Article

OBJECTIVES: (1) To identify different patterns of changes in wheelchair exercise
capacity in the period between the start of active spinal cord injury (SCI)
rehabilitation and 5 years after discharge; (2) to examine the pattern
determinants of the change in wheelchair exercise capacity. DESIGN: Prospective
cohort study. Measurements were recorded at the start of active inpatient
rehabilitation, 3 months after the start, at discharge of inpatient
rehabilitation, 1 year after discharge, and 5 years after discharge. SETTING:
Eight rehabilitation centers. PARTICIPANTS: Persons with SCI (N=130; age range,
18-65y), who were wheelchair-dependent, at least for long distances.
INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE: Wheelchair exercise
capacity: peak power output (W). RESULTS: We found 4 different patterns of the
change of peak power output (mean +/- SD): (1) a pattern with high and
progressive scores (33% of total study group): high progressive scores (start of
rehabilitation: 49+/-15W to 5 years after discharge: 77+/-17.2W); (2) a pattern
of improvement during inpatient rehabilitation and deterioration after inpatient
rehabilitation (12%): progressive scores during inpatient rehabilitation with
deteriorating scores after discharge (start of rehabilitation: 29+/-8.7W, to
discharge: 60+/-8.4W, to 5 years after discharge: 39+/-13.1W); (3) a pattern with
low and only slightly progressive scores (52%): low progressive scores (start of
rehabilitation: 20+/-10.1W to 5 years after discharge: 31+/-15.9W); and (4) a
pattern with low scores during inpatient rehabilitation and a sharp rise after
discharge (3%): low inpatient scores with strong progressive scores after
discharge (start of rehabilitation: 29+/-15.5W to 5 years after discharge:
82+/-10.6W). A logistic regression of factors that may distinguish between
patterns with high and progressive scores and patterns with low and only slightly
progressive scores revealed that older age, being a woman, having a tetraplegic
lesion, and low functional status were associated with patterns with low and only
slightly progressive scores. The pattern of improvement during inpatient
rehabilitation and deterioration after inpatient rehabilitation showed more
neuropathic pain and lower sports participation than patterns with high and
progressive scores. CONCLUSIONS: For the vast majority of patients, wheelchair
exercise capacity after SCI shows a positive trend and can be described in
distinct patterns that are dependent on personal, lesion, and functional
characteristics.
CI - Copyright (c) 2013 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS