Race and ethnicity influence outcomes of patients with motor complete SCI

Scientists find variation in self-care and mobility outcomes by race and ethnicity in persons with complete spinal cord injury

Researchers have published a study examining racial and ethnic influences in the outcomes of patients with motor complete spinal cord injury (SCI). The article, "Racial and ethnic disparities in functioning at discharge and follow-up among patients with motor complete SCI," was published online ahead of print on August 2 by the Archives of Physical Medicine & Rehabilitation (doi: 10.1016/j.apmr.2014.07.398). Findings included small but significant differences in self-care and mobility at discharge; no differences were apparent at 1-year followup. Authors are Denise Fyffe, PhD, and Amanda Botticello, PhD, MPH, of Kessler Foundation, Steven Kirshblum, MD, of Kessler Institute for Rehabilitation, Anne Deutsch, RN, PhD, CRRN, of Rehabilitation Institute of Chicago and RTI International, and Kenneth Ottenbacher, PhD, OTR, of the University of Texas Medical Branch.

Data for 1,766 adults with motor complete SCI (ASIA grade A or B) were derived from the Spinal Cord Injury Model System Database, a national, longitudinal database funded by the National Institute on Disability and Rehabilitation Research (NIDRR). Patients selected represented the three largest groups with SCI: non-Hispanic whites, non-Hispanic blacks, and Hispanic. Functional outcomes were measured at admission, discharge and 1-year followup using the Functional Independence Measure (FIM) scale for self-care and mobility.

Few studies have been conducted on health disparities and functional outcomes in SCI despite the fact that racial and ethnic minorities are more likely to develop secondary complications, be unemployed, and have compromised quality of life. "In this study, at discharge from rehabilitation, greater improvement in FIM scores for self-care and mobility was seen in Hispanics and non-Hispanic whites, when compared with non-Hispanic blacks," noted Dr. Fyffe, research scientist in Spinal Cord Injury/Outcomes & Assessment Research at Kessler Foundation. "Further investigation into the mechanisms that underlie these differences is needed," said Dr. Fyffe, "in order to determine modifiable factors associated with successful transition, functional independence and quality of life for persons with complete SCI."