Defrin et al. 2007
Israel
PEDro=10
RCT
N=12

Population: Mean age = 54 yrs; Gender: males = 7, females = 4.
Treatment: Patients were randomly placed into two groups: real or sham 10 daily motor rTMS treatments (500 trains at 5 Hz for 10s; total of 5000 pulses at intensity of 115% of motor threshold) over a 2 week period, using figure-of-8 coil over the vertex. Primary outcome measure was of pain; while depression was a secondary outcome measure for the treatment.
Outcome Measures: BDI

1. Real and sham TMS groups showed a significant decrease in BDI values following the treatment period in comparison to pretreatment BDI values (P<0.01).
2. This reduction was maintained by both groups at follow-up (4.5 weeks) (P<0.01).
3. Only patients in the rTMS treatment group exhibited a decreased level of depression during follow-up in comparison to the values at the end of treatment (P<0.05).

Diego et al. 2002
USA
PEDro=8
RCT
N=20

Population: Mean age = 39 yrs; Gender: males = 15, females = 5; Level of injury: tetraplegia; Time since injury = minimum 1 year.
Treatment: One group received a 40 min massage 2 x per week for 5 weeks by a massage therapist while the other was taught an exercise routine that they performed 2 x per week for 5 wks on their own.
Outcome Measures: STAI, CESD.

1. Interaction effect on STAI scores (p<0.01).
2. Massage group had significantly lower anxiety scores immediately after treatment on the first (p<.001) and the last (p<0.01) sessions.
3. CES-D scores obtained on first day vs. last day assessment by group.  Repeated measures ANOVA showed a group by day interaction effect (p<0.05). 
4. t-tests revealed greater decrease in CES-D depression scores for the massage therapy group (p<0.05).

Zemper et al. 2003
USA
PEDro=4
RCT
Initial N=67; Final N=43

Population: Participants recruited from an outpatient clinic or Center for Independent living. Intervention group was more educated and had fewer retirees despite random assignment. SCI: Mean age = 47 yrs; Gender: males = 30, females  = 13; Level of injury: paraplegia = 42%, tetraplegia = 39%, ambulatory = 3%; Mean time since injury = 14 yrs; Marital status: single = 28%, married = 23%, divorced = 8%.
Treatment:  A series of six 4 hr workshop sessions held over a 3 month period, promoting health and wellness.  Sessions included lifestyle management, physical activity, nutrition, preventing secondary conditions, individual coaching sessions, follow-up phone calls during the 4 months following the workshops. Controls participated in pre/post assessment but received no intervention.
Outcome Measures: HPLP II, SCS, SAHP, PADS

1. The intervention group showed statistically significant improvement after intervention in several areas as compared to the control group: SAHP:  (p<0.05) HPLP-II: (p<0.001). Nutrition HPLP-II subscale: improvement in nutritional awareness and behaviour (p <0.05) Stress HPLP-II subscale: Increased use of stress management techniques and decreases in perceived stress (p =.001).
2. SCS: fewer and less serious secondary conditions (p<0.001) Depression was less though did not reach significance.
3. Physical Activity – (self-reported on various scales of the HPLP-II): Increased reported physical activity and improved physical fitness (p = 0.001).
4. However there was no improvement in either measured Physical Activity PADS or physical fitness measures.

Dunn et al. 2000
USA
Downs & Black score=17
Non-RCT
Initial N=371;
Final N=371

Population: Gender: mixed group-with more males; Mean time since injury = 18.44 yrs.
Treatment: Follow-up after initial rehabilitation was completed addressing the secondary conditions post-SCI as well as the primary effects of their spinal cord injury.  The focus is wellness, health promotion, and illness prevention through a continuum of coordinated care. 
Outcome Measures: The Secondary Surveillance Instrument (SCSI) and the Check Your Health Questionnaire (CHY) (rating the “absence” of depression).

1. An overall difference between the two groups was found (p=0.0004).
2. Medical Follow-up group reported a significantly higher subjective rating than did the No-F/U group on 3 variables: Health (p=0.0068), Independence (p=0.005), Absence of depression (p<0.0001). (Fisher’s protected least significant diff. test).
3. A MANOVA showed a main effect on education on health, independence and absence of depression (p=0.0098).  Further analysis showed that as education increased subjects reported greater health, and independence and lower depression.