Abstract:
Introduction Spinal cord injury (SCI) is one field of neurotrauma where fierce research has been going on to achieve a cure for the dreaded disease. Complete cure of this condition still remains elusive. Although focus is mainly on reversing the physical disability, not much importance is given to other factors which have an immense bearing on quality of life (QOL) of the victim. These factors include social health, psychological health, and environmental factors. The Indian Armed Forces offers the unique advantage of following up a patient from the time of injury till rehabilitation. This prospective longitudinal study is the first of its kind in India, undertaken to assess the QOL of the SCI patient from the time of trauma till end of 1 year. We have attempted to measure QOL of the SCI patients in four main domains (physical health, psychological health, social health, and environmental factors) and further tried to highlight the predictors which play a major role in improving QOL. It is proposed that identifying these important predictors and correcting them with appropriate targeted interventions can play a major role in improving the QOL in SCI patients.
Materials and Methods This prospective longitudinal study was carried out in a single tertiary care hospital from May 2017 to October 2019. All patients with SCI were treated and followed up for at least 1 year posttrauma using the World Health Organization Quality of Life-BREF questionnaire. A total of 68 patients were treated and studied. Results were analyzed and conclusions drawn.
Observations and Results Physical health was the most important domain to have an impact on QOL while environmental health had the least. Maximum improvement occurred in all domains during the first 6 months after which the improvement in scores was unimpressive. The degree of improvement correlated directly to the severity of initial motor deficits. Strong caregivers’ support and structured care in a rehabilitation center played important role in improving the QOL of SCI patients.
Conclusion Our study goes on to prove that in order to improve QOL of SCI patients an assessment needs to be undertaken going beyond physical domain. Factors playing a major role in deciding QOL should be identified and then subsequently be corrected with targeted interventions.
MRI investigation of the sensorimotor cortex and the corticospinal tract after acute spinal cord injury: a prospective longitudinal study