Determinants of participation in daily life activities and its relationship with quality of life in individuals with paraplegic spinal cord injury in Pakistan

Introduction: Individuals with paraplegic spinal cord injury (SCI) experience multiple challenges in daily life participation, significantly impacting their quality of life (QOL). Understanding the determinants of participation and their association with QOL is crucial for guiding rehabilitation strategies in low-resource settings like Pakistan. Method: A cross-sectional study of 140 individuals with paraplegic SCI was conducted in rehabilitation centres across Pakistan. Participation was measured using the World Health Organization Disability Assessment Schedule 2.0 (WHODAS-II), environmental barriers with the Craig Hospital Inventory of Environmental Factors–Short Form (CHIEF-SF), and QOL with the WHOQOL-BREF. Results: Participants were predominantly male (97.9%), with a mean age of 35 years. The majority sustained traumatic injuries, primarily due to gunshots and motor vehicle accidents. Employment status, supportive environments, and neurological impairment significantly influenced participation. A moderate negative correlation was found between WHODAS-II total scores and WHOQOL-BREF scores ( r = −0.586, p < 0.001), indicating that higher levels of disability were associated with lower QOL among individuals with paraplegic SCI. Conclusion: Employment status and supportive environments are modifiable factors that can enhance participation, ultimately improving QOL for individuals with paraplegic SCI in Pakistan. Addressing these factors can lead to better rehabilitation outcomes.