Age-related variation in mobility independence among wheelchair users with spinal cord injury: A cross-sectional study

Abstract

Objective: To evaluate age-related variation in mobility independence among community-living wheelchair users with spinal cord injury (SCI).

Design: Community Survey (2011–2013) as part of the Swiss Spinal Cord Injury Cohort Study.

Setting: Community.

Participants: Individuals aged 16 years or older with traumatic or non-traumatic SCI permanently residing in Switzerland and using a wheelchair for moving around moderate distances (10–100 m).

Interventions: Not applicable.

Outcome Measures: Mobility-related items of the Spinal Cord Independence Measure-Self Report were matched to the three principal domains “changing basic body position,” “transferring oneself” and “moving around.” Binary outcomes (“independence” vs. “no independence”) were created for every domain and analyzed using multivariable logistic regression (adjusted for sex, socioeconomic factors, SCI characteristics, and health conditions).

Results: Regression analyses (N = 949; 27% women; median age 51, interquartile range 41–61) showed a decline in the odds of independence (odds ratio; 95% confidence interval) with increasing age for “changing basic body position” (age 16–30 (reference), 31–45 (0.99; 0.53–1.83), 46–60 (0.64; 0.33–1.21), 61–75 (0.45; 0.22–0.92), 76+ (0.18; 0.07–0.44); P < 0.001), “transferring oneself” (age 16–30 (reference), 31–45 (0.77; 0.37–1.61), 46–60 (0.39; 0.18–0.84), 61+ (0.05; 0.02–0.14); P < 0.001), and “moving around” (age 16–30 (reference), 31–45 (0.79; 0.42–1.48), 46–60 (0.49; 0.26–0.94), 61–75 (0.49; 0.24–1.01), 75+ (0.11; 0.04–0.30); P < 0.001).

Conclusions: Mobility independence was negatively associated with age in wheelchair users with SCI. Future longitudinal analyses are required to gain further insights into the causal factors for the age-related decline.

Keywords:

• Spinal cord injuries
• Wheelchairs
• Disabled persons
• Movement
• Moving and lifting patients

Acknowledgments

The members of the Swiss Spinal Cord Injury Cohort Study (SwiSCI, http://www.swisci.ch) Steering Committee are: Olivier Dériaz (Clinique Romande de Réadaptation, Sion); Michael Baumberger, Hans Peter Gmünder (Swiss Paraplegic Center, Nottwil); Armin Curt, Martin Schubert (University Clinic Balgrist, Zürich); Margret Hund-Georgiadis, Kerstin Hug (REHAB Basel, Basel); Hans Georg Koch, Urs Styger (Swiss Paraplegics Association, Nottwil); Hardy Landolt (Representative of persons with SCI, Glarus); Hannjörg Koch (SUVA, Luzern); Mirjam Brach, Gerold Stucki (Swiss Paraplegic Research, Nottwil); Martin Brinkhof, Christine Thyrian (SwiSCI Study Center at Swiss Paraplegic Research, Nottwil). The authors would like to thank Birgit Prodinger (ICF Unit, Swiss Paraplegic Research) for advice on the use of ICF terminology.

Disclaimer statements

Contributors MB and IEH contributed to the design of the SwiSCI Cohort Study. TH initiated the present study on mobility independence, all authors substantially contributed to conception and design. VL contributed to data management. VL, TH and MB performed the statistical analyses. All authors interpreted the data. TH drafted the manuscript. All authors critically revised the manuscript and gave final approval of the version to be published.

Funding This study has been financed in the framework of SwiSCI, supported by the Swiss Paraplegic Foundation.

Conflict of interest None.

Ethics approval SwiSCI was approved by the ethics committee of the Canton of Lucerne (the location of the main study center) and subsequently endorsed by the ethics committees of the Cantons Zürich, Basel-Stadt and Valais.