Spinal cord injury and quality of life: what determines quality of life and what is the relationship between physical activity, fitness and quality of life

Abstract

This thesis is comprised of two investigations. The first investigation, using naturalistic inquiry, determined the domains that represented quality of life for persons with a spinal cord injury. Seven persons with complete quadriplegic injuries (one female, six males) and eight persons with complete paraplegic injuries (five females, three males) participated in this study. Results showed that quality of life for this population, regardless of severity of impairments, was represented by nine domains: 1) physical function and independence; 2) accessibility; 3) emotional well being; 4) stigma; 5) spontaneity; 6) relationships and social function; 7) occupation; 8) finances; and 9) physical well being. The domains of life quality were similar for quadriplegic and paraplegic individuals; however, physical function and independence and physical well being affected the quality of life of persons with a quadriplegic injury to a greater extent. These findings may provide health professionals with information necessary to assist in the development of programs to enhance quality of life. The objective of the second investigation in this thesis was to explore the relationships amongst four variables of interest; subjective and objective quality of life scores, and fitness and physical activity in individuals with a spinal cord injury. Both qualitative and quantitative methodologies were utilized in this second study and qualitative data collection was done in conjunction with Study One. The same 15 persons described in Study One, in addition to discussing quality of life, also provided information about physical activity and fitness and the role it played in their quality of life. Quantitative data collection with 40 individuals with spinal cord injury included measurements of: fitness, physical activity, subjective quality of life and objective quality of life. Results were reported for each of three level of injury groupings (high quadriplegia, low quadriplegia and paraplegia). Results showed that physical activity was significantly correlated with the total score for objective quality of life in the groups of persons with high quadriplegia and paraplegia. Qualitative results supported these findings especially in relation to the importance of fitness and physical activity to the objective domain of functional ability. There were no significant correlations between subjective quality of life and the other three primary variables; objective quality of life, fitness and physical activity, for any of the level of injury groupings. However, qualitative results suggested that activity may play an important role in an individual's perception of quality of life. Thus, although the results from this investigation suggest a relationship between fitness, physical activity and objective quality of life, the relationship with subjective quality of life requires further exploration.