Quality of life among individuals with rugby-related spinal cord injuries

We are riding a streak of rugby related manuscripts this week. This one just appeared at BMJ Open today. Rugby-related spinal cord injuries (SCIs) are rare but life altering and traumatic events. Little is known about the long-term consequences and outcomes of players who have sustained these injuries. This descriptive cross-sectional study investigated current quality of life (QoL) and factors associated with QoL, among individuals with rugby-related SCI in South Africa.

A total of 90 of the 102 registered players with SCI in South Africa agreed to participate in the study. The relationship between QoL, as measured with the WHO Quality of Life questionnaire (WHOQOL-BREF) and specific independent variables (demographic information, level of independence and participation in various activities and life roles) was investigated. Variables that were significantly associated with QoL in bivariate analyses were included in multiple linear regression analyses.

Factors associated with QoL based on the ICF-CR framework.

Factors associated with QoL based on the ICF-CR framework.

The mean score and SD of the WHOQOL-BREF was 15.1 ± 2.3 arbitrary units. Participation (an ICF framework construct) and income were significantly associated with overall QoL (p<0.001). Participation was the only variable significantly associated with all QoL subdomains (p<0.001). Additionally, number of health concerns, type of healthcare (public vs private) and level of education were significantly associated with various QoL domains (p<0.001).

On average, these individuals with rugby-related SCI presented with higher QoL scores than other comparable SCI studies. However, lower levels of participation and income, certain levels of education, increased health concerns and use of public healthcare were associated with lower levels of QoL. Sporting bodies have a responsibility to optimise player welfare, by acting on the modifiable factors associated with QoL.

Key points

  • This study addresses the paucity of knowledge of the long-term consequences of catastrophic sporting injuries.

  • The results from this study is a first step in describing specific factors associated with quality of life (QoL) in rugby players who sustain spinal cord injury (SCIs). Future studies should further investigate the relationships identified in this study.

  • Based on criticisms of existing objective participation measures, this study used a participation mea- sure that assesses participation limitations that are meaningful and important to the individual (subjective experience).

  • Although some of the modifiable factors in this study may be South African specific, concepts such as participation may be important for all individuals with SCI.

  • This study considered only certain variables and their association with QoL, while other factors, such as coping strategies, self-esteem and athletic identity, may also contribute to QoL.

The full paper can be accessed here (open access)

Badenhorst M, Brown J, Lambert M, et al. Quality of life among individuals with rugby-related spinal cord injuries in South Africa: a descriptive cross- sectional study. BMJ Open 2018;:1–12. doi:10.1136/bmjopen-2017-020890