Gunshot wounds were the main cause of SCI in our population, comprising mostly male individuals with thoracic injury, resulting in complete SCI. Data show a high incidence of SCI in young adults owing to violence in Brazil.
Introduction: Increased demands on the upper extremities (UE) have been associated with a higher occurrence of musculoskeletal pain in individuals with spinal cord injury (SCI). Study design: This is a cross-sectional retrospective study. Objective: The aim of this study was to characterize SCI subjects with musculoskeletal pain in the UE and to determine which variables could predict musculoskeletal pain in these individuals. Setting: The study was conducted in SARAH Network of Rehabilitation Hospitals, Brasília, Brazil. Methods: Five hundred sixty-four electronic medical records were investigated through a retrospective, exploratory and descriptive analysis to identify individuals with UE pain. A logistic regression model was applied to estimate (odds ratios) whether gender, age, the level of injury, severity of injury, time of injury, body mass index, type of mobility and locomotion aid could predict the occurrence of musculoskeletal pain. Results: The prevalence of musculoskeletal pain in the UE was 27.7%. The odds of having musculoskeletal pain were two times higher among woman and tetraplegic patients; those over 41 years of age had twice the frequency of pain than did those o24.7 years; o1 year of injury was a predictor of musculoskeletal pain, compared with the other quartiles (1.1-2.8, 2.9-6.8 and 6.9+ years of injury). There were no differences between the wheelchair and ambulatory individuals. INTRODUCTIONIndividuals with spinal cord injury (SCI) have shown a better quality of life and, consequently, greater survival than they did a few decades ago. The global prevalence of SCI is estimated to be~236-1009 cases per one million individuals per year. The estimated incidence in North America is 39 cases per million per year. 1 As a consequence of lower extremity weakness or paralysis after an SCI, the upper extremities (UE) are used for daily living activities and to aid in locomotion. The increased use of the UE has been associated with a higher occurrence of musculoskeletal pain in this population, with a prevalence ranging from 5 to 78%, based on cross-sectional surveys and out-patient evaluations. [2][3][4] Dalyan et al., 5 used a questionnaire to assess the interference of UE pain in the activities of daily living. Of the 130 subjects analyzed, 58.5% reported pain and 28% reported decreased independence. The pain interfered with activities such as transfer skills, pressure relief and wheelchair mobility, which require UE loading and/or repetitive movements. [4][5][6][7][8] An epidemiological, etiological and pathomechanical literature review showed that complaints of pain in the shoulder are more common in tetraplegics, patients with complete injuries, females and individuals with advanced age. Some risk factors are include the time
Study Design: Retrospective cohort. Objectives: The aim of this study was to evaluate the correlation between the level and completeness of the injury with Functional Independence Measure (FIM) score and the validity and responsiveness of the FIM in Brazilian individuals with spinal cord injury admitted to rehabilitation. Setting: SARAH Network of Rehabilitation Hospitals, Brasília, Brazil. Methods: A total of 218 patients with spinal cord injury admitted for rehabilitation in 2006 was included in this study. The validity was assessed as the ability of the FIM to discriminate different levels of disability (cervical, thoracic and lumbar) at admission and the responsiveness was obtained by analyzing admission and discharge data for each of the three injury groups. Results: Total FIM score, motor FIM score and each of the 13 items were valid when comparing three groups and comparing groups two by two, except the items 'eating' and 'grooming' among paraplegics, and 'stairs' at cervical and thoracic levels. The scale was not responsive to the five cognitive items, 'stairs' and 'eating', among paraplegics, or 'grooming', 'bathing' and 'dressing upper body' in lumbar level patients. The patient difficulty in performing tasks can vary among populations. Therefore, the continuous evaluation process of psychometric characteristics is important to validate the use of the instrument in different contexts.
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