ORIGINAL CONTRIBUTION Influence of Sport Participation on Community Integration and Quality of Life: A Comparison Between Sport Participants and Non-Sport Participants With Spinal Cord Injury

University of Toronto, Department of Medicine, Toronto Rehabilitation Institute, Lyndhurst Centre, Toronto,Ontario, CanadaReceived January 13, 2006; accepted November 3, 2008AbstractBackground/Objective: To determine whether community integration and/or quality of life (QoL)among people living with chronic spinal cord injury (SCI) are superior among sport participants vs non-sportparticipants.Study Design: Cross-sectional study.Participants/Methods: Persons (n¼90) living in the community with SCI (ASIA Impairment Scale A–D),level C5 or below, . 15 years of age, 12 months postinjury, and requiring a wheelchair for . 1 hours/daywere divided into 2 groups based on their self-reported sport participation at interview: sport participants (n¼ 45) and non-sport participants (n ¼ 45).Results: Independent-sample t tests revealed that both Community Integration Questionnaire (CIQ) andReintegration to Normal Living Index (RNL) total mean scores were higher among sport participants vs non-sport participants (P , 0.05). Significant correlation between CIQ and RNL total scores was found for allparticipants (Pearson correlation coefficients, P , 0.01). Logistic regression analysis revealed that theunadjusted odds ratio of a high CIQ mean score was 4.75 (95% CI 1.7, 13.5) among current sportparticipants. Similarly, the unadjusted odds ratio of a high RNL score was 7.00 (95% CI 2.3, 21.0) amongcurrent sport participants. Regression-adjusted odds ratios of high CIQ and high RNL scores were 1.36 (95%CI 0.09, 1.45) and 0.15 (95% CI 0.04, 0.55), respectively. The odds ratio for pre-SCI sport participationpredicting post-SCI sport participation was 3.06 (95% CI 1.23, 7.65).Conclusions: CIQ and QoL scores were higher among sport participants compared to non-sportparticipants. There was an association between mean CIQ and RNL scores for both groups. Sportparticipants were 4.75 and 7.00 times as likely to have high CIQ and QoL scores. Both groups had a similarlikelihood of high CIQ and RNL scores after adjusting for important confounders. Individuals whoparticipated in sports prior to SCI were more likely to participate in sports post-SCI.JSpinalCordMed.Apr2009;32(2):115–124Key Words: Spinal cord injuries; Tetraplegia; Paraplegia; Disability; Sport participation; Wheelchair sports;Community reintegration; Quality of lifeINTRODUCTIONIt is well established that participation in sports improvespsychological well-being among able-bodied individuals(1–5). There is increasing interest in the impact of sportparticipation on the psychological well-being of individ-uals with disabilities, particularly individuals with spinalcord injury (SCI). Psychological well-being is defined bythe constructs of mood, trait anxiety, self-esteem, and