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

Overview

The purpose of this cross-sectional, observational survey was to assess the importance individuals with Spinal Cord Injury (SCI) in Türkiye place on specific Activities of Daily Living (ADL) and their target levels of independence for these activities after rehabilitation. The primary question it aims to answer is: What are the functional priorities of individuals with SCI (e.g., eating, bathing, walking, wheelchair use), and what are their personal goals for independence in these activities? Participants will complete a two-part questionnaire (at Biruni University Hospital) regarding the importance of ADL and independence goals.

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 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) Questionnaire The primary data collection tool is the custom-designed, two-part ADLI Questionnaire. 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 10-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: Assessment of Independence Goals: The second part of the survey assessed the participants' targeted post-rehabilitation independence levels for the specified 10 ADLs. Participants selected one of four mutually exclusive categories that reflect standard rehabilitation outcomes: * Complete Independence (can perform without help), * Modified Independence (requires an assistive device), * Assisted (requires personal assistance), * Total Dependence (unable to perform the activity). Statistical Analysis: The data were analyzed using the SPSS Statistics 22.0 program. The normality of continuous variables was assessed using the Shapiro-Wilk test. For variables showing a normal distribution, independent samples t-tests and one-way ANOVA were used for group comparisons. For data that did not show a normal distribution, the Mann-Whitney U and Kruskal-Wallis tests were applied. The chi-square test was used for the analysis of categorical data; the Fisher exact test was used when the test conditions could not be met. The statistical significance level was set at p\<0.05.