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Spinal Cord (2016) 54, S24S27 Ofcial Journal of the International Spinal Cord Society
http://www.nature.com/sc
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GUIDELINES
The CanPain SCI Clinical Practice Guideline for Rehabilitation Management of Neuropathic Pain after Spinal Cord: recommendations for model systems of care
optimal and equitable access and resource utilization, and include appropriate and culturally sensitive interventions. A comprehensive and systematic process is required to develop a model of care.4 This process needs to facilitate both quality improvement and change management, throughout the entire spectrum of planning, developing, implementing, evaluating and assessing the sustainability of the model. According to Spinal Cord Injury Rehabilitation Evidence, no internationally accepted denition or essential elements of SCI rehabilitation has yet been formulated.5 In fact, the eld of SCI rehabilitation has been referred to as a black box, whereby the lack of working denitions and/or standardized guidelines has contributed to a lack of cohesion of the eld to more established domains of medicine.6
The need for a Canadian model system of care for SCI-related pain Advances in SCI care in Canada include the development of national standards for SCI rehabilitation services by Accreditation Canada.7 Although these standards contain suggestions for developing models of care for this patient population, none is specic to the management of NP.
In Canada, the delivery of health care is not under the auspice of the federal government. Rather, the individual provinces and territories
1Lawson Health Research Institute, London, Ontario, Canada; 2Western University, London, Ontario, Canada; 3Parkwood Institute, London, Ontario, Canada; 4Spinal Cord Injury Ontario, London, Ontario, Canada; 5University of British Columbia, Vancouver, British Columbia, Canada; 6The University of Sydney, Sydney, New South Wales, Australia; 7Stan Cassidy Centre for Rehabilitation, Fredericton, New Brunswick, Canada; 8Institut National d'Excellence en Sant et Services Sociaux, Montral, Qubec, Canada; 9Toronto Rehabilitation Institute, Toronto, Ontario, Canada; 10Mount Sinai Hospital, New York, NY, USA; 11Centre interdisciplinaire de reserche en radaptation et integration sociale, Qubec City, Qubec, Canada; 12Aarhus University, Aarhus, Denmark; 13St. Josephs Hospital, London, Ontario, Canada; 14London Health Sciences Centre, London, Ontario, Canada; 15Dalhousie University, Halifax, Nova Scotia, Canada; 16University of Miami, Coral Cables, FL, USA and 17St. Josephs Health Care Pain Clinic, London, Ontario, Canada Correspondence: Dr E Loh, Parkwood Institute, Main Building, Department of Physical Medicine and Rehabilitation, 550 Wellington Road, London,...