Recovery of Biopsychosocial Functions Following 15 Years after Spinal Cord Injury

Background: Spinal cord injury (SCI) causes the loss of biopsychosocial functions, body dysfunctions, decreased functional independence level, limitations in activities, and participation restriction. For recovery of functioning, comprehensive inpatient rehabilitation programs are necessary, which are more focused on recovery of physical status, capacity, functional independence level, maintenance of existing skills, and improvement of activities in daily life. In the long-term context, functioning improves naturally by engaging in various activities of everyday life. The aim of this study was to evaluate the changes in functioning and functional independence following 15 years after SCI. Material and Methods: A total of 109 people with SCI were enrolled in the study during 2007-2015. The study was carried out during inpatient rehabilitation in the Centre of Rehabilitation, Physical and Sports Medicine. The second assessment was performed after 1-15 years. For evaluation functional independence, the Functional Independence Measure (FIM) was used. Functional problems were assessed by the Comprehensive ICF Core Set for SCI. Results: Rehabilitation mostly increased the functional independence level and significantly decreased the severity of body dysfunctions and participation restriction in daily life. In the long-term context, the reached functional independence level of persons with SCI did not change significantly and remained stable, but dysfunctions of muscle strength, physical endurance, moving around, and participation in household and leisure activities significantly decreased. In the long-term context, the percentage of employed subjects and having higher education increased. Conclusion: Rehabilitation after SCI effectively improves patients’ severe functional problems, but in the following periods, functioning increases each year after SCI by naturally engaging in daily living activities.