Abstract
Study design:
Despite significant progress in bladder management, urinary tract infections (UTIs) are still common among individuals with spinal cord injury (SCI), and could negatively impact their health and quality of life. However, there are no data available on bladder management and frequency of UTIs among elite athletes with SCI.
Methods:
Athletes were assessed during the London 2012 Paralympic Games and 2013 Paracycling World Championships. Athletes completed the standard form of the International Standards to Document remaining Autonomic Functions after SCI, along with the standardized Autonomic Function Questionnaire.
Results:
A total of 61 (age=35.5±7.7 years (mean±s.d.); time since injury=16.0±7.6 years) elite athletes from 15 countries with traumatic SCI and who used clean intermittent catheterization were included in this study. The majority (75%) were from developed nations. Athletes catheterized on average 6±2 times per day. We found that individuals who reused catheters experienced more frequent UTIs (P<0.001). We also demonstrated that 83% of individuals from developed nations never reused a single-use catheter, whereas only 27% of individuals from developing nations used a new catheter each time (P<0.001). We also noted a twofold increase in the frequency of UTIs in individuals from developing nations (P=0.027).
Conclusions:
This study demonstrates that catheter reuse is intimately linked to UTI frequency and provides novel insight on bladder function and management in elite athletes with SCI. Reasons for catheter reuse may be due to a lack of health education and/or a lack of bladder-management resources. (Support: Craig Neilsen Foundation, ICORD, IPC)
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Acknowledgements
We would like to thank all Paralympic athletes who took part in this study and the International Paralympic Committee and Paracycling Association for help and logistical support during the study that took place during the London 2012 Paralympics Games and 2013 World Paracycling Championship Quebec, Canada. We also express thanks to Ms S Wong and Ms M Pak for assistance during the study. The Cardiovascular Health Clinic during 2012 Paralympic Games was supported by a Craig H Neilsen Foundation Quality of life grant (PI Dr Krassioukov). Dr C West is funded by a Craig H Neilsen Postdoctoral Fellowship. Research in the laboratory of Dr Krassioukov is supported by grants from Canadian Institutes of Health Research, Heart and Stroke Foundation of BC & Yukon, Canadian Foundation for Innovation and others. Ms J Cragg is supported by a University of British Columbia Killam Doctoral Award. Dr C Voss is supported by a Heart and Stroke Foundation of Canada and the Michael Smith Foundation for Health Research fellowships.
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Krassioukov, A., Cragg, J., West, C. et al. The good, the bad and the ugly of catheterization practices among elite athletes with spinal cord injury: a global perspective. Spinal Cord 53, 78–82 (2015). https://doi.org/10.1038/sc.2014.208
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DOI: https://doi.org/10.1038/sc.2014.208
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