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Ayed SA, El-Zoghby SM, Ibrahim ME, Zeid WA, Nour-Eldein H. Determinants of low satisfaction with life among wheelchair users with spinal cord injury in Egypt: a cross-sectional study. BMC Neurol 2024; 24:373. [PMID: 39369202 PMCID: PMC11452966 DOI: 10.1186/s12883-024-03836-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2024] [Accepted: 08/28/2024] [Indexed: 10/07/2024] Open
Abstract
BACKGROUND Spinal cord injury (SCI) is one of the most catastrophic injuries that might lead to permanent use of a wheelchair and severely affects the quality of life, hence SCI patients report lower satisfaction with life (SWL) than the general population. Therefore, it is important to identify factors that determine SWL among wheelchair users with SCI. Our study aimed to assess the prevalence of low SWL and to identify its determinants among wheelchair users with SCI in Egypt. METHODS A cross-sectional study included 105 wheelchair users with SCI from the Al Hassan Foundation for wheelchair users in Egypt. The main outcome measure was low SWL, while the independent variables included sociodemographic characteristics, injury-related characteristics, anxiety, depression, neuropathic pain, functional independence, and environmental barriers. RESULTS The prevalence of low SWL among study participants was 57.1%. We found significant associations between SWL and age, area of living, and age at injury. Additionally, SWL correlated negatively with anxiety, depression, neuropathic pain, and environmental barriers, and positively with functional independence. Finally, the binary multiple logistic regression revealed that living in Upper Egypt (p = 0.017, OR = 13.7), depression (p = 0.034, OR = 6.08), older age (p = 0.002, OR = 1.21), and work and school environmental barriers (p = 0.022, OR = 0.46) were the predictors of low SWL. CONCLUSION To improve the SWL for wheelchair users with SCI we need to effectively manage neuropathic pain, depression, and anxiety, and promote functional independence. There is an urgent need to reinforce legislation to improve the living conditions for wheelchair users with SCI in Egypt, especially in Upper Egypt.
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Affiliation(s)
- Sarah Abdelaaty Ayed
- Department of Family Medicine, Faculty of Medicine, Suez Canal University, Ismalia, Egypt.
| | - Safaa M El-Zoghby
- Department of Family Medicine, Faculty of Medicine, Suez Canal University, Ismalia, Egypt
| | - Maha Emad Ibrahim
- Department of Physical Medicine, Rheumatology and Rehabilitation, Faculty of Medicine, Suez Canal University, Ismalia, Egypt
| | - Wael Ahmed Zeid
- Department of Family Medicine, Faculty of Medicine, Suez Canal University, Ismalia, Egypt
| | - Hebatallah Nour-Eldein
- Department of Family Medicine, Faculty of Medicine, Suez Canal University, Ismalia, Egypt
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Williams TL, Nilsson Wikmar L, Phillips J, Joseph C. Healthcare providers perspective of chronic pain management in persons with traumatic spinal cord injury accessing the public system in a region of South Africa. Disabil Rehabil 2024:1-9. [PMID: 39263816 DOI: 10.1080/09638288.2024.2399228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 08/27/2024] [Accepted: 08/28/2024] [Indexed: 09/13/2024]
Abstract
PURPOSE Persons with traumatic spinal cord injury (PWTSCI) have expressed a lack of education from healthcare providers and poor shared-decision making between providers and clients. The aim was to explore the healthcare providers' perspective on factors influencing the optimal management of chronic pain. METHODS Healthcare providers were recruited from two institutions at tertiary healthcare level. Interviews explored current chronic pain management practices, influencing factors and recommendations for improvement. Data saturation occurred after interviewing 11 participants. Thematic analysis was used through a socio-ecological model. RESULTS The challenges to optimal pain management include appropriate assessment and management of psychological health (intrapersonal level), substance abuse amongst patients (intrapersonal level), access to medication for providers and lack of knowledge by providers (interpersonal and organizational level). To improve chronic pain management, an interdisciplinary team approach should be operationalized at policy and organizational level, monitoring and adjustment of interventions should take place (interpersonal), and family members/caregivers should be involved in the planning and monitoring (interpersonal). CONCLUSION Factors, at the interpersonal, intrapersonal, organizational and policy levels, influence optimal chronic pain management in the traumatic spinal cord injury (TSCI) population. To mitigate challenges, guidelines for chronic pain management should be developed, particularly for low-resourced developing countries.
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Affiliation(s)
- Tammy-Lee Williams
- Department of Physiotherapy, Faculty of Community and Health Sciences, University of the Western Cape, Cape Town, South Africa
| | - Lena Nilsson Wikmar
- Department of Neurobiology, Faculty of Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Joliana Phillips
- Department of Research Development and Postgraduate Support, Faculty of Research and Innovation, University of The Western Cape, Cape Town, South Africa
| | - Conran Joseph
- Division of Physiotherapy, Faculty of Health and Rehabilitation services, Stellenbosch University, Stellenbosch, South Africa
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Williams TL, Joseph C, Nilsson-Wikmar L, Phillips J. The interrelationship between pain, life satisfaction and mental health in adults with traumatic spinal cord injury, in the context of a developing country. Spinal Cord Ser Cases 2024; 10:9. [PMID: 38453883 PMCID: PMC10920914 DOI: 10.1038/s41394-024-00622-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 02/22/2024] [Accepted: 02/26/2024] [Indexed: 03/09/2024] Open
Abstract
STUDY DESIGN Cross-sectional, analytical study design using a conveneient sampling strategy. OBJECTIVES To examine the interrelationship between pain, life satisfaction and indices of negative mental well-being amongst the traumatic spinal cord injury (TSCI) population. SETTING Western Cape Rehabilitation Center in Cape Town, South Africa. METHODS Participants (n = 70) were adults (mean age of 36.3, SD = 9.2) with TSCI. Participants completed the following instruments: 10 satisfaction items from the World Health Organization Quality of Life Brief Version, short forms of the Center for Epidemiological Studies Depression Scale and the trait scale of the State-Trait Anxiety Inventory, a one-item measure of pain intensity taken from the International Spinal Cord Injury Pain Basic Data Set and the interference scale of the Brief Pain Inventory. RESULTS Correlational analysis (Pearson r) demonstrated that all the indices of mental well-being as well as the two indices of pain was significantly negatively related to life satisfaction. In addition, life satisfaction mediated the relationship between pain intensity and depression as well as anxiety. Life satisfaction only mediated the relationship between pain interference and depression but not anxiety. CONCLUSIONS An improvement in life satisfaction may lead to improvements in pain interference, pain intensity as well as psychological distress, amongst persons suffering from TSCI Future research should focus on assessing measures/treatment which may improve life satisfaction in the TSCI population.
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Affiliation(s)
- Tammy-Lee Williams
- Department of Physiotherapy, University of the Western Cape, Cape Town, 7535, South Africa.
| | - Conran Joseph
- Division of Physiotherapy, Stellenbosch University, Stellenbosch, 7602, South Africa
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, 141 52 Huddinge, Solna, Sweden
| | - Lena Nilsson-Wikmar
- Department of Neurobiology, Care Sciences and Society, Division of Physiotherapy, Karolinska Institutet, 141 52 Huddinge, Solna, Sweden
| | - Joliana Phillips
- Department of Physiotherapy, University of the Western Cape, Cape Town, 7535, South Africa
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Burgos-Gutiérrez C, Álvarez-Buylla-Álvarez P, Álvarez-Viejo M, Pérez-López S, Pérez-Basterrechea M, Bea-Muñoz M, Pérez-Arias Á, De-Vicente-Rodríguez JC. Treatment of pressure ulcers in patients with spinal cord injury: Conventional surgery vs. cellular therapy. J Spinal Cord Med 2024; 47:246-254. [PMID: 34982655 PMCID: PMC10885747 DOI: 10.1080/10790268.2021.2014234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
CONTEXT Relapse and recurrence rates of pressure injuries (PIs) are very high in spinal cord injured patients. That is the reason why alternative therapies, such the stem cells derived from bone marrow, have been developed. OBJECTIVE To compare this new technique of infiltration-infusion of mononuclear cells from bone marrow with conventional surgery. DESIGN A retrospective study was carried out in patients with spinal cord injuries who had PIs, category III/IV, in the pelvic area, during a 14-year follow-up period. SETTING One group was treated with conventional surgery and, in the other group, mononuclear cells were infused. PARTICIPANTS One hundred and forty-nine patients were registered, 63 (42.3%) in the conventional surgery group and 86 (57.7%) in the mononuclear cell group. RESULTS A comparative study between these 2 groups was carried out. There were no significant differences in ulcer healing in the first 6 months, but 6 months and one-year post-treatment, they were found. At 6 months, no patient in the conventional surgery group showed dehiscence or fistulization of the wound and, one year after surgery, only 3.17% recurred in the conventional group. In addition, there was a statistically significant relationship between days of hospitalization and the type of bacterial contamination and the intervention group. CONCLUSION Bone marrow mononuclear cell infusion-infiltration is an alternative treatment for PIs and fistula during the first 6 months, instead of conventional surgery. However, in the medium-long term, conventional surgery is more effective.
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Affiliation(s)
| | | | - María Álvarez-Viejo
- Unidad de Terapia Celular y Medicina Regenerativa, Servicio de Hematología y Hemoterapia, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Silvia Pérez-López
- Unidad de Terapia Celular y Medicina Regenerativa, Servicio de Hematología y Hemoterapia, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Marcos Pérez-Basterrechea
- Unidad de Terapia Celular y Medicina Regenerativa, Servicio de Hematología y Hemoterapia, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Manuel Bea-Muñoz
- Servicio de Rehabilitación, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Ángel Pérez-Arias
- Servicio de Cirugía Plástica, Hospital Universitario Central de Asturias, Oviedo, Spain
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Mputu Mputu P, Beauséjour M, Richard-Denis A, Fallah N, Noonan VK, Mac-Thiong JM. Classifying clinical phenotypes of functional recovery for acute traumatic spinal cord injury. An observational cohort study. Disabil Rehabil 2024:1-8. [PMID: 38390856 DOI: 10.1080/09638288.2024.2320267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 02/14/2024] [Indexed: 02/24/2024]
Abstract
PURPOSE Identify patient subgroups with different functional outcomes after SCI and study the association between functional status and initial ISNCSCI components. METHODS Using CART, we performed an observational cohort study on data from 675 patients enrolled in the Rick-Hansen Registry(RHSCIR) between 2014 and 2019. The outcome was the Spinal Cord Independence Measure (SCIM) and predictors included AIS, NLI, UEMS, LEMS, pinprick(PPSS), and light touch(LTSS) scores. A temporal validation was performed on data from 62 patients treated between 2020 and 2021 in one of the RHSCIR participating centers. RESULTS The final CART resulted in four subgroups with increasing totSCIM according to PPSS, LEMS, and UEMS: 1)PPSS < 27(totSCIM = 28.4 ± 16.3); 2)PPSS ≥ 27, LEMS < 1.5, UEMS < 45(totSCIM = 39.5 ± 19.0); 3)PPSS ≥ 27, LEMS < 1.5, UEMS ≥ 45(totSCIM = 57.4 ± 13.8); 4)PPSS ≥ 27, LEMS ≥ 1.5(totSCIM = 66.3 ± 21.7). The validation model performed similarly to the original model. The adjusted R-squared and F-test were respectively 0.556 and 62.2(P-value <0.001) in the development cohort and, 0.520 and 31.9(P-value <0.001) in the validation cohort. CONCLUSION Acknowledging the presence of four characteristic subgroups of patients with distinct phenotypes of functional recovery based on PPSS, LEMS, and UEMS could be used by clinicians early after tSCI to plan rehabilitation and establish realistic goals. An improved sensory function could be key for potentiating motor gains, as a PPSS ≥ 27 was a predictor of a good function.
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Affiliation(s)
- Pascal Mputu Mputu
- Hôpital du Sacré-Cœur de Montréal/CIUSSS NÎM, Montreal, Canada
- Faculty of Medicine, Université de Montréal, Montreal, Canada
| | - Marie Beauséjour
- Department of Community Health Sciences, Université de Sherbrooke, Sherbrooke, Canada
- CHU Sainte-Justine, Montreal, Canada
| | - Andréane Richard-Denis
- Hôpital du Sacré-Cœur de Montréal/CIUSSS NÎM, Montreal, Canada
- Centre de recherche interdisciplinaire en réadaptation (CRIR), Montreal, Canada
| | - Nader Fallah
- Praxis Spinal Cord Institute, Vancouver, Canada
- University of British Columbia, Vancouver, Canada
| | - Vanessa K Noonan
- Praxis Spinal Cord Institute, Vancouver, Canada
- University of British Columbia, Vancouver, Canada
| | - Jean-Marc Mac-Thiong
- Hôpital du Sacré-Cœur de Montréal/CIUSSS NÎM, Montreal, Canada
- Faculty of Medicine, Université de Montréal, Montreal, Canada
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Kato C, Uemura O, Sato Y, Tsuji T. Decision Tree Analysis Accurately Predicts Discharge Destination After Spinal Cord Injury Rehabilitation. Arch Phys Med Rehabil 2024; 105:88-94. [PMID: 37714507 DOI: 10.1016/j.apmr.2023.08.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 05/13/2023] [Accepted: 08/10/2023] [Indexed: 09/17/2023]
Abstract
OBJECTIVES To predict discharge destination after spinal cord injury (SCI) rehabilitation. STUDY DESIGN A retrospective, single-center study. We collected the following data from medical charts: age, sex, living arrangement before injury, acute length of stay (LOS), level of injury on admission, American Spinal Injury Association Impairment Scale (AIS) on admission, Upper Extremity Motor Score (UEMS) on admission, Lower Extremity Motor Score on admission (LEMS), Spinal Cord Independence Measure (SCIM) scores on admission and discharge, and discharge destination. A decision tree algorithm was used to establish prediction models in a train-test split manner using features on admission or discharge. SETTING A spinal center in Tokyo, Japan. PARTICIPANTS Participants were individuals with SCI admitted to our hospital from March 2016 to October 2021 for the first rehabilitation after the injury. The study included 210 participants divided into 2 groups: training (n=140) and testing (n=70). Random sampling without replacement was used. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Prediction accuracy was evaluated with sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the receiver operating curve (AUC). RESULTS AIS was significantly different between the groups. The prediction model using total SCIM scores on discharge (D-Classification and Regression Tree [CART]) revealed that a cut-off value of 40 accurately predicted the discharge destination. In contrast, the prediction model using features on admission (A-CART) revealed that subtotal SCIM mobility scores of 5, age of 74 years, and UEMS of 23 were significant predictors. Sensitivity, specificity, PPV, NPV, and AUC of D-CART and A-CART were 0.837, 0.810, 0.911, 0.680, and 0.832 and 0.857, 0.810, 0.913, 0.708, and 0.869, respectively. CONCLUSIONS D-CART and A-CART showed comparable prediction accuracies. This suggests that, even during the early stages of rehabilitation, it is possible to predict the discharge destination.
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Affiliation(s)
- Chihiro Kato
- National Hospital Organization Murayama Medical Center, Tokyo, Japan; Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Osamu Uemura
- National Hospital Organization Murayama Medical Center, Tokyo, Japan.
| | - Yasunori Sato
- Department of Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo, Japan
| | - Tetsuya Tsuji
- Department of Rehabilitation Medicine, Keio University School of Medicine, Tokyo, Japan
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Zhao H, Cole S. Leisure, Recreation, and Life Satisfaction: A Longitudinal Study for People With Spinal Cord Injury. Top Spinal Cord Inj Rehabil 2023; 29:61-72. [PMID: 38076495 PMCID: PMC10704216 DOI: 10.46292/sci23-00020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Background Leisure and recreation (LR) are positively associated with social integration and life satisfaction in people with spinal cord injury (SCI). However, few studies have longitudinally observed long-term changes in LR participation among people with SCI and discussed the association of these activities with social integration and life satisfaction. Objectives This study aims to determine for people with SCI, within a 45-year period, the association between mobility and LR participation; the associations between LR participation and social integration and life satisfaction, respectively; and whether the association between LR participation and life satisfaction is mediated by social integration. Methods Growth modeling and linear mixed modeling were employed as the primary data analysis tools to explore longitudinal changes in LR participation, social integration, and life satisfaction. A mediation test was conducted to examine the potential mediation effect of social integration on the relationship between LR participation and life satisfaction. Results The mobility level, LR participation hours, and social integration of people with SCI decreased gradually during the 45-year period, whereas life satisfaction increased as they lived longer with the injury. LR participation was consistently and positively associated with social integration and life satisfaction of people with SCI. A mediation effect by social integration was observed between LR and life satisfaction. Conclusion A decline in mobility level was associated with a decrease in LR participation over time for people with SCI. Engaging in LR activities regularly and maintaining a certain level of social interaction are consistently and positively associated with long-term life satisfaction.
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Affiliation(s)
- Haoai Zhao
- Department of Health and Wellness Design, School of Public Health, Indiana University Bloomington, Bloomington, Indiana, USA
| | - Shu Cole
- Department of Health and Wellness Design, School of Public Health, Indiana University Bloomington, Bloomington, Indiana, USA
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8
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Gutierrez NC, Fullmer N, Chai S, Rosario ER. Return to work post spinal cord injury through a comprehensive rehabilitative program: A case series. J Spinal Cord Med 2023:1-7. [PMID: 37975760 DOI: 10.1080/10790268.2023.2265099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2023] Open
Abstract
CONTEXT Spinal cord injury (SCI) can impair bodily functions and limit an individual's ability to maintain or gain steady employment. Vocational rehabilitation programs have been shown to effectively facilitate individuals with a SCI to return to work, however, further research is needed on the implementation, outcomes, and feasibility of such programs including with the integration of healthcare. OBJECTIVE The objective of this single-group study was to assess the effectiveness of a comprehensive vocational rehabilitation program, as measured by improvements in employment, work confidence, life satisfaction, and quality of life for individuals with a SCI. METHODS Four individuals with a SCI participated in the vocational rehabilitation program. Participants were assigned responsibilities within their department of interest and attended weekly meetings with the vocational rehabilitation team to address barriers, discuss resources and education, and set professional goals. Completion of pre and post-test assessments was required to evaluate the program's impact on participants' work readiness and overall well-being. RESULTS Each participant worked with an interdisciplinary team on an individualized work-plan (over 100 h of employment) with necessary accommodations for successful rehabilitation. Participants reported beneficial changes in multiple post-program assessment categories including physical, social, and emotional functions, with all reporting a general improvement in physical strength upon completion of the program. CONCLUSION Our findings suggest that a comprehensive vocational rehabilitation program can be effective in facilitating individuals with SCI to gain greater functional independence and confidently pursue employment. Further studies are crucial to advance the knowledge required to implement a successful rehabilitative program.
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Affiliation(s)
- Nakisha C Gutierrez
- Research Institute, Casa Colina Hospital and Centers for Healthcare, Pomona, California, USA
| | - Niko Fullmer
- Research Institute, Casa Colina Hospital and Centers for Healthcare, Pomona, California, USA
| | - Stephen Chai
- Research Institute, Casa Colina Hospital and Centers for Healthcare, Pomona, California, USA
| | - Emily R Rosario
- Research Institute, Casa Colina Hospital and Centers for Healthcare, Pomona, California, USA
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Tsoy N, Langewitz W, Müri S, Notter S, Pannek J, Post MWM, Rednic LN, Rubinelli S, Scheel-Sailer A. Quality of life from the patient perspective at the end of the first rehabilitation after the onset of spinal cord injury/disorder - A qualitative interview-based study. J Spinal Cord Med 2023:1-12. [PMID: 37819653 DOI: 10.1080/10790268.2023.2263235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/13/2023] Open
Abstract
CONTEXT At present, there is a lack of information concerning patients' perspectives on their quality of life (QoL) after a recently acquired spinal cord injury/disorder (SCI/D). OBJECTIVE To explore patients' perspectives on their QoL during their first inpatient rehabilitation after the onset of SCI/D. METHODS Qualitative study. Semi-structured face-to-face interviews were conducted with 20 participants aged 18 years or older at least three months after the onset of SCI/D and two weeks before they were discharged from their first rehabilitation. Audio-recorded interviews were transcribed and analyzed according to the thematic content analysis. Interviewees rated their QoL with the SCI QoL data set. RESULTS The interviewees judged their satisfaction with life as a whole, their physical and mental health, as relatively high with values between six and eight (with 10 meaning complete satisfaction). They highlighted social aspects, health topics, and the experience of autonomy as relevant to their concept of QoL. The aspects that positively influenced QoL included the level of well-being in the current social and institutional environment, the increased level of energy, strength, and autonomy in daily life, and an improved mental state derived from general positive personal attitudes. In contrast, the social restrictions during the COVID-19 pandemic, physical issues including pain, a lack of progress associated with psychological dissatisfaction, and limitations in personal independence decreased patients' QoL. CONCLUSION Since the interviewees described different aspects from the areas of social, health and autonomy as important for their QoL, exploring and addressing these areas should be used to achieve an individualized first rehabilitation.
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Affiliation(s)
| | - Wolf Langewitz
- Basel University Hospital, Psychosomatic Medicine - Communication in Medicine, Basel, Switzerland
| | - Selina Müri
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Seraina Notter
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
| | - Jürgen Pannek
- Swiss Paraplegic Centre, Nottwil, Switzerland
- Department of Urology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Marcel W M Post
- University of Groningen, University Medical Centre Groningen, Department of rehabilitation medicine, Groningen, the Netherlands
- Center of Excellence in Rehabilitation Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, the Netherlands
| | | | - Sara Rubinelli
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
- Swiss Paraplegic Research, Nottwil, Switzerland
| | - Anke Scheel-Sailer
- Swiss Paraplegic Centre, Nottwil, Switzerland
- Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
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10
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Zwecker M, Heled E, Bondi M, Zeilig G, Bluvstein V, Catz A, Dudkiewicz I. Determinants of Quality of Life in Individuals With Spinal Cord Injury Using Structural Equation Modeling. Arch Phys Med Rehabil 2022; 103:2375-2382. [PMID: 35810821 DOI: 10.1016/j.apmr.2022.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 06/14/2022] [Accepted: 06/15/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVE The objective of this study is to examine the interdependent associations between International Classification of Functioning, Disability and Health (ICF) domains and their relationship with environmental factors with regard to quality of life (QoL) in individuals with spinal cord injury (SCI). DESIGN Survey, cross-sectional study, and model testing using structural equation modeling. SETTING Two inpatient and outpatient SCI rehabilitation units, Sheba Medical Center and Loewenstein Hospital, Israel. PARTICIPANTS Convenience sample of 156 individuals with SCI (N=156). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES QoL assessed by the World Health Organization Quality of Life Assessment-BREF. Neurological impairment after SCI reflected by lesion completeness and neurologic level of injury as measured by the International Standards for Neurological Classification of Spinal Cord Injury. The Spinal Cord Independence Measure to assess SCI-related task performance. ICF Brief Core Sets composition scores to assess impairment in body structure and function domains, limitations in activities, restriction in participation constructs, and the effect of environmental factors within the ICF model. RESULTS Level of spinal cord injury and ICF Brief Core Sets composite score relating to activities and participation construct demonstrated a direct significant association with QoL. Moreover, a significant indirect association with QoL was found between the composite scores in ICF body structure and function and environmental factors, level of spinal cord injury, time since injury onset, and sex. Because the Spinal Cord Independence Measure was not related to QoL, we inferred that the categories related to instrumental activities of daily living and participation exert the most significant influence on QoL. CONCLUSIONS In order to optimize improvements in quality of life, current rehabilitation programs should target limitations specifically related to instrumental activities of daily living and participation restrictions. It may serve as a focal point for further development of current therapeutic models and analytical methods that optimize rehabilitation planning and decision making among both health care professionals and patients.
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Affiliation(s)
- Manuel Zwecker
- Department of Neurological Rehabilitation, Division of Rehabilitation, The Integrated Rehabilitation Hospital, Sheba Medical Center, Tel HaShomer; Sackler School of Medicine, Tel Aviv University, Tel Aviv.
| | - Eyal Heled
- Department of Neurological Rehabilitation, Division of Rehabilitation, The Integrated Rehabilitation Hospital, Sheba Medical Center, Tel HaShomer; Department of Behavioral Sciences, Ariel University, Ariel
| | - Moshe Bondi
- Department of Neurological Rehabilitation, Division of Rehabilitation, The Integrated Rehabilitation Hospital, Sheba Medical Center, Tel HaShomer; Sackler School of Medicine, Tel Aviv University, Tel Aviv
| | - Gabi Zeilig
- Department of Neurological Rehabilitation, Division of Rehabilitation, The Integrated Rehabilitation Hospital, Sheba Medical Center, Tel HaShomer; Sackler School of Medicine, Tel Aviv University, Tel Aviv; School of Health Professions, Ono Academic College, Kiryat Ono
| | - Vadim Bluvstein
- Sackler School of Medicine, Tel Aviv University, Tel Aviv; Department of Spinal Rehabilitation, Loewenstein Hospital, Raanana
| | - Amiram Catz
- Sackler School of Medicine, Tel Aviv University, Tel Aviv; Department of Spinal Rehabilitation, Loewenstein Hospital, Raanana
| | - Israel Dudkiewicz
- Sackler School of Medicine, Tel Aviv University, Tel Aviv; Division of Rehabilitation, The Integrated Rehabilitation Hospital, Sheba Medical Center, Tel HaShomer, Israel
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11
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Investigating Dynamics of the Spinal Cord Injury Adjustment Model: Mediation Model Analysis. J Clin Med 2022; 11:jcm11154557. [PMID: 35956172 PMCID: PMC9369731 DOI: 10.3390/jcm11154557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 07/28/2022] [Accepted: 08/01/2022] [Indexed: 01/25/2023] Open
Abstract
Spinal cord injury (SCI) is a severe neurological injury that results in damage to multiple bodily systems. SCI rehabilitation requires a significant focus on improving adjustment to the injury. This paper presents a detailed description of the Spinal Cord Injury Adjustment Model (SCIAM), which clarifies how individuals adjust to SCI and contends that adjustment to SCI is a multifactorial process involving non-linear dynamic adaptation over time. Evidence supporting SCIAM is also discussed. Mediation analyses were conducted to test the mediator dynamics proposed by the model. The analyses tested the relationship between two moderators (self-care and secondary health conditions), mediators (two self-efficacy items and appraisal of quality of life or QoL), and positive versus negative vitality/mental health as outcomes. Results showed that higher self-efficacy and perceived QoL was related to greater independence in self-care and reduced negative impacts of secondary health conditions. This study supported the mediation role of self-efficacy and other appraisals such as perceived QoL in enhancing self-care and buffering the negative impact of health challenges. In conclusion, it is important to employ a holistic model such as SCIAM to conceptualise and increase understanding of the process of adjustment following a severe neurological injury such as SCI.
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12
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Nizeyimana E, Joseph C, Phillips J. Quality of life after traumatic spinal cord injury in a developing context: the influence of contextual factors and injury characteristics. Disabil Rehabil 2022; 44:2020-2026. [DOI: 10.1080/09638288.2020.1827051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Eugene Nizeyimana
- Department of Physiotherapy, University of the Western Cape, Cape Town, South Africa
| | - Conran Joseph
- Department of Health and Rehabilitation Sciences, Division of Physiotherapy, Stellenbosch University, Cape Town, South Africa
| | - Joliana Phillips
- Department of Physiotherapy, University of the Western Cape, Cape Town, South Africa
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13
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Maggio MG, Naro A, De Luca R, Latella D, Balletta T, Caccamo L, Pioggia G, Bruschetta D, Calabrò RS. Body Representation in Patients with Severe Spinal Cord Injury: A Pilot Study on the Promising Role of Powered Exoskeleton for Gait Training. J Pers Med 2022; 12:jpm12040619. [PMID: 35455735 PMCID: PMC9030625 DOI: 10.3390/jpm12040619] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 04/05/2022] [Accepted: 04/08/2022] [Indexed: 12/15/2022] Open
Abstract
Patients with spinal cord injury (SCI) complain of changes in body representation, potentially leading to negative physical and psychological consequences. The purpose of our study is to evaluate the effects of robotic training with the Ekso-GT on body representation (BR) and on the quality of life in patients with SCI. The trial was designed as a pilot, assessor-blinded study. Forty-two inpatients with a diagnosis of SCI, classified as either American Spinal Cord Injury Association Impairment Scale (AIS), were enrolled in this study and randomized into either a control (CG: n = 21) or an experimental (EG: n = 21) group. Patients in the EG received rehabilitation training with the Ekso-GT device, whereas the CG patients were trained with conventional physical therapy (CPT), which consisted of physical and occupational therapy and psychological support. We considered as a primary outcome the modified Body Uneasiness Test (MBUT), focusing on three specific subscales on the patient’s perception of BR, i.e., the Global Severity Index (MBUT-GSI), which is an indicator of body suffering; the Positive Symptom Distress Index (MBUT-PSDI) that expresses an individual’s psychological distress; and the Lower Limb MBUT (MBUT-LL), which indicates the subject’s perception of their thighs/legs. The Short-Form-12 Health Status Questionnaire (SF12) and the Beck’s Depression Inventory (BDI) were used as secondary outcomes to evaluate the effect of the training on the quality of life and the psychological status. Non-parametric statistical analysis showed that the effect of the two treatments was significantly different on MBUT (BR), SF-12 (quality of life), and, partially, BDI (mood). Particularly, patients belonging to the EG achieved a major improvement in nearly all test scores compared to those in the CG. Our data suggest that the Ekso-GT training could be helpful in achieving positive changes in BR in patients with chronic SCI, especially in reducing psychological distress (PSDI) and thigh/leg perception (MBUT-LL) with an overall improvement in quality of life (SF-12).
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Affiliation(s)
- Maria Grazia Maggio
- Department of Biomedical and Biotechnological Science, University of Catania, 95123 Catania, Italy;
| | - Antonino Naro
- AOU Policlinico “G. Martino”, 98125 Messina, Italy; (A.N.); (D.B.)
| | - Rosaria De Luca
- IRCCS Centro Neurolesi “Bonino Pulejo”, 98121 Messina, Italy; (R.D.L.); (D.L.); (T.B.)
| | - Desiree Latella
- IRCCS Centro Neurolesi “Bonino Pulejo”, 98121 Messina, Italy; (R.D.L.); (D.L.); (T.B.)
| | - Tina Balletta
- IRCCS Centro Neurolesi “Bonino Pulejo”, 98121 Messina, Italy; (R.D.L.); (D.L.); (T.B.)
| | - Lory Caccamo
- Neuropsychology Unit, University of Padua, 35121 Padua, Italy;
| | - Giovanni Pioggia
- Institute for Biomedical Research and Innovation, National Research Council of Italy (IRIB-CNR), 98164 Messina, Italy;
| | | | - Rocco Salvatore Calabrò
- IRCCS Centro Neurolesi “Bonino Pulejo”, 98121 Messina, Italy; (R.D.L.); (D.L.); (T.B.)
- Correspondence: ; Tel.: +39-090-6012-3850
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14
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Zwecker M, Heled E, Bluvstein V, Catz A, Bloch A, Zeilig G. Assessment of the unmediated relationship between neurological impairment and health-related quality of life following spinal cord injury. J Spinal Cord Med 2022; 45:293-300. [PMID: 32703106 PMCID: PMC8986250 DOI: 10.1080/10790268.2020.1788884] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
Objective: To assess the unmediated association between neurological impairment and quality of life (QoL) among persons with spinal cord injury (SCI), in the context of both early post-acute and long-term rehabilitation settings.Design: An observational prospective cross-sectional study.Setting: Two neurological rehabilitation centers, specializing in spinal cord injury, within a university hospital.Methods: 156 adults with spinal cord injury in the early post-acute and chronic stages of rehabilitation.Outcome Measures: Participants were categorized into tetraplegia or paraplegia groups based on neurological level of injury, and into complete or incomplete groups based on American Spinal Injury Association (ASIA) Impairment Scale (AIS) score. QoL was assessed by means of the World Health Organization Quality of Life Assessment-BREF (WHOQOL-BREF), Satisfaction with Life Scale (SWLS), Life Satisfaction Questionnaire (LISAT-9), and Personal Well-Being Index (PWI).Results: WHOQOL-BREF and PWI predicted Level of Injury group classification and WHOQOL-BREF predicted Setting group classification. None of the questionnaires differentiated between the Type of Injury groups. At the early post-acute stage of rehabilitation, the QoL scores of participants with tetraplegia and paraplegia did not differ significantly, while significantly higher QoL scores were revealed in paraplegics in the long-term setting group.Conclusions: A direct, unmediated effect of severity of neurological impairment was revealed with the WHOQOL-BREF, which distinguished between the tetraplegia and paraplegia groups, but not between the complete and incomplete injuries. QoL was significantly higher in paraplegia than in tetraplegia following the early post-acute stage of rehabilitation.
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Affiliation(s)
- Manuel Zwecker
- Department of Neurological Rehabilitation, Sheba Medical Center, Tel Hashomer, Israel,Department of Physical and Rehabilitation Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel,Correspondence to: Manuel Zwecker, Sheba Medical Center, Tel-Hashomer 52621, Ramat-Gan, Israel. Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel. E-mail:
| | - Eyal Heled
- Department of Neurological Rehabilitation, Sheba Medical Center, Tel Hashomer, Israel,Department of Behavioral Sciences, Ariel University, Ariel, Israel
| | - Vadim Bluvstein
- Department of Spinal Rehabilitation, Loewenstein Hospital, Raanana, Israel,Department of Physical and Rehabilitation Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Amiram Catz
- Department of Spinal Rehabilitation, Loewenstein Hospital, Raanana, Israel,Department of Physical and Rehabilitation Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ayala Bloch
- The National Institute for the Rehabilitation of the Brain Injured, Tel Aviv, Israel,Department of Behavioral Sciences, Ariel University, Ariel, Israel
| | - Gabi Zeilig
- Department of Neurological Rehabilitation, Sheba Medical Center, Tel Hashomer, Israel,Department of Physical and Rehabilitation Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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15
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Rohn EJ, Hakbijl-van der Wind AJ, Post MWM, Forchheimer M, Charlifue S, New PW, Greve JMD, Tate DG. A cross-cultural mixed methods validation study of the spinal cord injury quality of life basic dataset (SCI QoL-BDS). Spinal Cord 2022; 60:177-186. [DOI: 10.1038/s41393-021-00742-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 12/16/2021] [Accepted: 12/19/2021] [Indexed: 11/09/2022]
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16
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Tasiemski T, Kujawa J, Tederko P, Rubinelli S, Middleton JW, Craig A, Post MWM. Comparison of life satisfaction in persons with spinal cord injury living in 22 countries with different economic status. Arch Phys Med Rehabil 2021; 103:1285-1293. [PMID: 34922932 DOI: 10.1016/j.apmr.2021.11.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 11/17/2021] [Accepted: 11/24/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To analyze and compare life satisfaction (LS) in persons with spinal cord injury (SCI) living in 22 countries participating in the International SCI (InSCI) community survey. The study tested the hypothesis that there are differences in LS across InSCI countries according to the countries' economic status specified as gross domestic product per capita purchased power parity (GDP-PPP). DESIGN Cross-sectional survey. SETTING Community setting (22 countries representing all 6 World Health Organization regions). PARTICIPANTS Persons (N=12,108) with traumatic or non-traumatic SCI aged at least 18 years, living in the community and able to respond to one of the available language versions of the questionnaire. INTERVENTIONS Not applicable. MAIN OUTCOMES Life satisfaction measured by 5 items selected from the World Health Organization Quality of Life Assessment-BREF (WHOQOL-5): satisfaction with overall quality of life, health, daily activities, relationships, and living conditions. LS index was calculated as the mean of these 5 items. RESULTS The highest level of LS was reported by persons with SCI living in USA, Malaysia, and Switzerland (mean range: 3.76-3.80), and the lowest by persons with SCI living in South Korea, Japan and Morocco (mean range: 2.81-3.16). There was a significant cubic association between LS index and GDP-PPP. Regression Trees analysis revealed the main variables differentiating LS index were GDP-PPP and monthly income, followed by time since injury and education. CONCLUSIONS Life satisfaction reported by persons with SCI related mainly to their country economic situation expressed by GDP-PPP and monthly income. The results of this study underscore the need for policy dialogues to avoid inequalities and improve the life experience in persons with SCI.
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Affiliation(s)
- Tomasz Tasiemski
- Department of Adapted Physical Activity, Faculty of Sport Sciences, Poznan University of Physical Education, Poland.
| | - Jolanta Kujawa
- Department of Medical Rehabilitation, Faculty of Health Sciences, Medical University of Lodz, Poland
| | - Piotr Tederko
- Department of Rehabilitation, Faculty of Medicine, Medical University of Warsaw, Poland
| | - Sara Rubinelli
- Department of Health Science and Medicine, University of Lucerne and Swiss Paraplegic Research
| | - James W Middleton
- John Walsh Centre for Rehabilitation Research, Kolling Institute of Medical Research, Royal North Shore Hospital, NSW Australia and Faculty of Medicine and Health, The University of Sydney, Australia
| | - Ashley Craig
- John Walsh Centre for Rehabilitation Research, Kolling Institute of Medical Research, Royal North Shore Hospital, NSW Australia and Faculty of Medicine and Health, The University of Sydney, Australia
| | - Marcel W M Post
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht and De Hoogstraat, Utrecht, The Netherlands; University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, The Netherlands
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17
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García-Rudolph A, Cegarra B, Opisso E, Tormos JM, Saurí J. Relationships Between Functionality, Depression, and Anxiety With Community Integration and Quality of Life in Chronic Traumatic Spinal Cord Injury. Am J Phys Med Rehabil 2021; 100:840-850. [PMID: 33935149 DOI: 10.1097/phm.0000000000001773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The aims of the study were (1) to identify relationships between functional and psychological aspects with community integration and quality of life assessments in people with chronic traumatic spinal cord injury and (2) to analyze clinical and demographic predictors of quality of life dimensions. DESIGN This is an observational cohort study, and correlation coefficients were calculated between the Functional Independence Measure, the Hospital Anxiety and Depression Scale, the Community Integration Questionnaire, and the World Health Organization Quality of Life-BREF dimensions (physical [D1], psychological [D2], social [D3], and environmental [D4]). Quality of life predictors were identified using multiple linear regression analyses. RESULTS Nine hundred seventy-five people with traumatic spinal cord injury assessed since 2007-2020 were included. The Community Integration Questionnaire home integration correlated strongly with the Functional Independence Measure self-care (r = 0.74) and transfers (r = 0.62) for participants with tetraplegia. The specific Hospital Anxiety and Depression Scale items (known as the anhedonia subscale) correlated strongly with D1 (r = -0.65), D2 (r = -0.69), D3 (r = -0.53), and D4 (r = -0.51) for participants with paraplegia and D1 (r = -0.53), D2 (r = -0.61), D3 (r = -0.47), and D4 (r = -0.53) for participants with tetraplegia. The Hospital Anxiety and Depression Scale-depression was the most relevant predictor of D1 (β = -0.61) and D2 (β = -0.76). CONCLUSIONS The Functional Independence Measure transfers and self-care were strongly associated with the Community Integration Questionnaire home integration (in participants with tetraplegia). Anhedonia was strongly related to all four World Health Organization Quality of Life-BREF Scale dimensions, being the Hospital Anxiety and Depression Scale-depression the most relevant predictor of D1 and D2. TO CLAIM CME CREDITS Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME. CME OBJECTIVES Upon completion of this article, the reader should be able to (1) Determine the associations between functional and psychological measures with community integration domains and quality of life from a multidimensional perspective (physical, psychological, social, and environmental) in persons with chronic traumatic paraplegia or tetraplegia living in the community; (2) Identify long-term clinical and demographic predictors of specific quality of life dimensions (e.g., physical and psychological) in persons with paraplegia or tetraplegia living in the community; and (3) Illustrate the strength of the identified associations and the impact of the quality of life predictors to suggest possible specific aspects to be addressed by professionals in clinical practice. LEVEL Advanced. ACCREDITATION The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The Association of Academic Physiatrists designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.
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Affiliation(s)
- Alejandro García-Rudolph
- From the Department of Research and Innovation, Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la UAB, Badalona, Barcelona, Spain; Universitat Autònoma de Barcelona, Bellaterra (Cerdanyola del Vallès), Spain; and Fundació Institut d'Investigació en Ciències de la Salut Germans Trias i Pujol, Badalona, Barcelona, Spain
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18
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Sturm C, Gutenbrunner CM, Egen C, Geng V, Lemhöfer C, Kalke YB, Korallus C, Thietje R, Liebscher T, Abel R, Bökel A. Which factors have an association to the Quality of Life (QoL) of people with acquired Spinal Cord Injury (SCI)? A cross-sectional explorative observational study. Spinal Cord 2021; 59:925-932. [PMID: 34239041 PMCID: PMC8338547 DOI: 10.1038/s41393-021-00663-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 06/24/2021] [Accepted: 06/25/2021] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN Cross-sectional explorative observational study. OBJECTIVES To identify factors which have an association to the self-perceived Quality of Life (QoL) for persons with acquired spinal cord injury (SCI). SETTING Eight specialized SCI-centers in Germany. The GerSCI survey is the German part of the International Spinal Cord Injury Survey (InSCI). METHODS Self-disclosure questionnaire, created from the InSCI group, translated and adapted for Germany. The questionnaire collects a very broad range of data and, and due to its design as a self-report, is particularly suitable for the analysis on QoL. Because of the content, which is binding for all participating states, it allows a direct comparability of the results. Included in Germany were 1479 persons with acquired SCI aged 18 years and older. RESULTS Various factors were identified with high associations to QoL, including changeable and unchangeable ones, such as those of particular importance: pain, sleep problems, sexual dysfunction, age, and time since onset of SCI. Some results confirmed reports of previous studies, others were surprising. CONCLUSION this study provides an important basis for the planned analysis of the InSCI participating countries in the 6 WHO regions. Germany was able to contribute the largest study population. The concrete study design of InSCI allows us to directly compare data and helps us to improve ourselves within the framework of a "learning health system". Medical measures can be orientated towards the found results, in order to ensure the best possible care and support by the therapeutic team, individually adapted to the person, place of residence and impairment.
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Affiliation(s)
- Christian Sturm
- Department of Rehabilitation Medicine, Hannover Medical School, Hanover, Germany.
| | | | - Christoph Egen
- Department of Rehabilitation Medicine, Hannover Medical School, Hanover, Germany
| | | | | | - Yorck B Kalke
- RKU - University and Rehabilitation Clinics Ulm, Ulm, Germany
| | - Christoph Korallus
- Department of Rehabilitation Medicine, Hannover Medical School, Hanover, Germany
| | - Roland Thietje
- Center for spinal injuries, Trauma Hospital Hamburg, Hamburg, Germany
| | - Thomas Liebscher
- Treatment Centre for Spinal Cord Injuries, Trauma Hospital Berlin, Berlin, Germany
| | - Rainer Abel
- SCI Unit, Klinikum Bayreuth GmbH, Bayreuth, Germany
| | - Andrea Bökel
- Department of Rehabilitation Medicine, Hannover Medical School, Hanover, Germany
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19
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Zhao H, Zhang Y, Wang W, Cole S. Contribution of travel participation to social integration and life satisfaction after spinal cord injury. Disabil Health J 2021; 14:101167. [PMID: 34247966 DOI: 10.1016/j.dhjo.2021.101167] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 06/28/2021] [Accepted: 06/30/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Research has found that participation in travel declines for people after spinal cord injury (SCI) because the traumatic injury usually results in impaired physical mobility and sensation, and barriers in the environment make travel more challenging. While travel participation can offer numerous physical, psychological, and emotional benefits, empirical evidence on positive outcomes of travel for people after SCI is scarce in the literature. OBJECTIVE To empirically examine the effects of travel participation on social integration and life satisfaction for people with SCI, along with other personal characteristics including income, self-perceived health status, levels of physical independence, occupational activities, and travel barriers. METHODS Cross sectional data are collected from 250 patients enrolled in a SCI Model System. Hierarchical regression analyses, followed by mediation analyses, are conducted to assess the effects of travel participation on social integration and life satisfaction. RESULTS Travel participation along with occupational activities is shown to significantly impact social integration, with participation in occupational activities partially mediating the relation from travel participation to social integration. The significant effect of travel participation on life satisfaction is fully mediated by social integration. Income and self-perceived health status both significantly contribute to social integration and life satisfaction. CONCLUSIONS Travel participation should be considered as an independent domain that directly impacts the social integration of people with SCI, which in turn enhances their life satisfaction. Systematic interventions with standard protocols for travel-related skill training and assessments procedures are needed for people after SCI.
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Affiliation(s)
- HaoAi Zhao
- School of Public Health, Indiana University, Bloomington, IN, 47405, USA
| | - Ye Zhang
- College of Business, Florida Atlantic University, Boca Raton, FL, 33431, USA
| | - Weixuan Wang
- School of Public Health, Indiana University, Bloomington, IN, 47405, USA
| | - Shu Cole
- School of Public Health, Indiana University, Bloomington, IN, 47405, USA.
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20
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Media portrayal of spinal cord injury and its impact on lived experiences: a phenomological study. Spinal Cord 2021; 59:504-511. [PMID: 33837298 DOI: 10.1038/s41393-021-00630-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 03/26/2021] [Accepted: 03/29/2021] [Indexed: 11/08/2022]
Abstract
STUDY DESIGN This is a qualitative, phenomenological study. OBJECTIVE To investigate media portrayal of spinal cord injury (SCI) as perceived by people with SCI and explore its impact on their lived experience. SETTING People with SCI living in Australia. METHOD Twenty-four participants, recruited using purposive and snowball sampling, completed in-depth, semi-structured interviews. Thematic data analysis followed an inductive, iterative process. RESULTS Participants perceived media portrayed SCI through a narrow lens, describing how people with SCI were 'absent' or portrayed as either 'pity or pedestal'. Participants said media portrayed an inaccurate picture of their lived experience that perpetuated misunderstandings of SCI. This portrayal fostered unreasonable public expectations and assumptions about living with SCI, which presented in the participant's lives as uncomfortable interactions and inappropriate remarks. The impact for participants was a burden to explain SCI and justify what it meant for them. People with SCI would like media to portray a broader, more authentic representation of SCI to improve public understanding and to reduce the negative impact on their lives. CONCLUSION People with SCI perceived a narrow and inaccurate portrayal of SCI in media that overlooked potential quality of life, overshadowed health and life domains they considered important and reinforced the idea that SCI can be overcome. People with SCI were mostly concerned with what was absent in media portrayal of SCI rather than what was present. Action for change lies in promoting information, expanding narratives and raising awareness to diverse abilities of people with SCI.
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21
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Badenhorst M, Verhagen E, Lambert M, van Mechelen W, Brown J. Accessing healthcare as a person with a rugby-related spinal cord injury in South Africa: the injured player's perspective. Physiother Theory Pract 2021; 38:1639-1655. [PMID: 33491535 DOI: 10.1080/09593985.2021.1872753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Background: Rugby carries a risk for serious injuries, including acute spinal cord injuries. The lifetime health consequences of these injuries may be far-reaching.Purpose: In this study, we aimed to describe barriers and facilitators to healthcare and rehabilitation, in individuals with rugby-related spinal cord injuries in South Africa.Methods: This study adopted a pragmatic qualitative approach. Stratified purposive sampling was used to select interviews from players from a variety of socio-economic status and geographical areas for inclusion in this study. The final sample consisted of thirty-one (n = 31) participants. Thematic analysis was used to analyze the data.Results: Participants described long-term, accessible, affordable, quality healthcare and rehabilitation as important contributors to their quality of life. Even though public healthcare is accessible from a cost point of view, quality of care, availability of rehabilitation services and factors such as affordability and availability of adequate transport remain a barrier for lower socio-economic groups.Conclusion: This population was unique, as the support from a dedicated organization enabled participants to overcome some barriers, highlighting the challenges of the healthcare system in maintaining the health of people with spinal cord injuries. Every effort should be made to create equitable access to healthcare and rehabilitation for persons with spinal cord injuries in South Africa.
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Affiliation(s)
- Marelise Badenhorst
- Division of Exercise Science and Sports Medicine, Department of Human Biology, University of Cape Town, Cape Town, South Africa.,Amsterdam Collaboration on Health and Safety in Sports, Department of Public and Occupational Health and Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije University, VU University Medical Center, Amsterdam, Netherlands.,Institute of Sport and Exercise Medicine (ISEM), Division of Orthopaedic Surgery, Department of Surgical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg Hospital, Cape Town, South Africa.,International Olympic Committee (IOC) Research Centre, South Africa, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg Hospital, Cape Town, South Africa
| | - Evert Verhagen
- Division of Exercise Science and Sports Medicine, Department of Human Biology, University of Cape Town, Cape Town, South Africa.,Amsterdam Collaboration on Health and Safety in Sports, Department of Public and Occupational Health and Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije University, VU University Medical Center, Amsterdam, Netherlands.,Australian Centre for Research into Injury in Sport and Its Prevention (ACRISP), Edith Cowan University, Joondalup, Australia
| | - Mike Lambert
- Division of Exercise Science and Sports Medicine, Department of Human Biology, University of Cape Town, Cape Town, South Africa.,Amsterdam Collaboration on Health and Safety in Sports, Department of Public and Occupational Health and Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije University, VU University Medical Center, Amsterdam, Netherlands
| | - Willem van Mechelen
- Division of Exercise Science and Sports Medicine, Department of Human Biology, University of Cape Town, Cape Town, South Africa.,Amsterdam Collaboration on Health and Safety in Sports, Department of Public and Occupational Health and Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije University, VU University Medical Center, Amsterdam, Netherlands.,School of Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, Human Movement Studies Building, St Lucia, University of Queensland, Brisbane, Australia.,School of Public Health, Physiotherapy and Population Sciences, University College Dublin, Woodview House Belfield, Dublin, Ireland
| | - James Brown
- Institute of Sport and Exercise Medicine (ISEM), Division of Orthopaedic Surgery, Department of Surgical Sciences, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg Hospital, Cape Town, South Africa.,International Olympic Committee (IOC) Research Centre, South Africa, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg Hospital, Cape Town, South Africa
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22
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Jörgensen S, Costa Andersson MV, Lexell J. Changes in health-related quality of life among older adults aging with long-term spinal cord injury. Spinal Cord 2020; 59:769-776. [PMID: 33184513 PMCID: PMC8257479 DOI: 10.1038/s41393-020-00579-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 10/22/2020] [Accepted: 10/26/2020] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN Cross-sectional and longitudinal. OBJECTIVES To (i) describe health-related quality of life (HRQoL) and changes over 6 years in older adults aging with long-term spinal cord injury (SCI) and (ii) investigate how changes in HRQoL are associated with age, gender, and injury characteristics. SETTING Community in southern Sweden. METHODS From the initial 123 participants (years 2011-2012) in the Swedish Aging with Spinal Cord Injury Study (SASCIS), 77 individuals (32% women, C1-L3, AIS A-D, median age 66 years, median time since injury 31 years, 30% complete injuries) were assessed 6 years later. HRQoL was rated with the Spinal Cord Injury Quality of Life Questionnaire (SCI QL-23). Associations were investigated using multivariable linear regression analyses. RESULTS The median rating of global QoL (scale range 0-100) was relatively high at both assessments (67 and 83, respectively). There was a large variability in all HRQoL-domains and no significant changes over 6 years. As compared to an AIS D injury, a tetraplegia AIS A-C injury and tetraplegia and paraplegia AIS A-C injuries were associated with positive change in depressive symptoms and global QoL, respectively. CONCLUSIONS Older adults aging with long-term SCI show large variations in all HRQoL-domains and have the potential to maintain a high and stable level of HRQoL over time. Persons with AIS D injuries may need increased attention to mitigate negative changes in depressive symptoms and global QoL. Further studies are needed to identify modifiable factors associated with changes in HRQoL in older adults aging with long-term SCI.
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Affiliation(s)
- Sophie Jörgensen
- Department of Health Sciences, Lund University, Lund, Sweden. .,Department of Rehabilitation Medicine, Skåne University Hospital, Lund, Sweden.
| | | | - Jan Lexell
- Department of Health Sciences, Lund University, Lund, Sweden.,Department of Rehabilitation Medicine, Skåne University Hospital, Lund, Sweden
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23
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Mah C, Noonan VK, Bryan S, Whitehurst DGT. Empirical Validity of a Generic, Preference-Based Capability Wellbeing Instrument (ICECAP-A) in the Context of Spinal Cord Injury. PATIENT-PATIENT CENTERED OUTCOMES RESEARCH 2020; 14:223-240. [PMID: 32981008 DOI: 10.1007/s40271-020-00451-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND Assessing the validity of generic instruments across different clinical contexts is an important area of methodological research in economic evaluation and outcomes measurement. OBJECTIVE Our objective was to examine the empirical validity of a generic, preference-based capability wellbeing instrument (ICECAP-A) in the context of spinal cord injury. METHODS This study consisted of a secondary analysis of data collected using an online cross-sectional survey. The survey included questions regarding demographics, injury classifications and characteristics, secondary health conditions, quality of life and wellbeing, and functioning in activities of daily living. Analysis comprised the descriptive assessment of Spearman's rank correlations between item-/dimension-level data for the ICECAP-A and four preference-based health-related quality of life (HRQoL) instruments, and discriminant and convergent validity approaches to examine 21 evidence-informed or theoretically derived constructs. Constructs were defined using participant and injury characteristics and responses to a range of health, wellbeing and functioning outcomes. RESULTS Three hundred sixty-four individuals completed the survey. Mean index score for the ICECAP-A was 0.761; 12 (3%) individuals reported full capability (upper anchor; score = 1), and there were no reports of zero capabilities (lower anchor; score = 0). The strongest correlations were dominated by items and dimensions on the comparator (HRQoL) instruments that are non-health aspects of quality of life, such as happiness and control over one's life (including self-care). Of 21 hypothesised constructs, 19 were confirmed in statistical tests, the exceptions being the exploratory hypotheses regarding education and age at injury. CONCLUSION The ICECAP-A is an empirically valid outcome measure for assessing capability wellbeing in people with spinal cord injury living in a community setting. The extent to which the ICECAP-A provides complementary information to preference-based HRQoL instruments is dependent on the comparator.
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Affiliation(s)
- Cassandra Mah
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada.,Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada
| | - Vanessa K Noonan
- Praxis Spinal Cord Institute, Vancouver, BC, Canada.,Blusson Spinal Cord Centre, Vancouver, BC, Canada
| | - Stirling Bryan
- Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada.,School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - David G T Whitehurst
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada. .,Centre for Clinical Epidemiology and Evaluation, Vancouver Coastal Health Research Institute, Vancouver, BC, Canada. .,International Collaboration on Repair Discoveries (ICORD), Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
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Davari M, Amani B, Amani B, Khanijahani A, Akbarzadeh A, Shabestan R. Pregabalin and gabapentin in neuropathic pain management after spinal cord injury: a systematic review and meta-analysis. Korean J Pain 2020; 33:3-12. [PMID: 31888312 PMCID: PMC6944364 DOI: 10.3344/kjp.2020.33.1.3] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 12/10/2019] [Accepted: 12/10/2019] [Indexed: 01/07/2023] Open
Abstract
Neuropathic pain after spinal cord injury (SCI) has a significant negative impact on the patients’ quality of life. The objective of this systematic review is to examine the safety and efficacy of pregabalin (PGB) and gabapentin (GBP) in the treatment of neuropathic pain due to SCI. PubMed, the Cochrane Library, Embase, Scopus, and the Web of Science were searched up to December 2018. The reference lists of key and review studies were reviewed for additional citations. The quality of the studies was evaluated using the Cochrane Collaboration’s tools for assessing the risk of bias. A meta-analysis was performed for primary and secondary outcomes. Eight studies were eligible for inclusion. Meta-analysis of PGB vs. placebo showed that PGB was effective for neuropathic pain (standardized mean difference [SMD] = −0.40; 95% confidence interval [CI]: −0.78, −0.01), anxiety (MD = −0.68; 95% CI: −0.77, −0.59), depression (mean difference [MD] = −0.99; 95% CI: −1.08, −0.89), and sleep interference (MD = −1.08; 95% CI: −1.13, −1.02). Also, GBP was more effective than a placebo for reducing pain. No significant difference was observed between the efficacy of the two drugs (MD = −0.37; 95% CI: −1.67, 0.93). There was no significant difference between the two drugs for discontinuation due to adverse events (risk ratio = 3.00; 95% CI: 0.81, 11.15). PGB and GBP were effective vs. placebos in decreasing neuropathic pain after SCI. Also, there was no significant difference between the two drugs for decreasing pain and adverse events.
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Affiliation(s)
- Majid Davari
- Department of Pharmacoeconomics and Pharmaceutical Administration, Tehran University of Medical Sciences, Tehran, Iran
| | - Bahman Amani
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Behnam Amani
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad Khanijahani
- Department of Health Administration and Public Health, John G. Rangos School of Health Sciences, Duquesne University, Pittsburgh, PA, USA
| | - Arash Akbarzadeh
- Department of Biostatistics and Epidemiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Rouhollah Shabestan
- Department of Biostatistics and Epidemiology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Monden KR, Sevigny M, Ketchum JM, Charlifue S, Severe E, Tefertiller C, Berliner J, Coker J, Taylor HB, Kolakowsky-Hayner SA, Morse LR. Associations Between Insurance Provider and Assistive Technology Use for Computer and Electronic Devices 1 Year After Tetraplegia: Findings From the Spinal Cord Injury Model Systems National Database. Arch Phys Med Rehabil 2019; 100:2260-2266. [DOI: 10.1016/j.apmr.2019.06.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 06/13/2019] [Accepted: 06/21/2019] [Indexed: 11/28/2022]
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Latella D, Maggio MG, Manuli A, Militi D, Calabrò RS. Sexual dysfunction in male individuals with spinal cord iniury: What do we know so far? J Clin Neurosci 2019; 68:20-27. [DOI: 10.1016/j.jocn.2019.07.038] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 07/06/2019] [Indexed: 12/31/2022]
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Mapatwana D, Tomita A, Burns JK, Robertson LJ. Predictors of quality of life among community psychiatric patients in a peri-urban district of Gauteng Province, South Africa. Int J Soc Psychiatry 2019; 65:322-332. [PMID: 31035835 DOI: 10.1177/0020764019842291] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Few studies on quality of life (QoL) among people with mental illness have been conducted in South Africa, and none in community dwelling individuals. However, a greater understanding of subjective QoL may inform community-based medical, psychotherapeutic, or social interventions. This study examined the QoL, clinical and sociodemographic characteristics of psychiatric patients attending community mental health clinics in the Gauteng Province of South Africa. METHODS A cross sectional interview-based study was conducted with 121 adult patients attending community psychiatric clinics. To reduce the impact of acute psychiatric symptoms on subjective QoL, only clinically stable patients were included. Sociodemographic details and clinical characteristics were recorded. Subjective QoL was assessed using the World Health Organization QOL-Bref scale (WHOQOL-Bref), and severity of psychiatric illness measured with the Brief Psychiatric Rating Scale, expanded version 4.0 (BPRS-E). RESULTS Just over half of the sample rated their overall QoL as good or very good. Residual psychiatric symptomatology was the strongest predictor of a poor QoL in all four domains of the WHOQOL-Bref. The most severe BPRS scores were for the symptoms of depression, anxiety and somatic concern. Perceived social support significantly predicted a better QoL in the psychological, social relationships and environmental domains. CONCLUSION This study highlights the negative impact of residual psychiatric symptoms on subjective QoL and the importance of social support in enhancing QoL.
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Affiliation(s)
- Dumakazi Mapatwana
- 1 Department of Psychiatry, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Andrew Tomita
- 2 Centre for Rural Health, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa.,3 KwaZulu-Natal Research Innovation and Sequencing Platform (KRISP), Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
| | - Jonathan K Burns
- 1 Department of Psychiatry, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa.,4 Institute of Health Research, University of Exeter, Exeter, UK
| | - Lesley J Robertson
- 5 Department of Psychiatry, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa
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Wang Y, Zhao X, Xie H. Quality of life and its predictors in people with traumatic spinal cord injury in mainland China. Spinal Cord 2019; 57:739-746. [DOI: 10.1038/s41393-019-0279-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Revised: 03/04/2019] [Accepted: 03/12/2019] [Indexed: 11/09/2022]
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Abstract
OBJECTIVES The purpose of this project was to investigate whether there is an association between tinnitus diagnosis and suicide and whether depression and anxiety strengthen that association. Given that tinnitus is the top service-connected disability among U.S. Veterans () and that suicide among Veterans has been occurring at a higher frequency as compared with community suicide rates (), the possible associations between tinnitus and suicide will be explored. Co-occurring physical conditions also will be examined to determine if they increase the risk of suicide in the context of tinnitus. DESIGN Administrative health care data related to Operations Enduring Freedom/Iraqi Freedom/New Dawn (OEF/OIF/OND) were used to identify Veterans who accessed the Veterans Administration (VA) health care system from January 1, 2002, to December 31, 2011. Veterans who were deceased as of December 2011 were identified using the National Death Index (NDI) files. Tinnitus cases were followed until either they were deceased or to the end of the study period. The International Classification of Diseases 9th Revision Clinical Modification (ICD-9-CM) codes were used to identify all conditions and diseases. As per mortality research standards, International Classification of Diseases 10th Revision (ICD-10) codes were used to identify cause of death. RESULTS Of 769,934 OEF/OIF/OND Veterans receiving VA care January 2002 to December 2011, 15% (n =116,358) were diagnosed with tinnitus. Of these Veterans diagnosed with tinnitus, 21% were also diagnosed with depression, another 8% with anxiety, and another 17% with both depression and anxiety. Fifty-four percentage were identified as having tinnitus without depression or anxiety. Among individuals with tinnitus, 41.9% had co-occurring hearing loss. Suicide rates were lower among Veterans with tinnitus than Veterans without tinnitus. Co-occurring diagnoses of mental-health conditions did not significantly increase the risk of suicide. CONCLUSIONS The study results do not confirm clinical and anecdotal reports that tinnitus could be related to suicide among Veterans. However, tenets from rehabilitation psychology suggest that the onset of chronic impairment or disability does not predict an individual's subsequent psychological states; other personal attributes may be more influential. Health care professionals, such as audiologists and psychologists, should be cognizant of the associations between tinnitus and mental health issues and be prepared to address the psychological needs of individuals who have tinnitus.
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Badenhorst M, Brown JC, Lambert MI, Van Mechelen W, Verhagen E. Quality of life among individuals with rugby-related spinal cord injuries in South Africa: a descriptive cross-sectional study. BMJ Open 2018; 8:e020890. [PMID: 29961017 PMCID: PMC6045750 DOI: 10.1136/bmjopen-2017-020890] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 04/10/2018] [Accepted: 06/06/2018] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Rugby-related spinal cord injuries (SCIs) are rare but life altering and traumatic events. Little is known about the long-term consequences and outcomes of players who have sustained these injuries. This study investigated current quality of life (QoL) and factors associated with QoL, among individuals with rugby-related SCI in South Africa, by using the International Classification of Functioning, Disability and Health (ICF) framework. DESIGN Descriptive cross-sectional study. SETTING Rugby-related SCI population of South Africa, as captured in the BokSmart/Chris Burger Petro Jackson Players' Fund database. PARTICIPANTS Ninety (n=90) of the 102 eligible players on the database agreed to participate in the study. MAIN OUTCOME MEASURE The relationship between QoL, as measured with the WHO Quality of Life questionnaire (WHOQOL-BREF) and specific independent variables (demographic information, level of independence and participation in various activities and life roles) was investigated. Variables that were significantly associated with QoL in bivariate analyses were included in multiple linear regression analyses. RESULTS The mean score and SD of the WHOQOL-BREF was 15.1±2.3 arbitrary units. Participation (an ICF framework construct) and income were significantly associated with overall QoL (p<0.001). Participation was the only variable significantly associated with all QoL subdomains (p<0.001). Additionally, number of health concerns, type of healthcare (public vs private) and level of education were significantly associated with various QoL domains (p<0.001). CONCLUSIONS On average, these individuals with rugby-related SCI presented with higher QoL scores than other comparable SCI studies. However, lower levels of participation and income, certain levels of education, increased health concerns and use of public healthcare were associated with lower levels of QoL. Sporting bodies have a responsibility to optimise player welfare, by acting on the modifiable factors associated with QoL.
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Affiliation(s)
- Marelise Badenhorst
- Division of Exercise Science and Sports Medicine, Department of Human Biology, University of Cape Town, Cape Town, Western Cape, South Africa
- Amsterdam Collaboration on Health and Safety in Sports, Department of Public and Occupational Health and Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| | - James Craig Brown
- Division of Exercise Science and Sports Medicine, Department of Human Biology, University of Cape Town, Cape Town, Western Cape, South Africa
- Amsterdam Collaboration on Health and Safety in Sports, Department of Public and Occupational Health and Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| | - Mike I Lambert
- Division of Exercise Science and Sports Medicine, Department of Human Biology, University of Cape Town, Cape Town, Western Cape, South Africa
- Amsterdam Collaboration on Health and Safety in Sports, Department of Public and Occupational Health and Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| | - Willem Van Mechelen
- Division of Exercise Science and Sports Medicine, Department of Human Biology, University of Cape Town, Cape Town, Western Cape, South Africa
- Amsterdam Collaboration on Health and Safety in Sports, Department of Public and Occupational Health and Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
- School of Human Movement and Nutrition Sciences, Faculty of Health and Behavioural Sciences, University of Queensland, Brisbane, Queensland, Australia
- School of Public Health, Physiotherapy and Population Sciences, University College Dublin, Dublin, Ireland
| | - Evert Verhagen
- Division of Exercise Science and Sports Medicine, Department of Human Biology, University of Cape Town, Cape Town, Western Cape, South Africa
- Amsterdam Collaboration on Health and Safety in Sports, Department of Public and Occupational Health and Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
- Australian Centre for Research into Injury in Sport and its Prevention (ACRISP), Federation University Australia, Ballarat, Australia
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Yasami S, Khadem M, Safaei G, Latifi S, Koushki D, Yazdanshenas Ghazwin M. The association between bladder-emptying methods and health-related quality of life among Iranian individuals with spinal cord injury. J Spinal Cord Med 2017; 40:530-537. [PMID: 27104684 PMCID: PMC5815148 DOI: 10.1080/10790268.2016.1173320] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES In this study, we compared the health-related quality of life (HRQoL) among patients with spinal cord injury (SCI) using different bladder emptying methods including normal spontaneous micturition (NSM), micturition with assisted maneuvers (MAM), aseptic intermittent catheterization by patient (IC-P), aseptic IC by an attendant/caregiver (IC-A) and indwelling catheterization. DESIGN Cross-sectional. SETTING Tertiary rehabilitation center. PARTICIPANTS Patients referred to Brain and Spinal Cord Injury Research Center between 2012 and 2014. OUTCOME MEASURES HRQoL was assessed by Short Form Health Survey (SF-36). Hierarchical regression analysis with adjustment for probable confounders (demographic and injury-related variables) was performed to assess the relationship between bladder-emptying method and total SF-36 score. RESULTS Patients with injury at cervical sections had significantly lower scores in domain of physical functioning (PF), physical component summary (PCS) and total score (P: 0.001, <0.0001 and 0.027, respectively). Longer time since injury was associated with better scores of PCS, Mental component summary (MCS) and total score (P: 0.002, <0.0001 and 0.003, respectively). Regression analysis showed that the effect of bladder-emptying method on total score of SF-36 was significant (P < 0.0001) and this relationship remained significant after adjustment for probable confounders in the second step of hierarchical regression analysis (R: 0.923, R2: 0.852, Adjusted R2: 0.847, P < 0.0001). Patients with NSM had the highest scores in SF-36 instrument and individuals with indwelling catheterization had the poorest HRQoL in all domains. CONCLUSION This study shows that the type of bladder management method affects HRQoL significantly in patients with SCI. Intermittent catheterization are recommended to be administered instead of indwelling catheterization to improve HRQoL.
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Affiliation(s)
- Sara Yasami
- Islamic Azad University, Tehran Medical Branch, Tehran, Iran
| | | | - Golsa Safaei
- International Campus Tehran University of Medical Sciences, Tehran, Iran
| | - Sahar Latifi
- Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran,Correspondence to: Sahar Latifi, Brain and Spinal Cord Injury Research Center, Imam Khomeini Hospital, Gharib Street, Keshavarz Boulevard, Tehran, Iran.
| | | | - Manijeh Yazdanshenas Ghazwin
- Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
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Bunketorp-Käll L, Reinholdt C, Fridén J, Wangdell J. Essential gains and health after upper-limb tetraplegia surgery identified by the International classification of functioning, disability and health (ICF). Spinal Cord 2017; 55:857-863. [PMID: 28418396 DOI: 10.1038/sc.2017.36] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 03/03/2017] [Accepted: 03/12/2017] [Indexed: 11/09/2022]
Abstract
STUDY DESIGN A questionnaire-based survey. OBJECTIVES To describe functional gains and health following upper-limb tetraplegia surgery using the International Classification of Functioning, Disability and Health (ICF) as a reference and to explore interconnections across different dimensions of functioning and health. SETTING A specialized center for advanced reconstruction of extremities at Sahlgrenska University Hospital, Gothenburg, Sweden. METHODS Fifty-seven individuals who participated in a satisfaction survey were included in the present study. Besides questions concerned with the respondents' satisfaction with different aspects of surgery, the measures included perceived overall health status (EQ-VAS) and achieved grip strength. Univariate analyses were used to explore interconnections between measures. RESULTS The gains could be subcategorized and linked to the ICF domains 'mobility', 'self-care', 'communication', 'domestic life', and 'community, social and civic life', with 'handling objects' and 'maneuvering a wheelchair' as the most frequently reported gains. The mean EQ-VAS score was 67±22. No significant correlation was shown between grip strength and activity gains, nor between grip strength and perceived overall health. The degree of satisfaction was, however, associated with self-reported overall health among participants. CONCLUSION The functional gains achieved after tetraplegia surgery could be applied to the ICF constructs' body functions/structures and activity with possible implications on participation. The overall health perception was relatively high and could be linked to the degree of satisfaction among participants. Muscle strength is not necessarily transferable to activity performance. This emphasizes the importance of addressing factors other than strength in the post-surgical rehabilitation and assessments.
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Affiliation(s)
- L Bunketorp-Käll
- Department of Orthopaedics, Center for Advanced Reconstruction of Extremities (C.A.R.E.), Sahlgrenska University Hospital, Mölndal, Sweden.,Department of Clinical Neuroscience, Institute for Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - C Reinholdt
- Department of Orthopaedics, Center for Advanced Reconstruction of Extremities (C.A.R.E.), Sahlgrenska University Hospital, Mölndal, Sweden.,Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - J Fridén
- Department of Orthopaedics, Center for Advanced Reconstruction of Extremities (C.A.R.E.), Sahlgrenska University Hospital, Mölndal, Sweden.,Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Swiss Paraplegic Centre, Nottwil, Switzerland
| | - J Wangdell
- Department of Orthopaedics, Center for Advanced Reconstruction of Extremities (C.A.R.E.), Sahlgrenska University Hospital, Mölndal, Sweden.,Department of Orthopaedics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Ferdiana A, Post MWM, King N, Bültmann U, van der Klink JJL. Meaning and components of quality of life among individuals with spinal cord injury in Yogyakarta Province, Indonesia. Disabil Rehabil 2017; 40:1183-1191. [PMID: 28271725 DOI: 10.1080/09638288.2017.1294204] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE Knowledge on the meaning of quality of life in individuals with spinal cord injury in developing countries is limited. This study aims to explore the meaning and components of quality of life for individuals with spinal cord injury in a rural area in Indonesia. METHOD Data were obtained through semi-structured interviews with 12 individuals with paraplegia (8 males, 4 females) aged 24-67 years. Thematic analysis was used to identify themes that constitute meaning and components of quality of life. RESULTS Quality of life was not an easily understood concept, while "life satisfaction" and "happiness" were. Life satisfaction was associated with a person's feeling when achieving goals or dreams and related to fulfillment of needs. Thirteen components of life satisfaction were identified and categorized into five domains as follows: (1) participation: earning income and work, being useful to others, community participation, and having skills and knowledge, (2) social support: social support, social relationship, (3) relationship with God: injury is God's will, praying, (4) independence: being independent, mobility and accessibility, and health, and (5) psychological resources: accepting the condition, maintaining goals and motivation. CONCLUSIONS Social, cultural and religious influences were prominent in the perception of life satisfaction. The measurement of quality of life for individuals with spinal cord injury in Indonesia needs to consider locally perceived meaning and components of quality of life. Implications for Rehabilitation Financial, social and health needs of individuals with spinal cord injury in Indonesia must be immediately addressed. To increase financial independence, rehabilitation professionals should equip individuals with spinal cord injury with adequate self-employment skills. Sociocultural and religious aspects should be considered in the measurement of quality of life.
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Affiliation(s)
- Astri Ferdiana
- a Community and Occupational Medicine, Department of Health Sciences , University Medical Center Groningen, University of Groningen , Groningen , The Netherlands.,b Department of Public Health, Faculty of Medicine , University of Mataram , Mataram , Indonesia
| | - Marcel W M Post
- c Center of Excellence for Rehabilitation Medicine, Brain Center Rudolf Magnus, University Medical Center Utrecht and De Hoogstraat , Utrecht , The Netherlands.,d Department of Rehabilitation Medicine , University Medical Center Groningen, University of Groningen , Groningen , The Netherlands
| | - Nigel King
- e School of Human and Health Sciences, University of Huddersfield , Huddersfield , UK
| | - Ute Bültmann
- a Community and Occupational Medicine, Department of Health Sciences , University Medical Center Groningen, University of Groningen , Groningen , The Netherlands
| | - Jac J L van der Klink
- f Tranzo , School of Social and Behavioral Sciences, Tilburg University , Tilburg , The Netherlands
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Kljajić D, Eminović F, Dopsaj M, Pavlović D, Arsić S, Otašević J. The Impact Of Sports Activities On Quality Of Life Of Persons With A Spinal Cord Injury: VPLIV ŠPORTNIH AKTIVNOSTI NA KAKOVOST ŽIVLJENJA OSEB S POŠKODBO HRBTENJAČE. Zdr Varst 2016; 55:94-101. [PMID: 27284378 PMCID: PMC4845769 DOI: 10.1515/sjph-2016-0014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Accepted: 11/13/2015] [Indexed: 11/29/2022] Open
Abstract
Objectives Studying the quality of life of people with a spinal cord injury is of great importance as it allows the monitoring of both functioning and adaptation to disability. The aim of this study was to determine the difference between persons with a spinal cord injury involved in sports activities and those not involved in sports activities in relation to their quality of life and the presence of secondary health conditions (pressure ulcers, urinary infections, muscle spasms, osteoporosis, pain, kidney problems-infections, calculosis and poor circulation). Methods The study included a total of 44 participants with spinal cord injury-paraplegia of both genders; 26 of them were athletes and 18 were not athletes. The athletes were training actively for the last two years, minimally 2-3 times per week. A specially designed questionnaire, medical documentation and the Spinal Cord Injury Quality of Life Questionnaire (SCI QL-23) were used for research purposes. Chi-square test was used to analyze the differences between the groups, while multiple analysis of variance (MANOVA) was used to determine the differences between the sets of variables. Results Among the participants, the athletes perceived higher quality of life than the non-athletes (male gender p<0.001 and female gender p<0.05). Regarding secondary health conditions, the athletes reported the presence of less pain (p=0.034) and a subjective feeling of better circulation (p=0.023). Conclusion The implementation of sports activities significantly improves quality of life in the population of people with spinal cord injury-paraplegia. However, sports activities only partially affect secondary health conditions.
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Affiliation(s)
- Dragana Kljajić
- Higher Education School of Professional Health Studies, Cara Dušana 254, 11000 Belgrade, Serbia
| | - Fadilj Eminović
- University of Belgrade, Faculty of Special Education and Rehabilitation, Visokog Stevana 2, 11000 Belgrade, Serbia
| | - Milivoj Dopsaj
- University of Belgrade, Faculty of Sport and Physical Education, Blagoja Parovića 156, 11000 Belgrade, Serbia Received: Nov 6, 2014
| | - Dragan Pavlović
- University of Belgrade, Faculty of Special Education and Rehabilitation, Visokog Stevana 2, 11000 Belgrade, Serbia
| | - Sladjana Arsić
- University of Belgrade, Faculty of Special Education and Rehabilitation, Visokog Stevana 2, 11000 Belgrade, Serbia
| | - Jadranka Otašević
- University of Belgrade, Faculty of Special Education and Rehabilitation, Visokog Stevana 2, 11000 Belgrade, Serbia
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Pakpour AH, Kumar S, Scheerman JFM, Lin CY, Fridlund B, Jansson H. Oral health-related quality of life in Iranian patients with spinal cord injury: A case-control study. Injury 2016; 47:1345-52. [PMID: 27085836 DOI: 10.1016/j.injury.2016.03.022] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Revised: 03/15/2016] [Accepted: 03/16/2016] [Indexed: 02/02/2023]
Abstract
INTRODUCTION The study aimed to compare the oral health variables, general, and oral health-related quality of life (QoL), depression, and anxiety between spinal cord injury (SCI) patients and healthy controls and also to determine the key factors related to the oral health-related quality of life (OHRQoL) in the SCI patients. METHODS A total of 203 SCI patients and 203 healthy controls were enrolled. Patients and healthy adults were invited to attend a dental clinic to complete the study measures and undergo oral clinical examinations. OHRQoL was assessed by the 14-item Oral Health Impact Profile (OHIP-14), and the general health-related quality of life (GHRQoL) was evaluated by SF-36. In SCI patients, depression and anxiety were recorded using the Hospital Anxiety and Depression Scale (HADS), while Functional Assessment Measure (FAM) was used to assess dependence and disability. All the subjects were examined for caries which was quantified using the decayed, missing, and filled Teeth (DMFT) index, gingival bleeding index (GI), plaque index, and periodontal status by community periodontal index (CPI). RESULTS The analysis of covariance (ANCOVA) revealed significant differences between the two groups in terms of oral health expressed in DMFT, oral hygiene, and periodontal status, controlled for age, gender, family income, and occupational status (p<0.001). Using the hierarchical linear regression analyses, in the final model, which accounted for 18% of the total variance (F(126.7), p<0.01), significant predictors of OHRQoL were irregular tooth brushing (β=1.23; 95% CI=1.06; 1.41), smoking (β=0.82; 95% CI=0.66; 0.97), dry mouth (β=0.37; 95% CI=-0.65 to 0.10) functional and motor functioning (β=0.32; 95% CI=-0.45 to 0.17), DMFT (β=0.06; 95% CI=0.02; 0.09), CPI (β=0.22; 95% CI=0.04; 0.04), physical component measure of GHRQoL (β=-0.275; 95% CI=-0.42 to 0.13), lesion level at the lumbar-sacral (β=-0.18; 95% CI=-0.29 to -0.06) and thoracic level (β=-0.09; 95% CI=-0.11 to -0.06). CONCLUSION SCI patients had poor oral hygiene practices, greater levels of plaque, gingival bleeding, and caries experience than the healthy controls. In addition, more number of SCI patients had periodontal pockets and dry mouth than the comparative group. SCI patients experienced more depression and anxiety, poor GHRQoL, and OHRQoL than the healthy control group. The factors that influenced OHRQoL in SCI patients were age, toothbrushing frequency, smoking, oral clinical status, depression, physical component of GHRQoL, and level of lesion.
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Affiliation(s)
- Amir H Pakpour
- Social Determinants of Health Research Center, Qazvin University of Medical Sciences, Shahid Bahounar BLV, Qazvin 3419759811, Iran.
| | - Santhosh Kumar
- Population Social Health Research Program, Griffith Health Institute & School of Dentistry and Oral Health, Griffith University, Gold Coast, Australia
| | - Janneke F M Scheerman
- Academic Centre of Dentistry Amsterdam, Department of Preventive Dentistry, ACTA University, Gustav Mahlerlaan 3004, 1081 LA Amsterdam, The Netherlands; Oral Hygiene, Department of Health, Sports & Welfare, Inholland University of Applied Sciences, Amsterdam, The Netherlands
| | - Chung-Ying Lin
- Department of Rehabilitation Sciences, Faculty of Health & Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Bengt Fridlund
- School of Health Sciences, Jönköping University, Jönköping, Sweden
| | - Henrik Jansson
- Center for Oral Health, Department of Natural Science and Biomedicine, School of Health Sciences, Jönköping University, Jönköping, Sweden
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Tavakoli SAH, Kavian M, Bakhsh SC, Ghajarzadeh M, Hamedan MS, Ghazwin MY, Latifi S. Is Level of Injury a Determinant of Quality of Life Among Individuals with Spinal Cord Injury?
A Tertiary Rehabilitation Center Report. Oman Med J 2016; 31:112-6. [PMID: 27168921 DOI: 10.5001/omj.2016.22] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES The role of injury-related variables in determining health-related quality of life (HRQOL) among Iranian persons with spinal cord injury (SCI) has not yet been fully described. In this study, we compared HRQOL between individuals with injury at cervical level and those with injury at thoracolumbar sections and evaluated the discriminating value of injury level as a determinant of HRQOL among Iranian people with SCI. METHODS Individuals with SCI, who were referred to Brain and Spinal Cord Injury Research Center, were invited to participate in this investigation. HRQOL was assessed using the Short Form (SF-36) questionnaire to determine the quality of life (QOL) in eight domains: physical functioning (PF), role limitation due to physical problems (RP), bodily pain (BP), general health (GH), vitality (VT), social functioning (SF), role limitation due to emotional problems (RE), and mental health (MH). RESULTS Ninety patients with paraplegia and 94 quadriplegic patients participated in this investigation. The mean score of PF domain was significantly lower in patients with injury at cervical level (p < 0.0001). There was no significant difference in other domains of SF-36 between subjects with paraplegia and quadriplegia (p = 0.670, 0.700, 0.910, 0.710, 0.730, 0.290 and 0.850 for RP, RE, VT, MH, SF, BP and GH, respectively). Similarly, the mean physical component summary (PCS) score was significantly higher among individuals with injury at thoracolumbar sections (p < 0.0001). The mean mental component summary (MCS) score did not differ between the two groups (p = 0.720). CONCLUSIONS Patients with SCI at the cervical level have similar mental health compared to those with injury at thoracolumbar sections, which shows proper mental adaptability in quadriplegic individuals. Injury level can be used as a major determinant of the physical component of QOL among people with SCI.
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Affiliation(s)
- Seyed Amir Hossein Tavakoli
- Iranian Tissue Bank and Research Center, Imam Khomeini Complex Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Kavian
- Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Mahsa Ghajarzadeh
- Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Imam Khomeini Complex Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Shabany Hamedan
- Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Imam Khomeini Complex Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Manijeh Yazdanshenas Ghazwin
- Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Imam Khomeini Complex Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Sahar Latifi
- Brain and Spinal Cord Injury Research Center, Neuroscience Institute, Imam Khomeini Complex Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Ametefe MK, Bankah PE, Yankey KP, Akoto H, Janney D, Dakurah TK. Spinal cord and spine trauma in a large teaching hospital in Ghana. Spinal Cord 2016; 54:1164-1168. [DOI: 10.1038/sc.2016.57] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Revised: 01/24/2016] [Accepted: 03/28/2016] [Indexed: 12/19/2022]
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Ganesh S, Mishra C. Physical Activity and Quality of Life among Adults with Paraplegia in Odisha, India. Sultan Qaboos Univ Med J 2016; 16:e54-61. [PMID: 26909214 DOI: 10.18295/squmj.2016.16.01.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Revised: 10/05/2015] [Accepted: 10/25/2015] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVES The complete rehabilitation of patients with spinal cord injuries (SCI) comprises both physical and psychosocial factors. This study therefore aimed to assess physical activity and quality of life (QOL) among paraplegic patients with SCI in Odisha, India. METHODS This cross-sectional prospective study was conducted between March 2010 and December 2013. All paraplegic patients treated at the Swami Vivekanand National Institute of Rehabilitation Training & Research in Odisha, India, during the study period who met the inclusion criteria were invited to participate in the study (n = 364). Structured face-to-face interviews were held with participants and QOL and physical activity were assessed using the abbreviated World Health Organization QOL instrument and the Physical Activity Scale for Individuals with Physical Disabilities, respectively. RESULTS A total of 84 people participated in the study (response rate: 23.1%). The mean age was 32.54 ± 10.75 years and 90.5% of the participants were male. Participants had a low mean metabolic equivalent score (18.18 ± 10.68 hours/day). Additionally, low mean scores were noted for the physical health, psychological well-being, social relationships and environment QOL domains (49.76 ± 18.74, 48.57 ± 17.04, 57.88 ± 17.04 and 49.85 ± 17.77, respectively). There was a strong positive association between levels of physical activity and all QOL domains (P <0.050). Physical activity and employment status were significant predictors of all QOL domains (P <0.001). CONCLUSION Low physical activity levels and QOL were noted among the paraplegic subjects. Interventions promoting physical activity and employment may help to improve QOL among this patient group.
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Affiliation(s)
- Shankar Ganesh
- Department of Physiotherapy, Swami Vivekanand National Institute of Rehabilitation Training & Research, Cuttack, Odisha, India
| | - Chittaranjan Mishra
- Department of Physiotherapy, Swami Vivekanand National Institute of Rehabilitation Training & Research, Cuttack, Odisha, India
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Post MWM, Reinhardt JD. Participation and Life Satisfaction in Aged People with Spinal Cord Injury: Does Age at Onset Make a Difference? Top Spinal Cord Inj Rehabil 2015; 21:233-40. [PMID: 26363590 DOI: 10.1310/sci2103-233] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Few studies have reported on outcomes in samples of elderly people with SCI and the impact of the age at onset of SCI is unclear. OBJECTIVE To study levels of participation and life satisfaction in individuals with SCI aged 65 years or older and to analyze differences in participation and life satisfaction scores between individuals injured before or after 50 years of age. METHODS This cross-sectional survey included 128 individuals with SCI who were at least 65 years old. Age at onset was dichotomized as <50 or ≥ 50 years of age. Participation was measured with the Frequency scale of the Utrecht Scale for Evaluation-Participation, and life satisfaction was measured with 5 items of the World Health Organization Quality of Life abbreviated form. RESULTS Participants who were injured before 50 years of age showed similar levels of functional status and numbers of secondary health conditions but higher participation and life satisfaction scores compared to participants injured at older age. In the multiple regression analysis of participation, lower current age, higher education, and having paraplegia were significant independent determinants of increased participation (explained variance, 25.7%). In the regression analysis of life satisfaction, lower age at onset and higher education were significant independent determinants of higher life satisfaction (explained variance, 15.3%). CONCLUSIONS Lower age at onset was associated with better participation and life satisfaction. This study did not reveal indications for worsening participation or life satisfaction due to an accelerated aging effect in this sample of persons with SCI.
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Affiliation(s)
- Marcel W M Post
- Brain Center Rudolf Magnus and Center for Excellence in Rehabilitation Medicine, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, the Netherlands.,Department of Rehabilitation Medicine, Center for Rehabilitation, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.,Swiss Paraplegic Research, Nottwil, Switzerland
| | - Jan D Reinhardt
- Swiss Paraplegic Research, Nottwil, Switzerland.,University of Lucerne, Department of Health Sciences and Health Policy, Lucerne, Switzerland.,Institute for Disaster Management and Reconstruction, Sichuan University and Hong Kong Polytechnic University, Chengdu, Sichuan Province, China
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Li XC, Zhong CF, Deng GB, Liang RW, Huang CM. Efficacy and safety of bone marrow-derived cell transplantation for spinal cord injury: a systematic review and meta-analysis of clinical trials. Clin Transplant 2015; 29:786-95. [PMID: 26115044 DOI: 10.1111/ctr.12580] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/23/2015] [Indexed: 02/06/2023]
Affiliation(s)
- Xiao Chuan Li
- Department of Orthopedics Surgery; Gaozhou People's Hospital; Guangdong China
| | - Cheng Fan Zhong
- Department of Orthopedics Surgery; Gaozhou People's Hospital; Guangdong China
| | - Gui Bin Deng
- Department of Orthopedics Surgery; Gaozhou People's Hospital; Guangdong China
| | - Rong Wei Liang
- Department of Orthopedics Surgery; Gaozhou People's Hospital; Guangdong China
| | - Chun Ming Huang
- Department of Orthopedics Surgery; Gaozhou People's Hospital; Guangdong China
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Lude P, Kennedy P, Elfström ML, Ballert CS. Quality of life in and after spinal cord injury rehabilitation: a longitudinal multicenter study. Top Spinal Cord Inj Rehabil 2014; 20:197-207. [PMID: 25484566 DOI: 10.1310/sci2003-197] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To investigate the changes in quality of life (QOL) in persons with spinal cord injury (SCI) and their close persons during the first 2 years post injury. METHOD Longitudinal multiple sample multiple wave panel design. Data included 292 patients recruited from Austrian British German Irish and Swiss specialist SCI rehabilitation centers and 55 of their close persons. Questionnaire booklets were administered at 6 weeks 12 weeks 1 year and 2 years after injury to both samples. RESULTS Study 1 investigated the WHOQOL-BREF domains in individuals with SCI and found differences mostly in the physical domain indicating that QOL increases for persons with SCI from onset. An effect of the culture was observed in the psychological and environmental domains with higher QOL scores in the German-speaking sample. Study 2 compared individuals with SCI to their close persons and found differences in the physical environmental and social domains over time. The scores on the psychological dimension did not significantly differ between the persons with SCI and their close persons over time. CONCLUSION QOL measured by the WHOQOL-BREF shows that QOL changes during rehabilitation and after discharge. Apart from the physical dimension the persons with SCI and their close persons seem to experience a similar change in QOL. Further longitudinal research is suggested to clarify the mutual adjustment process of people with SCI and their close persons and to explore cultural differences in QOL between English-and German-speaking countries.
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Affiliation(s)
- P Lude
- Swiss Paraplegic Research , Nottwil , Switzerland ; Swiss Paraplegic Centre , Nottwil , Switzerland ; School of Applied Psychology, Zurich University of Applied Sciences , Zurich , Switzerland ; Private Practice , Bad Zurzach , Switzerland
| | - P Kennedy
- Isis Education Centre, Warneford Hospital, University of Oxford , UK ; Department of Clinical Psychology, The National Spinal Injuries Centre, Stoke Mandeville Hospital , Aylesbury, Buckinghamshire , UK
| | - M L Elfström
- Department of Psychology, School of Health, Care and Social Welfare, Mälardalen University , Eskilstuna/Västerås , Sweden
| | - C S Ballert
- Swiss Paraplegic Research , Nottwil , Switzerland
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Tate D, Forchheimer M. Review of cross-cultural issues related to quality of life after spinal cord injury. Top Spinal Cord Inj Rehabil 2014; 20:181-90. [PMID: 25484564 DOI: 10.1310/sci2003-181] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Quality of life (QOL) is a dynamic concept that means different things to different people, both in the general public and within the research community. Because of this, a common definition of QOL has been hard to achieve. This article reviews cross-cultural issues related to QOL research in spinal cord injury (SCI). Many factors influence QOL for persons with SCI, including observable and objective indicators and subjective self-report ones. The World Health Organization's International Classification of Function, Disability and Health is used in this article as a framework to better understand how these factors may influence QOL. A number of important steps are summarized with respect to measurement issues in QOL. A comparison between data from 2 countries (United States and Brazil) using the International SCI QOL Basic Data Set shows similarities in scores and good reliability in the Brazilian sample. Substantial, significant correlations were observed among the SCI QOL Basic Data Set items and the WHOQOL-BREF within the US sample. The article ends with a set of recommendations for the development of cross-cultural measures of QOL for use in the SCI population.
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Affiliation(s)
- Denise Tate
- Department of Physical Medicine and Rehabilitation, University of Michigan , Ann Arbor
| | - Martin Forchheimer
- Department of Physical Medicine and Rehabilitation, University of Michigan , Ann Arbor
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Pressure ulcers in people with spinal cord injury in developing nations. Spinal Cord 2014; 53:7-13. [PMID: 25366536 DOI: 10.1038/sc.2014.179] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2014] [Revised: 09/22/2014] [Accepted: 09/28/2014] [Indexed: 11/08/2022]
Abstract
STUDY DESIGN Literature review. OBJECTIVES To explore the prevalence or incidence, risk factors, and costs of pressure ulcers among individuals with spinal cord injury (SCI), specifically in the context of the developing world. To highlight important targets for intervention and research for pressure ulcer management the world over. SETTING World Bank 'low-income' and 'middle-income' countries with a gross national income per capita <$12 746. METHODS PubMed search. RESULTS SCI-associated pressure ulcers are very prevalent in developing nations; however, reported prevalence and incidence numbers are highly variable. Risk factors for pressure ulcers are similar in developed and developing countries however many of the risk factors are more prevalent in developing nations. CONCLUSION SCI-associated pressure ulcers are common but can be prevented in the developing world. Key targets for interventions include acute care, nurse-to-patient ratios, support surfaces and education.
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Fekete C, Wahrendorf M, Reinhardt JD, Post MWM, Siegrist J. Work stress and quality of life in persons with disabilities from four European countries: the case of spinal cord injury. Qual Life Res 2014; 23:1661-71. [PMID: 24384737 DOI: 10.1007/s11136-013-0610-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/17/2013] [Indexed: 11/30/2022]
Abstract
BACKGROUND Evidence on the adverse effects of work stress on quality of life (QoL) is largely derived from general populations, while respective information is lacking for people with disabilities. We investigated associations between work stress and QoL and the potentially moderating role of socioeconomic circumstances in employed persons with spinal cord injury (SCI). METHODS Cross-sectional data from 386 employed men and women with SCI (≥18 work h/week) from the Netherlands, Switzerland, Denmark, and Norway were analyzed. Work stress was assessed with the 'effort-reward imbalance' (ERI) model and the control component of the 'demand/control' model. QoL was operationalized with five WHOQoL BREF items. Socioeconomic circumstances were measured by years of formal education and perception of financial hardship. We applied ordinal and linear regressions to predict QoL and introduced interaction terms to assess a potential moderation of socioeconomic circumstances. RESULTS Multivariate analyses showed consistent associations between increased ERI and decreased overall QoL (coefficient -1.55, p < 0.001), domain-specific life satisfaction (health -1.32, p < 0.001; activities of daily living -1.28, p < 0.001; relationships -0.84, p = 0.004; living conditions -1.05, p < 0.001), and the QoL sum score (-2.40, p < 0.001). Low job control was linked to decreased general QoL (0.13, p = 0.015), satisfaction with relationships (0.15, p = 0.004), and QoL sum score (0.15, p = 0.029). None of the tested interaction terms were significant. CONCLUSION ERI was consistently related to all indicators of QoL, while associations with job control were less consistent. Our results do not support the notion that unfavorable socioeconomic circumstances moderate the association between work stress and QoL among persons with SCI.
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Hitzig SL, Craven BC, Panjwani A, Kapadia N, Giangregorio LM, Richards K, Masani K, Popovic MR. Randomized trial of functional electrical stimulation therapy for walking in incomplete spinal cord injury: effects on quality of life and community participation. Top Spinal Cord Inj Rehabil 2013; 19:245-58. [PMID: 24244090 DOI: 10.1310/sci1904-245] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND Functional electrical stimulation (FES) therapy has been applied to achieve functional benefits post spinal cord injury (SCI), but little is known about its effects on well-being. OBJECTIVE Using a parallel-group randomized controlled trial (RCT) design (NCT00201968), the effects of a FES-assisted walking intervention on quality of life and participation post SCI were compared to a non-FES exercise program. METHODS Individuals with chronic (≥18 months) incomplete SCI (level C2 to T12, AIS C or D) were randomized to a FES-assisted walking (intervention) or aerobic/resistance training (control) sessions 3 times a week for 16 weeks. The Spinal Cord Independence Measure (SCIM), Satisfaction With Life Scale, Lawton Instrumental Activities of Daily Living, Craig Handicap and Assessment Reporting Technique, Reintegration to Normal Living Index, and perceptions of intervention(s) outcomes were completed at baseline, 4, 6, and 12 months. Repeated measures general linear models were used to assess between-group differences. Perceptions of intervention(s) were analyzed using qualitative content analysis. RESULTS Thirty-four individuals were randomized (17 per group); 27 remained at 12 months. The FES group had a significant increase (P < .01) on SCIM mobility subscores (mean [SD] = 17.27 [7.2] to 21.33 [7.6]) compared to the exercise group (mean [SD] = 19.9 [17.1] to 17.36 [5.5]). Although no significant between-group differences were detected for other outcomes, both groups reported positive gains in well-being from trial participation. CONCLUSIONS The present study provides insight into the perceived benefits acquired by participating in an RCT comparing exercise to FES therapy and serves as a model for pinpointing domains of well-being that could be targeted for assessment in future SCI trials.
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Affiliation(s)
- Sander L Hitzig
- Lyndhurst Centre, Toronto Rehabilitation Institute - University Health Network , Toronto, Ontario , Canada
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Oliveri RS, Bello S, Biering-Sørensen F. Mesenchymal stem cells improve locomotor recovery in traumatic spinal cord injury: systematic review with meta-analyses of rat models. Neurobiol Dis 2013; 62:338-53. [PMID: 24148857 DOI: 10.1016/j.nbd.2013.10.014] [Citation(s) in RCA: 105] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2013] [Revised: 09/13/2013] [Accepted: 10/10/2013] [Indexed: 12/13/2022] Open
Abstract
Traumatic spinal cord injury (SCI) is a devastating event with huge personal and societal costs. A limited number of treatments exist to ameliorate the progressive secondary damage that rapidly follows the primary mechanical impact. Mesenchymal stem or stromal cells (MSCs) have anti-inflammatory and neuroprotective effects and may thus reduce secondary damage after administration. We performed a systematic review with quantitative syntheses to assess the evidence of MSCs versus controls for locomotor recovery in rat models of traumatic SCI, and identified 83 eligible controlled studies comprising a total of 1,568 rats. Between-study heterogeneity was large. Fifty-three studies (64%) were reported as randomised, but only four reported adequate methodologies for randomisation. Forty-eight studies (58%) reported the use of a blinded outcome assessment. A random-effects meta-analysis yielded a difference in behavioural Basso-Beattie-Bresnahan (BBB) locomotor score means of 3.9 (95% confidence interval [CI] 3.2 to 4.7; P<0.001) in favour of MSCs. Trial sequential analysis confirmed the findings of the meta-analyses with the upper monitoring boundary for benefit being crossed by the cumulative Z-curve before reaching the diversity-adjusted required information size. Only time from intervention to last follow-up remained statistically significant after adjustment using multivariate random-effects meta-regression modelling. Lack of other demonstrable explanatory variables could be due to insufficient meta-analytic study power. MSCs would seem to demonstrate a substantial beneficial effect on locomotor recovery in a widely-used animal model of traumatic SCI. However, the animal results should be interpreted with caution concerning the internal and external validity of the studies in relation to the design of future clinical trials.
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Affiliation(s)
- Roberto S Oliveri
- Cell Therapy Facility, The Blood Bank, Department of Clinical Immunology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
| | - Segun Bello
- The Nordic Cochrane Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Fin Biering-Sørensen
- Department of Spinal Cord Injuries, Copenhagen University Hospital Rigshospitalet and Glostrup Hospital, Copenhagen, Denmark
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