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Background and Objectives: Generally, spinal cord injuries can lead to functional limitations and restrict participation in different areas of occupations. One of the areas of occupations that are less considered is rest and sleep. The aim of this study was to investigate the relationships between physiological, emotional status and daily activities, and sleep quality in patients with spinal cord injury.
Methods: The present study was a cross-sectional analytical study that was conducted in 2019-2020. The statistical population of this study was patients with spinal cord injury referring to the occupational therapy clinics in Tehran and Karaj as well as hospitalized patients and daily patients referring to the Kahrizak care unit in Alborz province. The sample size was considered 100 spinal cord injury patients who were randomly selected. Data were collected using Pittsburgh Sleep Quality Questionnaire, STOP-BANG Respiratory Apnea Probability Questionnaire, Beck Anxiety and Depression Questionnaire, Pain Scale, and Barthel Questionnaire.
Results: The results showed that there was a significant relationship between the risk factors of respiratory apnea, anxiety, depression, pain, the time elapsed after the accident and functional mobility, and sleep quality (P≤0.05).
Conclusion: Sleep quality in patients with spinal cord injury is low and is significantly associated with factors, such as the likelihood of respiratory apnea, pain, mood factors anxiety and depression, muscle tone, functional mobility, and independence in daily activities

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Background and Objectives: Spinal cord injury (SCI) is an irreversible and potentially life-altering event that creates poor economic conditions. The SCI healthcare model has shifted more towards patient-centered care, which focuses on the issues that affect the quality of life and community integration of people with such disabilities.
This systematic review was conducted to identify the factors influencing the community integration of SCI individuals in low- and middle-income countries. 
Methods: Three databases of Scopus, PsycINFO, and PubMed were searched with the keywords of “spinal cord injury”, “tetraplegia”, “paraplegia”, and “challenges” for relevant articles published from 2010 to 2020. Boolean operators “OR” and “AND” were used between the keywords, and cross-linking methods were applied to get better results. The quality assessment of the included studies was analyzed by the Critical Appraisal Skills Programme (CASP) and Thomas tool. The extracted data included demographic details, sample size, results, and outcome measures. 
Results: A total of 26 peer-reviewed studies were included in the review. The evidence extracted was classified into six categories that influence the community participation (either positive or negative) of SCI individuals.
Conclusion: The review revealed more barriers in the form of health-related, environmental, psychological, and social issues that hinder the community reintegration of individuals with SCI compared to facilitators such as spirituality, family/friends support, self-efficacy and resilience. Most research studies highlighted specific environmental obstacles in terms of accessibility and affordability. By working on these challenges, the authorities can enhance community integration of the SCI population in low- and middle-income countries.
 

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Background and Objectives: One of the crucial purposes of the rehabilitation of people with spinal cord injuries (SCI) is to integrate them into society and improve their quality of life. Therefore, it is necessary to research on the importance of people’s needs in self-development and integration in society. This study aims to determine the level of needs of people with SCI in Saqez City, Iran, and investigate its correlation with the level of integration of these people after the injury in society.
Methods: This research was conducted in a cross-sectional descriptive-analytical type. The necessary information was collected using a community integration questionnaire (CIQ) and Kimbrol’s needs in the form of a census from 110 people with SCI in the rehabilitation unit of the Welfare Department and other related departments (aid committee, Martyr Foundation) in Saqez City. A total of 99 people participated in this study. Finally, data were analyzed using SPSS software, version 24.0 at a significance level of 0.05.
Results: In this study, 72.73% of the participants were men and the mean age was 44.67±13.91. The mean score of integration at home was 3.55±3.23, the score of the production activities scale was 2.33±1.52, and the integration score in the community was 6.97±2.83. The need for an improved house that was adapted to the conditions of the SCI people was one of the critical unfulfilled demands for these people in the direction of integration at home and social integration and productivity. On the other hand, the need for effective social and friendly activity is one of the unappreciated needs of people with SCI, which has a significant impact on their quality of life, social integration, and employment.
Conclusion: The primary demands of people with SCI, especially the need to adapt the place of residence and the workplace to increase the social integration of people with SCI, should be evaluated and intervened.
 

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Background and Objectives: Since all aspects of occupational performance are affected by cervical spinal cord injury (SCI), one of the goals of occupational therapy for these clients is to restore the abilities and routines necessary for independence in activities of daily living (ADL). The model of human occupation (MOHO) seems to help occupational therapists develop a framework for clinical reasoning about the living conditions of people with cervical SCI emphasizing the interaction between volition, habituation, and performance capacity. This study aims to investigate the use of MOHO in occupational therapy for cervical SCI and focuses on the significance of comprehending and adjusting to these specific needs to improve their participation in purposeful daily activities leading to occupational adaptation.
Case Presentation: The focus of this study is on a 26-year-old man who experienced a cervical SCI at the C6 level due to a diving accident. He exhibits varying degrees of motor and sensory deficits, characterized by partial upper extremity function and complete loss of function in the lower extremities. The client expresses a strong desire to develop skills for safe and effective transfers, the need for strategies that promote community reintegration and social interaction, and adaptive strategies and utilize assistive devices that will enable him to perform ADLs with greater independence.
Conclusion: Because in a person with cervical SCI, values and interests, internalized roles, and performance capacities are affected by impairment, designing a program based on the MOHO will help occupational therapists perform more effectively.