, suicidal thoughts, and a lack of self-confidence. The levels of the aforementioned problems differ with respect to sex.
Persons suffering from SCI can face some serious psychosocial problems that may vary according to sex. For example, transportation difficulties can lead to problems such as unsociability. After recognizing these problems, the next step would be providing services to facilitate a productive lifestyle, enhancing social communication and psychological health, and ultimately creating a higher quality of life.
PMCID: PMC4064583  PMID: 24621045
Spinal cord injuries; Psychosocial issues; Employment; Social outcomes; Rehabilitation
10.  Comparison of the Efficacy of Two Brands of Triptorelin (Microrelin and Diphereline) in Reducing Prostate-Specific Antigen and Serum Testosterone in Prostate Cancer: A Double-Blinded Randomized Clinical Trial 
Nephro-urology Monthly  2015;7(3):e27107.
Gonadotropin-releasing hormone (GnRH) agonists initiate androgen deprivation in treating prostate cancer (PC). Triptorelin is a synthetic GnRH and many of its market brands such as Diphereline have been introduced so far.
We compared the efficacy of a sustained-release formulation of Triptorelin (Microrelin), domestically produced in Iran, and compared it with Diphereline in a double-blinded randomized clinical trial.
Patients and Methods:
Patients were randomly assigned to Group A (Microrelin S.R. 3.75 mg, Pooyesh Darou, Iran) and Group B (Diphereline S.R. 3.75 mg, IPSEN, France). Each patient received monthly intramuscular injections. Prostate-specific antigen (PSA) and circulatory testosterone were measured at baseline and after one, 3, and 6 months.
Each group contained 40 patients. In Group A, PSA was reduced from 75.78 ± 72.43 ng/mL to 1.93 ± 1.40 ng/mL after 6 months and testosterone was reduced from 3.50 ± 1.12 nmol/L to 0.81 ± 0.05 nmol/L. There was no significant difference between the efficacy of Microrelin and Diphereline. Two patients in the Microrelin Group and one patient in the Diphereline Group failed to reach medical castration (testosterone < 1.7 nmol/L), which illustrates that the power of Microrelin and Dipherelin in initiating medical castration is about 95% and 97.5%, respectively.
Our study showed that Microrelin is as effective as Diphereline in reducing PSA and testosterone and can be recommended to initiate medical castration in patients with PC.
PMCID: PMC4537641  PMID: 26290848
Prostate Cancer; Prostate-Specific Antigen; Testosterone; Gonadotropin-Releasing Hormone
11.  Comparison of serum vitamin D level in multiple sclerosis patients, their siblings, and healthy controls 
Iranian Journal of Neurology  2015;14(2):81-85.
Background: Multiple sclerosis (MS) is an autoimmune, neuro-inflammatory disease of central nervous system affecting physical, emotional, and cognitive aspects of patients. Association of vitamin D deficiency and MS has been shown in previous studies. The aim of this study was to evaluate serum vitamin D level in MS cases and their sex-matched healthy siblings (who are genetically near similar) and non-relative sex-matched healthy controls.
Methods: A total of 135 subjects enrolled in this case-control study. Group one (n = 45) consisted of patients with established MS. Group two (n = 45) included sex-matched healthy siblings of the group one and group three participants (n = 45) were non-relative sex-matched healthy controls. Demographic data (age, sex), level of education, daily sun exposure duration, and month of birth gathered for all. Serum sample of all participants was collected for 25-hydroxy vitamin D measurement.
Results: There was no significant difference between vitamin D level, sun exposure duration, education level, and season of birth in three evaluated groups. Mean vitamin D level was 8.2 ± 10.1 (nmol/l) in women and 13.3 ± 7 (nmol/l) in men (P = 0.001). There was a significant positive correlation between daily sun exposure duration and vitamin D level in whole participants (r = 0.28, P < 0.001) as well as in MS patients (r = 0.32, P = 0.030). Mean vitamin D level was significantly lower in participants who have born in spring and summer.
Conclusion: Vitamin D deficiency is high among Iranian population as well as MS patients.
PMCID: PMC4449398  PMID: 26056552
Multiple Sclerosis; Vitamin D; Population Control; Siblings
12.  Is Lipid Profile Associated with Bone Mineral Density and Bone Formation in Subjects with Spinal Cord Injury? 
Journal of Osteoporosis  2014;2014:695014.
Purpose. The association between serum lipids and bone mineral density (BMD) has been investigated previously but, up to now, these relationships have not yet been described in spinal cord injury (SCI). We tried to assess the correlation between serum triglyceride (TG), total cholesterol (TC), high-density lipoprotein (HDL), and low-density lipoprotein (LDL) and BMD in male subjects with SCI. Methods. Dual-energy X-ray absorptiometry (DXA) was used to assess BMD in femoral neck, trochanter, intertrochanteric zone, and lumbar vertebras. Blood samples were taken to measure serums lipids and bone biomarkers including osteocalcin, cross-linked type I collagen (CTX), and bone alkaline phosphatase (BALP). Partial correlation analysis was used to evaluate the relationships between mentioned measurements after adjustment for weight and age. Results. We found a positive correlation between HDL and femoral neck BMD (P: 0.004, r = 0.33). HDL was negatively correlated with osteocalcin (P: 0.017, r = −0.31) which was not in consistency with its relationship with BMD. TC and LDL were not related to CTX, BALP and BMD. Conclusion. This study does not support a strong association between serum lipids and BMD in subjects with SCI. Moreover it seems that positive association between HDL and BMD is not mediated through increased bone formation.
PMCID: PMC4158290  PMID: 25215260
13.  To Construction and Standardization of the Waiting Anxiety Questionnaire (WAQ) in Iran 
Iranian Journal of Psychiatry  2014;9(3):163-168.
This study aimed to develop and validate a questionnaire to measure waiting anxiety.
This was a cross-sectional study. Extensive review of literature and expert opinions were used to develop and validate the waiting anxiety questionnaire. A sample of 321 participants was recruited through random cluster sampling (n= 190 Iranian men and n= 131 women). The participants filled out WAQ, the Speilberger‘s State-Trait Anxiety Inventory (STAI), Burtner Rating scale (BRS) and Eysenk Personality questionnaire (EPQ) for adults.
Internal consistency of WAQ was revealed, meaning that all the 20 items were highly correlated with the total score. The Cronbach alpha equaled 0.83 for the Waiting Anxiety Questionnaire.
The Pearson correlation coefficient of the questionnaire with the STAI, BRS and extraversion and neuroticism subscales of EPQ was 0.65, 0.78, - 0.47 and 0.43, respectively, which confirmed its convergent and divergent validity. Factors analysis extracting four cognitive, behavioral, sentimental and physiological factors could explain 67% of the total variance with an Eigen value of greater than 1.
Our findings suggest that WAQ possesses appropriate validity and reliability to measure the individuals’ anxiety during the waiting time.
PMCID: PMC4277807  PMID: 25561958
Waiting Anxiety Questionnaire; validity; reliability; Construction
14.  Magnetic resonance imaging of transplanted stem cell fate in stroke 
Nowadays, scientific findings in the field of regeneration of nervous system have revealed the possibility of stem cell based therapies for damaged brain tissue related disorders like stroke. Furthermore, to achieve desirable outcomes from cellular therapies, one needs to monitor the migration, engraftment, viability, and also functional fate of transplanted stem cells. Magnetic resonance imaging is an extremely versatile technique for this purpose, which has been broadly used to study stroke and assessment of therapeutic role of stem cells. In this review we searched in PubMed search engine by using following keywords; “Stem Cells”, “Cell Tracking”, “Stroke”, “Stem Cell Transplantation”, “Nanoparticles”, and “Magnetic Resonance Imaging” as entry terms and based on the mentioned key words, the search period was set from 1976 to 2012. The main purpose of this article is describing various advantages of molecular and magnetic resonance imaging of stem cells, with focus on translation of stem cell research to clinical research.
PMCID: PMC4116580  PMID: 25097631
Cell fate; cell tracking; magnetic resonance imaging; nanoparticle; stem cells; stroke; tracking
15.  Perspectives of Iranian Medical Students About Do-Not-Resuscitate Orders 
Mædica  2013;8(3):261-264.
Objective: To study the attitudes of Iranian medical students towards the do-not-resuscitate (DNR) decision.
Methods: In this cross-sectional study, 220 medical students (110 interns and 110 residents) of Tehran University of medical sciences were selected. They asked to answer to the questionnaire which included two items: first item consisted of demographic questions (age, sex, and level of education); second item included questions about DNR Orders which derived from a previous study conducted by Hosaka et al.
Results: A total of 185 questionnaires returned (Response rate (RR=84%)). Ninety five were residents and ninety were interns. Seventy four percent of residents and 53% of interns felt that DNR order is sporadically necessary. Near 30% of interns and 40% of residents had participated in DNRs in their study period and the most case was the patient with terminal cancer. The most common person who decided DNR orders were physicians.
Most participants believed that DNR cards are useful for establishing in clinical settings.
Conclusion: As DNR is definitely a medical decision, it should be clearly discussed with patients and their families. So, it should be provided in standard format in medical situations.
PMCID: PMC3869115  PMID: 24371495
DNR; Iran; medical students; attitude
16.  Development, Validity and Reliability of Sexual Health Measures for Spinal Cord Injured Patients in Iran 
This study developed and validated a questionnaire to measure the sexual health of patients with spinal cord injuries (SCI).
Materials and Methods:
This was a cross-sectional study conducted at the Brain and Spinal Injury Research Center (BASIR), Tehran, Iran. Extensive review of literature, expert opinions, and encounters with SCI patients were used to develop and validate the questionnaires. There were 40 (32 males, 8 females) patients with SCI that presented for treatment at BASIR who enrolled in the study. Participants completed the questionnaires while they were admitted for medical care and during treatment follow-up visits. Participants completed the questionnaires twice, at a 2-4 week interval. Reliability testing for each measure was performed separately. Cronbach’s alpha was used for internal consistency and test-retest was used for reliability.
An expert committee approved the face and content validities of the questionnaires, Internal consistency of our questionnaires, was acceptable according to Cronbach’s alpha that ranged from 0.73 for the sexual activity measure to 0.90 for the sexual adjustment measure. Test-retest reliability was satisfactory. Intraclass Correlation Coefficient (ICC) of measures ranged from 0.65 for sexual function to 0.84 for sexual activity.
The sexual health measures has provided a valid assessment of sexualityrelated matters in this sample of patients with SCI, which suggests that evaluation of sexual well-being may be useful in clinical trials and practice settings. Overall, the sexual health measures shows good internal consistency and test-retest reliability.
PMCID: PMC3850335  PMID: 24520468
Spinal Cord Injury; Sexual Health; Validity; Reliability

Results 1-16 (16)