Socio-demographic and injury-related factors contributing to activity limitations and participation restrictions in people with spinal cord injury in Bangladesh

Study design: Cross-sectional study. Objectives: To identify socio-demographic and injury-related factors that contribute to activity limitations and participation restrictions in people with spinal cord injury (SCI) in Bangladesh. Setting: Centre for the Rehabilitation of the Paralysed (CRP), Savar, Dhaka, Bangladesh. Methods: This study involved 120 (83% men) participants with SCI; their median (interquartile range) age and injury duration were 34 (25–43) years and 5 (2–10) years, respectively. Data were collected from the follow-up records kept by the Community Based Rehabilitation (CBR) unit of CRP and a subsequent home visit that included interview-administered questions, questionnaires, and a neurological examination. The dependent variables were activity limitations and participation restrictions, assessed with the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0, scored 0–100; a high score indicates greater activity limitations and participation restrictions). Independent variables included socio-demographic factors (i.e., age, sex, marital status, educational level, monthly household income, employment status, and place of residence) and injury-related factors (i.e., injury duration, cause of injury, injury severity, and type of paralysis). Multivariable linear regression analyses were performed to identify the factors that independently contributed to activity limitations and participation restrictions. Results: Three significant independent variables explained 20.7% of the variance in activity limitations and participation restrictions (WHODAS 2.0 score), in which tetraplegia was the strongest significant contributing factor, followed by rural residence and complete injury. Conclusions: This study would indicate that tetraplegia, complete injury, and residing in a rural area are the major contributions in limiting the activity and participation following SCI in Bangladesh