Long term outcome of functional independence and quality of life after traumatic SCI in Germany

Abstract

Study design Multicenter observational study. Objective To describe the long-term outcome of functional independence and quality of life (QoL) for individuals with traumatic and ischemic SCI beyond the first year after injury. Setting A multicenter study in Germany. Methods Participants of the European multicenter study about spinal cord injury (EMSCI) of three German SCI centers were included and followed over time by the German spinal cord injury cohort study (GerSCI). Individuals’ most recent spinal cord independence measure (SCIM) scores assessed by a clinician were followed up by a self-report (SCIM-SR) and correlated to selected items of the WHO short survey of quality of life (WHO-QoL-BREF). Results Data for 359 individuals were obtained. The average time passed the last clinical SCIM examination was 81.47 (SD 51.70) months. In total, 187 of the 359 received questionnaires contained a completely evaluable SCIM-SR. SCIM scores remained stable with the exception of reported management of bladder and bowel resulting in a slight decrease of SCIM-SR of −2.45 points (SD 16.81). SCIM-SR scores showed a significant correlation with the selected items of the WHO-QoL-BREF (p < 0.01) with moderate to strong influence. Conclusion SCIM score stability over time suggests a successful transfer of acquired independence skills obtained during primary rehabilitation into the community setting paralleled by positively related QoL measurements but bladder and bowel management may need special attention.

The role of mindfulness in quality of life of persons with spinal cord injury: a cross-sectional study

“…These secondary complications and comorbidities further increase the frequency and duration of hospitalization [ 50 ], decreasing the QOL [ 14 , 15 , 51 ]. The present finding regarding the effect of functional limitation on QOL is not consistent with the literature suggesting the functional limitation’s negative impact on QOL [ 4 , 20 , 21 ]. A significant correlation between functional limitation and QOL in the present study explains that other factors in the model (e.g., pain, mindfulness, age, level of injury) might have attenuated the effect of functional limitation on QOL.…”

“…The individuals’ age [ 4 , 6 , 9 , 10 ], employment status [ 11 – 13 ], education status [ 14 , 15 ], marital status, and gender [ 16 ] have been reported to impact QOL among PwSCI. Similarly, level of injury [ 6 , 10 , 17 ], pain intensity [ 18 , 19 ], hospitalization, and functional limitation [ 4 , 6 , 20 , 21 ] were found to be associated with QOL. However, the effect of some sociodemographic and injury-related factors on QOL is still inconclusive [ 4 , 22 , 23 ].…”

Bowel Management in Patients With Chronic Spinal Cord Injury: A Cross-Sectional Survey

“…In a questionnaire-based study by Lynch et al from New Zealand [ 8 ], fecal incontinence affected the quality of life in 62% of SCI respondents compared with 8% of controls. Möller et al in their multicentric study from Germany [ 9 ] demonstrated a successful transfer of acquired independence skills obtained during primary rehabilitation into the community setting paralleled by positively related quality of life measurements; however, bladder and bowel management may need special attention. Bowel dysfunction after SCI mostly presents in two distinct entities [ 10 ]: upper motor neuron (UMN) bowel syndrome by injury above the conus medullaris and lower motor neuron (LMN) bowel syndrome caused by injury at the conus medullaris and cauda equina.…”