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Reciprocal association between pain and quality of life after newly acquired spinal cord injury

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Abstract

Purpose

Pain is highly prevalent in spinal cord injury (SCI) and a key determinant of quality of life (QoL). This is the first study to examine reciprocal associations between pain and QoL in patients undergoing their first inpatient rehabilitation after SCI.

Methods

Longitudinal data, with three measurement time points (1 month and 3 months after SCI onset, and at discharge from inpatient rehabilitation) from the Inception Cohort of the Swiss Spinal Cord Injury Cohort Study. Participants were 381 individuals aged ≥ 16 years with a newly diagnosed traumatic or non-traumatic SCI. 75.1% were male and the average age was 53.2 years. Random intercept cross-lagged panel models were conducted to examine the reciprocal association between pain intensity and QoL, as measured with the International SCI QoL Basic Data Set three individual items (satisfaction with life, physical health, and psychological health) and total score (mean of the three individual items).

Results

Both item and total QoL scores increased over time. 1 month: 5.3 (SD = 2.7), 3 months: 5.9 (SD = 2.3), discharge: 6.6 (SD = 2.0). Participants reported relatively low levels of pain intensity that remained stable over the course of inpatient rehabilitation. 1 month: 2.7 (SD = 2.3), 3 months: 2.6 (SD = 2.4), discharge: 2.7 (SD = 2.5). There were no significant cross-lagged associations between QoL and pain intensity across time.

Conclusion

Results indicate that pain intensity does not predict changes in QoL during first rehabilitation, and vice versa. Associations between pain intensity and QoL reported by previous studies may be attributable to individual characteristics and timely events that simultaneously influence pain and QoL.

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Data availability

Owing to our commitment to SwiSCI study participants and their privacy, datasets generated during the current study are not made publicly available but can be provided by the SwiSCI Study Center based on reasonable request (contact@swisci.ch).

Code availability

The analyses’ syntax is available from the last author, Anke Scheel-Sailer, upon request.

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Acknowledgements

We thank the SwiSCI Steering Committee with its members Xavier Jordan, Fabienne Reynard (Clinique Romande de Réadaptation, Sion); Michael Baumberger, Hans Peter Gmünder (Swiss Paraplegic Center, Nottwil); Armin Curt, Martin Schubert (University Clinic Balgrist, Zürich); Margret Hund-Georgiadis, Kerstin Hug (REHAB Basel, Basel); Laurent Prince (Swiss Paraplegic Association, Nottwil); Heidi Hanselmann (Swiss Paraplegic Foundation, Nottwil); Daniel Joggi (Representative of persons with SCI); Nadja Münzel (Parahelp, Nottwil); Mirjam Brach, Gerold Stucki (Swiss Paraplegic Research, Nottwil); and Armin Gemperli (SwiSCI Coordination Group at Swiss Paraplegic Research, Nottwil).

Funding

SwiSCI is hosted and funded by Swiss Paraplegic Research.

Author information

Authors and Affiliations

  1. Department of Psychology, Pace University, 861 Bedford Rd, Pleasantville, NY, 10570, USA

    Maren Westphal

  2. Swiss Paraplegic Research, Nottwil, Switzerland

    Valerie Carrard, Céline Braunwalder, Caroline Debnar, Christine Fekete, Mayra Galvis & Anke Scheel-Sailer

  3. Psychiatric Liaison Service, Department of Psychiatry, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland

    Valerie Carrard & Anke Scheel-Sailer

  4. Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland

    Céline Braunwalder, Caroline Debnar, Christine Fekete, Mayra Galvis & Anke Scheel-Sailer

  5. Institute of Complementary and Integrative Medicine, University of Bern, Bern, Switzerland

    Céline Braunwalder

  6. Center of Excellence in Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht and De Hoogstraat Rehabilitation, Utrecht, The Netherlands

    Marcel Post

  7. Department of Rehabilitation Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands

    Marcel Post

  8. Swiss Paraplegic Centre, Nottwil, Switzerland

    Anke Scheel-Sailer

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  1. Maren Westphal
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Contributions

MW contributed to conceptualization, methodology, conducting the literature review, writing the original draft, and writing and reviewing the manuscript. CB contributed to methodology, data curation, validation, data analysis, creation of data tables and figures, writing the methods and results sections, and reviewing the manuscript. CD contributed to data curation, resources, supervision, methodology, data analysis, validation, and reviewing the manuscript. VC contributed to conceptualization, data curation, reviewing methods, creating data tables, and writing, and reviewing the manuscript. MP contributed to conceptualization, methodology, data analysis, and writing and reviewing the manuscript. CF and MGA contributed to interpretation of the results, and writing and reviewing the manuscript. ASS contributed to conceptualization, project administration, supervision, resources, methodology, and writing and reviewing the manuscript.

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Correspondence to Maren Westphal.

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Ethical approval was granted by the Ethics Committee of Northwest- and Central Switzerland (EKNZ, Project-ID: 11042 PB_2016-02608, approved December 2016). We certify that all applicable institutional and governmental regulations concerning the ethical use of human volunteers were followed over the course of this research.

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Westphal, M., Carrard, V., Braunwalder, C. et al. Reciprocal association between pain and quality of life after newly acquired spinal cord injury. Qual Life Res 33, 1347–1357 (2024). https://doi.org/10.1007/s11136-024-03615-1

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