Functional independence of persons with long-standing motor complete spinal cord injury in the Netherlands

The Journal of Spinal Cord Medicine, 2020 · DOI: 10.1080/10790268.2018.1504427 · Published: May 1, 2020

Spinal Cord Injury Participation Rehabilitation

Simple Explanation

This study investigated the long-term functional independence of individuals with motor complete spinal cord injury (SCI) in the Netherlands, focusing on the relationship between time since injury (TSI) and functional abilities. The researchers also explored how factors like the level of injury, comorbidities, mental health, waist circumference, and secondary health conditions (SHCs) might affect functional independence. The study found no direct link between the time since the injury and functional independence, suggesting that individuals with SCI can maintain their functional abilities over a long period. However, the level of injury and waist circumference were found to be determinants of functional independence.

Study Duration

Not specified

Participants

226 persons with long-standing motor complete SCI

Evidence Level

Cross-sectional study

Key Findings

1
No significant differences in SCIM scores were found between TSI strata, suggesting that functional independence does not decline with increasing time since injury.
2
SCIM scores were lower for persons with tetraplegia, autonomic dysreflexia, hypotension, more than four SHCs and a high waist circumference.
3
Level of injury was identified as the strongest independent determinant of long-term functioning, with waist circumference also playing a role.

Research Summary

This cross-sectional study examined the functional independence of individuals with long-standing motor complete SCI in the Netherlands, using the Spinal Cord Independence Measure III (SCIM III). The study found no association between time since injury (TSI) and functional independence, indicating that individuals with SCI can maintain their functional abilities over many years. Level of injury was the strongest determinant of functional independence, while waist circumference also had a significant, but weaker, effect. These findings emphasize the importance of managing weight to promote functional abilities in individuals with SCI.

Practical Implications

Long-Term Care

The study suggests that long-term care strategies should focus on maintaining functional independence, rather than assuming a decline due to aging or time since injury.

Weight Management

The association between waist circumference and functional independence highlights the importance of weight management programs for individuals with SCI.

Targeted Interventions

Interventions should be tailored to the level of injury, with specific attention to the unique needs of individuals with tetraplegia to maintain functional independence.

Study Limitations

1
The cross-sectional design limits conclusions about the true effects of aging.
2
There may have been a survivor effect, with healthier subjects being more likely to participate.
3
The inclusion of only motor complete injuries restricts generalization of the results to all people living with SCI.

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