Abstract
Design: The present study is part of a programme of longitudinal research on ageing and spinal cord injury involving three populations – American, British and Canadian. The design was multivariate.
Objective: To identify international differences in outcomes associated with ageing and spinal cord injury.
Setting: A sample of 352 participants was assembled from five large, well-established databases. The Canadian sample was derived from the member database of the Canadian Paraplegic Association (Ontario and Manitoba divisions). The British sample was recruited from Southport Hospital's Northwest Regional Spinal Injuries Centre and Stoke-Mandeville Hospital's National Spinal Injuries Centre. The American sample has been recruited through Craig Hospital in Denver, Colorado.
Methods: The sample included individuals who had incurred a spinal cord injury at least 20 years previously; were admitted to rehabilitation within 1 year of injury; were between age 15 and 55 at the time of injury. Data were collected using a combination of self-completed questionnaires and interviews. Data included medical information, general health, hospitalisations, and changes in bladder and bowel management, equipment, pain, spasticity, the need for assistance, and other health issues.
Results: Clear international differences existed between the three samples in the three different countries. After controlling for sampling differences (ie, differences in age, level of lesion, duration of disability, etc.), the following differences were seen: (1) American participants had a better psychological profile and fewer health and disability-related problems; (2) British participants had less joint pain and less likelihood of perceiving they were ageing more quickly; (3) Canadians had more health and disability-related complications (particularly bowel, pain and fatigue problems).
Conclusion: These differences are discussed in terms of socio-political, health care system and cultural factors that might be used to explain them, and to generate hypotheses for future research.
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Acknowledgements
The authors gratefully acknowledge the following assistance and support to the project: The financial support of the Ontario Neurotrauma Foundation, in partnership with the Rick Hansen Institute; The sponsoring institution, Queen's University in Kingston, ON, Canada; The five partner organisations: the Canadian Paraplegic Association–Ontario and Manitoba divisions, the Northwest Regional Spinal Injuries Centre (NRSIC) in Southport, UK, the National Spinal Injuries Centre (NSIC) in Aylesbury, UK, and Craig Hospital in Englewood, Colorado, USA; Research staff and consultants who assisted in the data analysis, specifically, Dr Robert Arnold, David Weitzenkamp, Hang Pham-Bowman and Jan Baker; Interviewers who assisted in the data collection, specifically, Sharon Nishihama, Debbie Donald, Bala Baker; All those who participated in the study and shared aspects of their experience of ageing with a spinal cord injury.
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McColl, M., Charlifue, S., Glass, C. et al. International differences in ageing and spinal cord injury. Spinal Cord 40, 128–136 (2002). https://doi.org/10.1038/sj.sc.3101264
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