Relationship of patient characteristics and rehabilitation services to outcomes following spinal cord injury: The SCIRehab Project

The Journal of Spinal Cord Medicine, 2012 · DOI: 10.1179/2045772312Y.0000000057 · Published: November 1, 2012

Spinal Cord Injury Healthcare Rehabilitation

Simple Explanation

This study investigates how patient characteristics and the amount of therapy received during inpatient rehabilitation for spinal cord injury (SCI) relate to patient outcomes. The study found that patient characteristics are strong predictors of outcomes, but the amount of treatment time from different therapy disciplines adds only slightly to the predictive power. More time in physical therapy was linked to better motor function and social participation, while more time in therapeutic recreation also had positive associations with outcomes.

Study Duration

5 years

Participants

1376 patients with spinal cord injury

Evidence Level

Practice-based evidence (PBE) observational study

Key Findings

1
Patient characteristics are strong predictors of outcome; treatment duration adds slightly more predictive power.
2
More time in physical therapy was associated positively with motor Functional Independence Measure at discharge and the 1-year anniversary, CHART Physical Independence, Social Integration, and Mobility dimensions, and smaller likelihood of rehospitalization after discharge and reporting of pressure ulcer at the interview.
3
More time in therapeutic recreation also had multiple similar positive associations.

Research Summary

The SCIRehab study examined the relationship between patient characteristics, rehabilitation treatment time, and outcomes at discharge and 1-year post-injury for 1376 patients with SCI. Patient characteristics were found to be strong predictors of outcomes, with treatment duration adding only a small amount of additional predictive power. Increased time in physical therapy and therapeutic recreation were associated with better outcomes, while time spent in other disciplines had fewer and mixed relationships.

Practical Implications

Personalized Rehabilitation

Rehabilitation programs should be tailored to individual patient characteristics to optimize outcomes.

Optimize Therapy Dosage

Further research is needed to determine the optimal amount and type of therapy for specific patient subgroups.

Resource Allocation

Healthcare resources should be allocated efficiently to maximize the benefits of rehabilitation services for individuals with SCI.

Study Limitations

1
The participating facilities were not a probability sample of all SCI rehabilitation facilities, limiting generalizability.
2
Data were not collected on treatment delivered by respiratory care, chaplaincy, and rehabilitation engineering.
3
Treatment time reported may have been subject to errors through omissions, duplicate reports, and documentation errors.

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