ABSTRACT
PURPOSE: Spinal cord injury (SCI) is a life-changing condition, almost always leading to disability. The aim was to determine the period-prevalence of activity limitations, participation restrictions, and environmental barriers in community-dwelling persons with traumatic spinal cord injury (TSCI) in Kenya. METHODS: A cross-sectional survey of 90 community-dwelling adult persons living with TSCI for more than 1 year, recruited from the database of the only specialised rehabilitation, in-patient, facility in Kenya. Modules of the International Spinal Cord Injury community survey (InSCI) used were demographic and injury characteristics; activity and participation; and environmental factors. RESULTS: Most prevalent activity limitations and participation restrictions in the total sample were using public transportation (90%), standing unsupported (83%), getting to destination (76%), and toileting (76%). The top environmental barriers were inadequate finances (96%), inaccessibility of public places (92%), and problems with long distance transportation (90%). Participants with tetraplegia were more affected with activity limitations and participation restrictions than those with paraplegia. CONCLUSION: Functioning problems and environmental barriers are prevalent among adults living with TSCI in Kenya. Although this is the best-case scenario with respect to healthcare services, where individuals received inpatient rehabilitation previously, a need exists to examine the principles and models of rehabilitation and explore the value proposition of primary care/community level rehabilitation to further optimise independence and functioning.
The functioning problems of persons with spinal cord injury (SCI) in Kenya appear to be diverse in nature, which calls for the evaluation of current rehabilitation services and models with the aim of bolstering independence and participation by including evidence-based interventions to standard treatment packages.A high degree of experiencing environmental challenges was found, calling for a whole-of-government approach to enhance inclusivity of persons with SCIs in society.It appears that additional resources or equity measures are allocated to persons with tetraplegia due to their accentuated experience of disability and negative environmental factors.