Measuring Quality of Life and Function During Early Recovery in Adults with Traumatic Spinal Cord Injury
Background: Traumatic spinal cord injury (SCI) is a tragic, life-altering event that can result in varying levels of handicap and disability. Recent initiatives have encouraged the use of patient-reported outcome measures to assess quality of life (QoL) alongside function in the SCI population. Given that most SCI research is conducted in the chronic population, little is known about the relationship between QoL and function throughout rehabilitation.
Purpose: The purpose of this research is to explore the relationship between measurements of QoL and function in adults with traumatic SCI during the early phase of recovery.
Methods: This dissertation study is an analysis of data from the ongoing prospective cohort study called Transforming Research and Clinical Knowledge in SCI (TRACK-SCI). Adult participants admitted with an acute traumatic SCI from December 2017 to October 2020 were eligible for this analysis (N=114). We explored associations between functional independence, health-related QoL, and overall QoL across two timepoints within the first year post-SCI. Functional independence was measured using the Spinal Cord Independence Measure III (SCIM-III), health-related QoL was measured using 11 Neuro-QoL Measurement System short forms, and overall QoL was measured using the International SCI QoL Basic Data Set (ISCI-QoL).
Results: We found that the most amount of variance in overall QoL was explained by the Neuro-QoL Mental Health domain (R2=0.43), followed by the Social Health domain (R2=0.38). In a backwards stepwise regression model, the only health-related QoL measures that maintained significance with overall QoL at 6-12 months post-SCI were Depression and Satisfaction with Social Roles/Activities (R2=0.46). Overall QoL was not significantly associated with baseline injury severity, functional independence, or physical function health-related QoL.
Conclusion: This early dissertation research suggests that depression and satisfaction with social roles might be more important than measures of physical function in predicting overall QoL during the early recovery phase after SCI.