Evidence-Based Practice in Primary Prevention of Spinal Cord Injury

Top Spinal Cord Inj Rehabil, 2013 · DOI: 10.1310/sci1901-25 · Published: January 1, 2013

Simple Explanation

A spinal cord injury (SCI) not only causes paralysis, but also has long-term impact on physical and mental health. There are between 236,000 to 327,000 individuals living with the consequences of SCI in the United States, and the economic burden on the individuals sustaining the injury, their support network, and society as a whole is significant. Primary prevention is defined as the “care that consists of measures taken to prevent diseases or injuries rather than curing them or treating their symptoms.” Currently, there are not as many policies to encourage prevention as there are to promote the latest and best treatment options. The leading causes of SCI are motor vehicle crashes (MVCs), falls, violence, and sports. There are efforts being made to identify measures and implement prevention programs to reduce the chance that someone will experience an SCI secondary to one of these etiologies.

Study Duration

Not specified

Participants

950 adults nationwide (in a poll regarding support for prevention efforts) and 947 community-dwelling individuals with an SCI (in a sample size)

Evidence Level

Not specified

Key Findings

1
The leading etiology of SCI is MVC at 39.2%. Safety tips such as always wearing a seat belt or utilizing an air bag, obeying the speed limit, paying attention, and following rules of the road are vitally important to the primary prevention of an SCI.
2
The second leading cause of SCI is falls (28.3%). For people over the age of 65, falls are the number one cause of SCI. Primary prevention techniques to avoid a fall include holding onto a handrail while climbing stairs and keeping the floor free from debris and hazards.
3
Incidents involving firearms are the third leading cause of SCI (14.6%). Prevention of these injuries involves safe and responsible gun use. It should always be assumed that a firearm is loaded to ensure careful handling.

Research Summary

A spinal cord injury (SCI) not only causes paralysis, but also has long-term impact on physical and mental health. The consequences of SCI require that health care professionals begin thinking about primary prevention. Efforts are often focused on care and cure, but evidence-based prevention should have a greater role. Primary prevention is often not the first element that comes to mind in regard to treatment of an SCI, however it may be the most important. Society often focuses on prevention of secondary complications or on finding a cure, rather than putting into practice ways to eradicate the occurrence of SCIs. Primary prevention of SCI requires the cooperation and education of members of the community and health care professionals. Countless prevention programs exist across the world with agencies and committees working to eliminate SCI and its life-changing effects.

Practical Implications

Motor Vehicle Safety

Emphasize seat belt use, adherence to speed limits, and avoidance of distracted driving (especially cell phone use) and driving under the influence of drugs or alcohol to reduce MVC-related SCIs.

Fall Prevention

Implement home safety measures such as installing handrails, securing rugs, improving lighting, and using grab bars to prevent falls, particularly among older adults and children.

Firearm Safety

Promote responsible gun ownership, including safe storage practices (locked and unloaded), education on gun safety, and violence prevention strategies, to minimize firearm-related SCIs.

Study Limitations

1
Evaluation of the long-term effectiveness and overall outcomes of prevention programs is a challenge.
2
Incidence and prevalence data of morbidity and mortality may not be directly relevant to specific prevention programs.
3
Limitations related to the overall population made it difficult to draw conclusions related to behavioral modification.

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