Adjustment to traumatic spinal cord injury. A longitudinal study of self-reported quality of life

Stensman, Richard

doi:10.1038/sc.1994.68

Cited by 92 publications

(73 citation statements)

References 8 publications

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“…We found pain severity to be a significant predictor of functioning on all measures. This is consistent with previous studies that have demonstrated the major impact of pain on physical functioning [14][15][16] and the association between pain and mood dysfunction. 16 In this SCI population the effect of pain on cognitive function may be owing to a combination of factors that are secondary to the presence of pain, such as sleep disturbance and increased use of medications.…”

Section: Discussionsupporting

confidence: 93%

“…For example, chronic pain is one of the most frequently recorded reasons for reduced QOL following SCI and may have more impact on QOL scores than the extent of damage associated with SCI. [14][15][16][17] Pain severity was one of the few factors that predicted well-being in a large study of 1668 persons with tetraplegia. 18 However, an Australian survey which examined QOL for both SCI and those with traumatic brain injuries did not identify pain as one of the 10 key issues affecting QOL.…”

Section: Introductionmentioning

confidence: 99%

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Impact of spinal cord injury on self-perceived pre- and postmorbid cognitive, emotional and physical functioning

et al. 2007

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Study Design: Cross-sectional study with repeated measurements. Objectives: To examine the patient's perspective of the impact of spinal cord injury (SCI) on physical, cognitive, emotional function, and quality of life (QOL). Setting: Australia. Methods: A sample of 63 patients with SCI, 32 of whom had recent injuries, and 31 with established injuries were administered the Ruff Neurobehavioral Inventory to examine patients' subjective evaluation of pre-and post-injury functioning. Current happiness levels were also evaluated using the Subjective Happiness Scale. A follow up assessment was performed 6 months later to examine changes over time. Results: A significant difference was found between perception of pre-and postmorbid function on composite Cognitive (t ¼ 5.99, df ¼ 62, Po0.001), Physical (t ¼ 11.56, df ¼ 62, Po0.001), and QOL (t ¼ 7.16, df ¼ 62, Po0.001) scales and on several of the Emotional subscales including anxiety, paranoia and suspicion, and substance abuse (Po0.001). A series of hierarchical regression analyses indicate that post-SCI pain was a significant predictor of: cognitive (R 2 ¼ 0.20, Po0.001); emotional (R 2 ¼ 0.13, Po0.004); and of QOL (R 2 ¼ 0.22, Po0.001) functioning. With the exception of a decrease in happiness (Po0.01), there were no significant changes in any measures over the 6 month time period. Conclusions: There are significant changes in patients' perceptions of physical and cognitive functioning, and of QOL before and after SCI and some aspects of emotional functioning. Pain has a significant adverse effect on functioning. Happiness decreased slightly in the 6 months between surveys.

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Impact of spinal cord injury on self-perceived pre- and postmorbid cognitive, emotional and physical functioning

et al. 2007

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“…These chronic changes can lead to detrusor fibrosis and prevent the restoration of useful bladder function despite successful axonal regeneration and bladder recentralization. 26 Urodynamics and clinical studies of our patients before and 12 months after operation showed that reflex of voiding, EMG of external urethral sphincter, diary of micturition and quality of life 27 were increased.…”

Section: Discussionmentioning

confidence: 72%

Reinnervation of the neurogenic bladder in the late period of the spinal cord trauma

Livshits

Catz²,

Folman

et al. 2004

Spinal Cord

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Study design: Intercostal nerve to spinal nerve root anastomosis in chronic spine-injured patients. Objectives: To analyze the effectiveness of neurogenic bladder reinnervation in spinal cordinjured patients through artificial creation of sprouting (intercostal nerve to spinal nerve root anastomosis). Setting: Center of Neurosurgery, Moscow, Russia. Operations were performed by Professor A Livshits. (At present, Professor A Livshits is working at the Spinal Care Unit, Meir General Hospital, Kfar Saba, Israel.) Methods: A total of 11 patients with spinal cord injury of the L1 level were operated on in the late (chronic) stage. The neurological status and urodynamics were investigated before and 12 months after operation. A laminectomy from T11 to L3 was performed. Next, a neurolysis of the 11th and 12th intercostal nerves was carried out, at a distance of 20-21 cm, and transferred to the vertebral canal. The S2-S3 roots were then cut in their proximal portion and anastomosed end-to-end to the intercostal nerves. The results of urodynamic studies were calculated by the Wilcoxon signed rank test for comparison before and 12 months after operation. Results of urodynamic studies: Bladder capacity (ml) before operation -489779, after operation -350739, urine volume (ml) before -18.2717, after -306.4739.8, residual urine (ml) before -459799.4, after -50711.8. Detrusor tone (rel. units) before -0.671.5, after 1.270.2; voiding pressure (cmH 2 O) before -4.475.2, after -30.574.9. Force of detrusor contraction before -575.8, after -32.875.5. Sphincter resistance (cmH 2 O) before -6.573.8, after -21.174.2. Significant improvements in bladder function were observed during the 10th to 12th postoperative months. Restoration of reflex voiding occurred in all patients; in eight of the 11 paresthesic in the groin and scrotum and reappearance of the bulbocavernous, anal and cremasteric reflexes were noted. Conclusion: These results suggest that a restitutive process occurs in the bladder under novel conditions of its nerve supply provided by the intercostal nerve and by new connections established between it and the bladder nerves. Spinal cord lesions that might benefit from nerve crossover surgery would be located at the conus, so functional intercostal nerves could be connected to sacral roots to bypass the injury in an attempt to restore central connections to the bladder.

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“…For example, pain has been shown to signi®cantly in¯uence QOL for persons with SCI. 33 Documented research has not demonstrated consistent results with respect to the magnitude of the relationship between QOL and activity. Signi®cant correlations have been documented between QOL and function in daily activities, 26,29 however other studies 16,32 Di erences in the measures used to evaluate functional independence and QOL could explain the varied results.…”

Section: External Componentmentioning

confidence: 98%

“…The ability to cope with pain has been shown to a ect adjustment to spinal cord injury and QOL. 33 The item referring to`doing things for fun' has been discussed with respect to the limitations of ®nancial resources a ecting participation. 13 The notion of life situations presented here is somewhat distinct and may re¯ect issues and life challenges more speci®c to persons with SCI.…”

Section: Structural Component Domainsmentioning

confidence: 99%

Measuring quality of life of persons with spinal cord injury: external and structural validity

May

Warren

2002

Spinal Cord

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Study design: Measurement evaluation of the external and structural components of validity. Objectives: To examine the relationships between quality of life (QOL) as measured by the spinal cord injury (SCI) version of the Ferrans and Powers Quality of Life Index (QLI) and other constructs represented within the model of disablement; and to examine the domains and scoring model of the QLI by exploring item and overall score/section score relationships. Setting: Community, Alberta, Canada. Methods: A convenience sample of 98 individuals with SCI living in the community completed the QLI and measures representing the model of disablement including the ASIA motor index, Functional Independence Measure, Reintegration to Normal Living index, Rosenberg's Self-Esteem Scale and Rotter's Internal ± External Locus of Control scale. Results: Four of the ®ve a priori hypotheses were supported. Locus of control was not signi®cantly related to QOL as expected. Factor analysis resulted in a ®ve-factor structure that di ered from the four-domain model of the original QLI. Scoring relationships indicated that both the satisfaction and importance ratings contribute to the overall score, although not equally. Conclusion: There is support for the external component of validity although further examination regarding locus of control for persons with SCI is warranted. The structural component of validity requires further investigation to elucidate the domains of the SCI version of the QLI and the contribution of the importance scores.

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Adjustment to traumatic spinal cord injury. A longitudinal study of self-reported quality of life

Cited by 92 publications

References 8 publications

Impact of spinal cord injury on self-perceived pre- and postmorbid cognitive, emotional and physical functioning

Impact of spinal cord injury on self-perceived pre- and postmorbid cognitive, emotional and physical functioning

Reinnervation of the neurogenic bladder in the late period of the spinal cord trauma

Measuring quality of life of persons with spinal cord injury: external and structural validity

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