title: Impact of health problems secondary to SCI one and five years after first inpatient rehabilitation.
abstract: METHODS
  This is a multicenter prospective cohort study.
  
  
  OBJECTIVE
  The objective of this study was to describe and compare the impact of health problems secondary to spinal cord injury (SCI) on functioning at home and on social activities at 1 and 5 years after discharge from first inpatient rehabilitation.
  
  
  METHODS
  The study was conducted in a Dutch community.
  
  
  METHODS
  Participants with SCI who use a wheelchair for everyday mobility (N=110) completed a self-report questionnaire as part of a larger cohort study including four items on extra time needed (body care, bladder and bowel regulation, 'organization' and transportation) and impact of 10 health problems on functioning at home and on social activities. The 10 health problems include secondary health conditions (bladder regulation, bowel regulation, decubitus, pain, spasticity, gain in body weight and edema), psychosocial problems (sexuality, having difficulty with being dependent on help from others) and handicap management.
  
  
  RESULTS
  Median extra time needed for self-management and transportation was not significantly higher 1 year after discharge (16 (IQR 13.5) h per week) compared with 5 years after discharge (13 (IQR 17) h per week) (P=0.925). Participants reported slightly less impact, comparing the severity sum-score (range 10-50) of the 10 health problems on functioning at home and in social activities, 5 years post discharge (20 and 17, respectively) than 1 year post discharge (21 and 18, respectively; P<0.05). Most frequently mentioned health problems were handicap management, being dependent on help from others, bladder regulation, bowel regulation, pain and sexuality.
  
  
  CONCLUSIONS
  The impact of health problems after SCI is considerable and hardly diminishes over time. These results emphasize the need for structured long-term care for people with SCI.
authors.affiliation: Brain Center Rudolf Magnus and Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands.|Spinal Cord injury Department, Sophia Rehabilitation, Den Haag, The Netherlands.
authors.forename: P
authors.initials: P
authors.lastname: van der Meer
authors.affiliation: Brain Center Rudolf Magnus and Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands.|University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, The Netherlands.
authors.forename: M W M
authors.initials: MW
authors.lastname: Post
authors.affiliation: Brain Center Rudolf Magnus and Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands.|Spinal Cord injury Department, De Hoogstraat Rehabilitation, Utrecht, The Netherlands.
authors.forename: C M C
authors.initials: CM
authors.lastname: van Leeuwen
authors.affiliation: Spinal Cord Injury Department, Sint Maartenskliniek Rehabilitation, Nijmegen, The Netherlands.
authors.forename: H J M
authors.initials: HJ
authors.lastname: van Kuppevelt
authors.affiliation: Spinal Cord injury Department, Reade Rehabilitation and Research Center, Amsterdam, The Netherlands.
authors.forename: C A J
authors.initials: CA
authors.lastname: Smit
authors.affiliation: Brain Center Rudolf Magnus and Center of Excellence for Rehabilitation Medicine, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands.
authors.forename: F W A
authors.initials: FW
authors.lastname: van Asbeck
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007297:Inpatients; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012648:Self Care; D057566:Self Report; D012720:Severity of Illness Index; D012919:Social Behavior; D013119:Spinal Cord Injuries / Q000150:complications* / Q000503:physiopathology / Q000523:psychology / Q000534:rehabilitation*; D013997:Time Factors; D016896:Treatment Outcome; D014910:Wheelchairs; D055815:Young Adult