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Background: As the European population with Spinal Cord Injury (SCI) is expected to become older, a better understanding of ageing with SCI using functioning, the health indicator used to model healthy ageing trajectories, is needed. We aimed to describe patterns of functioning in SCI by chronological age, age at injury and time since injury across eleven European countries using a common functioning metric, and to identify country-specific environmental determinants of functioning., Methods: Data from 6'635 participants of the International Spinal Cord Injury Community Survey was used. The hierarchical version of Generalized Partial Credit Model, casted in a Bayesian framework, was used to create a common functioning metric and overall scores. For each country, linear regression was used to investigate associations between functioning, chronological age, age at SCI or time since injury for persons with para- and tetraplegia. Multiple linear regression and the proportional marginal variance decomposition technique were used to identify environmental determinants., Results: In countries with representative samples older chronological age was consistently associated with a decline in functioning for paraplegia but not for tetraplegia. Age at injury and functioning level were associated, but patterns differed across countries. An association between time since injury and functioning was not observed in most countries, neither for paraplegia nor for tetraplegia. Problems with the accessibility of homes of friends and relatives, access to public places and long-distance transportation were consistently key determinants of functioning., Conclusions: Functioning is a key health indicator and the fundament of ageing research. Enhancing methods traditionally used to develop metrics with Bayesian approach, we were able to create a common metric of functioning with cardinal properties and to estimate overall scores comparable across countries. Focusing on functioning, our study complements epidemiological evidence on SCI-specific mortality and morbidity in Europe and identify initial targets for evidence-informed policy-making., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Sabariego et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Objective: To analyze and compare how performance of the health system are linked to the self-reported quality of life (QOL) of people with spinal cord injury (SCI) in 22 countries participating in the International Spinal Cord (InSCI) community survey., Design: Cross-sectional survey., Setting: Twenty-two countries representing all 6 World Health Organization regions, community setting., Participants: Persons (N=12,591) with traumatic or nontraumatic SCI aged ≥18 years., Interventions: Not applicable., Main Outcomes: Self-reported satisfaction on several indicators that include: health, ability to perform daily activities, oneself, personal relationships, and living conditions. A total score of QOL was calculated using these 5 definitions., Results: The most important indicators for self-reported QOL of persons with SCI were social attitudes and access to health care services, followed by nursing care, access to public spaces, the provision of vocational rehabilitation, transportation, medication, and assistive devices. In general, persons with SCI living in higher-income countries reported a higher QOL than people in lower-income countries, with some exceptions. The top performing country was The Netherlands with an estimated median QOL of 66% (on a 0%-100% scale)., Conclusions: The living situation of people with SCI is highly influenced by the performance of the health system. Measuring and comparing health systems give accountability to a country's citizens, but it also helps to determine areas for improvement., (Copyright © 2020 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.)

Introduction: Spinal cord injury (SCI) is a devastating condition and a challenge for every health system and every society. This EBPP represents the official position of the European Union through the UEMS PRM Section and designates the professional role of PRM physicians for people with SCI. The aim of the paper was to improve Physical and Rehabilitation Medicine (PRM) physicians' professional practice for persons with SCI in order to improve their functionality, social and community reintegration, and to overcome activity limitations and/or participation restrictions., Evidence Acquisition: A systematic review of the literature and a consensus procedure by means of a Delphi process have been performed involving the delegates of all European countries represented in the UEMS PRM Section., Evidence Synthesis: The systematic literature review is reported together with thirty-eight recommendations resulting from the Delphi procedure., Conclusions: The professional role of PRM physicians who have expertise in the rehabilitation of SCI is to run rehabilitation programmes in multi-professional teams, working in an interdisciplinary way in a variety of settings to improve the functioning of people with SCI.

The general objective of the International Spinal Cord Injury Survey (InSCI) is to identify factors that explain the functioning and well-being of people living with SCI. Being a cohort study, these medical, social, economic components with impact on the evolution of the individual with spinal cord trauma in Romania will be treated in a descriptive and comparative manner, through the prism of the data obtained from the patients who were included in this research. The participants included in the study were a total of 216 aged between 16 and 75 admitted to the Băile-Felix Medical Rehabilitation Clinical Hospital, where they underwent a complex medical rehabilitation treatment specific to SCI. Participants with traumatic SCI feel more alive compared to non-traumatic participants (t(214)=3.820; p<.001) possibly due to etiological differences in SCI. Regarding psychomotor agitation, the registered coefficient (t(214)=2.076; p<.03) highlights the participants with traumatic SCI. Differences are recorded in the case of assistance from friends in traumatic versus non-traumatic SCI, which indicates the increased need for social support in traumatic SCI. We argue that a patient's worries and concerns about SCI and its consequences can affect overall health. From a psychological point of view, a limited knowledge of specialists regarding the behavior of patients and their inherent mnesic cutouts, more information can generate confusion and helplessness instead of generating mechanisms of change. [ABSTRACT FROM AUTHOR]