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Secondary Impairments After Spinal Cord Injury: A Population-Based Study

Noreau, Luc PhD; Proulx, Pierre MD; Gagnon, Lisette MSc, RN; Drolet, Mélanie MSc, PT; Laramée, Marie-Thérèse MSc, PT

American Journal of Physical Medicine & Rehabilitation: November-December 2000 - Volume 79 - Issue 6 - p 526-535
CME Article: Spinal Cord Injury

Objective To determine the prevalence of secondary impairments among individuals with long-standing spinal cord injury in Quebec and the potential relationships between these impairments and several variables.

Design A review of 2200 medical files was conducted to determine the target population; 976 patients were selected randomly and mailed questionnaires. The results were based on 482 individuals with spinal cord injury who returned the completed questionnaire. The questionnaire included 14 subsections, such as sociodemographic, medical, psychosocial, and environmental information. The medical section, including the type and level of lesion and the presence of secondary impairments, was analyzed.

Results Urinary tract infection, spasticity, and hypotension were the most frequently reported secondary impairments, regardless of the severity of injury. Relationships between the prevalence of secondary impairments and the duration of injury, as well as perceived health status, were observed.

Conclusions This is the first study to describe secondary impairments after long-standing spinal cord injury in Quebec. Patients with spinal cord injury still present a high prevalence of secondary impairments many years after their rehabilitation, despite preventive education or medical follow-up visits. Further studies are required to determine the specific impact that these impairments have on the patients’ social role and their quality-of-life.

From the Rehabilitation Institute of Quebec City (LN), Montreal Rehabilitation Institute (LN, PP, LG, M-TL), and the Department of Rehabilitation (LN, MD), Laval University, Quebec City, Quebec, Canada.

All correspondence and requests for reprints should be addressed to Luc Noreau, PhD, Rehabilitation Institute of Quebec City, 525 Boul. Hamel, Québec, PQ, Canada G1M 2S8.

Supported, in part, by The Quebec Automobile Insurance Plan and The Fondation André Senécal.

Objectives: Upon completion of this article, the reader should be able to (1) identify the most prevalent secondary impairments after spinal cord injury (SCI), overall and with regard to the severity of injury; (2) explain the reasons for some of the variations in the prevalence of secondary impairments after SCI; and (3) describe potential patterns of variations over time in the prevalence of secondary impairments after SCI.

Level: Advanced

Accreditation: The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to sponsor continuing medical education for physicians.

The Association of Academic Physiatrists designates this continuing medical education activity for a maximum of one credit hour in Category 1 of Physician’s Recognition Award of the American Medical Association. Each Physician should claim only those hours of credit that he/she actually spent in the education activity.

Disclosure: Disclosure statements have been obtained regarding the authors’ relationships with financial supporters of this activity. There is no apparent conflict of interest related to the context of participation of the authors of this article.

How to Obtain CME Category 1 Credits

To obtain CME Category 1 credit, this educational activity must be completed and postmarked by December 31, 2001. Participants may read the articles and take the exams issue by issue or wait to study several issues together. After reading the three CME Articles in this issue, participants may complete the Self-Assessment Exam by answering the questions on the CME Answering Sheet and the Evaluation pages, which appear later in this section. Send the completed forms to: CME Department, Association of Academics Physiatrists, 5987 E. 71st Street, Suite 112, Indianapolis, In 46220. Documentation can be received at the AAP National Office at any time throughout the year, and accurate records will be maintained for each participant. CME certificates are issued only once a year in January for the total number of credits earned during the prior year.

© 2000 Lippincott Williams & Wilkins, Inc.