TY - JOUR
T1 - Validation of Upper Extremity Motor Function as a Key Predictor of Bladder Management After Spinal Cord Injury
AU - Elliott, Christopher S.
AU - Stoffel, John T.
AU - Myers, Jeremy B.
AU - Lenherr, Sara M.
AU - Welk, Blayne
AU - Elliott, Sean P.
AU - Shem, Kazuko
N1 - Publisher Copyright:
© 2019 American Congress of Rehabilitation Medicine
PY - 2019/10
Y1 - 2019/10
N2 - OBJECTIVE: To validate if better upper extremity (UE) motor function predicts clean intermittent catheterization (CIC) adoption and adherence after spinal cord injury (SCI) using a validated instrument (as opposed to prior research using scales based on expert opinion).DESIGN: We examined data from the Neurogenic Bladder Research Group SCI registry, a multicenter, prospective, observational study assessing persons with neurogenic bladder following SCI. All participants who were unable to volitionally void and were >1 year post injury were included. Participants were dichotomized into those performing CIC vs those using other bladder management methods. In addition to demographic and clinical characteristics, UE motor function was examined using the SCI-Fine Motor Function Index using validated categorization levels: (1) no activities requiring hand function, (2) some activities involving gross hand movement, (3) some activities requiring dexterity or coordinated UE movement, or (4) most activities requiring dexterity and coordinated UE movement. Associations were examined using logistic regression.SETTING: Multicenter study.PARTICIPANTS: Registry participants unable to volitionally void after SCI (N=1236).INTERVENTION: Not applicable.MAIN OUTCOME MEASURE: Upper extremity motor function association with CIC.RESULTS: A total of 1326 individuals met inclusion criteria (66% performing CIC, 60% male, and 82% white). On multivariate analysis, better UE motor function was associated with a statistically increased odds of performing CIC (odds ratio, 3.10 [Level 3] and odds ratio, 8.12 [Level 4] vs Levels 1 and 2 [P<.001]).CONCLUSION: In persons with SCI who are unable to volitionally void, UE motor function is highly associated with CIC. These results validate prior findings and continue to suggest that following SCI, the degree of preserved UE motor function is associated with CIC more than any other factor.
AB - OBJECTIVE: To validate if better upper extremity (UE) motor function predicts clean intermittent catheterization (CIC) adoption and adherence after spinal cord injury (SCI) using a validated instrument (as opposed to prior research using scales based on expert opinion).DESIGN: We examined data from the Neurogenic Bladder Research Group SCI registry, a multicenter, prospective, observational study assessing persons with neurogenic bladder following SCI. All participants who were unable to volitionally void and were >1 year post injury were included. Participants were dichotomized into those performing CIC vs those using other bladder management methods. In addition to demographic and clinical characteristics, UE motor function was examined using the SCI-Fine Motor Function Index using validated categorization levels: (1) no activities requiring hand function, (2) some activities involving gross hand movement, (3) some activities requiring dexterity or coordinated UE movement, or (4) most activities requiring dexterity and coordinated UE movement. Associations were examined using logistic regression.SETTING: Multicenter study.PARTICIPANTS: Registry participants unable to volitionally void after SCI (N=1236).INTERVENTION: Not applicable.MAIN OUTCOME MEASURE: Upper extremity motor function association with CIC.RESULTS: A total of 1326 individuals met inclusion criteria (66% performing CIC, 60% male, and 82% white). On multivariate analysis, better UE motor function was associated with a statistically increased odds of performing CIC (odds ratio, 3.10 [Level 3] and odds ratio, 8.12 [Level 4] vs Levels 1 and 2 [P<.001]).CONCLUSION: In persons with SCI who are unable to volitionally void, UE motor function is highly associated with CIC. These results validate prior findings and continue to suggest that following SCI, the degree of preserved UE motor function is associated with CIC more than any other factor.
KW - Intermittent urethral catheterization
KW - Rehabilitation
KW - Spinal cord injuries
KW - Urinary bladder, neurogenic
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U2 - 10.1016/j.apmr.2019.06.011
DO - 10.1016/j.apmr.2019.06.011
M3 - Article
C2 - 31348899
AN - SCOPUS:85070372067
SN - 0003-9993
VL - 100
SP - 1939
EP - 1944
JO - Archives of Physical Medicine and Rehabilitation
JF - Archives of Physical Medicine and Rehabilitation
IS - 10
ER -