Age, resilience, social support, and health literacy as predictors of functional ability in people with spinal cord injury: a 6-month follow-up study.

OBJECTIVE: To longitudinally examine age, resilience, social support, and health literacy as predictors of functional ability in people with spinal cord injury from rehabilitation initiation through to 6-month follow-up. DESIGN: Follow-up study. SETTING: The spinal surgery department of the Third Affiliated Hospital of Soochow University, China. SUBJECTS/PATIENTS: This study included 367 inpatients with traumatic spinal cord injury at a single centre. METHODS: Functional ability (Modified Barthel Index, MBI), resilience (Connor-Davidson Resilience Scale), social support (Social Support Rating Scale), and health literacy (Brief Health Literacy Screening) were assessed at baseline, 3-month, and 6-month follow-up. Linear mixed-effects models analysed predictors of MBI change. RESULTS: MBI scores improved slightly from baseline to 6-month follow-up (43.50 [21.48] to 46.81 [22.10]), indicating a modest magnitude of change. Multivariate analysis identified younger age (β = -0.02; p = 0.028), higher resilience (β = 0.22; p < 0.001), and higher health literacy (β = 0.32; p = 0.001) as significant independent predictors of greater functional ability over time. Social support was significant only in univariate analysis (β = 0.44; p = 0.038). CONCLUSIONS: Although the observed improvement in functional ability was modest, younger age, stronger psychological resilience, and higher health literacy were independent predictors of better functional ability in the first 6 months after discharge from spinal cord injury. Further research is warranted to determine the clinical significance of these changes. Rehabilitation strategies may consider integrating interventions targeting these modifiable psychosocial and cognitive resources.