Abstract:
Background: Spinal cord injury can lead to long-term physical limitations and has
profound effects on psychological well-being. Depression, anxiety, and sleep
disturbances are common among these individuals and may influence their functional
recovery. Objectives: To assess the psychological status and examine its association
with functional outcomes in individuals with paraplegic spinal cord injury.
Methodology: A cross-sectional study was conducted with 92 participants diagnosed
with paraplegic SCI at the Centre for the Rehabilitation of the Paralysed (CRP), Savar.
Psychological status was measured using the Patient Health Questionnaire-9 (PHQ-9),
Generalized Anxiety Disorder scale-7 (GAD-7), and Insomnia Severity Index (ISI).
Functional outcomes were assessed using the Spinal Cord Independence Measure
(SCIM III). Pearson’s correlation coefficients were used to determine the relationship
between psychological factors and functional performance. Results: Most participants
reported moderate (31.5%) to moderately severe depression (26.1%), mild (40.2%) to
moderate anxiety (32.6%), and subthreshold (46.7%) to clinically significant insomnia
(26.1%). Strong negative correlations were found between psychological status and
SCIM III total score (r = -0.609, p < 0.05), anxiety (r = -0.556, p < 0.05), and sleep
quality (r = -0.372, p < 0.05). That means, if depression, anxiety, and poor sleep quality
increase the functional outcome of participants will be decreased significantly.
Depression and anxiety were found to be the most profound issues, and among SCIM
domains, mobility showed the strongest inverse correlations with psychological factors.
Discussion: The study reveals a significant association between psychological health
and functional outcomes in paraplegic SCI patients. Higher levels of depression,
anxiety, and poor sleep quality are linked to lower functional outcomes, especially in
mobility and self-care as well as respiration and sphincter management. These findings
highlight the need of holistic patient care, and integrated psychological support in
rehabilitation programs to improve overall outcomes in SCI patients.
Keywords: Paraplegic SCI, depression, anxiety, sleep quality, functional outcome,
SCIM III.
Description:
This dissertation is submitted in partial fulfillment of the requirements for the Degree of Bachelor of Science in Physiotherapy, Bangladesh Health Professions Institute, Faculty of Medicine, the University of Dhaka, Bangladesh.
