Article

OBJECTIVE: To evaluate change in functional outcomes over 1 year after spinal
cord injury (SCI). DESIGN: Observational longitudinal secondary analysis.
SETTING: Six rehabilitation facilities participating in the SCIRehab project.
PARTICIPANTS: Patients (N=1146) with SCI enrolled from 2007 to 2010.
INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: FIM instrument 13-item and
11-item motor, 3-item transfer, 6-item self-care, 3-item self-care
upper-extremity, and 3-item self-care lower-extremity subscores modeled as
trajectories of change. RESULTS: Patients were on average 37 years old,
non-Hispanic white, with high school or higher education, a body mass index of
25, and a Comprehensive Severity Index score of 20. Most were men with paraplegia
(37%) or high tetraplegia (27%). Median time frames were 22 days from injury to
admission, 46 days from admission to discharge, 407 days from admission to
follow-up, and 44 days for rehabilitation length of stay. The motor subscores
were higher on admission for paraplegia and American Spinal Injury Association
(ASIA) Impairment Scale (AIS) grade D groups, and recovered faster for the AIS
grade D group. Lower function at admission was associated with older age, higher
Comprehensive Severity Index score, longer length of stay, fewer physical therapy
and therapeutic recreation hours, and more occupational therapy hours. Slower
recovery rates were associated with older age, more days from injury to
admission, and fewer physical therapy hours per week. CONCLUSIONS: Longitudinal
outcomes modeled as individual trajectories of change are clinically meaningful.
Individual growth curve models could facilitate recovery prediction and outcome
evaluation at individual and group levels. However, assessment of the effects of
treatment on outcome trajectories will require the addition of outcome measures
at time points during intervention and may require the use of outcome measures
specific to aspects of rehabilitation, such as mobility and self-care.
CI - Copyright (c) 2013 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS