Recommendations for long-term follow-up care of secondary health conditions in spinal cord injury/disorder: a systematic review

Front. Rehabil. Sci., 2024 · DOI: 10.3389/fresc.2024.1371553 · Published: October 11, 2024

Spinal Cord Injury Healthcare Rehabilitation

Simple Explanation

Spinal cord injuries or disorders can lead to various complications, known as secondary health conditions. These conditions significantly affect a person's well-being and quality of life. Regular follow-up care is essential for preventing or detecting these secondary health conditions early. Check-up appointments can help manage these conditions, improve long-term health, and enhance functioning. This study reviewed existing literature to identify recommendations for follow-up care programs for people with spinal cord injuries or spina bifida, focusing on the content, frequency, and setting of these programs.

Study Duration

Jan. 2008–Dec. 2018

Participants

Varied from 28 to 167’600 (SCI/D) and 38 to 2016 (Spina Bifida)

Evidence Level

Systematic Review

Key Findings

1
The review found a limited number of publications on follow-up care programs, highlighting a gap in comprehensive medical follow-up guidelines for individuals with SCI/D.
2
The content of follow-up care should cover a broad range of health conditions, including urological problems, pain, pressure injuries, and osteoporosis.
3
The setting for follow-up care varies, with some publications focusing on specialized SCI/D centers, while others emphasize the role of family physicians or telemedicine.

Research Summary

This systematic review aimed to provide an overview of published follow-up care programs for primary and secondary health conditions in spinal cord injury/disorder (SCI/D) and spina biﬁda. The review found a limited number of publications and guidelines describing comprehensive follow-up care approaches for all relevant health conditions in persons with SCI/D or spina biﬁda. Based on the literature, the authors recommend regular (annual) follow-up care appointments at specialized SCI clinics and highlight the need for a comprehensive clinical practice guideline (CPG).

Practical Implications

Development of Comprehensive Guidelines

The findings emphasize the urgent need for the development of comprehensive clinical practice guidelines for long-term follow-up care in SCI/D, ensuring all relevant health conditions are addressed.

Coordination of Care

Highlight the importance of a multidisciplinary approach to care, ideally coordinated by a specialist in SCI care (preferably a PMR specialist) in close collaboration with all included healthcare specialists and the general practitioner.

Telemedicine Integration

Promote the use of telemedicine, particularly for individuals in remote areas or low- and middle-income countries, to improve access to healthcare services and specialized care.

Study Limitations

1
The search was performed in 2019, potentially missing relevant articles and guidelines published after December 2018.
2
The review only considered publications in German and English, potentially excluding relevant studies in other languages.
3
There is an underrepresentation of evidence on long-term follow-up care in low and middle income countries.

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