Factors Affecting Self-Care Activities and Mobility in Patients With Incomplete Tetraplegia

To investigate the factors affecting activities of daily living and mobility in patients with incomplete spinal cord injury (SCI) and to suggest the direction of training necessary for functional improvement.

Sixty-three adult patients with SCI who were admitted to the National Rehabilitation Center (Seoul, Korea) formed our study population. Scores of 2 categories (self-care and mobility) in the Korean version of the Spinal Cord Independence Measure-III (KSCIM-III) were compared to the upper extremity motor score (UEMS), lower extremity motor score (LEMS), Modified Ashworth Scale (MAS), Visual Analog Scale (VAS), Graded Redefined Assessment of Strength, Sensibility, and Prehension (GRASSP), grip and pinch strength, Functional Ambulation Category (FAC), Berg Balance Scale (BBS), Trunk Impairment Scale (TIS), Korean version of Beck Depression Inventory-II, Korean version of the Pittsburgh Sleep Quality Index, and Lean indices. Correlation analysis was performed to investigate any correlation between each variable, and multiple regression analysis was performed to evaluate a causal relationship.

Self-care correlated significantly with American Spinal Injury Association Impairment Scale (AIS) classification D (B = -3.54, P = .035), GRASSP total (B = 0.05, P ≤ .001), and TIS total (B = 0.46, P ≤ .001). Mobility correlated significantly with GRASSP total (B = 0.05, P = .005), FAC (B = 3.21, P ≤ .001), and TIS total (B = 0.64, P = .005).

This study demonstrated that upper and lower extremity functions and trunk control ability significantly affect self-care and mobility in patients with incomplete SCI. Thus, trunk control training should be emphasized in patients with incomplete SCI.