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The Relationship Between Quality of Life and Change in Mobility 1 Year Postinjury in Individuals With Spinal Cord Injury

  • Melissa S. Riggins
    Affiliations
    College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR
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  • Padmaja Kankipati
    Affiliations
    Human Engineering Research Laboratories, Department of Veterans Affairs, Pittsburgh, University of Pittsburgh, Pittsburgh, PA

    Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA
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  • Michelle L. Oyster
    Affiliations
    Human Engineering Research Laboratories, Department of Veterans Affairs, Pittsburgh, University of Pittsburgh, Pittsburgh, PA

    Departments of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA
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  • Rory A. Cooper
    Affiliations
    Human Engineering Research Laboratories, Department of Veterans Affairs, Pittsburgh, University of Pittsburgh, Pittsburgh, PA

    Departments of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA

    Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, PA
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  • Michael L. Boninger
    Correspondence
    Reprint requests to Michael L. Boninger, MD, VAPHS-Human Engineering Research Laboratories, 7180 Highland Dr, Bldg 4, 2nd Fl, 151R1-H, Pittsburgh, PA 15206
    Affiliations
    Human Engineering Research Laboratories, Department of Veterans Affairs, Pittsburgh, University of Pittsburgh, Pittsburgh, PA

    Departments of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA
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      Abstract

      Riggins MS, Kankipati P, Oyster ML, Cooper RA, Boninger ML. The relationship between quality of life and change in mobility 1 year postinjury in individuals with spinal cord injury.

      Objective

      To examine quality-of-life (QOL) factors and change in mobility in individuals with traumatic spinal cord injury (SCI) 1 year after injury.

      Design

      Retrospective case study of National SCI Database data.

      Setting

      SCI Model Systems (SCIMS) sites (N=18).

      Participants

      Subjects (N=1826; age >18y) who presented to an SCIMS site after traumatic SCI between June 2004 and July 2009 and returned for 1-year follow-up. All subjects had FIM mobility data for both assessments.

      Interventions

      Not applicable.

      Main Outcome Measures

      Assessment of impairment based on Lower-Extremity Motor Score. Assessment of QOL based on Craig Handicap Assessment and Reporting Technique, Patient Health Questionnaire, Satisfaction With Life Scale, Self-perceived Health Status, and pain severity scores.

      Results

      Of the sample, 55 individuals transitioned from walking to wheelchair use within 1 year of discharge. This group had the highest number of individuals from minority groups (52.8%) and the lowest employment rate (7.3%). Compared with individuals who transitioned from wheelchair use to walking or maintained wheelchair use or ambulation, the walking-to-wheelchair transition group had significantly lower QOL scores (P<.01), including higher depression (P<.01) and higher pain severity (P<.001).

      Conclusions

      Individuals with SCI who transitioned from walking at discharge to wheelchair use within 1 year had low QOL factors, including high pain and depression scores. Rehabilitation professionals should consider encouraging marginal ambulators to work toward functional independence from a wheelchair, rather than primary ambulation during acute inpatient rehabilitation.

      Key Words

      List of Abbreviations:

      AA (ambulation to ambulation), AW (ambulation to wheelchair), CHART (Craig Handicap Assessment and Reporting Technique), CHART Mob (Craig Handicap Assessment and Reporting Technique Mobility subscale), CHART Occ (Craig Handicap Assessment and Reporting Technique Occupation subscale), CHART PI (Craig Handicap Assessment and Reporting Technique Physical Independence subscale), CHART SI (Craig Handicap Assessment and Reporting Technique Social Integration subscale), LEMS (Lower-Extremity Motor Score), MDS (major depressive syndrome), NSCID (National Spinal Cord Injury Database), QOL (quality of life), SCI (spinal cord injury), SCIMS (Spinal Cord Injury Model Systems), SDS (Severity of Depression Scale), SPHS (Self-perceived Health Status), SWLS (Satisfaction With Life Scale), WA (wheelchair to ambulation), WW (wheelchair to wheelchair)
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