Ambulation and complications related to assistive devices after spinal cord injury

Saunders, Lee L.; Krause, James S.; DiPiro, Nicole D.; Kraft, Sara; Brotherton, Sandra S.

doi:10.1179/2045772312y.0000000082

Cited by 29 publications

(30 citation statements)

References 32 publications

(34 reference statements)

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“…Specifically, many people with an incomplete SCI may be unaware of, or unconvinced of, the pain-relief benefits associated with an active lifestyle [30]. Poor affective attitudes may be born out of apathy for the chronic pain often experienced by those with an incomplete SCI [7] and a fear that daily pain could be exacerbated by physical activity. Furthermore, given pain is often interlinked with fatigue [31], and with ambulant day-to-day living considered more energy-intensive than wheelchair-based living [9,10], LTPA may be perceived as both burdensome and unnecessary.…”

Section: Discussionmentioning

confidence: 99%

“…As a barrier, LTPA could aggravate feelings of pain: I think there's always, anything I talk about in reference to spinal injury or activity there has to be reference to the pain, because that's been a constant factor and it's never been something that I've been able to totally control As described above by Tom (L1, incomplete), an inability to properly manage ongoing pain detracted from his efforts to be regularly active. Although pain as a barrier to LTPA is likely to be equally relevant to wheelchair users, it may be accentuated in the ambulant population due to the pain aggravation and fatigue accumulation associated with walking and standing [7].…”

Section: Experiencing Chronic Painmentioning

confidence: 99%

“…For instance, compared to wheelchair-reliant individuals with SCI, those who ambulate report greater fatigue, pain, and pain interference in their daily lives [7]. These symptoms could undermine ambulators' sense of perceived control over their ability to be physically active on a routine basis [8].…”

mentioning

confidence: 99%

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Psychosocial factors associated with physical activity in ambulatory and manual wheelchair users with spinal cord injury: a mixed-methods study

Ginis

Papathomas

Perrier

et al. 2015

Disability and Rehabilitation

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Section: Discussionmentioning

confidence: 99%

Section: Experiencing Chronic Painmentioning

confidence: 99%

See 1 more Smart Citation

Psychosocial factors associated with physical activity in ambulatory and manual wheelchair users with spinal cord injury: a mixed-methods study

Ginis

Papathomas

Perrier

et al. 2015

Disability and Rehabilitation

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“…6,7 Many ambulatory persons with SCI use assistive devices to help with walking. 8 Even though these devices can aid with ambulation, there is evidence that certain devices may impede balance and increase risk of falls. 9 Brotherton et al 10 identified risk of falls (an unplanned, unexpected contact with the supporting surface) among persons with ambulatory SCI, finding that 75% reported at least 1 fall in the previous year.…”

mentioning

confidence: 99%

Risk of Fall-Related Injuries among Ambulatory Participants with Spinal Cord Injury

Saunders

DiPiro

Krause

et al. 2013

Topics in Spinal Cord Injury Rehabilitation

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Background: With medical and rehabilitation advances, many people are able to regain or maintain ambulation after spinal cord injury (SCI). However, those who are ambulatory may be at increased risk for falls. Objective: To assess the relationships between walking devices and behaviors, including alcohol use, prescription medication use, and exercise, with falls among persons with SCI who are ambulatory. Methods: A total of 515 adults with chronic SCI who were able to ambulate provided self-report of their use of assistive devices for ambulation, prescription medication use, alcohol use, exercise, and falls resulting in injury (FRI). Results: At least 1 FRI was reported by 20.3% of participants in the past year. Ambulatory participants who reported using a wheelchair as their primary mode of mobility were less likely to have an FRI than those who reported walking more than using a wheelchair. Those with perceived poor balance were 2.41 times more likely to have an FRI than those without poor balance. Those who reported less exercise than other persons with a comparable SCI severity were 2.77 times more likely to have an FRI than those reporting the same or more amount of exercise. Pain medication misuse also was associated with higher odds of an FRI. Conclusions: Health care providers should be aware of the risk for FRI among those who are ambulatory. They should assess and consider not only ambulatory ability, but also behaviors, including prescription medication use and exercise, when recommending ambulation techniques.

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“…30 Research to determine the impact of the level of injury would help further understand the factors related to fatigue in SCI.…”

Section: Discussionmentioning

confidence: 99%

The relationship between fatigue and participation in spinal cord injury

et al. 2015

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Study design: Cross-sectional national survey. Objectives: To explore the association between fatigue and community participation frequency and provide an adjusted model of the relationship including important covariates. Setting: Canada; Community. Methods: Data were obtained from the Rick Hansen Spinal Cord Injury Registry Community Survey. We used multi-variable regression analyses with hierarchical backward elimination, including variable specification, interaction assessment and confounding assessment. Variables with statistically significant correlation with the primary-dependent variable (participation) were included for modeling.Results: The crude model of association between fatigue and participation accounted for 7.2% of the variance in participation scores. The full model with all a priori selected variables accounted for 25.1% of variance in participation scores. The adjusted model, including the identified confounders (pain, depressive mood, comorbidities and level of injury), accounted for 21.1% of variance in participation scores. Depressive mood variables had the highest standardized beta coefficients, reflecting the largest contribution to this model. Conclusion: Fatigue has a statistically significant negative association with participation for individuals with spinal cord injury, when controlling for pain, depressive mood, comorbidities and level of injury. Multifaceted clinical interventions and research addressing fatigue, pain and depressive symptoms are warranted.

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Ambulation and complications related to assistive devices after spinal cord injury

Abstract: Among ambulatory persons with SCI, increased pain intensity, pain interference, and fatigue are associated with minimal wheelchair usage (50% or less) and less supportive assistive device (unilateral cane) usage.

Cited by 29 publications

References 32 publications

Psychosocial factors associated with physical activity in ambulatory and manual wheelchair users with spinal cord injury: a mixed-methods study

Psychosocial factors associated with physical activity in ambulatory and manual wheelchair users with spinal cord injury: a mixed-methods study

Risk of Fall-Related Injuries among Ambulatory Participants with Spinal Cord Injury

The relationship between fatigue and participation in spinal cord injury

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