Kader Manzur, Perera Nirmala K P, Sohrab Hossain Mohammad, Islam Redwanul
Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden.
Faculty of Health, Federation University Australia, Ballarat, Australia.
Spinal Cord. 2018 Mar;56(3):239-246. doi: 10.1038/s41393-017-0001-y. Epub 2017 Nov 2.
Cross-sectional study.
To identify socio-demographic and injury-related factors that contribute to activity limitations and participation restrictions in people with spinal cord injury (SCI) in Bangladesh.
Centre for the Rehabilitation of the Paralysed (CRP), Savar, Dhaka, Bangladesh.
This study involved 120 (83% men) participants with SCI; their median (interquartile range) age and injury duration were 34 (25-43) years and 5 (2-10) years, respectively. Data were collected from the follow-up records kept by the Community Based Rehabilitation (CBR) unit of CRP and a subsequent home visit that included interview-administered questions, questionnaires, and a neurological examination. The dependent variables were activity limitations and participation restrictions, assessed with the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0, scored 0-100; a high score indicates greater activity limitations and participation restrictions). Independent variables included socio-demographic factors (i.e., age, sex, marital status, educational level, monthly household income, employment status, and place of residence) and injury-related factors (i.e., injury duration, cause of injury, injury severity, and type of paralysis). Multivariable linear regression analyses were performed to identify the factors that independently contributed to activity limitations and participation restrictions.
Three significant independent variables explained 20.7% of the variance in activity limitations and participation restrictions (WHODAS 2.0 score), in which tetraplegia was the strongest significant contributing factor, followed by rural residence and complete injury.
This study would indicate that tetraplegia, complete injury, and residing in a rural area are the major contributions in limiting the activity and participation following SCI in Bangladesh.
横断面研究。
确定导致孟加拉国脊髓损伤（SCI）患者活动受限和参与受限的社会人口学因素及与损伤相关的因素。
孟加拉国达卡萨瓦尔的瘫痪者康复中心（CRP）。
本研究纳入了120名SCI患者（83%为男性）；他们的年龄中位数（四分位间距）和损伤持续时间分别为34（25 - 43）岁和5（2 - 10）年。数据收集自CRP社区康复（CBR）单元保存的随访记录以及随后的家访，家访包括访谈式问题、问卷和神经学检查。因变量为活动受限和参与受限，采用世界卫生组织残疾评定量表2.0（WHODAS 2.0，评分0 - 100；高分表明活动受限和参与受限程度更高）进行评估。自变量包括社会人口学因素（即年龄、性别、婚姻状况、教育水平、家庭月收入、就业状况和居住地点）以及与损伤相关的因素（即损伤持续时间、损伤原因、损伤严重程度和瘫痪类型）。进行多变量线性回归分析以确定独立导致活动受限和参与受限的因素。
三个显著的自变量解释了活动受限和参与受限（WHODAS 2.0评分）中20.7%的方差，其中四肢瘫痪是最强的显著影响因素，其次是农村居住和完全性损伤。
本研究表明，在孟加拉国，四肢瘫痪、完全性损伤以及居住在农村地区是限制SCI后活动和参与的主要因素。
