Functioning Information Reference Lab

• Consultation on study design, including research questions, hypotheses, endpoints, and statistical approaches
• Sample size calculations
• Support with and collaboration on statistical analyses
• Support with grant applications
• Methodological and statistical support and review of study protocols
• Support with and review of abstracts, posters, and publications
• Support with statistical programming (R, Stata, Matlab)
• Consultation on data sharing and reproducible research

• Sampling techniques
• Randomization and minimization techniques
• Descriptive and non-parametric statistics
• Data visualization
• Regression models and AN(C)OVA
• Generalized, mixed effects linear models
• Time series, longitudinal, and repeated measures analyses
• Time-to-event, competing risk, and multi-state analyses
• Scale development and validation (classical test theory, IRT, Rasch models)
• Development and validation of prediction models and prediction rules
• Dimension reduction (e.g., factor analysis, PCA)
• Structural equation modelling, machine learning, and Bayesian methods
• Systematic reviews, meta-analyses, and network meta-analyses
• Missing data and imputation methods

• Introduction into R programming for health researchers
• Machine learning and prediction modelling in health research
• Psychometric analysis of questionnaire data using modern test theory

Together with the Ageing, Functioning Epidemiology and Implementation group, we validated the Spinal Cord Injury Secondary Conditions Scale (SCI-SCS). We comprehensively examined the quality of SCI-SCS data and its potential for measuring the burden of secondary health conditions experienced by people with spinal cord injury.

One study compared self-reported information with clinical assessments by treating physicians. Another study examined whether the SCI-SCS performs consistently across different cultural contexts, using data from 35 countries participating in the International Spinal Cord Injury Survey (InSCI).

The analyses showed that the SCI-SCS has good measurement properties across countries. However, the self-reported information reflects the lived experience of secondary health conditions and does not necessarily align with the clinical perspective, which places greater emphasis on diagnoses and symptoms when evaluating these conditions.

In collaboration with the Neuro-Musculoskeletal Functioning and Mobility group, we estimated aerobic capacity reference values during primary rehabilitation for spinal cord injury (SCI) patients. The established reference values support the interpretation of aerobic capacity in individuals undergoing primary SCI rehabilitation, enabling both within-person comparisons over time and between-person benchmarking. The reference values also support the development of individualized training or other therapeutic recommendations aimed at improving aerobic capacity.

Neurogenic bowel dysfunction following spinal cord injury (SCI) can substantially reduce quality of life and independence, as bowel management is often a time-consuming and burdensome process.

In a pilot study, we evaluated the effects of 16 weeks of neuromuscular electrical stimulation (NMES) in people with chronic SCI, in collaboration with the International Centre for Functional Electrical Stimulation (FES) at the Swiss Paraplegic Centre. NMES significantly reduced both defecation time and bowel transit time.

We support the FES Centre in planning a randomized cross-over trial to compare neuromuscular electrical stimulation with sensory electrical stimulation. The study is supported by an SNSF Project Funding grant.

After spinal cord injury, specialized rehabilitation is essential to optimize recovery, prevent complications, and support reintegration into daily life. However, current evidence for the benefits of early rehabilitation is limited and primarily based on retrospective studies. Notably, no studies to date have specifically examined the timing of admission to specialized rehabilitation centers and its potential beneficial or detrimental effect on clinical outcomes.

This evidence gap highlights the need to better characterize both the timing and determinants of first admission to specialized rehabilitation following SCI and to evaluate its impact on functional outcomes. Because randomized studies are difficult to conduct in this context for ethical and practical reasons, we aim to apply causal modeling methods to investigate the effect of rehabilitation timing on functional recovery, as assessed by the Spinal Cord Independence Measure (SCIM) score.