Describing Functioning in People Living With Spinal Cord Injury in Switzerland: A Graphical Modeling Approach

Abstract

Objective: To describe functioning in people living with spinal cord injuries (SCI) in Switzerland.

Design: Secondary analysis of cross-sectional survey data.

Setting: Community, Switzerland.

Participants: Individuals (N=1549) 16 years of age or older with a history of traumatic or nontraumatic SCI and permanently residing in Switzerland.

Interventions: Not applicable.

Main outcome measures: Functioning was operationalized through 4 domains: (1) impairments in body functions; (2) impairments in mental functions; (3) independence in performing activities; and (4) performance problems in participation.

Results: Univariate analysis indicated a high prevalence of problems in 5 areas: (1) housework; (2) climbing stairs; (3) tiredness; (4) spasticity; and (5) chronic pain. Graphical modeling showed a strong association among the four domains of functioning. Moreover, we found that the differences in the dependence structures were significant between the paraplegia SCI population and the tetraplegia SCI population.

Conclusions: This study is a first study in the epidemiology of functioning of people living with SCI in Switzerland. Using univariate and graphical modeling approaches, we proposed an empirical foundation for developing hypotheses on functioning in each domain and category that could inform health systems on people's health needs.

Keywords: International Classification of Functioning, Disability and Health; Prevalence; Rehabilitation; Spinal cord injuries; Undirected graph.