Need for a comprehensive epidemiologic study of spinal cord injury in Poland: findings from a systematic review

Abstract

Objective: To review and assess the quality of available epidemiologic data of spinal cord injury (SCI) in Poland in the context of general International Classification of Functioning (ICF) domains and to answer the question whether there is a need for a comprehensive epidemiologic study of SCI in Poland. Methods: Databases Medline, Embase and Polish Medical Bibliography were searched using keywords 'spinal cord injury', 'paraplegia', 'tetraplegia' and 'Poland'. Inclusion criteria: studies on humans, original papers, publication in 1979 or later. Case reports and studies with unclear inclusion criteria or performed on a population other than Polish were excluded. Full texts were reviewed for data on incidence, prevalence, etiology, mortality, natural history and outcome of comprehensive treatment. Quality of studies was assessed according to the modified Downs and Black criteria. The ICF model was applied to group the studies according to the ICF components. Results: Out of 536 identified papers, 224 articles were extracted and reviewed. Mean quality score was 11.04 points based on a 28-grade scale. Body functions and structures were assessed in 81.6%, activities in 22.4%, participation in 14.8%, environmental factors in 15.2% and personal factors in 47% of the studies reviewed. Conclusion: Current epidemiologic data on SCI in Poland are insufficient and biased toward biomedical aspects. There is a need to develop a long-term research strategy for SCI in Poland in the form of a comprehensive cohort study. Spinal Cord (2013) 51, 802-808; doi:10.1038/sc.2013.105; published online 17 September 2013Keywords: spinal cord injury; Poland; paraplegia; tetraplegia INTRODUCTIONMany people with disabilities worldwide, including those in Poland, do not have equal access to health care, education, employment and experience exclusion from activities of everyday life. 1 On 6 September 2012, Poland ratified the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD), which aims to ensure the equality of rights and opportunities for persons with disabilities. 2 Disability associated with spinal cord injury (SCI) is serious and can last a lifetime. All organs and systems below the level of lesion can be affected. In addition to the loss of sensory and somatic functions, a wide range of other functional and structural problems is observed in individuals with SCI. These may include cardiovascular and respiratory problems, spasticity, neurogenic bladder and bowel, sexual dysfunction and neurogenic pain. SCI also increases the risk of respiratory and urinary complications, pressure sores, gastrointestinal bleeding, osteoporosis, male infertility, diabetes mellitus, ischemic heart disease, depression and suicide. SCI affects health-related quality of life and is associated with increased preterm mortality. [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] Health and social care expenditure related to SCI varies according to severity of injury, but is generally high. Inpatient rehabilitation appears to be ...

Results of a long-term uniform system of neurorehabilitation in patients with incomplete thoracic spinal cord injury

“…In Poland, over 200 people suffer from spinal cord injury annually, a number that is even greater worldwide [1]. It concerns more often men up to 40 years of age, and the most common cause is a transport or swimming accident [2].…”