Self-reported communication and swallowing difficulties in people following spinal cord injury in New Zealand

Prevalence and long-term impact of communication and swallowing difficulties on ability to readjust after spinal cord injury (SCI) have been understudied. This study aimed to explore self-reported communication and swallowing difficulties in patients following SCI throughout their rehabilitation journey. 123 patients completed self-reported questionnaires at three time points: upon arrival at rehabilitation, at discharge and one month after discharge. All patients completed the Voice Handicap Index 10 (VHI-10), the Eating Assessment Tool (EAT-10), and the Communication Participation Item Bank (CPIB). Scores were compared across time periods. Forty-four percent of patients (71% male, mean age 54 yrs) had a cervical SCI, and 24% had an American Spinal Injury Association (ASIA) score of A (complete impairment). On admission to rehabilitation, 22% of patients had elevated EAT-10 and 12% had elevated VHI-10. Scores improved for ~50% of patients. The VHI-10, EAT-10 and CPIB were significantly worse for those who had required speech-language therapy (SLT) and those with cervical SCI and higher ASIA scores (p < 0.05). Only 8% of patients had received SLT during rehabilitation; 18 patients (15%) did not receive SLT input during their acute or rehabilitation stay despite self-reported swallowing (n = 5), voice (n = 6) or both swallowing and voice (n = 7) concerns. A proportion of patients in SCI rehabilitation reports concerns with their swallowing and/or voice. For some, this continues long after discharge. SLT should be available for SCI rehabilitation to support the return to enjoyable, safe oral intake and optimise communication skills. Validated self-reported questionnaires provide a simple way of identifying patients who require SLT.