Describing Functioning in People Living With Spinal Cord Injury Across 22 Countries: A Graphical Modeling Approach

Ehrmann, Cristina; Reinhardt, Jan D.; Joseph, Conran; Hasnan, Nazirah; Perrouin-Verbe, B.; Tederko, Piotr; Zampolini, Mauro; Middleton, James; Battistella, Linamara Rizzo; Li, Jianan; Gütenbrunner, Christoph; Rapidi, Christina-Anastasia; Wahyuni, Luh Karunia; Saitoh, Eiichi; Lee, Bum Suk; Juocevičius, Alvydas; Hajjıouı, Abderrazak; Post, Marcel W.M.; Johan, K; Popa, Daiana; Avellanet, M.; Baumberger, Michael; Kovindha, Apichana; Escorpizo, Reuben; Stucki, Gerold

doi:10.1016/j.apmr.2020.09.374

Cited by 23 publications

(21 citation statements)

References 35 publications

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“…The time since injury had a negative impact on functional independence as early as 6–10 years after SCI, and the scores decreased between all the time-since-injury groups. This result is worrying and seems to differ from the international results [ 21 ]. Recognising this problem can help us plan for future needs regarding health care and rehabilitation for persons with SCI.…”

Section: Discussioncontrasting

confidence: 78%

“…Although the analysing methods of these studies differ from ours, Prodinger et al [19] indicated that the generic and lesion characteristics are relevant factors in the analyses of SCIM-SR results, and we agree with that. Based on the results of InSCI [21], persons with complete tetraplegia had more problems with their functional independence than persons with paraplegia or incomplete tetraplegia, as in our study. In contrast to our results, the time since injury did not have a similar kind of negative impact on functional independence; for example, dressing lower body and grooming (parts of the self-care sub-scale) and moving <100 m (part of the mobility sub-scale) were more problematic among the participants who had been injured 5 or fewer years prior in comparison to those who have been injured for a longer time [21].…”

Section: Discussionsupporting

confidence: 77%

“…Based on the results of InSCI [21], persons with complete tetraplegia had more problems with their functional independence than persons with paraplegia or incomplete tetraplegia, as in our study. In contrast to our results, the time since injury did not have a similar kind of negative impact on functional independence; for example, dressing lower body and grooming (parts of the self-care sub-scale) and moving <100 m (part of the mobility sub-scale) were more problematic among the participants who had been injured 5 or fewer years prior in comparison to those who have been injured for a longer time [21]. The fact that the Finnish population with SCI was older than the population in InSCI might partly explain this result.…”

Section: Discussionsupporting

confidence: 77%

“…Currently, two studies using SCIM-SR have been published [ 19 , 21 ]. Although the analysing methods of these studies differ from ours, Prodinger et al [ 19 ] indicated that the generic and lesion characteristics are relevant factors in the analyses of SCIM-SR results, and we agree with that.…”

Section: Discussionmentioning

confidence: 99%

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Functional independence in the Finnish spinal cord injury population

et al. 2021

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Study design A cross-sectional survey of the Finnish population with spinal cord injury (FinSCI database). Objectives To describe the functional independence of the population with spinal cord injury (SCI) in Finland and to identify how generic and lesion characteristics affect their functional independence. Setting The participants were recruited from the registers of three SCI outpatient clinics responsible for lifelong follow-up and care for people with SCI in Finland. Methods The data were retrieved from FinSCI (n = 1772). The response rate was 50% (n = 884). The Spinal Cord Independence Measure-Self Report (SCIM-SR) was used. The data were analyzed with univariate testing, factor analyses, and multiple linear regression models. Results The median (percentiles 25; 75) SCIM-SR total score was 76.0 (58.8; 89.0), and the score was 18.0 (13.0; 20:0) for the self-care sub-scale, 33.0 (25.0; 39.0) for the respiration and sphincter management sub-scale and 29.0 (16.0; 36.8) for the mobility sub-scale. The higher the neurological level in groups AIS A, B, and C, the lower the functional ability. Group AIS D at any injury level had the highest level of functional ability. Age and the number of years since injury negatively influenced the SCIM-SR scores for every sub-scale. Conclusion Based on the International Spinal Cord Injury Core Data Set, the severity of SCI can differentiate persons with SCI according to their functional ability. The results suggest that SCI affects individuals’ health more than ageing alone does, thereby reducing the functional ability and independence of persons with SCI over time.

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Section: Discussioncontrasting

confidence: 78%

Section: Discussionsupporting

confidence: 77%

Section: Discussionsupporting

confidence: 77%

Section: Discussionmentioning

confidence: 99%

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Functional independence in the Finnish spinal cord injury population

et al. 2021

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“…People with chronic neurological conditions who are non-ambulatory are likely to experience decreased joint mobility ( Bushby et al, 2010 , Diong et al, 2012 ), spasticity ( Ehrmann et al, 2020 ), loss of bone mineral density ( Eser et al, 2003 , Shields et al, 2006 , Beaupre and Lew, 2006 , Lazoura et al, 2008 ), kidney and bladder issues ( Levi et al, 1995 , Yan et al, 2018 , Mahoney et al, 2007 , Chen et al, 2000 , Hansen et al, 2007 ), digestive conditions ( Bouras and Tangalos, 2009 , Rao and Go, 2010 ), and pressure injuries ( Flett et al, 2019 ) while managing their disease. These comorbidities can threaten the person’s health suddenly, and more seriously, than the primary medical diagnosis.…”

Section: Method: Bardach 8-step Policy Analysismentioning

confidence: 99%

Policy analysis on power standing systems

Masselink

LaBerge

Detterbeck

2021

Preventive Medicine Reports

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Power wheelchairs provide people with mobility disabilities opportunities for independence in mobility and repositioning themselves. However, current power wheelchair power options covered by Medicare limit the person to a horizontal plane. In the home, access to the vertical plane is also required for mobility related activities of daily living. Power standing systems on power wheelchairs are one option for providing access to the vertical environment, although currently these systems are not covered by Medicare. Power standing systems also aid in medical management and in preventing common comorbidities associated with chronic neurological and congenital healthcare conditions. Therefore, a legal group led an interdisciplinary effort to change Medicare policy on power standing systems. A policy analysis using Bardach’s Eightfold policy framework was conducted to analyze a clinical groups’ action within this interdisciplinary team. The clinical team considered three viable options to address the problem and evaluated these options against five criteria. Ultimately, a national coverage determination reconsideration would provide a needed opportunity for the coverage of power standing systems. Suggested coverage criteria for power standing systems, based on existing literature and expert clinical experience, are proposed.

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