Disability fingerprints: Patterns of disability in spinal cord injury and multiple sclerosis differ

Background. Models for causation of functional disability differ as to whet her different diseases lead to common expressions of disability versus prod ucing unique "disability fingerprints" Multiple sclerosis (MS) and Spinal C ord Injury (SCI) both affect the spinal cord; however, their pathophysiolog ies differ (progressive vs nonprogressive; multifocal vs unifocal). Methods. Patterns of disability were compared among veterans who reported i n a national survey thai they had MS (n = 1789) or SCI (n = 6361) as the so le cause of their spinal cord dysfunction. The study used self-reported inf ormation on disease duration, physical impairments, and self-care skills to compare the two samples for differences in disability overall and after st ratification according to (a) disease duration, and (b) specific physical i mpairments. Results, Patterns or disability differed significantly among persons with M S compared to SCI (p = .001). Differences in level of disability between th e two samples remained statistically significant after stratification on di sease duration. There were substantial, statistically significant differenc es between the two samples in the amount and kinds of physical impairment. However, differences in level of disability between the two conditions rema ined highly significant after stratifying on number of affected limbs (p = .003), amount of useful movement (p = .001), overall motor impairment (p = .003), amount of sensation (p = .001), impairment in memory and thinking (p = .001), and visual impairment(p =.001). Conclusions. This study shows differing diseases indeed have unique disabil ity fingerprints, which remain unique after controlling for disease duratio n and for population-specific differences in physical impairment. These fin dings point out the need to explain the disablement process more fully.