Health of people with spinal cord injury in Singapore : the implications for rehabilitation planning and implementation

Background: Knowledge about the health of people living with spinal cord injuries (SCIs) in the community is lacking in Singapore. Purpose: To describe the health of people with SCI in Singapore and formulate recommendations for long-term rehabilitation planning and implementation. Methods: This was a cross-sectional descriptive study of people living with traumatic SCI in Singapore. Demographic data, injury information and information about SCI-related secondary impairments, chronic conditions and their associated risk factors, medical and hospital utilization, participation (Craig Handicap Assessment and Reporting Technique [CHART]) and life satisfaction (Satisfaction with Life Scale [SWLS]) were collected through telephone or in-person interviews. Participants were stratified according to presence or absence of a full-time live in carer, time since injury, injury type and participation in regular exercise. Post-hoc comparisons were conducted for these groups. The association between participation and life satisfaction was examined. Results: On average, participants (50 men and 5 women) were aged 48.3±16.54 years and had had their SCIs for 5 years. Three quarters (78.2%) had tetraplegia. The most prevalent SCI-related secondary impairments were pain, spasms, bladder problems, bowel problems and edema. The prevalence of chronic conditions and their associated risk factors was greater among the participants than reported for Singaporeans overall. The prevalence of diabetes and hypertension was 9.1% and 10.9%, respectively. Almost a quarter of participants were told by doctors that they were overweight and/or had high cholesterol. One quarter (25.5%) of participants reported exercising regularly. The prevalence of binge drinking and daily smoking was 5.5% and 12.7%, respectively. Mean CHART scores ranged between 32.2 and 88.4 with lowest scores in the ‘occupation’ dimension. The mean SWLS score was 13.9. Participation and life satisfaction scores were lower than those reported for similar populations cross-culturally. Conclusion: People with SCI in Singapore may be less healthy than the population overall. Our findings support the need for a registry and database to help track the changing needs of this population over time with the aim to increase the quality of life of people with SCI in Singapore and, in turn, help minimize long-term social and economic burdens for the country.Medicine, Faculty ofGraduat