The relationship between quality of life and change in mobility 1 year postinjury in individuals with spinal cord injury

Melissa S Riggins, Padmaja Kankipati, Michelle L Oyster, Rory A Cooper, Michael L Boninger
Archives of Physical Medicine and Rehabilitation 2011, 92 (7): 1027-33

OBJECTIVE: To examine quality-of-life (QOL) factors and change in mobility in individuals with traumatic spinal cord injury (SCI) 1 year after injury.

DESIGN: Retrospective case study of National SCI Database data.

SETTING: SCI Model Systems (SCIMS) sites (N=18).

PARTICIPANTS: Subjects (N=1826; age >18y) who presented to an SCIMS site after traumatic SCI between June 2004 and July 2009 and returned for 1-year follow-up. All subjects had FIM mobility data for both assessments.

INTERVENTIONS: Not applicable.

MAIN OUTCOME MEASURES: Assessment of impairment based on Lower-Extremity Motor Score. Assessment of QOL based on Craig Handicap Assessment and Reporting Technique, Patient Health Questionnaire, Satisfaction With Life Scale, Self-perceived Health Status, and pain severity scores.

RESULTS: Of the sample, 55 individuals transitioned from walking to wheelchair use within 1 year of discharge. This group had the highest number of individuals from minority groups (52.8%) and the lowest employment rate (7.3%). Compared with individuals who transitioned from wheelchair use to walking or maintained wheelchair use or ambulation, the walking-to-wheelchair transition group had significantly lower QOL scores (P<.01), including higher depression (P<.01) and higher pain severity (P<.001).

CONCLUSIONS: Individuals with SCI who transitioned from walking at discharge to wheelchair use within 1 year had low QOL factors, including high pain and depression scores. Rehabilitation professionals should consider encouraging marginal ambulators to work toward functional independence from a wheelchair, rather than primary ambulation during acute inpatient rehabilitation.

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