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Frequency and age effects of secondary health conditions in individuals with spinal cord injury: a scoping review.

TitleFrequency and age effects of secondary health conditions in individuals with spinal cord injury: a scoping review.
Publication TypeJournal Article
AuthorsJensen MP, Truitt AR, Schomer KG, Yorkston KM, Baylor C, Molton IR
JournalSpinal Cord
Date Published2013 Dec

STUDY DESIGN: Scoping review. OBJECTIVES: To gain a better understanding of the prevalence, course and association with age of secondary health conditions in individuals with spinal cord injury (SCI). SETTING: Seattle, Washington, USA. METHODS: We performed searches of electronic databases for studies published from 1986-2011 that provided information regarding the prevalence, course or associations with age and duration of secondary health conditions in individuals with SCI. RESULTS: Ninety-two studies were included. The findings indicate that: (1) individuals with SCI experience a number of secondary health conditions, many of which occur at a higher rate in those with SCI than the normative population; (2) the most common conditions or symptoms are pain, bowel and bladder regulation problems, muscle spasms, fatigue, esophageal symptom and osteoporosis; (3) a number of conditions, including cardiovascular disease, diabetes, bone mineral density loss, fatigue and respiratory complications or infections, occur with higher frequency in older individuals or those with longer SCI duration, relative to younger individuals or those with shorter SCI duration; and (4) there is a marked lack of longitudinal research examining the natural course of health conditions in individuals aging with SCI. CONCLUSIONS: The findings support the conclusion that individuals with SCI show signs of 'premature aging' in different organ systems. Longitudinal research is needed to understand when problems are most likely to emerge, and to develop and test the efficacy of interventions to prevent these health conditions and their negative impact.

Full Text

Living with spinal cord injury: Watching for Secondary Conditions

What is this research about?  We know people living with spinal cord injury experience many problems that may not be directly caused by their injury, but are still related to it.  These problems may start any time after the injury.  They include things like chronic pain and fatigue.  These problems are called “secondary” or “secondary conditions.”  In fact, sometimes “secondary” problems can be even more troublesome and difficult to manage than the original condition itself.  However, they often don’t get as much attention from health care providers. Because some of these conditions may be prevented or treated, it is important to know when and how frequently they occur. 

What did the researchers do? We reviewed a wide range of published studies in order to find the proportion of those with spinal cord injury who have various secondary conditions.  We were also interested in when conditions occur.  For example, at what age did they begin?  How long after the spinal cord injury did they begin? The review was broad.  It included all types of studies from 1986 to 2011 related to potential secondary conditions in spinal cord injury.  We took detailed information from nearly 100 articles. 

What did the resarchers find?  Several conditions happen more often in those with spinal cord injury than in the general population.  These include problem with pain, bowel or bladder regulation, muscle spasms, fatigue, the esophagus (food tube) and bone thinning.  These conditions happen more often in older people.  They also occurred more often in those who have lived with spinal cord injury for a long time.  Unfortunately, we do not have a good understanding of their long-term course because research that tracks people over time is very rare.

How can you use this research?  People with spinal cord injury may experience premature aging. They may develop secondary conditions earlier than those in the general population.  It is important that people with spinal cord injury and their healthcare provide watch for these conditions.  Being alert to the conditions help to prevent serious problems or lessening their negative impact.

What you need to know:

  • Secondary conditions are an important part of the health picture for people aging with spinal cord injury.
  • Problem with pain, bowel or bladder regulation, muscle spasms, fatigue, the esophagus (food tube) and bone thinning are common.
  • Getting appropriate treatment for these problems is important and can start with a conversation with your doctor.
  • Early treatment may prevent or lessen the impact of these conditions.
PubMed ID24126851