Generating Rasch-based activity of daily living measures from the Spinal Cord Injury Longitudinal Aging Study

Spinal Cord, 2018 · DOI: 10.1038/sc.2017.99 · Published: January 1, 2018

Spinal Cord Injury Participation Research Methodology & Design

Simple Explanation

This study aimed to create a new way to measure how well people with spinal cord injuries (SCI) can do everyday tasks, using data collected over 20 years. The researchers wanted to see if their new measurement tool, called SCI_ADL, was reliable and could accurately track changes in people's ability to perform daily activities over time. By understanding these changes, the study hopes to help improve long-term care and rehabilitation for individuals with SCI, especially as they age.

Study Duration

20 Years

Participants

344 adults with traumatic SCI

Evidence Level

Level 3, Retrospective Longitudinal Study

Key Findings

1
The SCI_ADL measure showed good reliability and could detect changes in self-care function over a 20-year period.
2
Individuals with higher-level SCI (C1–C4) had lower self-care function compared to those with lower-level injuries (C5–C8 and T1–S5).
3
Self-care function decreased over time across all injury levels, but the C1–C4 group showed the most significant decline.

Research Summary

This study generated the SCI_ADL measure using existing data from the SCI Longitudinal Aging Study to assess self-care abilities of individuals with SCI over a 20-year period. The SCI_ADL measure demonstrated adequate psychometric properties and the ability to detect longitudinal changes in ADL function across different SCI levels. The findings highlight the importance of long-term monitoring and targeted interventions to address the specific needs of individuals with SCI as they age, particularly those with high cervical injuries.

Practical Implications

Targeted Rehabilitation Programs

The study suggests tailoring rehabilitation programs to address the specific functional declines observed in different SCI levels, such as upper body training for C5–C8 and lower extremity training for T1–S5.

Policy Changes for Long-Term Care

The findings underscore the need for policy changes that expand insurance coverage to provide regular evaluations and adaptive equipment to help individuals with SCI maintain or compensate for functional decline as they age.

Preventive Interventions

The research suggests focusing on preventive interventions to delay or prevent functional changes, targeting resources to address the most likely changes to occur as individuals with SCI age.

Study Limitations

1
The study only included individuals who survived across 20 years, potentially biasing the results towards healthier or higher functioning individuals.
2
The small sample size of the C1–C4 group may have limited the statistical power of the analyses.
3
The study did not control for length of time post injury at baseline and the neurological completeness (e.g. AIS levels) since the data are not available.

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