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儿童期与成年期脊髓损伤后成人的健康、参与度和生活满意度结果差异。

Differences in health, participation and life satisfaction outcomes in adults following paediatric- versus adult-sustained spinal cord injury.

作者信息

Ma J K, Post M W M, Gorter J W, Martin Ginis K A

机构信息

Department of Kinesiology, Physical Activity Centre for Excellence, McMaster University, Hamilton, Ontario, Canada.

Brain Center Rudolf Magnus and Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands.

出版信息

Spinal Cord. 2016 Dec;54(12):1197-1202. doi: 10.1038/sc.2016.45. Epub 2016 Sep 20.

Abstract

STUDY DESIGN

Cross-sectional.

OBJECTIVES

To compare differences in self-reported health status, participation and life satisfaction outcomes between adults with a spinal cord injury (SCI) sustained during paediatric (P) versus adulthood (A) years.

SETTING

Ontario, Canada.

METHODS

Secondary analysis of data from the Study of Health and Activity in People with SCI. Eighty-seven participants who sustained an SCI prior to age 19 (M±s.e.=25±1.5 years postinjury (YPI)) were matched for lesion level (C2-L5), severity (complete/incomplete), gender, age, education and ethnicity with 87 participants who sustained an SCI at ⩾age 19 years (M=12.8±1.1).

RESULTS

Those with a paediatric SCI reported significantly less pain, fewer visits to the physician in the past year, greater functional independence, social participation, occupational participation and minutes per day of moderate-to-vigorous physical activity than those who sustained an SCI in adulthood. No significant differences were found for the measures of depression, perceived health status or life satisfaction (P>0.05). With the exception of moderate-to-vigorous physical activity and visits to the physician in the past year, between-group differences were independent of YPI.

CONCLUSIONS

Regardless of time since injury, people who sustained a paediatric SCI reported better health and greater participation than those injured in adulthood. Nevertheless, both groups scored well below able-bodied normative values for all measures. The results highlight the importance of a comprehensive life-course approach to SCI rehabilitation, irrespective of age at the time of injury.

摘要

研究设计

横断面研究。

目的

比较儿童期(P)与成年期(A)发生脊髓损伤(SCI)的成年人在自我报告的健康状况、参与度和生活满意度方面的差异。

研究地点

加拿大安大略省。

方法

对脊髓损伤患者健康与活动研究中的数据进行二次分析。87名在19岁之前发生脊髓损伤的参与者(损伤后平均年龄±标准误=25±1.5岁),根据损伤水平(C2-L5)、严重程度(完全性/不完全性)、性别、年龄、教育程度和种族,与87名19岁及以上发生脊髓损伤的参与者(平均年龄=12.8±1.1岁)进行匹配。

结果

与成年期发生脊髓损伤的患者相比,儿童期发生脊髓损伤的患者报告的疼痛明显更少,过去一年看医生的次数更少,功能独立性、社会参与度、职业参与度以及每天中等至剧烈体育活动的分钟数更高。在抑郁、自我感知健康状况或生活满意度方面未发现显著差异(P>0.05)。除了过去一年的中等至剧烈体育活动和看医生次数外,组间差异与损伤后时间无关。

结论

无论受伤后的时间长短,儿童期发生脊髓损伤的患者比成年期受伤的患者报告的健康状况更好,参与度更高。然而,两组在所有测量指标上的得分均远低于健全人的标准值。结果强调了采用全面的生命历程方法进行脊髓损伤康复的重要性,无论受伤时的年龄如何。

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