Health related functional status in men with spinal cord injury: relationship with lesion level and endurance capacity

Abstract

Study design: Cross-sectional study. Objectives: To determine the relationship of health related functional status with lesion level and endurance capacity in persons with spinal cord injury (SCI). Methods: Thirty-seven men with SCI were divided in four lesion groups: high tetraplegia (motor complete; C5 ± C6, n=10), low tetraplegia (motor complete, C6/7 ± C8, n=9), motor incomplete tetraplegia (n=7), and paraplegia (n=11). Health related functional status was measured with the short version of the Sickness Impact Pro®le (SIP68), including a physical (SOM), psychological (PSY) and social subscore (SOC). Endurance capacity, de®ned as maximal power output (PO max ) and peak oxygen uptake (VO 2peak ), was measured in a maximal exercise test on a wheelchair ergometer. Results: Total SIP68-score and SOM were signi®cantly di erent between lesion groups, showing higher values in the high-and low-tetraplegia group. There were no di erences between lesion groups for PSY and SOC subscores. VO 2peak and PO max were signi®cantly higher in the paraplegia group, compared to the high and low tetraplegia groups. VO 2peak was also higher in the motor incomplete versus other tetraplegia groups. Signi®cant Spearman correlation coe cients were found for VO 2peak and PO max with SIP68 and SOM (ranging from 70.68 to 70.79) and SOC (ranging from 70.39 to 70.51). No signi®cant relationship was found with PSY. Hierarchical regression analysis showed that after correction for lesion level, 22% of the variance of SIP68, 8% of the variance of SOM, and 30% of the variance of SOC was explained by PO max or VO 2peak . Conclusions: Results indicate that there is an evident relationship between the physical dimensions of health related functional status and lesion level, but not for the psychological and social dimensions. After controlling for lesion level a signi®cant amount of the variance of health related functional status can be explained by endurance capacity parameters. Although no causal relationships can be established in this cross-sectional study, these results suggest that functional status may be improved by increasing the endurance capacity.

Physical capacity in wheelchair-dependent persons with a spinal cord injury: a critical review of the literature

“…Subsequently, an inactive lifestyle may further reduce physical capacity. 2,3 A low level of physical capacity is associated with a decrease in activity, 3,4 functional status 5,6 and participation. 2,7 This may result in the vicious circle of decreased physical capacity leading to decreased activity and participation, which further reduces physical capacity, and so on.…”

Lesión medular y ejercicio físico: revisión desde una perspectiva deportiva

“…A pesar de que para las personas con LM, los beneficios de la práctica regular de EF son mucho más relevantes que para el resto de la población (Dallmeijer y van der Woude, 2001;Dallmeijer et al, 2004;Nash, 2005;Haisma et al, 2006;Brizuela et al, 2010;Figoni et al, 2010), siguen conformando la porción de la población más sedentaria e inactiva ya que, además, se enfrentan a numerosos problemas adicionales para acceder a la práctica de EF (Rimmer y Rowland, 2008). Noreau y Shephard (1995) realizaban ya dos décadas atrás, una valiosa revisión que destacaba cómo, a pesar del incremento de la esperanza de vida de las personas con LM, todavía no se había sistematizado el estudio metódico del efecto del EF sobre su condición física.…”

Prognostic Models for Physical Capacity at Discharge and 1 Year Postdischarge From Rehabilitation in Persons With Spinal Cord Injury

“…Therefore, the endurance capacity may give a more valid functional prognosis than would muscle strength alone. 15,16 Third, earlier studies did not always report the prediction accuracy of models. 17 A model's accuracy, that is, whether the outcome it predicts corresponds with the observed outcome, partly determines its clinical relevance.…”