Recovery of Biopsychosocial Functions Following 15 Years after Spinal Cord Injury

Abstract

BackgroundDuring recent years, intensively changing people's living habits, associated with changes in the country's social, economic, and demographic situation, are increasing the risk of traumatism; therefore, spinal cord injury (SCI) are more common especially among young people. The incidence of SCI in developed European countries is increasing: an average of 25.5 new SCI cases per million population per year (95% CI: 21.7 to 29.4), with frequency in different countries ranging from 2.1 to 130.7 new SCI cases each year [1,2]. The incidence of SCI in Lithuania is 24 new SCI cases per million per year [3][4][5]. Many studies [6][7][8] have confirmed that SCI more often occurs among young and physically active men aged from 29.7 to 35.2 years on average (from 72.1% to 85.3%). In Lithuania, two-thirds of people with SCI are younger than 30 years, and the ratio of men to women is 3.2:1.0 [9]. The prevalence of traumatic SCI ranges from 74.4% to 82.0% of all SCI cases, and of them, 49.4% to 62.1% are caused by motor transport accidents; 26.7% to 43.1%, by falls or jumps into water; and 16.8% to 22.3%, sports injuries [10].SCI causes a loss of biopsychosocial functions: altered body functions, decreased physical capacity and disrupted mobility, functional independence in daily life and social activities [1]. After SCI for recovery of biopsychosocial functions, comprehensive multidisciplinary rehabilitation as a biopsychosocial model is necessary, which is more focused on improving the physical status and physical capacity as well as developing functional independence and mobility skills. During re-rehabilitation inpatient programs (1-3 years after SCI), efforts are made to maintain the existing skills and to improve functioning, physical activity, participation in daily living activities, and successful social integration [11,12]. However, during this period, psychological and social problems and obstacles emerge as people with SCI often distance themselves from society [13]. In the long-term period, physical strength, endurance, and functional skills of people with SCI slightly improve, and functioning and socialization processes improving each year after SCI by naturally engaging and participating in everyday life show capabilities to adapt to the environment, greater involvement in different activities and better outcomes although it often depends on the surrounding environment [14,15].Other authors [16,17] discuss about associations between functioning in daily life of this population and social interactions as well as relationships with loved ones (friends, family, acquaintances), community support by ensuring training of independent living skills and adjustment to a new life, continuity and integration of selfrealization in the community [18]. It should be noted that depending on successfully solved problems, favorable social conditions, social support, and state policy during the primary rehabilitation program Abstract Background: Spinal cord injury (SCI) causes the loss of biopsychosocial functions, body dy...