A comparison of independent living outcomes following traumatic brain injury and spinal cord injury

This study compares independent living outcomes in persons with traumatic brain injury (TBI) and spinal cord injury (SCI). Both injuries represent life-altering events that are known to have a negative impact on independent living and are predominantly experienced by members of the same demographic group. However, the types of resultant impairments and disabilities experienced by the two populations differ substantially. The TBI participants were recruited consecutively from Canadaʼs largest tertiary care trauma centre and followed prospectively for four years. The SCI participants were recruited via a mailed survey to members of a provincial branch of the Canadian Paraplegic Association. Independent living outcomes were measured using DeJong and Hughesʼ (1982) classification system of productivity status, the Reintegration to Normal Living Index, and questions on assistance from environmental supports in the form of wheelchair use and paid/unpaid personal assistance. The TBI group was found to be significantly more productive, have higher levels of satisfaction with their current experience of community integration, and use fewer environmental supports than their SCI counterparts (P ≤0.0001). Methodological and demographic differences between the samples are discussed in relation to the results. The results suggest that various aspects of independent living in these two defined groups (TBI and SCI) although highly related require specific attention and that clinicians and researchers working with TBI and SCI might benefit from further collaborative efforts.In dieser Studie wird das Maß an Unabhängigkeit bei Patienten mit traumatischen Hirnverletzungen (TBI) und Rückenmarksverletzungen (SCI) verglichen. Beide Verletzungen stellen Ereignisse dar, die das Leben verändern und sich negativ auf die unabhängige Lebensweise auswirken und von denen überwiegend Angehörige derselben demographischen Gruppe betroffen sind. Jedoch unterscheiden sich die Arten der resultierenden Beeinträchtigungen und Behinderungen in den beiden Kollektiven erheblich. Die Teilnehmer mit Hirntraumata wurden fortlaufend aus Kanadas größtem Traumazentrum der Spezialversorgung rekrutiert und prospektiv 4 Jahre lang beobachtet. Die Teilnehmer mit Rückenmarksverletzungen wurden mittels Fragebogen rekrutiert, der an Mitglieder eines regionalen Zweiges der Canadian Paraplegic Association verschickt wurde. Die Parameter der unabhängigen Lebensweise wurden anhand des Klassifikationssystems des Pr