title: Association of mode of locomotion and independence in locomotion with long-term outcomes after spinal cord injury.
abstract: OBJECTIVE
  To explore the association of mode of locomotion (ambulation vs wheelchair use) and independence in locomotion (independent vs require assistance) with health, participation, and subjective well-being (SWB) after spinal cord injury (SCI).
  
  
  METHODS
  Secondary analysis was conducted on survey data collected from 2 rehabilitation hospitals in the Midwest and a specialty hospital in the southeastern United States. The 1,493 participants were a minimum of 18 years of age and had traumatic SCI of at least 1 year duration at enrollment.
  
  
  METHODS
  Three sets of outcome measures were used: SWB, participation, and health. SWB was measured by 8 scales and a measure of depressive symptoms, participation by 3 items, health by general health ratings, days in poor health, hospitalizations, and treatments.
  
  
  RESULTS
  Small but significant associations were observed between independence in locomotion and every outcome. Ambulation was associated with greater participation but a mixed pattern of favorable and unfavorable health and SWB outcomes. Supplemental analyses were conducted on those who ambulated but who were dependent on others to do so (n = 117), because this group reported poor outcomes in several areas. Individuals who were independent in wheelchair use reported substantially better outcomes than nonwheelchair users and those dependent on others in wheelchair use.
  
  
  CONCLUSIONS
  Although ambulation is often a recovery goal, individuals with SCI who ambulate do not uniformly report better outcomes than wheelchair users, and those who depend on others for assistance with ambulation may experience a unique set of problems.
authors.affiliation: College of Health Professions, Medical University of South Carolina, Charleston, SC 29425, USA. krause@musc.edu
authors.forename: James
authors.initials: J
authors.lastname: Krause
authors.forename: Rickey E
authors.initials: RE
authors.lastname: Carter
authors.forename: Sandra
authors.initials: S
authors.lastname: Brotherton
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D004185:Disability Evaluation; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008124:Locomotion / Q000502:physiology*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods*; D012720:Severity of Illness Index; D012959:Socioeconomic Factors; D013119:Spinal Cord Injuries / Q000503:physiopathology* / Q000534:rehabilitation*; D011795:Surveys and Questionnaires; D016138:Walking; D014910:Wheelchairs