Availability and need of home adaptations for personal mobility among individuals with spinal cord injury

J Spinal Cord Med. 2018 Jan;41(1):91-101. doi: 10.1080/10790268.2017.1308995. Epub 2017 Mar 30.


Objective: To identify the availability and unmet need of home adaptations (HAs) among the Swiss population with spinal cord injury (SCI).

Design: Cross-sectional study.

Setting: Swiss Spinal Cord Injury Community Survey 2012.

Participants: Individuals aged 16 or older with chronic SCI living in Switzerland.

Interventions: Not applicable.

Outcome measures: The availability of ten HAs (self-report) was analyzed by sex, age, living situation, indoor mobility, SCI severity, SCI etiology and time since SCI. The unmet need (self-report of not having a HA but needing it) of HAs was analyzed by financial hardship.

Results: Among the 482 study participants (mean age 55.2 years, standard deviation 15.0 years, 71.6% males), 85.1% had at least one HA. The most frequent HA was a wheelchair accessible shower (62.7%). Availability of HAs markedly varied with indoor mobility (e.g. 38.4% of participants using a wheelchair had a stair lift compared to 17.4% of those walking) and with SCI severity (e.g. 54.8% of those with complete paraplegia had a wheelchair accessible kitchen worktop compared to 26.0% of those with incomplete paraplegia). Unmet need was highest for adjustable kitchen worktops (78.7% of those with a need) and adjustable kitchen cabinets (75.7%) and lowest for wheelchair accessible showers (9.4%) and grab bars next to the toilet (8.5%). No significant differences in unmet need were found when stratifying for financial hardship.

Conclusion: Availability of HAs is dependent on indoor mobility and SCI severity. There is a considerable degree of unmet need for selected HAs, which couldn't be explained by financial hardship.

Keywords: Architectural accessibility; Disability; Disability and Health (ICF); International Classification of Functioning; Mobility limitation; Spinal cord injury.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activities of Daily Living*
  • Adolescent
  • Adult
  • Aged
  • Architectural Accessibility
  • Female
  • Humans
  • Male
  • Middle Aged
  • Needs Assessment
  • Neurological Rehabilitation / standards
  • Neurological Rehabilitation / statistics & numerical data*
  • Spinal Cord Injuries / epidemiology
  • Spinal Cord Injuries / rehabilitation*

Grants and funding

This study has been financed in the framework of SwiSCI, supported by the Swiss Paraplegic Foundation.