Functional independence in the Finnish spinal cord injury population

Spinal Cord, 2022 · DOI: https://doi.org/10.1038/s41393-021-00700-x · Published: September 15, 2021

Spinal Cord Injury Participation Rehabilitation

Simple Explanation

Spinal cord injury (SCI) can lead to sensory and motor loss and affect the autonomic nervous system. Tetraplegia impacts the arms, body, and legs, possibly requiring ventilation. Paraplegia affects the trunk and legs. This study aimed to describe the functional independence of individuals with SCI in Finland using the Spinal Cord Independence Measure-Self Report (SCIM-SR). It also examined how characteristics affected SCIM-SR scores. The study found that the severity of SCI, age, and time since injury all impact functional ability. Those with non-traumatic SCI generally had higher functional independence.

Study Duration

Not specified

Participants

884 Finnish adults with spinal cord injury

Evidence Level

Cross-sectional survey

Key Findings

1
The higher the neurological level in groups AIS A, B, and C, the lower the functional ability.
2
Group AIS D at any injury level had the highest level of functional ability.
3
Age and the number of years since injury negatively inﬂuenced the SCIM-SR scores for every sub-scale.

Research Summary

This study assessed functional independence in the Finnish SCI population using the SCIM-SR. It found that lesion characteristics, particularly the severity of SCI, and generic characteristics like age and time since injury significantly impact functional ability. Individuals with non-traumatic SCI showed higher functional independence. Those with more severe SCI (C1-4 AIS A, B, C) had the most limitations, while the AIS D group demonstrated the highest functional ability. The study highlights the need for ongoing healthcare and rehabilitation for individuals with SCI, especially elderly individuals, as functional independence decreases with time since injury. The results also serve as baseline information for future studies and interventions.

Practical Implications

Healthcare Planning

The findings can help in planning future healthcare and rehabilitation services for individuals with SCI, particularly elderly individuals.

Rehabilitation Goals

The study provides reference values for functional ability, which can be used to set realistic rehabilitation goals.

SCIM-SR Development

The results suggest that SCIM-SR should be further developed to account for standardizations based on the International SCI Core Data Set and to better differentiate functioning in individuals with good functional independence.

Study Limitations

1
The response rate was only 50%, which might introduce bias.
2
ISNCSCI is not fully validated to measure persons with NTSCI.
3
The ceiling effect was considerable in the sub-scales of self-care and in respiration and sphincter management.

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