OBJECTIVES: We examined whether persons with spinal cord injury (SCI) from countries with differential resources and resource distribution differ in the level and structure of functioning and disability. METHODS: We analysed cross-sectional data of 1,048 persons with SCI from 14 countries based on the International Classification of Functioning, Disability and Health (ICF). We used penalized logistic regression to identify ICF categories distinguishing lower- and higher-resourced countries. Hierarchical linear models were employed to predict the number of problems in functioning. The association structure of ICF categories was compared between higher- and lower-resourced countries using graphical models. RESULTS: A total of 96 ICF categories separated lower- and higher-resourced countries. Differences were not univocal. Lower resources and unequal distribution were predictive of more functional problems in persons with higher age or tetraplegia. In the graphical models, few associations between ICF categories persisted across countries. CONCLUSION: Higher-resourced countries do not score higher in all ICF categories. Countries' economic resources and their distribution are significant predictors of disability in vulnerable groups such as tetraplegics and the elderly. Functioning is multi-dimensional and structures of association suggest that country-specific pathways towards disability exist.
OBJECTIVES: We examined whether persons with spinal cord injury (SCI) from countries with differential resources and resource distribution differ in the level and structure of functioning and disability. METHODS: We analysed cross-sectional data of 1,048 persons with SCI from 14 countries based on the International Classification of Functioning, Disability and Health (ICF). We used penalized logistic regression to identify ICF categories distinguishing lower- and higher-resourced countries. Hierarchical linear models were employed to predict the number of problems in functioning. The association structure of ICF categories was compared between higher- and lower-resourced countries using graphical models. RESULTS: A total of 96 ICF categories separated lower- and higher-resourced countries. Differences were not univocal. Lower resources and unequal distribution were predictive of more functional problems in persons with higher age or tetraplegia. In the graphical models, few associations between ICF categories persisted across countries. CONCLUSION: Higher-resourced countries do not score higher in all ICF categories. Countries' economic resources and their distribution are significant predictors of disability in vulnerable groups such as tetraplegics and the elderly. Functioning is multi-dimensional and structures of association suggest that country-specific pathways towards disability exist.
Authors: I Kirchberger; F Biering-Sørensen; S Charlifue; M Baumberger; R Campbell; A Kovindha; H Ring; A Sinnott; M Scheuringer; G Stucki Journal: Spinal Cord Date: 2009-09-15 Impact factor: 2.772
Authors: F Biering-Sørensen; M Scheuringer; M Baumberger; S W Charlifue; M W M Post; F Montero; N Kostanjsek; G Stucki Journal: Spinal Cord Date: 2006-09 Impact factor: 2.772
Authors: C K Kwoh; G T O'Connor; M G Regan-Smith; E M Olmstead; L A Brown; J B Burnett; R F Hochman; K King; G J Morgan Journal: J Rheumatol Date: 1992-07 Impact factor: 4.666
Authors: Jan D Reinhardt; Marcel W M Post; Christine Fekete; Bruno Trezzini; Martin W G Brinkhof Journal: PLoS One Date: 2016-11-22 Impact factor: 3.240
Authors: Surona Visagie; Arne H Eide; Karin Dyrstad; Hasheem Mannan; Leslie Swartz; Marguerite Schneider; Gubela Mji; Alister Munthali; Mustafa Khogali; Gert van Rooy; Karl-Gerhard Hem; Malcolm MacLachlan Journal: PLoS One Date: 2017-10-12 Impact factor: 3.240