Impacts of bladder managements and urinary complications on quality of life: Cross-sectional perspectives of persons with spinal cord injury living in Malaysia, Indonesia, and Thailand

The impact of bladder care and urinary complications on quality of life (QoL) in persons with spinal cord injury (SCI) who have neurogenic lower urinary tract dysfunction has not been elucidated, especially in those living in low-resource countries. This multinational cross-sectional survey was conducted in rehabilitation facilities in Malaysia, Indonesia, and Thailand. Community-dwelling adults with traumatic or non-traumatic SCI participating in the International Spinal Cord Injury Community Survey (InSCI) from 2017 to 2018 were enrolled. Data regarding bladder management/care, presence of bladder dysfunction, urinary tract infection (UTI), and QoL score were extracted from the InSCI questionnaire. The impact of bladder care and urinary complications on QoL was determined using univariable and multivariable regression analysis. Questionnaires from 770 adults were recruited for analysis. After adjusting for all demographic and SCI-related data, secondary conditions, as well as activity and participation factors, UTI was an independent negative predictive factor of QoL score (p = 0.007, unstandardized coefficients = -4.563, multivariable linear regression analysis, enter method). Among bladder care and urinary complication factors, UTI is the only factor negatively impacting QoL. These results address the importance of proper bladder management and UTI prevention in persons with SCI to improve their QoL

The social security health insurance model in Pattani, Thailand: health status and patterns of utilization

Bibliography: p. 185-194

Quantifying anterior knee pain during specific activities after using the bone-patellar tendon-bone graft for arthroscopic anterior cruciate ligament reconstruction

Background/objective: There has been much debate about the optimal graft choice for an anterior cruciate ligament (ACL) reconstruction. Anterior knee pain is a common donor site problem when using a bone-patellar tendon-bone (BPTB) graft. However, knowledge of the characteristics of anterior knee pain during different daily activities is still limited. This study aimed to determine the incidence of anterior knee pain and to quantify the degree of pain during a range of daily living activities. Methods: Thirty-five patients who were scheduled to undergo an ACL reconstruction with an autologous BPTB graft between February 2015 and December 2016 were enrolled. A visual analogue scale (VAS) for pain was recorded during each of the following activities: ascending at 30-degree slope, ascending and descending stairs, running, jumping, squatting, kneeling, sitting cross-legged, and sitting one-legged. Demographic data, the range of motion, the area of decreased sensation, and the IKDC score were collected and compared 3 and 6 months postoperatively. Results: The 35 male patients had a mean age of 29.7 years. Postoperatively, the mean IKDC scores were 58.1 ± 9.8 at 3 months and 72.7 ± 10.5 at 6 months. The incidences of overall anterior knee pain were 62.9% and 34.3% at the 3- and 6-month time points. Kneeling was the only activity that produced severe pain. At 3 months postoperatively, kneeling's mean VAS pain score was 3.9 ± 2.9 (2.9, 4.9; 95% CI for mean for 17 patients [48.5%] with considerable pain), whereas at 6 months postoperatively, it was 2 ± 2.5 (1.2–2.9; 95% CI for mean for 9 patients [25.7%] with considerable pain). The area of numbness of the proximal leg decreased from 12.8 ± 18.3 cm2 (6.4, 19.2; 95% CI for mean) to 3.2 ± 9.1 cm2 (0.1, 6.5; 95% CI for mean) at 3 and 6 months postoperatively. Conclusions: Kneeling was the most challenging activity in terms of creating considerable levels of anterior knee pain in patients who had undergone an ACL reconstruction using a BPTB graft. Other knee activities, however, did not create moderate or severe degrees of anterior knee pain. Both anterior knee pain and numbness at the proximal leg improved over time.Trial registration number: TCTR2018–0630002. Keywords: Anterior cruciate ligament reconstruction, Anterior knee pain, Bone-patellar tendon-bone graft, Incidence and kneelin

Quality of Life of Stroke Patients at 1 Year after Discharge from Inpatient Rehabilitation: A Multicenter Study

Objective: To investigate quality of life (QoL) and its related factors 1-year after discharge from post-stroke inpatient rehabilitation. Methods: This longitudinal study was performed among 9 rehabilitation centres. Quality of life of stroke patients was evaluated using the WHOQOL-BREF. Its scores ranged from 26-130, with a higher score representing better quality of life. The QoL scores at 1-year follow-up were compared with the scores at discharge.  Factors related to quality of life at 1-year after discharge were analysed using univariate and multiple linear regression. Results: One hundred and ninety-seven patients were recruited, with a mean age of 62.3 years. The mean quality of life score at 1-year after discharge was significantly lower than the score at discharge. In multiple linear regression analysis, only 5 factors were associated with quality of life, including having a leisure activity, modified Barthel (Activity of Daily Living, ADL) Index (mBI) at follow-up period, need caregiver, anxiety score, and depression score with the regression coefficient (b) of 6.29 (95%CI: 2.23, 10.35), 0.63 (95%CI: 0.07, 1.20), -7.72 (95%CI: -12.04, -3.40), -0.78 (95%CI: -1.40, -0.17), and -1.14 (95% CI: -1.72, -0.57) respectively. Conclusion: At one year after discharge from inpatient rehabilitation, patients with stroke had poorer quality of life. Factors related to poor quality of life included no leisure activity, and need for caregiver, low functional scores at follow-up, anxiety and depression. Strategies to prevent these factors could enhance QoL of stroke patients