STUDY DESIGN Cross-sectional. OBJECTIVES To examine the associations between activities, body structures and functions, and their relationship with aetiology, age and sex in persons with spinal cord injury (SCI) at discharge from first rehabilitation. SETTING Swiss SCI Cohort Study (SwiSCI). METHODS The study included 390 participants with newly acquired SCI and the International Classification of Functioning, Disability and Health (ICF) as conceptual frame of reference. Body structures were represented by injury level and severity; body functions by cardiovascular, pulmonary, skin, bowel and urinary functions and pain; mental functions by anxiety, depression, optimism and self-esteem; and activities by independence in performing activities of daily living (ADL). Using structural equation modelling (SEM), indirect effects of body structures and functions on independence in performing ADL through mental functions were tested for each mental function separately. For each structural model, fit was assessed using several indices and differences in aetiology, age and sex groups were explored. RESULTS The structural model about optimism showed good fit in all indices; the models about anxiety, depression and self-esteem showed conflicting fit indices, respectively. Within all models, effects on independence in performing ADL were mainly direct. Pain showed significant (P < 0.05) indirect effects on independence in performing ADL within the depression, optimism and self-esteem models. The model about anxiety showed differences in aetiology groups. CONCLUSIONS Using an ICF-based modelling approach, this study presents an attempt towards a more comprehensive understanding of functioning in first rehabilitation of persons with SCI, which might be fundamental for rehabilitation planning.

中文翻译：

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使用结构方程模型检查在瑞士参加第一次康复治疗的脊髓损伤患者的功能复杂性。

研究设计横断面。目的 研究脊髓损伤 (SCI) 患者首次康复出院时的活动、身体结构和功能之间的关联，以及它们与病因、年龄和性别的关系。设置瑞士 SCI 队列研究 (SwiSCI)。方法 该研究包括 390 名以新获得的 SCI 和国际功能、残疾和健康分类 (ICF) 作为概念参考框架的参与者。身体结构由损伤程度和严重程度表示；身体机能由心血管、肺、皮肤、肠和泌尿功能和疼痛引起；焦虑、抑郁、乐观和自尊导致的心理功能；独立进行日常生活活动 (ADL)。使用结构方程模型 (SEM)，分别针对每种心理功能测试了身体结构和功能对通过心理功能执行 ADL 的独立性的间接影响。对于每个结构模型，使用几个指标评估拟合度，并探讨了病因、年龄和性别组的差异。结果乐观的结构模型在所有指标中均表现出良好的拟合；关于焦虑、抑郁和自尊的模型分别显示出相互矛盾的拟合指数。在所有模型中，对执行 ADL 的独立性的影响主要是直接的。在抑郁、乐观和自尊模型中，疼痛对 ADL 的独立性有显着的间接影响（P < 0.05）。关于焦虑的模型显示出病因组的差异。结论 使用基于 ICF 的建模方法，