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We explore the effects and interplay of physical and social environments on the inaccessibility of gynecological health care for women with spinal cord injury. We also explore women’s responses to the inaccessibility of this care, in hopes of trying to understand better how women navigate their gynecological health and health care when faced with physical and social environmental constraints.

The data for this phenomenological study were gathered using in-depth, qualitative interviews with 20 women living with spinal cord injuries in or around Detroit, Michigan. Each interviewee was questioned about overall health and physical functioning, accessibility of doctor offices, interactions with health care providers, gynecological health-seeking behaviors, and complementary and alternative medicine use. In this paper we report on data on women’s difficulties in securing gynecological health care experiences and related attitudes and practices.

Findings echo past literature about the inaccessibility of doctor’s offices, including the lack of suitable exam tables and medical equipment. Office staff varied in their willingness to help transfer women from wheelchairs to exam tables as well, often creating what we term an inaccessible social environment. Individual women in our sample found different strategies for navigating the environmental contexts of a doctor’s office and the encounters that they had with providers within medical settings. These strategies had varying impacts on individuals’ abilities to secure gynecological health care.

Our findings point to the possibility of an interplay between and intersection of physical and social environments within medical settings that needs to be explored further and, potentially, the primary importance of the social environment over the physical environment in determining whether an individual’s disability makes health care inaccessible.

Sustaining a spinal cord injury (SCI) at any point in time is life-altering – physically, emotionally, and financially – for all persons affected by the injury, but it can place unique challenges on younger married couples. This study examines the transition to injury for 18 couples (ages 21–55). Data were collected using individual interviews with each partner at three time points following injury and observation in the rehabilitation setting (Creekview). This resulted in 96 individual interviews and 300 hours of observation. Using the life course perspective as a guiding theoretical framework and thematic analysis, I examined how the healthcare institution influenced the couples' relationship during their rehabilitation stay and the subsequent transition home. Creekview staff and couples accepted and reinforced the dominant cultural narrative that women are natural caregivers, but larger social structures of class, gender, and the division of paid and unpaid labor worked together to push some women into caregiving faster or prevented other women from engaging in caregiving. This study examines how younger couples move through the caregiving career during an off-time transition when the expected outcome is not long-term care placement or death. This study identified three main types of caregivers, each with their own path of caregiving – naturalized, constrained, and resistant caregivers. Overall, the transition to injury is complex and this study highlights some of the ways the marital relationship is affected by a nonnormative, unexpected transition.

The purpose of this paper is to evaluate the perceptions of research priorities as expressed by people with spinal cord injury (SCI).

A descriptive study based on feedback from patients, rehabilitated following SCI was conducted in order to explore their felt needs for further research. A questionnaire was sent to 225 people who were rehabilitated following SCI. They were asked to indicate three priorities for further research on disability related issues. The questionnaire had a list of issues on different facets of disability following SCI. In total, 62 patients responded to the questionnaire.

Research on urinary incontinence was stated to have the highest priority among these different groups according to their age, marital status, duration of disability, and employment status. Rehabilitated patients of all age groups, irrespective of marital or employment status or duration of disability, indicated that further research is to be done on urinary incontinence.

A similar study among groups in a larger population would add further information.

Practitioners should address these expressed needs of the persons with SCI in the community.

These expressed needs will increase awareness among the team involved in the management of SCI in the community thus fill the gap between research and practice.

Research focussing on various problems associated with spinal cord injury have been carried out globally. On most of the occasions, the perceptions of the affected people regarding research areas are seldom obtained. This research would guide future directions of rehabilitation research in the field of spinal cord injury.

The intent of this chapter is to examine the historical and present-day intersections of injury, impairment, pain and risk-taking in the Paralympic Movement. While much has been written about injuries that end an athlete’s career, far less consideration has been given to how an injury might launch a sports career. In this chapter, I explore the experiences of athletes for whom injury and sports participation are fundamentally entwined.

To accomplish this, I draw on sociological literature on sport and injury, psychological literature on identities and sport retirement and feminist disability theories. The discussion is further enriched by interviews with Paralympic athletes and informed by own experience as a researcher, guide and volunteer in the Paralympic Movement.

This work illustrates how systems of representation intersect to (re)produce identities. This includes demonstrating how some individuals use sport as a means of claiming an athletic identity while distancing themselves from devalued disabled identities and the subsequent impact this can have on their psycho-social well-being.

This chapter demonstrates how sociologists of sports can engage with critical disability scholarship to deepen understandings of how and why individuals with impairments enter into sport and their experiences therein.

The purpose of this paper is to evaluate the response of the spinal cord, the transmembrane potential, during lumbar magnetic stimulation, using a figure of eight coil.

In order to obtain a precise stimulation of the spinal cord and not the nearby nervous fibres, the coil from the electric circuit of the magnetic stimulator is optimized. The new proposed design is based on the turns’ placement inside the coil, the number of turns required to produce activation. Once the coil configuration is established, the paper addresses other issues that need to be solved: reducing power consumption (the low efficiency of power transfer from the coil to the tissue is a major drawback) and reducing coil heating.

The traditional commercial coils, used for magnetic stimulation in some preliminary experiments, had proved their inability to specifically stimulate the target tissue, without activating the surrounding areas and the low efficiency of power transfer from the coil to the nervous tissue. A more realistic modelling of the stimulating coil, based on the distribution of turns inside the coil can lead to directly stimulation of the spinal cord, during lumbar magnetic stimulation.

If the electrical circuit of the magnetic stimulator is improved, the direct stimulation of the spinal cord is obtained; so, this technique could facilitate functional motor activities, including standing and stepping in paralyzed people, without requiring implantation of electrodes like in electrical stimulation.

The authors underlined that the spinal cord stimulation can be achieved by magnetic stimulation, only if the parameters of the stimulator circuit are optimized. Therefore an original and realistic modelling of the inductive coil was proposed based on number and turns’ distribution within the coil. The coil is designed so that reducing the excessive heating makes it difficult in obtaining a more frequent repetition of stimulus.

The purpose of this paper is to estimate the electrical field induced in the spinal cord and nearby area during lumbar magnetic stimulation.

The spinal cord is modelled as a continuous cylinder, while the vertebral column is also represented by a concentric interrupted cylinder. The coil used for magnetic stimulation is a figure of eight, whose centre is placed above T12‐L1 vertebras. The electrical field is induced and its derivative is computed using the finite difference method.

Preliminary results suggest that magnetic stimulation may be able to induce a sufficiently intense electric field inside the spinal cord, leading to the direct activation of spinal nerve roots.

If the spinal cord can be stimulated directly by magnetic stimulation, this technique can facilitate functional motor activities, including standing and stepping in paralyzed people, in a non‐invasive way.

The authors revealed the fact that functional magnetic stimulation can be applied to the spinal cord, and should be further investigated as an alternative to invasive techniques such as electrical stimulation.

The purpose of this paper is to present a preliminary psychometric evaluation of the electronic mobile shower commode assessment tool (eMAST) 1.0.

A cross-sectional validation study was undertaken with 32 adults with spinal cord injury (SCI), aged 18 years or older, who use mobile shower commodes for toileting and/or showering. The eMAST 1.0, Quebec user evaluation of satisfaction with assistive technology, Version 2.0 (QUEST 2.0), and modified system usability scale (SUS) were administered online via SurveyMonkey. The eMAST 1.0 was re-administered approximately seven days later. Psychometric properties of internal consistency, test-retest reliability, and convergent validity were assessed.

As hypothesised, the eMAST 1.0 demonstrated strong internal consistency (Cronbach’s α=0.73, N=32); acceptable test-retest reliability (intra-class coefficient (3, 1)=0.75 (0.53-0.88, 95 per cent confidence interval) (n=27)); and strong, positive correlations with the QUEST 2.0’s devices subscale and modified SUS (Pearson’s correlation coefficients 0.70 and 0.63, respectively).

The sample was not fully representative of Australian data in terms of gender, or state of residence, but was representative in terms of SCI level. Age data were not assessed. The sample size was small but adequate for a preliminary psychometric evaluation.

The preliminary psychometric evaluation indicates the eMAST 1.0 is a valid and reliable instrument that measures usability of MSCs for adults with SCI. It may be useful for exploring relationships between usability and satisfaction of MSCs.

The purpose of this paper is to describe a standing style transfer system, ABLE, designed to enable a person with disabled lower limbs to do daily‐life activities without special infrastructure. Actually, ABLE is mainly intended for use by people who have spinal cord injuries and who cannot move hip joints and lower extremities: the level of spinal cord injury is L1.

ABLE comprises three modules: a powered lower extremity orthosis, a pair of telescopic crutches, and a pair of mobile platforms. When traveling in a standing position, the user wears the powered lower extremity orthosis to fix his posture, and rides on the mobile platforms. The user uses crutches to keep his body stable. These telescopic crutches also play an important role of power assistance in standing‐up and sitting‐down motions, or going up/down a step. The user can enter narrow spaces, although stability is emphasized in wide spaces because it is possible to alter the contact points of the crutches freely.

Motions are discussed in a standing position: traveling and rotating, and the chair and step motions. Experimental results related to these motions confirm the design's effectiveness. The authors improve previously developed mobile platforms for better operationality and stability. An ultrasonic motor was used for steering the mobile platform instead of the prior DC motor. The benefits of the ultrasonic motor enable the new platform to reduce its backlash in steering. A supporting plate and an active ankle joint attached to each mobile platform contribute stability when traveling in the standing position. The authors show the experimental results using new mobile platforms.

The paper demonstrates novelty and originality of ABLE in its composition, which enables a person with disabled lower limbs to travel in a standing position on a pair of small mobile platforms. This system is regarded as a biped‐type leg‐wheeled robot system that has high energy efficiency and good mobility for steps because of its wheels and legs; moreover, it has a pair of crutches for stability.

Many youth with a disability would like to work but encounter challenges finding employment. Vocational interventions can help youth with disabilities gain employment skills and jobs. In this chapter, we assess: (1) how vocational programs for youth with physical disabilities influence employment-related skills and outcomes; and (2) the common components of vocational programs for these youth.

Our research team conducted a systematic review of peer-reviewed literature with six major databases: Medline, PsychInfo, Scopus, Web of Science, CINAHL, and Embase. Publications selected for inclusion met the following criteria: (1) peer-reviewed journal article, dissertation, or conference paper, published between 1990 and January 2014; (2) addresses vocational program or intervention for youth with physical disabilities; and (3) sample includes at least 50% youth (aged 15–25) with an acquired or congenital physical disability.

Of the 4,588 studies identified in our search, 8 met the inclusion criteria. In six of the studies, the majority of participants gained paid or unpaid employment after participating in a vocational program. Five studies showed improved knowledge and perceptions of employment. Most studies showed improvements in at least one vocational outcome such as knowledge about job searching, job interviews, advocating for workplace adaptations, and how to access services and supports. Common intervention components included: experiential learning, mentorship, and family involvement. Most programs took place in the community or rehabilitation centers that varied in length and were delivered by a variety of professionals. Most programs had a combination of group and individual components.

There is some evidence to suggest that vocational programs can influence employment outcomes for youth with physical disabilities. However, further research is needed with more rigorous and longitudinal designs.