The document summarizes a study on the quality of life and social function of earthquake survivors with spinal cord injuries in China one year after returning to their communities. It finds that their quality of life and social function significantly improved after returning home compared to when they were discharged from initial rehabilitation. However, chronic pain and depression still negatively impacted their functioning. The conclusion emphasizes the importance of early and comprehensive rehabilitation as well as long-term support focused on vocational training and social integration.

1. Quality of life and social function of
earthquake survivors with spinal cord
injury one year after returning to
community
Xiaorong HU，Jian’an LI
Department of Physical Medicine and Rehabilitation
Nanjing Medical University, China
S

2. Background
S 30 months after Wenchuan Earthquake
S Functional recovery after the early-stage of
rehabilitation rescue in SCI survivors
S ? QOL & social function in the community
S ? What will be paid attention to in the long-
term rehabilitation strategy for SCI?

3. Method Gender/ Age/ Marriage/
Education/ Employment/
Annual income
Quality of AISA
Life
On-site Survey Complication
Social
Function Pain
Ability of Daily
Living
Depression

4. Method Gender/ Age/ Marriage/
Education/ Employment/
Annual income
Quality of AISA
Life
World HealthOn-site Survey Complication
Organization Quality of Life
Assessment Instrument-Bref (WHOQOL-BREF)
Social
Pain
Function appropriate scale for QOL of SCI patient
 The most
Ability of Daily
• Individual’s overall perception of QOL & health
• Domain: Physical Health/ Psychological/ Living
Social Relationship/ Environment
Depression
*Hill MR, Noonan VK, Sakakibara BM, Miller WC. Quality of life instruments and definitions in individuals
with spinal cord injury: a systematic review. Spinal Cord. 2009

5. Method Gender/ Age/ Marriage/
Education/ Employment/
Annual income
Craig Handicap Assessment
AISA
Quality of
and Reporting Technique Short
Life
Form（CHART-SF）
On-site Survey Complication
• Physical Independence
Social • Cognitive Independence
Function • Mobility Pain
• Occupation
Ability of Daily
• Social Integration
Living
• Economic Self-Sufficiency
Depression
• Gerhart KA, Weitzenkamp DA, Kennedy P, Glass CA, Charlifue SW. Correlates
of stress in long-term spinal cord injury. Spinal Cord. 1999; 37(3):183-190

6. Method Gender/ Age/ Marriage/
Education/ Employment/
Annual income
Quality of AISA
Life
On-site Survey Complication
Social
Function Pain
Ability of Daily
Living
Depression

7. Method Gender/ Age/ Marriage/
Education/ Employment/
Annual income
Quality of AISA
Life
（1）AIS A-C Survey
On-site Complication
（2）AIS D-E & SCI Syndrome
Social
Function Pain
Ability of Daily
Living
Depression

8. Method Gender/ Age/ Marriage/
Education/ Employment/
Annual income
Quality of AISA
Life
On-site Survey Complication
Social
Pressure Sore/ UTI / Cystolith /
Function Pain
Neurogenic Bladder/ Rectum
Impairment of Renal Function …
Ability of Daily
Living
Depression

9. Method Gender/ Age/ Marriage/
Education/ Employment/
Annual income
Quality of AISA
Life
On-site Survey Complication
Social
Function Pain
Ability of Daily
Visual Analogue Scale (VAS)
Living
Depression

10. Method Gender/ Age/ Marriage/
Education/ Employment/
Annual income
Quality of AISA
Life
On-site Survey Complication
Social
Function Pain
Ability of Daily
Living
Depression
Modified Barthel Index (MBI)

11. Method Gender/ Age/ Marriage/
Education/ Employment/
Annual income
Quality of AISA
Patient Health Questionnaire Depression
Life
Module (PHQ-9)
• < 5 point: No need forSurvey
On-site treatment Complication
• Only 9 question
• Social for community life waiting
5-14 point: Support, watchful
Suitable
• > 15 point: Antidepressant and/or of depression
Function screening the symptom psychotherapy
• Accurate Pain
• Good internal consistency and construct validity in
SCI patient Ability of Daily
* Sakakibara BM, Miller WC, Orenczuk SG, Wolfe DL; SCIRE Research Team. A systematic review of depression
Living
and anxiety measures used with individuals with spinal cord injury. Spinal Cord. 2009; 47(12):841-851
Depression

12. Result
Age
40.00%
30.00%
20.00%
10.00%
0.00%
19-40 41-60 > 60
Age from 20 to 79 (52.6±15.8 years old)

13. Result
Gender Marriage
15.4%
3.85%
41.2%
58.8% 80.8%
Male Married
Single
Female
Widowed

14. Result
Education Employment
15.4%
The average family income in 2010:
46.2%
RMB 5375±3186
53.8%
84.6%
Below the average annual income in rural China
Illiteracy Employed
Be educated At home

15. Result
Above Below Percentag
AIS C8-T6 T7-L2 L3-S2 Total
C7 S2 e
A 1 5 6 23.1%
B 2 2 7.60%
C 7 7 26.9%
D 3 5 1 2 11 42.3%
Total 3 1 19 1 2 26

16. Result
Abov Below Percentag
C8-T6 T7-L2 L3-S2 Total
e C7 S2 e
Wheelchair
Independent 1 13 14 53.8%
Using orthotics
and/or aids 4 1 1 6 23.1%
Walk
independently 3 5 1 6 23.1%
Total 3 1 19 1 2 26

17. Result
Above Below Percentag
C8-T6 T7-L2 L3-S2 Total
C7 S2 e
Pain 3 1 19 1 2 26 100%
New pressure
sore 1 10 1 12 46.2%
Neurogenic
bladder 1 12 1 14 53.8%
Cystolith 2 2 7.69%
Neurogenic
Rectum 1 8 2 11 42.3%
Heterotopic
ossification 1 1 3.85%

18. Result
S Discharge VS Return to community for 1 year
S Paired T test
QOL In
CHART DischargeDischarge In community T T T
Dischargecommunity
In PP
P
community
Total Score 68.3±12.6 71.4±10.2 -1.66 0.011
MBI score
Total 71.2±25.8322±87.0
overall perception of
81.9±18.7
2.65±1.09
344±80.8 -3.37
3.84±0.731
-1.58 0.002
0.127
-6.48 0.000
Physical
QOL
VAS perception of 89.4±11.2
5.38±2.38
Independence
overall
96.4±4.70 0.548
5.12±1.70 -3.90 0.589
0.001
2.65±1.23 3.81±0.749 -5.62 0.000
Cognitive
PHQ-9health10.5±5.38 19.0±4.98 56.9±19.8 -0.652
Independence
Physical Health
78.5±24.511.9±12.3
20.6±2.58
4.01 0.000
0.520
-1.63 0.117
Mobility
Psychological 51.2±20.5
17.0±3.89 67.4±28.0
17.8±3.38 -2.84
-1.31 0.009
0.202
Social Relationship 39.5±32.0
Occupation 8.27±2.31 42.2±35.4
9.42±1.92 -2.90
-2.55 0.108
0.017

19. Attention for the next step
S Chronic neuropathic pain
S Depression
S Employment

20. Rehabilitation Rescue
after the Disaster
S Early and comprehensive intervention of rehab
S Functional impact：
Improve ADL, reduce complication and relieve
symptom of depression
S Long-term impact：
Improve QOL and social participation, promote
re-employment
[1]Rathore FA, Farooq F, Muzammil S, New PW, Ahmad N, Haig AJ. Spinal cord injury management and rehabilitation: highlights and
shortcomings from the 2005 earthquake in Pakistan. Arch Phys Med Rehabil. 2008 Mar;89(3):579-85.
[2]Li JJ, Gao F, Liu SJ, Treatment and rehabilitation of patients with spinal cord injury after earthquake. Chn J Rehabil Theory Pract. Jul.
2008. Vol. 14.No.7

21. Conclusion
S QOL and social function were significantly
improved after Returning to the community.
S Main factors: ADL, pain and depression.
S Early rehabilitation can improve QOL and social
function, even can be extended in the community.
S Long-term rehabilitation strategy should pay
attention to vocational training and social
integration.

22. Thank you!