Long term outcome of functional independence and quality of life after traumatic SCI in Germany

Spinal Cord, 2021 · DOI: https://doi.org/10.1038/s41393-021-00659-9 · Published: June 25, 2021

Spinal Cord Injury Participation Rehabilitation

Simple Explanation

This study investigates the long-term functional independence and quality of life (QoL) of individuals with traumatic and ischemic spinal cord injuries (SCI) in Germany. The study followed participants from three German SCI centers over time, correlating their self-reported spinal cord independence measure (SCIM-SR) scores with their quality of life (WHO-QoL-BREF). The results showed that SCIM scores remained stable over time, indicating a successful transfer of independence skills from rehabilitation to the community. However, bladder and bowel management showed a slight decrease, requiring special attention.

Study Duration

81.47 months

Participants

359 individuals with traumatic and ischemic SCI

Evidence Level

Multicenter observational study

Key Findings

1
SCIM scores remained stable over time, suggesting a successful transfer of acquired independence skills obtained during primary rehabilitation into the community setting.
2
SCIM-SR scores showed a significant correlation with selected items of the WHO-QoL-BREF, indicating a positive relationship between functional independence and quality of life.
3
Management of bladder and bowel showed a slight decrease in SCIM-SR scores, suggesting that this area may need special attention in long-term care.

Research Summary

The study aimed to describe the long-term outcome of functional independence and quality of life (QoL) for individuals with traumatic and ischemic SCI beyond the first year after injury. Data for 359 individuals were obtained, with an average time passed since the last clinical SCIM examination of 81.47 months. SCIM scores remained stable, except for reported management of bladder and bowel. The study concludes that SCIM score stability over time suggests a successful transfer of acquired independence skills obtained during primary rehabilitation into the community setting, paralleled by positively related QoL measurements, but bladder and bowel management may need special attention.

Practical Implications

Rehabilitation Program Effectiveness

Comprehensive primary rehabilitation efforts by dedicated SCI centers achieve levels of independence and QoL which remain stable over time.

Targeted Interventions

Special attention should be given to bladder and bowel management in long-term care for individuals with SCI to prevent deterioration of functional independence.

Quality of Life Improvement

Empowering individuals with the highest level of independence achievable within their primary rehabilitation is a long-lasting investment in their quality of life.

Study Limitations

1
The study only included traumatic and ischemic causes of SCI, excluding a substantial portion of non-traumatic causes.
2
A substantial number of individuals did not participate, and some were lost to follow-up, potentially affecting the representativeness of the sample.
3
The use of the self-reported SCIM-III-SR might be biased by the unsupervised self-report, and poor reporting for bladder- and bowel management items might impair reliability.

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