Reclaiming Independence: Daily Activities and Rehabilitation Goals in Spinal Cord Injury

Details

This study is a cross-sectional, single-center, observational study designed to address a recognized gap in rehabilitation literature concerning person-centered care in Spinal Cord Injury (SCI) . While aligning treatment with patient-specific goals is critical for improving motivation and adherence, most research identifying patient functional priorities has been conducted in Western populations . This research specifically aims to investigate these priorities within the Turkish SCI population, for which currently no data is available, thereby providing a foundation for culturally-relevant and patient-specific rehabilitation planning . The study will be conducted at the Biruni University Hospital Physical Medicine and Rehabilitation inpatient and outpatient clinics . Participants and Data Collection The target sample size is 92 participants . This sample size was determined by a power analysis using G\*Power ver 3.1.9.4, calculated to achieve 90% power to detect a medium effect size (0.3) for correlation tests at an alpha level of 0.05 . Participants will complete a custom-designed two-part survey. In addition to the survey responses, relevant clinical and demographic data will be collected. Survey Instrument: Activities of Daily Living Importance (ADLI) Survey The primary data collection tool is the custom-designed, two-part ADLI Survey. The ADL items were selected based on their relevance to the rehabilitation framework for SCI patients, covering self-care, mobility, and essential functional tasks. Part 1: Functional Importance Assessment: This section assesses the patient's perceived importance of 10 key ADLs. Participants rate the significance of each ADL using an 11-point Visual Analog Scale (VAS) ranging from 0 (Not important at all) to 10 (Extremely important). The ADLs assessed include Eating, Bathing, Clean Intermittent Catheterization (Bladder emptying), Dressing, Oral/Face Care (Grooming), Sitting, Walking, Wheelchair Use, Transferring, and Sexual Activity. Part 2: Targeted Independence Goal: This section evaluates the participant's personal rehabilitation goal for the same 10 ADLs. For each activity, patients select one of four mutually exclusive independence levels, reflecting realistic outcomes often targeted in a rehabilitation program: Can do independently (Complete Independence), Can do with an assistive device (Modified Independence), Can do with personal assistance (Dependent on a person), or Will remain dependent in this activity (Total Dependence). Statistical Analysis: Data analysis will be performed using SPSS ver 18.0 . The normality of data distribution will be assessed using the Shapiro-Wilk test . Descriptive statistics will be presented as mean (Standard Deviation) for normally distributed data, median (Interquartile Range) for non-normally distributed data, and frequencies/percentages for categorical variables . Relationships between categorical variables will be analyzed using the Chi-square or Fischer's exact test . For inter-group comparisons, Independent sample t-tests and One-Way ANOVA will be used for parametric data, while Kruskal-Wallis and Mann-Whitney U tests will be used for non-parametric data . A significance level of p \< 0.05 will be adopted .