Functional independence in the Finnish spinal cord injury population

Abstract 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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Incidence and Factors Associated With Falls in Independent Ambulatory Individuals With Spinal Cord Injury: A 6-Month Prospective Study

Physical Therapy ◽

10.2522/ptj.20120467 ◽

2013 ◽

Vol 93 (8) ◽

pp. 1061-1072 ◽

Cited By ~ 30

Author(s):

Sirisuda Phonthee ◽

Jiamjit Saengsuwan ◽

Wantana Siritaratiwat ◽

Sugalya Amatachaya

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Functional Ability ◽

Spinal Injury ◽

Self Report ◽

Functional Improvement ◽

Medical Attention ◽

Factors Associated ◽

Cord Injury ◽

Risk Of Falls

BackgroundSensorimotor impairments following spinal cord injury (SCI) affect mobility and subsequently increase the risk of falls to patients. However, most of the fall data for these patients were retrospectively gathered.ObjectivesThis study prospectively assessed falls and intrinsic factors associated with falls in 89 independent ambulatory individuals with SCI over the course of 6 months. In addition, functional ability between participants who did and did not fall was compared.MethodsParticipants were interviewed and assessed for their baseline data and functional ability using the Timed “Up & Go” Test and the Six-Minute Walk Test. Then they were interviewed by telephone to complete a self-report questionnaire once per week to gather fall data for 6 months. A stepwise multiple logistic regression was utilized to determine the effects of demographics and SCI characteristics on occurrence of falls. The functional data between participants who fell and those who did not fall were compared using the Mann-Whitney U test.ResultsThirty-five participants (39%) experienced at least 1 fall during 6 months (range=1–11). Two participants required medical attention due to patellar and sternum fractures after falling. Participants with an educational level of high school graduate or greater, an American Spinal Injury Association Impairment Scale C (AIS-C) classification, and a fear of falling (FOF) significantly increased their risk of falls approximately 4 times more than those who graduated primary education, had an AIS-D classification, and did not have FOF. Moreover, the functional abilities of participants who fell were significantly poorer than those who did not fall.LimitationsThe sample size was calculated based on the primary objective (incidence of falls), which may not be sufficient to clearly indicate factors associated with falls for the participants.ConclusionsMore than one third of the independent ambulatory participants with SCI experienced at least 1 fall during the 6-month period of the study. The findings suggest the importance of functional improvement on the reduction of fall risk in these individuals.

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Classifications Used in Spinal Cord Injuries

Sinir Sistemi Cerrahisi Dergisi ◽

10.5222/sscd.2021.84856 ◽

2021 ◽

Author(s):

Erek Öztürk ◽

Yener Akyuva ◽

Erdinç Çivelek

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Spinal Cord Injuries ◽

Spinal Injury ◽

Functional Independence ◽

International Standards ◽

Data Set ◽

Multidimensional Pain Inventory ◽

Cord Injury

Creating a common language allows information to be shared well/wholesome/healthily. Classifications have a important role in the formation of this language, which provides many benefits such as follow-up of the clinical course. Classifications in spinal cord injuries are based on examination, so the results of different treatments can be revealed more clearly with a standardized examination and registration. The International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) which is the most sensitive and common classification was developed by the American Spinal Injury Association (ASIA) and the International Spinal Cord Society (ISCoS), although its foundations were laid in 1969 by Frankel. Apart from neurological evaluation, there are scales such as Functional Independence Scale, Modified Barthel Index, Spinal Cord Independence Scale, Quadriplegia Functional Index, Walking Index for Spinal Cord Injury, Spinal Cord Injury Functional Ambulation Inventory to determine the functional status in spinal cord injuries. Additionally scales such as Assessment of Spinal Cord Injury Basic Pain Data Set, Multidimensional Pain Inventory, DN4 (DouleurNeuropathique DN4) can be used for pain assessment in a patient with spinal cord injury.

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Reliability and validity of the International Spinal Cord Injury Basic Pain Data Set items as self-report measures

Spinal Cord ◽

10.1038/sc.2009.112 ◽

2009 ◽

Vol 48 (3) ◽

pp. 230-238 ◽

Cited By ~ 39

Author(s):

M P Jensen ◽

E Widerström-Noga ◽

J S Richards ◽

N B Finnerup ◽

F Biering-Sørensen ◽

...

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Reliability And Validity ◽

Self Report ◽

Data Set ◽

Cord Injury

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Development and Validation of Crosswalks Between FIM® and SCIM III for Voluntary Musculoskeletal Movement Functions

Neurorehabilitation and Neural Repair ◽

10.1177/15459683211033854 ◽

2021 ◽

pp. 154596832110338

Author(s):

Linda A. T. Jones ◽

Chih-Ying Li ◽

David Weitzenkamp ◽

John Steeves ◽

Susie Charlifue ◽

...

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Functional Recovery ◽

Systems Of Care ◽

Functional Independence Measure ◽

Correlation Coefficients ◽

Functional Independence ◽

Cord Injury ◽

Parametric Analyses ◽

Development And Validation

Background. In spinal cord injury, there are multiple databases containing information on functional recovery, but data cannot be pooled or compared due to differences in how function is measured. A crosswalk is needed to link or convert scores between instruments. Objectives. To create a crosswalk between the voluntary musculoskeletal movement items in the Functional Independence Measure (FIM®) and the Spinal Cord Independence Measure III (SCIM III) for spinal cord injury. Methods. Retrospective datasets with FIM® and SCIM III on the same people were used to develop (Swiss dataset, n = 662) and validate (US, n = 119, and Canadian datasets, n = 133) the crosswalks. Three different crosswalk methods (expert panel, equipercentile, and Rasch analysis) were employed. We used the correlation between observed scores on FIM® and SCIM III to crosswalked scores as the primary criterion to assess the strength of the crosswalk. Secondary criteria such as score distributions, Cohen’s effect size, point differences, and subgroup invariance were also evaluated. Results. All three methods resulted in strong correlation coefficients, exceeding the primary criterion value of r = .866 (.897–.972). Assessment of secondary criteria suggests the equipercentile and Rasch methods produced the strongest crosswalks. Conclusions. The Rasch FIM®/SCIM III crosswalk is recommended because it is based on co-calibration of linearized measures, allowing for more sophisticated parametric analyses. The crosswalk will allow comparisons of voluntary musculoskeletal functional recovery across international databases using different functional measures, as well as different systems of care and rehabilitation approaches.

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Long term outcome of functional independence and quality of life after traumatic SCI in Germany

Spinal Cord ◽

10.1038/s41393-021-00659-9 ◽

2021 ◽

Author(s):

Florian Möller ◽

Rüdiger Rupp ◽

Norbert Weidner ◽

Christoph Gutenbrunner ◽

Yorck B. Kalke ◽

...

Keyword(s):

Quality Of Life ◽

Spinal Cord ◽

Spinal Cord Injury ◽

Functional Independence ◽

Term Outcome ◽

Long Term Outcome ◽

Cord Injury ◽

Over Time

Abstract Study design Multicenter observational study. Objective To describe the long-term outcome of functional independence and quality of life (QoL) for individuals with traumatic and ischemic SCI beyond the first year after injury. Setting A multicenter study in Germany. Methods Participants of the European multicenter study about spinal cord injury (EMSCI) of three German SCI centers were included and followed over time by the German spinal cord injury cohort study (GerSCI). Individuals’ most recent spinal cord independence measure (SCIM) scores assessed by a clinician were followed up by a self-report (SCIM-SR) and correlated to selected items of the WHO short survey of quality of life (WHO-QoL-BREF). Results Data for 359 individuals were obtained. The average time passed the last clinical SCIM examination was 81.47 (SD 51.70) months. In total, 187 of the 359 received questionnaires contained a completely evaluable SCIM-SR. SCIM scores remained stable with the exception of reported management of bladder and bowel resulting in a slight decrease of SCIM-SR of −2.45 points (SD 16.81). SCIM-SR scores showed a significant correlation with the selected items of the WHO-QoL-BREF (p < 0.01) with moderate to strong influence. Conclusion SCIM score stability over time suggests a successful transfer of acquired independence skills obtained during primary rehabilitation into the community setting paralleled by positively related QoL measurements but bladder and bowel management may need special attention.

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Resilient Coping Types in People With Spinal Cord Injury: Latent Class Analysis

Rehabilitation Counseling Bulletin ◽

10.1177/0034355221990736 ◽

2021 ◽

pp. 003435522199073

Author(s):

Chungyi Chiu ◽

Jessica Brooks ◽

Alicia Jones ◽

Kortney Wilcher ◽

Sa Shen ◽

...

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Life Satisfaction ◽

Latent Class Analysis ◽

Latent Class ◽

Psychosocial Interventions ◽

Self Report ◽

Class Analysis ◽

Multivariate Tests ◽

Cord Injury

Resilience is central to living well with a spinal cord injury (SCI). To provide a timely, targeted, and individualized intervention supporting resilience, it is necessary to assess an individual’s resilience level and characteristics of resilience on an ongoing basis. We aimed to validate the different types of resilient coping among people with SCI (PwSCI), using the Connor–Davidson resilience scale, and to identify the relationships between resilience and other psychosocial factors among the types of resilient coping. We recruited 93 PwSCI, who took the self-report measures of resilience, depression, life satisfaction, and spirituality. Using latent class analysis, we found three types: (a) goal-pursuing, bouncing-back, and persevering, named GP; (b) uncertainty about coping with setbacks, named UC; and (c) loss of resilient coping, named LOSS. The multivariate tests indicated that the three types differed on a linear combination of resilience, depression, and life satisfaction, with a large effect size. We discussed the three types of resilient coping and the implications for psychosocial interventions. We also recommended that rehabilitation clinicians examine PwSCI’s resilience levels and types of resilience during initial and follow-up visits. In doing so, PwSCI will have timely, targeted supports for developing and/or re-building their resilience.

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Effect of pelvic laparoscopic implantation of neuroprosthesis in spinal cord injured subjects: a 1-year prospective randomized controlled study

Spinal Cord ◽

10.1038/s41393-021-00693-7 ◽

2021 ◽

Author(s):

Helge Kasch ◽

Uffe Schou Løve ◽

Anette Bach Jønsson ◽

Kaare Eg Severinsen ◽

Marc Possover ◽

...

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Outcome Measures ◽

Outcome Measure ◽

Secondary Outcome ◽

Controlled Study ◽

Control Group ◽

Walking Ability ◽

Data Set ◽

Cord Injury

Abstract Study design 1-year prospective RCT. Objective Examine the effect of implantable pulse generator and low-frequency stimulation of the pelvic nerves using laparoscopic implantation of neuroprosthesis (LION) compared with neuromuscular electrical stimulation (NMES) in SCI. Methods Inclusion criteria: traumatic spinal cord injury (SCI), age 18–55 years, neurological level-of-injury Th4–L1, time-since-injury >1 year, and AIS-grades A–B. Participants were randomized to (A) LION procedure or (B) control group receiving NMES. Primary outcome measure: Walking Index for Spinal Cord Injury (WISCI-II), which is a SCI specific outcome measure assessing ability to ambulate. Secondary outcome measures: Spinal Cord Independence Measure III (SCIM III), Patient Global Impression of Change (PGIC), Penn Spasm Frequency Scale (PSFS), severity of spasticity measured by Numeric Rating Scale (NRS-11); International Spinal Cord Injury data sets-Quality of Life Basic Data Set (QoLBDS), and Brief Pain Inventory (BPI). Results Seventeen SCI individuals, AIS grade A, neurological level ranging from Th4–L1, were randomized to the study. One individual was excluded prior to intervention. Eight participants (7 males) with a mean age (SD) of 35.5 (12.4) years were allocated to the LION procedure, 8 participants (7 males) with age of 38.8 (15.1) years were allocated to NMES. Significantly, 5 LION group participants gained 1 point on the WISCI II scale, (p < 0.013; Fisher´s exact test). WISCI II scale score did not change in controls. No significant changes were observed in the secondary outcome measures. Conclusion The LION procedure is a promising new treatment for individuals with SCI with significant one-year improvement in walking ability.

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