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Do individuals from an SCI-specialized rehabilitation facility have fewer secondary health conditions than those from a non-SCI-specialized rehabilitation facility? Analysis of the InSCI database from a middle-income country

The Journal of Spinal Cord Medicine, 2025 · DOI: 10.1080/10790268.2023.2289690 · Published: December 7, 2023

Spinal Cord InjuryParticipationRehabilitation

Simple Explanation

This study investigates whether individuals with spinal cord injuries (SCI) receiving care at SCI-specialized rehabilitation facilities (SSRF) experience fewer secondary health conditions (SHCs) compared to those at non-SSRFs in a middle-income country. The study found that attending an SSRF was associated with a lower likelihood of developing bladder dysfunction, sexual dysfunction, and pressure ulcers. These findings underscore the importance of specialized rehabilitation centers in middle-income countries for providing effective SCI care and standardized healthcare provider education.

Study Duration
February 1st, 2017 and August 31st, 2018
Participants
313 individuals with chronic SCI
Evidence Level
Cross-sectional observational study

Key Findings

  • 1
    Being recruited from the SSRF was an independent negative correlating factor of the SHC sum score with an unstandardized coefficient of −1.12.
  • 2
    Being recruited from the SSRF was also an independent negative correlating factor of having bladder dysfunction, sexual dysfunction, and pressure ulcer SHC.
  • 3
    Attending an SSRF was not significantly associated with higher health service utilizations, indicated by comparable numbers of different health care providers visited and lower numbers of hospitalizations per year.

Research Summary

This cross-sectional study in Thailand analyzed data from the International Spinal Cord Injury Community Survey (InSCI) to compare secondary health conditions (SHCs) in individuals with chronic SCI attending SCI-specialized rehabilitation facilities (SSRF) versus non-SSRFs. The study found that attending an SSRF was significantly associated with fewer SHCs, particularly bladder dysfunction, sexual dysfunction, and pressure ulcers. The findings suggest that SSRFs play a crucial role in delivering effective care and standardized education in middle-income countries, potentially leading to improved health outcomes and reduced healthcare utilization.

Practical Implications

Rehabilitation Nursing Training

There is an urgent need for rehabilitation nursing training to reduce the opportunity to develop nursing care-related SHCs such as bladder and pressure ulcer problems.

Increase SSRF

An increasing number of SSRFs should be considered simultaneously with the IMC to improve rehabilitation outcomes, including both functional improvement and SHC prevention aspects.

Public Health Policy

The SSRF should be involved in the development processes of the training as it could provide the relevant knowledge, skills, and experience.

Study Limitations

  • 1
    The analyses of this study were conducted using data from the Thai InSCI only.
  • 2
    Due to the convenience sampling method, there could have been selection bias.
  • 3
    Since the InSCI survey used self-report questionnaires, there could be a recall bias in nature.

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