Physical Health Conditions in Persons with Spinal Cord Injury Across 21 Countries Worldwide

Abstract

Objectives: To describe the three-month prevalence and correlates of self-reported physical health conditions in persons with spinal cord injury (SCI) worldwide. 
 Study design: Multinational cross-sectional survey.
 Subjects: Community living persons with traumatic or non-traumatic SCI aged > 18 years from 21 countries representing all the six World Health Organization regions.
 Methods: We used data from 11 058 participants in the International SCI Community Survey (InSCI). The survey, based on the International Classification of Functioning, Disability and Health Core Sets for SCI, was conducted in 2017-2019 simultaneously in the participating countries. The health conditions were reported on a modified version of the SCI Secondary Conditions Scale.
 Results: Overall, 95.8% of the participants reported having experienced one or more health problems secondary to SCI. Having pain was the most prevalent problem (77.3%), followed by spasticity/muscle spasms (73.5%) and sexual dysfunction (71.3%), and the least was respiratory problems (28.8%). The participants reported on average 7.4 concurrent health conditions. Unmet health care needs, being a smoker, being a female, having a complete lesion and a traumatic injury exhibited significant associations with comorbidity.
 Conclusions: Physical health problems secondary to SCI are extremely common worldwide and demands investment in appropriate management, medical care and preventative measures.

Surveying people with spinal cord injuries in Brazil to ascertain research priorities

“…This can be attributed to hindered mobility, urinary and fecal incontinence, sensitivity, pain, embarrassment towards their own body, low self-esteem, difficulty reaching orgasm, and difficulty maintaining lubrification 27,28 . Furthermore, this result shows that interventions in sexual dysfunction after SCI should be developed, as international studies have found that sexual dysfunction exhibited the highest self-reported level of severity, but with the lowest treatment rate 29 .…”

“…Recently, a multinational cross-sectional survey, described the prevalence and correlates of self-reported physical health conditions in persons with spinal cord injury (SCI) from 21 countries, representing all the 6 World Health Organization regions, with 11,058 participants in the International SCI Community Survey (InSCI) 29 . The survey, based on the International Classification of Functioning, Disability and Health (ICF) Core Sets for SCI identified that 95.8% of the participants reported having experienced 1 or more health problems secondary to SCI.…”

“…The survey, based on the International Classification of Functioning, Disability and Health (ICF) Core Sets for SCI identified that 95.8% of the participants reported having experienced 1 or more health problems secondary to SCI. Having pain was the most prevalent problem (77.3%), followed by spasticity/muscle spasms (73.5%), sexual dysfunction (71.3%), bowel dysfunction (70.8%) and bladder dysfunction (62.0%) 29 . This relevant study, like ours, showed that physical health problems secondary to SCI, reported by participants, are extremely common worldwide and demand investment in appropriate management, medical care and preventative measures.…”

“…The most cited were stem cell research 144 (23%), rehabilitation 91 (15%), and cure 89 (14%), among others (Table 1 The others category (10%) (Table 1) covers topics that were cited by the participants but were not included among the other topics, as they appeared less frequently. This option included wounds/skin (9), myelitis (11), spasms (11), and other responses that did not fit into any of the other categories (29).…”

The effectiveness and safety of repetitive transcranial magnetic stimulation on spasticity after upper motor neuron injury: A systematic review and meta-analysis

“…Spasticity is characterized by a velocity-dependent increase in tonic stretch reflexes (muscle tone) with exaggerated tendon jerk ( Feldman et al, 1980 ). Roughly, the prevalence of spasticity reaches to 42.6% ( Harb and Kishner, 2022 ) in stroke patients, and 73.5% of patients with SCI may accompany spasticity ( Strom et al, 2022 ). Moreover, approximately 80% of patients with MS ( Arroyo González, 2018 ) and 69.8% children with CP ( Pulgar et al, 2019 ) experience spasticity.…”