Ambulatory individuals with spinal cord injury using walking aids generally do not report better long-term outcomes than wheelchair users: results from the InSCI-NL survey
DOI:
https://doi.org/10.2340/jrm.v58.44939Keywords:
Disability and Health, ICF core set, mobility limitation, Quality of life, Spinal Cord Injuries, ambulationAbstract
Objective: Greater mobility independence after spinal cord injury is thought to lead to better long-term outcomes. However, evidence is inconclusive for ambulation compared with wheelchair dependency. This study aimed to describe and compare long-term outcomes across mobility levels in individuals with spinal cord injury.
Design: Cross-sectional survey.
Subjects: Community-dwelling individuals with spinal cord injury in the Netherlands.
Methods: Data were collected via the Dutch arm of the International Spinal Cord Injury (InSCI-NL) Survey (2018). Mobility level was assessed using the modified Spinal Cord Independence Measure-Self-Report. Long-term outcomes were compared across mobility levels, using generalised linear models.
Results: 253 participants were included with a mean (standard deviation) age of 58.7 (13.6) years and median [interquartile range] time since injury of 10 [5.0–22.0] years. Electric wheelchair users reported lower functional independence, and more participation problems and secondary health conditions compared with manual wheelchair users (p < 0.001). Ambulatory individuals using walking aids reported no better outcomes than manual wheelchair users, except for functional independence (p < 0.001). Ambulatory individuals without walking aids reported more paid work than those with walking aids (62.7% vs 34.3%, p < 0.001).
Conclusion: In general, electric wheelchair users reported the least favourable long-term outcomes. Remarkably, ambulatory individuals using walking aids generally did not report better outcomes than manual wheelchair users.
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Copyright (c) 2026 Marthe C.G. Langerwerf, Karin Postma, Janneke Stolwijk-Swuste, Marga Tepper, Majanka Heijenbrok-Kal, Marcel Post , Rita J.G. van den Berg-Emons, Rutger Osterthun
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