首页 | 本学科首页   官方微博 | 高级检索  
     


Relationship of physical therapy inpatient rehabilitation interventions and patient characteristics to outcomes following spinal cord injury: The SCIRehab project
Authors:Laura Teeter  Julie Gassaway  Sally Taylor  Jacqueline LaBarbera  Shari McDowell  Deborah Backus  Jeanne M. Zanca  Audrey Natale  Jordan Cabrera  Randall J. Smout  Scott E. D. Kreider  Gale Whiteneck
Affiliation:1.Shepherd Center, Atlanta, Georgia, GA, USA;2.Institute for Clinical Outcomes Research, Salt Lake City, UT, USA;3.Rehabilitation Institute of Chicago, Chicago, IL, USA;4.Carolinas Rehabilitation, Charlotte, NC, USA;5.Mount Sinai Medical Center, New York, NY, USA;6.Craig Hospital, Englewood, CO, USA
Abstract:

Background/objective

Examine associations of type and quantity of physical therapy (PT) interventions delivered during inpatient spinal cord injury (SCI) rehabilitation and patient characteristics with outcomes at the time of discharge and at 1 year post-injury.

Methods

Physical therapists delivering routine care documented details of PT interventions provided. Regression modeling was used to predict outcomes at discharge and 1 year post-injury for a 75% subset; models were validated with the remaining 25%. Injury subgroups also were examined: motor complete low tetraplegia, motor complete paraplegia, and American Spinal Injury Association (ASIA) Impairment Scale (AIS) D motor incomplete tetra-/paraplegia.

Results

PT treatment variables explain more variation in three functionally homogeneous subgroups than in the total sample. Among patients with motor complete low tetraplegia, higher scores for the transfer component of the discharge motor Functional Independence Measure () are strongly associated with more time spent working on manual wheelchair skills. Being male is the most predictive variable for the motor FIM score at discharge for patients with motor complete paraplegia. Admission ASIA lower extremity motor score (LEMS) and change in LEMS were the factors most predictive for having the primary locomotion mode of “walk” or “both (walk and wheelchair)” on the discharge motor FIM for patients with AIS D injuries.

Conclusion

Injury classification influences type and quantity of PT interventions during inpatient SCI rehabilitation and is a strong predictor of outcomes at discharge and 1 year post-injury. The impact of PT treatment increases when patient groupings become more homogeneous and outcomes become specific to the groupings.

Note

This is the second of nine articles in the SCIRehab series.
Keywords:Spinal cord injuries   Rehabilitation   Physical therapy   Paraplegia   Tetraplegia   Participation   Quality of life   Employment   Functional outcome practice-based evidence   SCI model systems
设为首页 | 免责声明 | 关于勤云 | 加入收藏

Copyright©北京勤云科技发展有限公司  京ICP备09084417号