Abstract
Objective
To validate if better upper extremity (UE) motor function predicts clean intermittent
catheterization (CIC) adoption and adherence after spinal cord injury (SCI) using
a validated instrument (as opposed to prior research using scales based on expert
opinion).
Design
We examined data from the Neurogenic Bladder Research Group SCI registry, a multicenter,
prospective, observational study assessing persons with neurogenic bladder following
SCI. All participants who were unable to volitionally void and were >1 year post injury
were included. Participants were dichotomized into those performing CIC vs those using
other bladder management methods. In addition to demographic and clinical characteristics,
UE motor function was examined using the SCI-Fine Motor Function Index using validated
categorization levels: (1) no activities requiring hand function, (2) some activities
involving gross hand movement, (3) some activities requiring dexterity or coordinated
UE movement, or (4) most activities requiring dexterity and coordinated UE movement.
Associations were examined using logistic regression.
Setting
Multicenter study.
Participants
Registry participants unable to volitionally void after SCI (N=1236).
Intervention
Not applicable.
Main Outcome Measure
Upper extremity motor function association with CIC.
Results
A total of 1326 individuals met inclusion criteria (66% performing CIC, 60% male,
and 82% white). On multivariate analysis, better UE motor function was associated
with a statistically increased odds of performing CIC (odds ratio, 3.10 [Level 3]
and odds ratio, 8.12 [Level 4] vs Levels 1 and 2 [P<.001]).
Conclusion
In persons with SCI who are unable to volitionally void, UE motor function is highly
associated with CIC. These results validate prior findings and continue to suggest
that following SCI, the degree of preserved UE motor function is associated with CIC
more than any other factor.
Keywords
List of abbreviations:
BMI (body mass index), CIC (clean intermittent catheterization), OR (odds ratio), SCI (spinal cord injury), SF-12 (12-Item Short Form Health Survey), UE (upper extremity)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: July 23, 2019
Footnotes
Supported by the Patient-Centered Outcomes Research Institute (award no. CER14092138). All statements in this report, including its findings and conclusions, are solely those of the authors and do not necessarily represent the views of the Patient-Centered Outcomes Research Institute.
Dr Stoffel has financial relationships with Uroplasty, Ipsen, and the US Department of Defense outside the submitted work. Dr Elliott has financial relationships with Boston Scientific, PercuVision, and Urotronic outside the submitted work. The other authors have nothing to disclose.
Identification
Copyright
© 2019 by the American Congress of Rehabilitation Medicine
