Determining priorities in functional rehabilitation related to quality of life one-year following a traumatic spinal cord injury

The Journal of Spinal Cord Medicine, 2020 · DOI: 10.1080/10790268.2018.1517138 · Published: March 1, 2020

Spinal Cord Injury Participation Rehabilitation

Simple Explanation

Traumatic spinal cord injuries (TSCI) lead to severe functional limitations and secondary complications affecting physical, emotional and social areas of health. The rehabilitation process is a critical part of the coping process following such a severe injury, and comprises multidisciplinary therapies throughout the continuum care encompassing various functional aspects. This study aims at identifying which specific functional aspects should be prioritized during rehabilitation in order to optimize QOL following a TSCI.

Study Duration

March 2011 and October 2016

Participants

One hundred and forty-two individuals sustaining an acute traumatic SCI

Evidence Level

Retrospective review of a prospective cohort

Key Findings

1
Mobility subscore was the only functional aspect significantly associated with all QOL domains (physical, psychological, social and environmental).
2
Females present better chronic social and environmental QOL when compared to males.
3
The level of injury may also influence environmental QOL.

Research Summary

The results suggest that improved mobility is significantly associated with higher QOL scores for all domains of the WHOQOL-Bref instrument (physical, psychological, social and environmental) during the chronic phase after TSCI. Mobility in the SCIM questionnaire refers to the ability to mobilize in bed, as well as move on various distances, indoor or outdoor, with or without technical aids or wheelchair. Mobility training should thus be prioritized during the rehabilitation phase following a TSCI in order to optimize the chronic QOL.

Practical Implications

Mobility Training Prioritization

Rehabilitation programs should prioritize mobility training to improve the overall quality of life for individuals with TSCI.

Gender-Specific Interventions

Consideration should be given to gender-specific interventions to address the social and environmental QOL differences between males and females with TSCI.

Early Intervention

Mobility training should be initiated as early as possible to prevent medical complications and facilitate further gains in mobility throughout the rehabilitation process.

Study Limitations

1
A recognized limitation of this study is the relatively low percentage of variance (6–24%) of QOL explained by the regression models
2
factors other than those considered in the current study can also influence QOL. For instance, the functional status prior to the injury, social functioning and various psychological factors can influence chronic QOL
3
The presence of similar items between the SCIM and WHOQol-Bref instrument can also affect the results, leading to overestimation of the strength of association between specific functional aspects and QOL domains.

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