Predictors of functional outcomes in adults with traumatic spinal cord injury following inpatient rehabilitation: A systematic review

The Journal of Spinal Cord Medicine, 2017 · DOI: 10.1080/10790268.2016.1238184 · Published: May 1, 2017

Spinal Cord Injury Participation Rehabilitation

Simple Explanation

This study looks at what factors can predict how well someone recovers after a spinal cord injury (SCI) during and after rehabilitation. It uses the International Classification of Functioning, Disability and Health (ICF) model to categorize these factors. The review found that different factors are important at different times. During rehab, physical abilities are key, but later on, what a person does and how they participate in activities becomes more important. The results can help doctors and therapists set realistic goals for patients with SCI, both while they're in rehab and after they return home.

Study Duration

February 2000 to February 2015

Participants

Individuals with traumatic SCI

Evidence Level

Level III and IV, Retrospective and Prospective cohort studies

Key Findings

1
Variables in the Body Structure and Function domain were the most consistent predictors of mFIM score at discharge.
2
Variables in the Activity and Participation domain were the most consistent predictors of mFIM score at one-year follow-up.
3
Contextual factors were the least frequent predictors at both discharge and one-year follow-up.

Research Summary

This systematic review aimed to identify, categorize, and rank predictors of functional outcomes for individuals with SCI following rehabilitation, using the ICF model. The review identified 27 predictors of mFIM score spanning the ICF domains, with different domains having more influence at discharge versus one-year follow-up. The study concludes that understanding these predictors can help clinicians set realistic goals to maximize functional independence for patients with SCI during and after rehabilitation.

Practical Implications

Realistic Goal Setting

Clinicians can set more realistic goals for patients with SCI by understanding the predictors of functional outcomes.

Prioritizing Services

The findings can help prioritize services received as a patient prepares for discharge and guide discharge planning.

Targeted Interventions

Tailored interventions can be facilitated for particular age populations to accommodate their specific needs.

Study Limitations

1
The mapping of predictors into the ICF domains was not entirely straightforward.
2
The included studies did not explicitly include formal outcomes measures of participation.
3
The QUIPS assessment revealed moderate to high level of bias in the selected studies due to confounding.

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