To provide prevalence estimates for problems in functioning of community-dwelling persons with spinal cord injury (SCI) and to examine associations between various areas of functioning with the purpose of supporting countries in identifying targets for interventions.
Community, 22 countries including all World Health Organization regions.
Persons (N=12,591) with traumatic or nontraumatic SCI aged 18 years or older.
Main Outcome Measures
We estimated the prevalence of problems in 53 areas of functioning from the Brief International Classification of Functioning, Disability and Health (ICF) core set for SCI, long-term context, or ICF rehabilitation set covering 4 domains: impairments in body functions, impairments in mental functions, independence in performing activities, and restrictions in participation. Associations between areas of functioning were identified and visualized using conditional independence graphs.
Participants had a median age of 52 years, 73% were male, and 63% had paraplegia. Feeling tired, bowel dysfunction, sexual functions, spasticity, pain, carrying out daily routine, doing housework, getting up off the floor from lying on the back, pushing open a heavy door, and standing unsupported had the highest prevalence of problems (>70%). Clustering of associations within the 4 functioning domains was found, with the highest numbers of associations within impairments in mental functions. For the whole International Spinal Cord Injury sample, areas with the highest numbers of associations were circulatory problems, transferring bed-wheelchair, and toileting, while for the World Health Organization European and Western Pacific regions, these were dressing upper body, transferring bed-wheelchair, handling stress, feeling downhearted and depressed, and feeling happy.
In each domain of functioning, high prevalence of problems and high connectivity of areas of functioning were identified. The understanding of problems and the identification of potential targets for intervention can inform decision makers at all levels of the health system aiming to improve the situation of people living with SCI.
List of abbreviations:CIG (conditional independence graph), ICF (International Classification of Functioning, Disability and Health), InSCI (International Spinal Cord Injury), LASSO (least average shrinkage and selection operator), SCI (spinal cord injury), WHO (World Health Organization)
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Published online: September 24, 2020
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- CorrectionArchives of Physical Medicine and RehabilitationVol. 102Issue 4
- PreviewIn the article by Ehrmann et al, Describing Functioning in People Living With Spinal Cord Injury Across 22 Countries: A Graphical Modeling Approach, published in the Archives of Physical Medicine and Rehabilitation 2020;101:2112-2143 https://www.archives-pmr.org/article/S0003-9993(20)30958-8/fulltext , an author’s name was spelled incorrectly in the byline. It should be Brigitte Perrouin-Verbe.
- CorrectionArchives of Physical Medicine and RehabilitationVol. 102Issue 11
- PreviewIn the authorship listing for the InSCI group in “Describing functioning in people living with spinal cord injury across 22 countries: a graphic modeling approach” ( https://www.archives-pmr.org/article/S0003-9993 (20)30958-8/fulltext) Daniela Utiyama, PhD should be listed in that group in place of Prof. Liniamara Batistella.