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An assessment of disability and quality of life in people with spinal cord injury upon discharge from a Bangladesh rehabilitation unit

Abstract

Design

Cross-sectional.

Objectives

The purpose of the study was to determine the level of disability and quality of life of people with spinal cord injury at the end of their inpatient rehabilitation at a rehabilitation center in Bangladesh. These outcomes were considered indicators of successful rehabilitation and a basis for comparing the success of reintegration into community.

Setting

Center for the Rehabilitation of the Paralyzed, Bangladesh.

Methods

Two standard structured questionnaires, the WHODAS 2.0 and WHOQOL-BREF, was used to collect data to assess level of disability and quality of life (QOL). Data were analyzed using Mann–Whitney-U test and Kruskal–Wallis test.

Results

One hundred participants (91 men and 9 women) with SCI were recruited. Just prior to discharge from in-patient rehabilitation at CRP people with SCI perceived themselves overall as having on average a mild level of disability, and good QOL in physical, psychological, and environmental health domains. They indicated poor QOL in the social health domain. There were some specific differences in various WHODAS 2.0 Domains and overall scores when comparing age, gender, type and level of injury, occupation, and income. Between-group comparisons indicated that male participants had a significantly higher quality of life in the Environmental Health Domain and those with a paraplegic injury had a significantly higher quality of life in the Physical Health Domain.

Conclusion

By the end of their rehabilitation people with SCI had a relatively positive perception of level of disability and QOL. However, the results of other research has found that post-discharge their disability level increase and QOL decrease across all domains. Hence, it is recommended that more monitoring of level of disability and QOL is conducted post-discharge, along with a greater focus on community-based rehabilitation strategies and procedures to contribute to long-term reduction in level of disability and improved QOL.

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Fig. 1: Full range and interquartile range score of domains of WHODAS 2.0.
Fig. 2: The quality of life of the participants according to four domains of WHOQOL-BREF.
Fig. 3: Full range and interquartile range domain scores of WHOQOL-BREF.

Data availability

Any reasonable request for individual participant data will be considered by the authors.

References

  1. Üstün N, Aras M, Özgür T, Bayraktar HS, Sefil F, Özden R, et al. Thymoquinone attenuates trauma induced spinal cord damage in an animal model. Ulus Travma Acids Cerrahi Derg. 2014;20:328–32.

    Article  Google Scholar 

  2. Barclay L, McDonald R, Lentin P. Social and community participation following spinal cord injury: a critical review. Int J Rehabil Res. 2015;38:1–19.

    Article  Google Scholar 

  3. Jørgensen V, Forslund EB, Franzén E, Opheim A, Seiger Å, Ståhle A, et al. Factors associated with recurrent falls in individuals with traumatic spinal cord injury: a multicenter study. Arch Phys Med Rehabil. 2016;97:1908–16.

    Article  Google Scholar 

  4. Kader M, Perera NK, Hossain MS, Islam R. Socio-demographic and injury-related factors contributing to activity limitations and participation restrictions in people with spinal cord injury in Bangladesh. Spinal Cord. 2018;56:239–46.

    Article  Google Scholar 

  5. World Health Organization. WHOQOL user manual. Geneva: World Health Organization; 2012. https://www.who.int/tools/whoqol.

  6. Lude P, Kennedy P, Elfström M, Ballert C. Quality of life in and after spinal cord injury rehabilitation: a longitudinal multicenter study. Top Spinal Cord Inj Rehabil. 2014;20:197–207.

    Article  CAS  Google Scholar 

  7. Hossain MS, Rahman MA, Bowden JL, Quadir MM, Herbert RD, Harvey LA, et al. Psychological and socioecononmic status, complications and quality of life in people with spinal cord injuries after discharge from hospital in Bangladesh: a cohort study. Spinal Cord. 2016;54:483–9.

    Article  CAS  Google Scholar 

  8. Hossain MS, Rahman MA, Herbert RD, Quadir MM, Bowden JL, Harvey LA, et al. Two-year survival following discharge from hospital after spinal cord injury in Bangladesh. Spinal Cord. 2016;54:132–6.

    Article  CAS  Google Scholar 

  9. Gupta A, Deepika S, Taly AB, Srivastava A, Surender V, Thyloth M, et al. Quality of life and psychological problems in patients undergoing neurological rehabilitation. Ann Indian Acad Neurol. 2008;11:225–30.

    Article  Google Scholar 

  10. Lidal IB, Veenstra M, Hjeltnes N, Biering-Sørensen F. Health related quality of life in persons with long-standing spinal cord injury. Spinal Cord. 2008;46:710–5.

    Article  CAS  Google Scholar 

  11. Barker RN, Kendall MD, Amsters DI, Pershouse KJ, Haines TP, Kuipers P, et al. The relationship between quality of life and disability across the lifespan for people with spinal cord injury. Spinal Cord. 2009;47:149–55.

    Article  CAS  Google Scholar 

  12. Rohn E, Tate D, Forchheimer M, DiPonio L. Contextualising the lived experience of quality of life of persons with spinal cord injury: a mixed-methods application of the response shift model. J Spinal Cord Med. 2019;42:469–77.

    Article  Google Scholar 

  13. Vural M, Yalcinkaya E, Celik E, Gunduz G, Bozan A, Erhan B, et al. Assessment of quality of life in relation to spasticity severity and socio-demographic and clinical factors among patients with spinal cord injury. J Spinal Cord Med. 2020;34:193–200.

    Article  Google Scholar 

  14. Centre for Rehabilitation of the Paralyzed. Annual report. July 2019 to June 2020. Bangladesh: CRP Printing Press; 2020.

  15. Quadir MM, Sen K, Sultana MR, Ahmed MS, Taoheed F, Andalib A, et al. Demography, diagnosis and complications of spinal cord injury patients in a rehabilitation center of Bangladesh. Int J Neurorehabilit. 2017;4:244.

    Google Scholar 

  16. Hossain MS, Islam MS, Rahman MA, Glinsky JV, Herbert RD, Ducharme S, et al. Health status, quality of life and socioeconomic situation of people with spinal cord injuries six years after discharge from a hospital in Bangladesh. Spinal Cord. 2019;57:652–61.

    Article  Google Scholar 

  17. Üztün T, Kostanjsek N, Chatterji S, Rehm J. Measuring health and disability: manual for WHO Disability Assessment Schedule (WHODAS 2.0). Geneva: World Health Organization; 2010. https://www.who.int/publications/i/item/measuring-health-and-disability-manual-for-who-disability-assessment-schedule-(-whodas-2.0).

  18. Nachar N. The Mann-Whitney U: a test for assessing whether two independent samples come from the same distribution. Tutor Quant Methods Psychol. 2008;4:13–20.

    Article  Google Scholar 

  19. Bewick V, Cheek L, Ball J. Statistics review 10: further nonparametric methods. Crit Care. 2004;8:1–4.

    Google Scholar 

  20. Kumar N, Gupta B. Effect of spinal cord injury on quality of life of affected soldiers in India: a cross-sectional study. Asian Spine J. 2016;10:267.

    Article  Google Scholar 

  21. Tzanos IA, Kyriakides A, Gkintoni E, Panagiotopoulos E. Quality of Life (QoL) of people with Spinal Cord Injury (SCI) in Western Greece. Rehabilitation. 2019;4:7–12.

    Article  Google Scholar 

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Acknowledgements

We are very thankful to all the participants for the voluntary participation. Also, we truly acknowledge the assistance of Abid Hasan Khan.

Funding

The study is solely a self-funded and academic work.

Author information

Authors and Affiliations

Authors

Contributions

ER and NB designed the study. ER, MC, MSI, and MFKP conducted the statistical analysis and interpreted the results. ER, NB, MC, MSI, MFKP, and SKD wrote and reviewed the paper.

Corresponding author

Correspondence to Ehsanur Rahman.

Ethics declarations

Competing interests

The authors declare no competing interests.

Ethical approval

This study conducted with the ethical clearance of the Institutional Review Board (IRB) of Bangladesh Health Professions Institute (CRP/BHPI/IRB/11/2021/537). Also written consent was taken from all the participants.

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Rahman, E., Bardhan, N., Curtin, M. et al. An assessment of disability and quality of life in people with spinal cord injury upon discharge from a Bangladesh rehabilitation unit. Spinal Cord (2022). https://doi.org/10.1038/s41393-022-00852-4

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