Fitness and Independence after SCI: Defining Meaningful Change and Thresholds.

摘要

Quality of life after SCI/D is depends more on participation, mobility, and personal care independence than injury level/severity. Fitness is a major determinant of transfer and general ADL independence in persons with SCI/D. Fitness can prevent or delay further aging related independence losses. We propose fitness represents an underappreciated approach to meaningfully improve independence and thus QOL of people living with SCI/D, no matter their injury level, age, or injury duration. In Phase 1 we interview SCI/D clinicians and consumers to determine if the candidate variables for the clinical risk calculator could be collected clinically; identify clinical techniques to assess patients fitness; and document factors clinicians and consumers identify as fitness-function relationship confounds. In Phase 2 we collect data on 300 persons with SCI/D describing personal characteristics, criterion fitness, clinical fitness predictors, neurological impairment, balance, and functional independence. In Phase 3 we analyze Phase 2 data and develop the CRC, a tool that clinicians and consumers to determine if low fitness is limiting transfer ability.