Experiences with COVID-19 Pandemic in the Spinal Cord Injury Community...American Congress of Rehabilitation Medicine (ACRM) Annual Conference, November 8-11, 2022, Chicago, Illinois

Document the experiences of people with chronic spinal cord injury (SCI) during the COVID-19 pandemic. A cross-sectional survey. An academic medical center. A convenience sample of 35 participants from a local SCI Model Systems Center who completed a survey online or by phone between September 2021 and March 2022. Not applicable. A scale "COVID-19: Impact of the pandemic and HRoL in cancer patients and survivors" obtained from NIH PhenX Toolkit was adapted for SCI population that measures personal COVID-19 exposures and experiences, including COVID-19 specific emotional and physical reactions, health care disruption and concerns, disruption to daily activities and social interactions, financial hardship, perceived benefits, functional social support, and perceived stress management. This sample had a mean age of 51.8 years, a mean duration of injury of 22.2 years, and 55.9 % had paraplegia with American Spinal Injury Association Impairment Scale A, B, or C. 17.1% of participants had COVID-19 infection. Forty percent of participants were fully vaccinated which is lower than that of general population in the state (53.5%). More than half of participants were concerned about family members or close friends getting or dying from COVID-19, had feelings of sadness or depression, and experienced disruptions in day to day social interactions with family and/or friends. The majority reported perceived benefits, had functional social supports, and had ability to manage stress. Participants reported varying COVID-19 related impacts, including employment (eg, 8.5% lost job), health care disruption (eg, 37.1% general care disruption), and financial hardship (eg, 34.3% financial difficulties). These results provide important markers for developing interventions for SCI population in future crises. No disclosure.

Experiences with COVID-19 Pandemic in the Spinal Cord Injury Community

Research Objectives Document the experiences of people with chronic spinal cord injury (SCI) during the COVID-19 pandemic. Design A cross-sectional survey. Setting An academic medical center. Participants A convenience sample of 35 participants from a local SCI Model Systems Center who completed a survey online or by phone between September 2021 and March 2022. Interventions Not applicable. Main Outcome Measures A scale “COVID-19: Impact of the pandemic and HRoL in cancer patients and survivors” obtained from NIH PhenX Toolkit was adapted for SCI population that measures personal COVID-19 exposures and experiences, including COVID-19 specific emotional and physical reactions, health care disruption and concerns, disruption to daily activities and social interactions, financial hardship, perceived benefits, functional social support, and perceived stress management. Results This sample had a mean age of 51.8 years, a mean duration of injury of 22.2 years, and 55.9 % had paraplegia with American Spinal Injury Association Impairment Scale A, B, or C. 17.1% of participants had COVID-19 infection. Forty percent of participants were fully vaccinated which is lower than that of general population in the state (53.5%). More than half of participants were concerned about family members or close friends getting or dying from COVID-19, had feelings of sadness or depression, and experienced disruptions in day to day social interactions with family and/or friends. The majority reported perceived benefits, had functional social supports, and had ability to manage stress. Participants reported varying COVID-19 related impacts, including employment (eg, 8.5% lost job), health care disruption (eg, 37.1% general care disruption), and financial hardship (eg, 34.3% financial difficulties). Conclusions These results provide important markers for developing interventions for SCI population in future crises. Author(s) Disclosures No disclosure.

A Study Protocol for a Multisite Randomized Controlled Trial of an Intervention to Improve Outcomes After Spinal Cord Injury.

Background: The consequences of spinal cord injury (SCI) can place significant demands on an individual's coping mechanisms. Interventions to promote psychological adjustment and coping are often included in inpatient rehabilitation programs; however, following discharge, many individuals with SCI do not receive ongoing counseling or education about psychological adjustment to disability. Effective postacute treatment models are needed to help individuals with SCI build skills that help them adapt to the stresses associated with a chronic physical disability, alleviate the consequences of anxiety and depression, and enhance subjective well-being. Objectives: To describe the protocol for a randomized clinical trial (RCT) of a 6-week intervention designed to improve psychosocial outcomes after SCI. Methods: To test efficacy and replicability of the intervention, we designed a three-arm, multisite RCT with assessments conducted at six time points. Our primary hypothesis is that participants in the Group arm will report greater improvements in psychosocial outcomes than participants who complete the intervention individually via video (Individual arm) or those who do not receive the intervention (Control arm). We also hypothesize that participants in the Group arm will maintain greater improvements in psychosocial outcomes longer than those in the individual or control arms. Conclusion: Results of the RCT will be presented and published to professionals and consumers, and intervention training and materials will be made available upon request.

Healthcare Disruptions and Use of Telehealth Services Among People With Multiple Sclerosis During the COVID-19 Pandemic.

OBJECTIVE: The current study examined health care disruptions and use of telehealth services among people with multiple sclerosis (pwMS) during the COVID-19 pandemic. DESIGN: Cross-sectional survey. SETTING: General community. PARTICIPANTS: Participants (N=163) included 70 pwMS and 93 healthy controls (HCs). The majority of respondents were from the United States (88%). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Rates of health care disruptions (eg, missing/canceling appointments, experiencing delays) and telehealth use for MS and non-MS medical care and mental health care. RESULTS: In this U.S. majority, predominantly White, and high socioeconomic status sample, 38% to 50% of pwMS reported experiencing disruptions in their MS and non-MS medical care and 20% to 33% reported disruptions in their mental health care; this was significantly lower than the rates observed among HCs. Compared with HCs, pwMS were more likely to use telehealth than in-person services, especially for mental health care. The majority of pwMS and HCs reported being satisfied with telehealth services. Individuals with higher degrees of functional limitation experienced more health care disruptions and were more likely to use telehealth services than individuals with lower degrees of functional limitation. CONCLUSIONS: Despite high health care disruption rates, pwMS frequently used and were highly satisfied with telehealth services during the COVID-19 pandemic. Due to physical limitations commonly observed in the MS population that may preclude travel, telehealth services should be continued even after resolution of the pandemic to expand access and reduce health care disparities.

The impact of the COVID-19 pandemic on engagement in activities of daily living in persons with acquired brain injury.

PRIMARY OBJECTIVES: This study examined (a) the impact of coronavirus disease-2019 (COVID-19) pandemic on engagement in activity participation in persons with acquired brain injury (ABI); and (b) whether changes in activity participation during the pandemic were associated participants' health-related quality of life (HRQoL). RESEARCH DESIGN: Exploratory online survey study. METHODS: Eighty-seven respondents with ABI and 98 healthy adults (HA) participated in this study. Engagement in activity participation during COVID-19 was calculated as a percentage of the activities participants performed before the pandemic. MAIN RESULTS: Participants with ABI modified their activities less than HA in order to maintain level of engagement in activity participation. They stopped performing more activities during the pandemic compared to HA and compared to their pre-pandemic engagement. Both groups continued to do similar percentage of activities without modifications compared to before the pandemic. Better HRQoL in both groups was predicted by a larger percentage of activities continued and fewer activities stopped. CONCLUSION: Results emphasize the importance of addressing activity participation changes during situations where there are disruptions of the individual's habits and routines in order to minimize negative consequences of such changes.

Relationships between changes in daily occupations and health-related quality of life in persons with multiple sclerosis during the COVID-19 pandemic.

BACKGROUND: The COVID-19 pandemic provided a unique opportunity to explore the impact of the mandated lockdown and social distancing policies on engagement in daily occupations for individuals with multiple sclerosis (MS) and able bodied (i.e. healthy) adults. The study also examined whether the changes in daily occupations were associated with health-related quality of life (HrQOL). METHODS: Between the spring and early fall of 2020, 69 persons with MS and 95 healthy adults completed an online survey that included measurements of 26 activities of daily life. For each activity, participants reported whether they continued to perform the activity (with or without adjustments), whether they stopped, or started to perform the activity during the pandemic. Social support, HrQOL, and demographics, including financial distress were also obtained. RESULTS: Participants with MS and healthy adults both reduced the number of activities performed during the pandemic. Healthy adults continued to do more activities with and without adjustments compared with participants with MS. In both groups, better HrQOL was associated with the number of activities participants continued to do with and without adjustments, and worse HrQOL with the number of activities they stopped doing. CONCLUSIONS: Fewer persons with MS engaged in everyday occupations than healthy adults following the COVID-19 pandemic. The ability to maintain occupational engagement and to participate in social and daily activities is important for maintaining high HrQOL in both groups. Thus, these results call for attention in treatment and self-management of MS symptomatology.