Longitudinal Comparisons in Health, Participation, Life Satisfaction, and Depressive Symptoms From Pre- to Post-COVID-19 Pandemic Among People With Spinal Cord Injuries.

Abstract

To identify changes in health, health care utilization, participation, life satisfaction, and depressive symptoms from before the coronavirus disease 2019 pandemic to after among ambulatory and nonambulatory participants with spinal cord injury. Longitudinal study with the first measurement taken within 3 months prior to pandemic restrictions and 2 follow-ups at approximately 1-year intervals. Medical university. Adult participants (N=219) with spinal cord injury, including ambulatory (n=155) and nonambulatory (n=64). Not applicable. Self-report assessment of health outcomes from the Behavioral Risk Factor Surveillance System; health service utilization including physician visits, emergency department visits, and hospitalizations; items from the Craig Handicap Assessment Reporting Technique; 3 life satisfaction scales from the Life Situation Questionnaire; and the brief version of the Patient Health Questionnaire. After using a z score correction for nonnormality, none of the time effects or interaction effects of time by ambulatory status were significant. Six comparisons between ambulatory and nonambulatory were statistically significant. Ambulatory participants reported 3 more days in poor physical health (P=.02; statistically significant) and 2 more days feeling worried, tense, or anxious in the last 30 days (P=.03). They visited the emergency department on 0.3 fewer occasions (P=.02) while reporting leaving the house 1 more day every week (P=.02), 2 hours more of sitting tolerance (P<.01), and 1 higher score of vocational satisfaction (P=.03). The absence of statistically significant changes from before to after the pandemic and the absence of time by ambulatory status interactions suggest stability of outcomes, even in the presence of pandemic challenges.