Relationships between Specific Functional Abilities and Health-Related Quality of Life in Chronic Spinal Cord Injury
Goulet J, Mac-Thiong J
Université de Montréal, Montreal, Quebec, Canada
Traumatic spinal cord injury (tSCI) is a debilitating condition that leads to important challenges for patients and that affects health-related quality of life (HRQoL). Qualitative research has shown that motor function and sphincter management are significant factors influencing HRQoL following tSCI. No study objectively assessed which specific functional abilities are most important in the HRQoL of patients in the chronic phase of tSCI. The objective of this study is to explore the relationships between specific functional abilities assessed from the 3rd version of the Spinal Cord Injury Measure (SCIM), and HRQoL assessed by the SF-36v2 following a tSCI.
A prospective cohort of 195 patients that had sustained a tSCI from C1 to L1, and consecutively admitted to a single Level 1 SCI-specialized trauma center between April 2010 and September 2016 was studied. SCIM and SF-36v2 questionnaires were administered concurrently during routine follow-up visit between 6 to 12 months after the trauma. Correlation coefficients were calculated between SCIM scores (total, subgroups and individual items scores), and SF-36v2 summary scores (Physical component score, PCS; Mental component score, MCS). All analyses were repeated separately for subjects with tetraplegia and paraplegia.
The total SCIM score correlated moderately with the PCS in the entire cohort, correlated strongly with PCS in tetraplegics, did not correlate with PCS in paraplegics, and did not correlate with MCS in any of the population subdivisions. Mobility subgroup and individual items scores showed the strongest correlations with the PCS in the entire cohort, followed by self-care and sphincter management. In tetraplegic patients, correlation was also strongest with mobility subgroup and individual items scores followed by self-care and sphincter management. Only mobility subgroup and individual items scores correlated with PCS in patients with paraplegia. Correlations between SCIM scores and MCS for all patients were negligible.
This is the first study to objectively evaluate the relative importance of specific functional abilities in the HRQoL in tSCI patients. This work is significant because it determines which specific functional abilities are mostly related to HRQoL, and highlights the differences between tetraplegic and paraplegic patients. Our findings could help clinicians to guide the treatment and rehabilitation plan based on the importance of specific functional abilities in relationship with the HRQoL.
Fonds de recherche du Quebec - Sante
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