Life satisfaction and wheelchair exercise capacity in the first years after spinal cord injury
- Casper van Koppenhagen, MD (Researcher)
- Marcel Post, PhD (Project leader)
- Lucas van der Woude, PhD
- Sonja de Groot, PhD
- Eline Lindeman, PhD
- Floris van Asbeck, MD, PhD
On May 15, 2013 Casper van Koppenhagen will defend his dissertation entitled: Life satisfaction and wheelchair exercise capacity in the first years after spinal cord injury.
In Chapter 1 an overview was given of the research context of this thesis.
The results of Chapter 2 showed a marked decrease in life satisfaction of persons with spinal cord injury at one year after discharge from inpatient rehabilitation, compared to the general population and to their own life satisfaction before spinal cord injury.
Decrease of life satisfaction was strongest for the domains Sexual life, Self care and Vocational situation. Partner relations, Family life and Contacts with friends and acquaintances appeared the least affected life domains. Age, gender and education had little influence on life satisfaction after spinal cord injury or change of life satisfaction. High level of lesion, suffering from pain and from secondary impairments were associated with a decrease of life satisfaction and with low life satisfaction one year after discharge.
The results of Chapter 3 showed that life satisfaction improved during inpatient rehabilitation, especially during the first 3 months of active rehabilitation and remained stable during the first year after discharge. Having few pain sensations and a low number of other secondary impairments and having a better functional status were predictors of a more favourable course of life satisfaction early after spinal cord injury.
Wheelchair exercise capacity
Our results in Chapter 4 were showed that no significant changes in mean wheelchair exercise capacity were found between discharge and five years later. No significant determinants for the course of wheelchair exercise capacity in the one to five year interval were detected. Again age, gender, level and completeness of lesion were determinants for peak oxygen uptake and level of lesion and gender for peak power output, a confirmation of other international studies. The loss to follow up-group was older of age and included more persons with tetraplegia, probably leading to a slight overestimation of the model outcome for wheelchair exercise capacity.
Chapter 5 confirmed that different wheelchair exercise capacity trajectories exist after spinal cord injury.. We found four different trajectories in the course of peak power output: 1) high progressive scores; 2) deteriorating scores: progressive scores during inpatient rehabilitation with deteriorating figures after discharge; 3) low progressive scores: low scores at start of rehabilitation with relative strong progressive scores after discharge; and 4) low inpatient scores with very strong progressive scores after discharge. Logistic regression of factors that might be distinctive between the trajectories with high progressive scores and low progressive scores, revealed that older age, female gender, tetraplegic lesion and low functional status were associated with the class with low progressive scores.
Relationships between wheelchair exercise capacity and life satisfaction
In Chapter 6 we examined that wheelchair exercise capacity and life satisfaction in spinal cord injury population are longitudinally associated up to five years after discharge of inpatient rehabilitation. Further analyses revealed that the relationship between exercise capacity and life satisfaction was mainly based on the within-subject variance, suggesting that improvement of physical fitness might lead to improvement of life satisfaction
Finally, Chapter 7 summarized the general aim and main findings of this study.
You can read more about this project in the Dutch newsletters of April 2009, November 2009, May 2010, November 2010, and August 2011 or in the Dutch report for the participants of SPIQUE.
Casper van Koppenhagen won the prestigious LIVIT Orthtopedics trophy 'Most promising rehabilitation trainee 2009 in the Netherlands' for his research work in the SPIQUE Project.
Publications from this thesis
- Determinants and changes of life satisfaction after spinal cord injury: a cohort study. Van Koppenhagen CF, Post MWM, Van der Woude LHV, de Witte LP, van Asbeck FW, de Groot S, van den Heuvel W, Lindeman E. Arch Phys Med Rehab 89(9): 1733-40, 2008.
- Recovery of life statisfaction in persons with spinal cord injury during inpatient rehabilitation. Van Koppenhagen CF, Post MWM, Van der Woude LHV, de Groot S, de Witte LP, van Asbeck FW, van den Heuvel W, Lindeman E. Am J Phys Med Rehab. 2009; 88(11): 887-95.
- Wheelchair exercise capacity in spinal cord injury up to 5 years after discharge of inpatient rehabilitation. Van Koppenhagen CF, de Groot S, Post MW, van Asbeck FW, Spijkerman D, Faber W, Lindeman E, van der Woude LH. J Rehabil Med. 2013; 45(7):646-52.
- Patterns of changes in wheelchair exercise capacity after spinal cord injury. Van Koppenhagen CF, de Groot S, Post MW, Hoekstra T, van Asbeck FW, Bongers W, Lindeman E, van der Woude LH. Arch Phys Med Rehabil. 2013; 94(7):1260-7.
- The longitudinal relationship between wheelchair exercise capacity and life satisfaction after spinal cord injury: a cohort study in the Netherlands. Van Koppenhagen CF, de Groot S, Post MW, van Leeuwen C, van Asbeck FW, Stolwijk J, van der Woude LH. J Spinal Cord Med. 2014; 37(3):328-37.