• Melissa S Riggins, Padmaja Kankipati, Michelle L Oyster, Rory A Cooper, and Michael L Boninger.
• College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
• Arch Phys Med Rehabil. 2011 Jul 1; 92 (7): 1027-33.

ObjectiveTo examine quality-of-life (QOL) factors and change in mobility in individuals with traumatic spinal cord injury (SCI) 1 year after injury.DesignRetrospective case study of National SCI Database data.SettingSCI Model Systems (SCIMS) sites (N=18).ParticipantsSubjects (N=1826; age >18y) who presented to an SCIMS site after traumatic SCI between June 2004 and July 2009 and returned for 1-year follow-up. All subjects had FIM mobility data for both assessments.InterventionsNot applicable.Main Outcome MeasuresAssessment of impairment based on Lower-Extremity Motor Score. Assessment of QOL based on Craig Handicap Assessment and Reporting Technique, Patient Health Questionnaire, Satisfaction With Life Scale, Self-perceived Health Status, and pain severity scores.ResultsOf the sample, 55 individuals transitioned from walking to wheelchair use within 1 year of discharge. This group had the highest number of individuals from minority groups (52.8%) and the lowest employment rate (7.3%). Compared with individuals who transitioned from wheelchair use to walking or maintained wheelchair use or ambulation, the walking-to-wheelchair transition group had significantly lower QOL scores (P<.01), including higher depression (P<.01) and higher pain severity (P<.001).ConclusionsIndividuals with SCI who transitioned from walking at discharge to wheelchair use within 1 year had low QOL factors, including high pain and depression scores. Rehabilitation professionals should consider encouraging marginal ambulators to work toward functional independence from a wheelchair, rather than primary ambulation during acute inpatient rehabilitation.Copyright © 2011 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

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