Examining the complexity of functioning in persons with spinal cord injury attending first rehabilitation in Switzerland: Preliminary results

Abstract

The aim of the first rehabilitation of persons with Spinal Cord Injury (SCI) is the optimization of functioning. Thus, a comprehensive understanding of the interaction between impairments in body functions, including impairments in mental functions, and limitations in daily activities is fundamental for an informed decision making amongst health professionals and patients throughout the rehabilitation process. Functioning has been scarcely studied in the context of SCI. This project aims to examine the associations between the health condition, functioning, and personal factors in persons with SCI attending first rehabilitation. Data from the national clinical Swiss Spinal Cord Injury Inception Cohort Study were used. Functioning was operationalized through impairments in body functions and daily activity limitations. Items from existing instruments, including ISCoS International SCI Data Set, the Hospital Anxiety and Depression Scale, Brief Pain Inventory, and SCI Independence Measure III were used to collect the respective data. As personal factors, age and sex were considered. Structural equation models were used to estimate the relation between impairments in body functions and limitations in daily activities and to test the moderation effect of personal factors. The models were controlled for etiology and lesion level as measured by the American Spinal Injury Association Impairment Scale. The preliminary results show the expected negative effect of impairments in body functions on limitations in daily activities. Nevertheless, this effect relies mainly on the impairments in body functions than on the impairments in mental functions. Therefore, the role of impairments in mental functions as moderators of the described effect requires further analysis. A moderation effect of personal factors is analysed. The analysis is currently ongoing but results will be available for presentation in July. This study will provide evidence for understanding the complexity of functioning in first rehabilitation of persons with SCI so to inform the rehabilitation process.