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The impact of early spasticity on the intensive functional rehabilitation phase and community reintegration following traumatic spinal cord injury |
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| Authors: | Andréane Richard-Denis Bich-Han Nguyen Jean-Marc Mac-Thiong |
| Institution: | 1. Department of Medicine, Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada;2. Department of Physical Medicine and Rehabilitation, H?pital du Sacré-C?ur de Montréal, Montreal, Quebec, Canada andreane.rdenis@gmail.com;4. Department of Physical Medicine and Rehabilitation, Institut de réadaptation Gingras-Lindsay de Montréal, Montréal, Québec, Canada;5. Department of Physical Medicine and Rehabilitation, H?pital du Sacré-C?ur de Montréal, Montreal, Quebec, Canada;6. Department of Surgery, Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada;7. Department of Surgery, Sainte-Justine University Hospital Research Center, Montréal, Quebec, Canada |
| Abstract: | Context/Objectives: To determine the impact of spasticity presenting during the acute care hospitalization on the rehabilitation outcomes following a traumatic spinal cord injury (TSCI). Design: Retrospective cohort study. Setting: A single Level 1 trauma center specialized in SCI care. Participants: 150 individuals sustaining an acute TSCI. Interventions: Not applicable. Outcome Measures: The total inpatient functional rehabilitation length of stay. The occurrence of medical complications and the discharge destination from the inpatient functional rehabilitation facility were also considered. Results: 63.3% of the cohort presented signs and/or symptoms of spasticity during acute care. Individuals with early spasticity developed medical complications during acute care and during intensive functional rehabilitation in a higher proportion. They were also hospitalized significantly longer and were less likely to return home after rehabilitation than individuals without early spasticity. Early spasticity was an independent factor associated with increased total inpatient rehabilitation length of stay. Conclusion: The development of signs and symptoms of spasticity during acute care following a TSCI may impede functional rehabilitation outcomes. In view of its association with the occurrence of early spasticity, higher vigilance towards the prevention of medical complications is recommended. Early assessment of spasticity during acute care is recommended following TSCI. |
| Keywords: | Spinal cord injury Spasticity Rehabilitation Acute care Outcome |