Article

OBJECTIVES: To identify the natural course of changes in participation,
employment, health and subjective quality of life over a 35-year interval among
participants with spinal cord injury (SCI). METHODS: Participants were enrolled
in 1973 from a specialty hospital in the Midwestern United States and assessed
again approximately 35 years later. The inclusion criteria were the following:
having traumatic SCI; being 18 years of age or older; and a minimum of 2 years
having elapsed post injury. There were 64 participants who responded on both
occasions. Average age at follow-up was 61.5 years, with 41.1 years having passed
since SCI onset. The Life Situation Questionnaire was used to measure outcomes.
RESULTS: Attrition analyses indicated that those who participated at follow-up
were younger and had better overall outcomes at baseline (1973) when compared
with those who dropped out of the study. Longitudinal analyses indicated a mixed
pattern of favorable and unfavorable changes over the 35 years. The overall
social participation decreased over time, although the sitting tolerance and
hours spent in gainful employment increased. Non-routine physician visits
increased. Satisfaction with employment improved over time, whereas satisfaction
with social life, sex life and health declined. Self-reported adjustment
improved, but the prediction of future adjustment in 5 years declined.
CONCLUSION: Our study suggests that the natural course of SCI is marked by a
survivor effect, whereby those with better outcomes are more likely to survive to
follow-up, and a mixed pattern of favorable and unfavorable changes.
Rehabilitation professionals should work to promote favorable outcomes in areas
of strength, as well as minimize the likelihood of adverse outcomes.

Langue : ANGLAIS