Validation of Upper Extremity Motor Function as a Key Predictor of Bladder Management After Spinal Cord Injury

Christopher S. Elliott, John T. Stoffel, Jeremy B. Myers, Sara M. Lenherr, Blayne Welk, Sean P. Elliott, Kazuko Shem

Research output: Contribution to journalArticlepeer-review

8 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)1939-1944
Number of pages6
JournalArchives of Physical Medicine and Rehabilitation
Issue number10
StatePublished - Oct 2019

Bibliographical note

Funding Information:
Supported by the Patient-Centered Outcomes Research Institute (award no. CER14092138). All statements in this report, including its findings and conclusions, are solely those of the authors and do not necessarily represent the views of the Patient-Centered Outcomes Research Institute.


  • Intermittent urethral catheterization
  • Rehabilitation
  • Spinal cord injuries
  • Urinary bladder, neurogenic

PubMed: MeSH publication types

  • Journal Article


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