Journal Club Discussion #18: ADLs Among SCI Patients 20 Years After Injury

Hey readers! Last week was my first week of the condensed summer semester, so I am about to get very busy! (I can already feel the stress piling on…) This summer I am taking OT in Physical Dysfunction, which relates to the topic we are discussing this week: spinal cord injuries (SCI). The article that we are reading is called “Longitudinal Change in Activities of Daily Living for Persons With Spinal Cord Injury Across 20 Years” by Chih-Ying (Cynthia) Li, Craig Velozo, Ickpy Hong, and Jill Newman. AOTA members can access the article here.

Background Info

Spinal cord injuries can lead to dramatic decreases in participation in daily activities. According to Li et al. (2017), the duration and intensity of mobility activities drops after hospital discharge and remains at the same level 1 year post-discharge. Due to this fact, this study aimed to assess longitudinal changes in ADL performance in individuals who have sustained an SCI after 20 years.

Methods & Participants

The authors used data from a 40 year longitudinal study. Participants were community dwelling individuals who had sustained an SCI, and they were split into three groups based on level of injury. The groups were as follows: C1-C4 (n=29), C5-C7 (n=161), and T1-S5 (n=181).

Results

All groups experienced significant decreases in self-reported ADL performance (Li et al., 2017). There was also a significant effect between group and time (Li et al., 2017). Read more in the article!

FAME Scale

Feasibility: A

Appropriateness: A

Meaningfulness: A

Effectiveness: A

I gave this article a score of an “A” in all areas because while the actual methods for this study are not practicable immediately, the idea of OT intervention for SCI patients over a long period of time is practicable immediately.

What I Think

I think that the role of OT in working with SCI patients is huge. The authors state that “long-term [OT] intervention and consultation may be beneficial, especially for individuals with C1-C4 SCI” (Li et al., 2017, n.p.). Occupational therapists can help to improve long-term performance in ADLs as well as other areas of meaningful occupation for individuals who have sustained SCIs or other injuries. Go OT!

Question of the Week: What interventions do you do with patients who have sustained an SCI to improve ADL performance? Comment below!

Citation: Li, C., Velozo, C., Hong, I., & Newman, J. (2017). Longitudinal change in activities of daily living for persons with spinal cord injury across 20 years. American Journal of Occupational Therapy, 71. doi: 10.5014/ajot.2017.71S1-RP302B

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