Factors Associated with Recovery in Motor Strength, Walking Ability, and Bowel and Bladder Function after Traumatic Cauda Equina Injury

JOURNAL OF NEUROTRAUMA, 2021 · DOI: 10.1089/neu.2020.7303 · Published: February 1, 2021

Simple Explanation

This study examines factors affecting recovery after traumatic cauda equina injury (TCEI), focusing on motor strength, walking, and bowel/bladder function. The research uses data from the Rick Hansen Spinal Cord Injury Registry, analyzing 214 participants with TCEI. Shorter time from injury to rehabilitation was linked to better walking and bowel function recovery, while longer rehabilitation stays and older age were associated with improved bladder function.

Study Duration

July 2004 to February 2017

Participants

214 persons with acute TCEI

Evidence Level

Not specified

Key Findings

1
Shorter rehabilitation onset (time from injury to rehabilitation admission) was a significant predictor for both improvement in walking ability and bowel function.
2
Longer rehabilitation stay and being an older female were associated with improved bladder function.
3
Older age and higher lower-extremity motor scores (LEMS) at acute admission were significantly associated with greater LEMS at discharge from care.

Research Summary

This study aimed to identify factors associated with recovery in motor strength, walking ability, and bowel and bladder function after traumatic cauda equina injury (TCEI). The study found that shorter time to rehabilitation onset was predictive of improved walking ability and bowel function, while longer rehabilitation stays and older age were associated with better bladder function. The authors conclude that individuals with TCEI have a reasonable chance of recovery, and the identified factors can aid in setting rehabilitation goals and communicating prognosis to patients and families.

Practical Implications

Rehabilitation Timing

Early rehabilitation intervention is crucial for improving walking ability and bowel function recovery in patients with TCEI.

Personalized Rehabilitation

Rehabilitation programs should consider patient's age and sex, especially for bladder function recovery.

Realistic Goal Setting

Understanding factors influencing recovery can help clinicians set realistic rehabilitation goals and communicate effectively with patients and their families.

Study Limitations

1
Lack of imaging data (CT/MRI) in the RHSCIR data set may have led to misclassification of some patients as having TCEI.
2
Missing data, particularly for bowel and bladder function outcomes, may have introduced bias in the results.
3
Assessment of bowel and bladder function was based on FIM scores, which measure independence rather than neurological function, and recovery was only assessed until discharge from rehabilitation.

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