Archives of physical medicine and rehabilitation 2017 06 21() pii S0003-9993(17)30411-2
The study examined differences in quality of life scores for groups based on transitions in locomotion status at 1, 5, and 10 years post-discharge in a sample of people with spinal cord injury (SCI). We also investigated whether demographic factors and transitions in locomotion status can predict quality of life measures at these time points.
Retrospective case study of the National SCI Database.
Model SCI Systems Centers.
10,190 individuals with SCI from 21 SCI Model Systems Centers, identified through the National SCI Model Systems Centers database between the years 1985-2012. Subjects had Functional Independence Measure (Locomotion-Mode) data at discharge and at least one of the following: 1, 5, or 10 years post-discharge.
Functional Independence Measure – Locomotion Mode; Severity of Depression Scale; Satisfaction with Life scale; Craig Handicap Assessment and Reporting Technique.
Participants who transitioned from ambulation to wheelchair use reported lower participation and life satisfaction, and higher depression levels (p<.05) than those who maintained their ambulatory status. Participants who transitioned from ambulation to wheelchair use reported higher depression levels (p<.05) and no difference for participation (p>.05) or life satisfaction (p>.05) compared to those who transitioned from wheelchair to ambulation. Demographic factors and locomotion transitions predicted quality of life scores at all time points (p<.05). CONCLUSIONS
The results of this study indicate that transitioning from ambulation to wheelchair use can negatively impact psychosocial health 10 years after SCI. Clinicians should be aware of this when deciding on ambulation training. Further work to characterize who may be at risk for these transitions is needed.