Dataset Information

Age-related variation in mobility independence among wheelchair users with spinal cord injury: A cross-sectional study.

ABSTRACT:

Objective

To evaluate age-related variation in mobility independence among community-living wheelchair users with spinal cord injury (SCI).

Design

Community Survey (2011-2013) as part of the Swiss Spinal Cord Injury Cohort Study.

Setting

Community.

Participants

Individuals aged 16 years or older with traumatic or non-traumatic SCI permanently residing in Switzerland and using a wheelchair for moving around moderate distances (10-100?m).

Interventions

Not applicable.

Outcome measures

Mobility-related items of the Spinal Cord Independence Measure-Self Report were matched to the three principal domains "changing basic body position," "transferring oneself" and "moving around." Binary outcomes ("independence" vs. "no independence") were created for every domain and analyzed using multivariable logistic regression (adjusted for sex, socioeconomic factors, SCI characteristics, and health conditions).

Results

Regression analyses (N?=?949; 27% women; median age 51, interquartile range 41-61) showed a decline in the odds of independence (odds ratio; 95% confidence interval) with increasing age for "changing basic body position" (age 16-30 (reference), 31-45 (0.99; 0.53-1.83), 46-60 (0.64; 0.33-1.21), 61-75 (0.45; 0.22-0.92), 76+ (0.18; 0.07-0.44); P?ConclusionsMobility independence was negatively associated with age in wheelchair users with SCI. Future longitudinal analyses are required to gain further insights into the causal factors for the age-related decline.

SUBMITTER: Hinrichs T

PROVIDER: S-EPMC5072494 | biostudies-literature | 2016

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Age-related variation in mobility independence among wheelchair users with spinal cord injury: A cross-sectional study.

Hinrichs Timo T Lay Veronika V Arnet Ursina U Eriks-Hoogland Inge I Koch Hans Georg HG Rantanen Taina T Reinhardt Jan D JD Brinkhof Martin W G MW

The journal of spinal cord medicine 20160308 2

<h4>Objective</h4>To evaluate age-related variation in mobility independence among community-living wheelchair users with spinal cord injury (SCI).<h4>Design</h4>Community Survey (2011-2013) as part of the Swiss Spinal Cord Injury Cohort Study.<h4>Setting</h4>Community.<h4>Participants</h4>Individuals aged 16 years or older with traumatic or non-traumatic SCI permanently residing in Switzerland and using a wheelchair for moving around moderate distances (10-100 m).<h4>Interventions</h4>Not appli ...[more]

PMID: 25832471

Similar Datasets

Project description:Highlights • Shorter time since injury and higher mobility levels as well as poor physical health are associated with higher risk of falls and fall-related injuries, respectively in wheelchair users with spinal cord injury.• The findings indicate good discriminant ability and clinical utility of the factors presented to identify wheelchair users who are at risk of falls and fall-related injuries. Objective To identify risk factors for falls and fall-related injuries for wheelchair users with spinal cord injury (SCI). Design Cross-sectional study. Setting Community setting. Participants Fifty-nine community dwelling wheelchair users (N=59), 47.5% male, median age of 52.5 years (IQR, 21 years) with chronic SCI, median time since injury of 16.6 years (IQR, 27.3 years). Interventions No intervention. Main Outcome Measures Outcomes were incidence of falls and fall-related injuries. Participants reported on falls and fall-related injuries experienced in the previous 6 months. Independent variables were self-reported and performance-based measures. Self-reported measures included demographics, characteristics of SCI, fear of falling, psychological measures, functional independence, wheelchair skills, environmental barriers, quality of life, and community participation. Performance-based measures included transfer quality and sitting balance assessments. Logistic regression analyses were conducted to identify factors influencing falls and fall-related injuries. Results In total, 152 falls and 30 fall-related injuries were reported from a total of 37 fallers. After logistic regression analysis, the model with the greatest levels of clinical utility and discriminative ability for falls (sensitivity 81%; specificity 55%; area under the receiving operating characteristic curve [AUC] statistics=0.73; 95% CI, 0.60-0.86) included the variables of shorter time since SCI, high mobility level, and having received education on fall prevention. The model for fall-related injuries (sensitivity 79%; specificity 75%; AUC statistics=0.77; 95% CI, 0.59-0.96) included the variables of older male individual, lower physical health score, and having received education on fall prevention. Conclusions The regression models presented may be used to identify wheelchair users with SCI at greater risk of falls and fall-related injuries. The findings may help to refer those in need to tailored fall and fall-related injury prevention programs. The findings presented in this study were based on a relatively small sample convenience; therefore, further prospective studies with a larger sample size are warranted.

Project description:Objective: To investigate the progression of rotator cuff tendon pathology across one year in manual wheelchair (MWC) users with spinal cord injury (SCI) and matched able-bodied individuals, and to explore the association between pain, age, and duration of wheelchair use with the progression of rotator cuff pathology.Design: Longitudinal cohort study, 1-year follow-up.Setting: Outpatient clinic at a tertiary medical center.Participants: Twenty-four adult MWC users with SCI (20 men) with an average age (SD) of 37(12) years and 24 age and sex-matched able-bodied individuals.Interventions: Not applicable.Main outcome measure(s): Presence of shoulder pain was collected. Magnetic resonance imaging (MRI) abnormalities of rotator cuff tendons including tendinopathy and tendon tears at baseline and 1-year follow-up visits were graded by a board-certified musculoskeletal radiologist, and three categories of tendon pathology scores including individual tendon scores, unilateral cuff scores, and bilateral cuff scores were calculated for each participant.Results: Fifty-four percent of the MWC users reported shoulder pain at both time points which was significantly higher than able-bodied cohort at baseline (17%, P = 0.012) and year 1 (21%, P = 0.021). Rotator cuff tendon pathology was detected as mainly mild tendinopathies and low-grade partial-thickness tears in both cohorts at both time points but was more common in MWC users. The results for the bilateral cuff scores indicated a significant (P < 0.008) progression of rotator cuff tendon pathology in the MWC users over one year. MRI findings did not change significantly for the able-bodied cohort across time. There was no association of pain, age, or duration of MWC use with progression of rotator cuff pathology in MWC user cohort.Conclusion: MWC users had a higher prevalence of pain than matched able-bodied cohort, but pain was minimal and not function-limiting. Bilateral cuff TOTAL scores showed pathology progression in MWC users, but MRI findings remained stable in the able-bodied cohort. MWC users were 3.4 times more likely to experience pathology progression than the able-bodied cohort.

Project description:IntroductionWheelchair users with spinal cord injury are at a high risk of falls. However, the perspectives of wheelchair users with spinal cord injury on their fall circumstances and their preferences for fall prevention strategies/interventions remain understudied. Therefore, we aimed to: a) describe the circumstances of falls experienced by wheelchair users with spinal cord injury over a six-month period, b) explore their perspectives of why falls occurred in certain situations, and c) explore their perspectives on recommended content/structure of fall prevention strategies/interventions.MethodsThis sequential explanatory mixed methods study had two phases. Phase I involved tracking of falls experienced by wheelchair users with spinal cord injury over six months, in which participants completed a survey after experiencing a fall to track the number/circumstance of each fall. Data from the surveys were descriptively reported. Phase II involved a photovoice focus group discussion of the survey findings and their preferences for fall prevention strategies/interventions. Data from the focus group discussion were analyzed using a thematic analysis.ResultsThirty-two participants completed phase I. More than half of the participants fell at least once in six months. Falls commonly occurred in the afternoon during a transfer, or when participants were wheeling over uneven ground. One-third of the falls caused an injury. Eleven participants that fell during phase I participated in the focus group. Two main themes were identified from the discussion: 1) "circumstances surrounding the falls" (e.g. when falls occurred, the home is a 'safe space') and 2) "suggestions and preferences for fall prevention strategies/interventions" (e.g. fall prevention involves all, fall prevention training available as needed).ConclusionFall prevention strategies/interventions should be an integral component of rehabilitation practices across the lifespan. Participants recommend customizing fall prevention strategies/interventions to their specific needs to guide the structure, content, and delivery of targeted fall prevention programs.

Dataset Information

Age-related variation in mobility independence among wheelchair users with spinal cord injury: A cross-sectional study.

Objective

Design

Setting

Participants

Interventions

Outcome measures

Results

Publications

Age-related variation in mobility independence among wheelchair users with spinal cord injury: A cross-sectional study.

Similar Datasets

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