Impact of Spinal Cord Dysfunction and Obesity on the Health-Related Quality of Life of Children and Adolescents

Abstract

Objectives: The objectives of this study were: (1) to compare the health-related quality of life (HRQOL) of children and adolescents with mobility impairments due to spinal cord injury (SCI) and spina bifida (SB) to the HRQOL of children and adolescent controls without mobility impairments (CTRL); and (2) to examine the impact of of obesity on the HRQOL of these subjects.Methods: The Pediatric Quality of Life Inventory (PedsQL) was administered to 42 SB, 71 SCI and 60 ablebodied subjects who were 8-20 years of age. Subjects were categorized as obese if their BMI exceeded the 95th percentile for age. Twenty-one CTRL, 26 SB and 26 SCI subjects were obese.Results: The SCI and SB subjects had significantly lower subscores than the control subjects on the physical (p , 0.001), emotional (p , .01), social (p , .001), and school (p , .001) domains of the PedsQL. The obese (CTRL) group had lower subscores on the physical (p , 0.001), social (p , 0.001), and psychosocial (p , 0.001) domains of the PedsQL as compared to the non-obese CTRL group, while there were no significant differences in subscores from the emotional and school domains. In contrast to the subjects without mobility impairment, there were no significant differences between the sub-scores of the obese and non-obese subjects with spinal cord dysfunction secondary to SCI or SB. The mean total PedsQL score of the non-obese control group (87.7 6 2.1) was significantly higher than the obese control group (75.2 6 3.4, p , 0.02), which in turn was significantly higher than the SCI group (63.7 6 2.2, p , 0.02), and the SB group (63.0 6 2.2, p , 0.02). Conclusion:Patients with SCI and SB have significantly lower HRQOL than children and adolescents without mobility impairments. Whereas obesity significantly reduces the quality of life scores of adolescents without mobility impairments, it has no significant incremental effect on subjects with SCI or SB.

Assessing health-related quality of life in children with spina bifida

“…9,12,14,18,20,22,23,25 Meanwhile, other studies have noted that HRQOL in spina bifida patients is unrelated to age, functional ability, lesion level, sex, obesity, or sexual function. 1,8,13,14,15,20 Our investigation of several variables that were applicable to the entire clinic population found none that correlated with HRQOL score. These variables included whether the survey was completed by patient or caregiver, type of insurance, and patient sex and race.…”

Spinal Clinic for Obese Out-Patient Project (SCOOP)—A 1 Year Report

“…Indeed, for long-term SCI individuals, morbidity and mortality from CVD have now exceeded those caused by renal and pulmonary conditions and CVD has become the primary cause of death [7]. In addition, overweight SCI patients are at a higher risk of developing pressure ulcers [8], increasing the difficulties in managing daily life with SCI [9].…”

Cognitive Abilities of Pre- and Primary School Children with Spina Bifida in Uganda

“…In Uganda an estimated 1,400 children are born with spina bifida annually (Warf, Wright, & Kulkarni, 2011). The majority of these have some degree of paralysis, which affects mobility as well as bowel and bladder control (Abresch et al, 2007;Andren & Grimby, 2000;Danielsson et al, 2008;Northrup & Volcik, 2000;Verpoorten & Buyse, 2008), and 66% develops hydrocephalus (Warf & Campbell, 2008). In hydrocephalus the natural circulation of cerebrospinal fluid (CSF) in the brain is obstructed and fluid accumulates.…”