Longitudinal prediction of quality-of-life scores and locomotion in individuals with traumatic spinal cord injury

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Study examined differences in quality-of-life (QOL) scores for locomotion groups at 1, 5, and 10 years postdischarge in people with spinal cord injury (SCI) and investigated whether demographic factors and transitions in locomotion status can predict QOL measures at these time points. Data were collected from 10,190 individuals with SCI from 21 SCI Model Systems Centers, identified through the National SCI Database between the years 1985 and 2012. Subjects were those who had Functional Independence Measure data for mode of locomotion at discharge and at least 1 of the following: 1, 5, or 10 years postdischarge. Based on locomotion change or no change, individuals were categorized at each follow-up time point into 1 of 4 groups: (1) ambulation to ambulation, (2) wheelchair to wheelchair, (3) wheelchair to ambulation or wheelchair to both, or (4) ambulation to wheelchair or ambulation to both. Participants who transitioned from ambulation to wheelchair use reported lower participation and life satisfaction, and higher depression levels than those who maintained their ambulatory status. Participants who transitioned from ambulation to wheelchair use reported higher depression levels and no difference for participation or life satisfaction compared with those who transitioned from wheelchair to ambulation. Demographic factors and locomotion transitions predicted QOL scores at all time points. Findings suggest that transitioning from ambulation to wheelchair use can negatively impact psychosocial health 10 years after SCI. Clinicians should be aware of this when deciding on ambulation training. Further work to characterize who may be at risk for these transitions is needed.

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