Successful mobility in a wheelchair and the health status of people with paraplegia

Abstract

Introduction. Possession of a wheelchair allows disabled people with paraplegia to compensate for mobility limitations. In order to build the rehabilitation process, it is important to know what factors hinder and what factors facilitate the development of a wheelchair. Aim. To determine functional independence, quality of life and secondary health conditions in persons with lower paraplegia and to assess their relationships with the degree of difficulty when moving around in a wheelchair. Materials and methods. We examined 396 patients with spinal cord injury (SCI) and lower paraplegia who used a wheelchair. The level of independence of the patients was determined using Functional Independence Measure (FIM) and Spinal Cord Independence Measure (SCIM III), quality of life was assessed using the SF-36 questionnaire, secondary health conditions were determined using the SCI SCS scale and the presence of problems moving around in the wheelchair was assessed using category d465 «moving around using equipment» of the International Classification of Functioning, Disability and Health. Results. Half of the examined patients with SCI had a sufficiently high level of independence when performing daily activities. 43.5 % of the patients showed either moderate, severe or absolute problems moving around in the wheelchair and 65.4 % demonstrated the presence of more than three secondary health conditions. We found negative correlations between the degree of difficulty experienced by the patients when moving around in the wheelchair and the levels of independence in daily life and the indicators of quality of life such as vitality, social functioning and mental health. In binary logistic regression it was ascertained that the significant independent factors associated with difficulty when using the wheelchair were spasticity, contractures of the muscles of the lower limb and circulatory disorders. Conclusion. The success in using the wheelchair is limited by spasticity, contractures of the muscles of the lower limb and circulatory disorders.