Evaluation of Functional Improvement and Community Integration Status among Persons with Spinal Cord Injury after a One-Year Follow-Up in the Community

Author(s): Shazal Kumar Das, Zahid Bin Sultan Nahid, Md. Amran Hossain, Mohammad Jahangir Alam, K. Zaman Utshab, Md. Furatul Haque, Md. Rafiqul Islam, Md. Anowar Khasru Parvez

Objective: This study compared functional improvement and community integration status among people with spinal cord injury at hospital discharge and after 1 year of follow-up in the community.

Methods: A longitudinal cohort–study design was used in which a total of two hundred patients with spinal cord injury completed demographic and medical questionnaires and underwent a medical examination at discharge from a hospital rehabilitation department; among them, one hundred and sixty-eight patients attended a 1-year follow-up in the community. The Spinal Cord Independence Measure (SCIM) and Community Integration Questionnaire (CIQ) were used to assess functional improvement and community integration status over this period.

Results: The median age of the participants was 32 years (25 to 45). A significant association was found between the severity of spinal cord injury and the severity of skeletal nerve injury. According to the Spinal Cord Independence Measure (SCIM), functional improvement status significantly increased (p < 0.05) from the time of discharge to the time of stay in the community. After discharge, nearly half of the patients developed a new pressure sore, and most patients experienced urinary complications. The social participation (i.e., community and home integration) results also showed a significant improvement (p < 0.05) while staying in the community.

Conclusion: This study examined the functional status and community integration of people with spinal cord injuries (SCIs) after one year of rehabilitation. The results show improvements in functional status, general health, and satisfaction with social relationships. However, medical complications, depression, cognitive function decline, and re-employment are still prevalent. The study suggested that rehabilitation should include emotional and cognitive functions, as well as re-employment, to achieve greater community integration. Clinicians can assist patients by providing resources, teaching self-care, emergency management, freehand exercise, and community participation.