Scoping review of peer reviewed publications addressing rehabilitation for people sustaining traumatic spinal cord injury

The Journal of Spinal Cord Medicine, 2020 · DOI: 10.1080/10790268.2019.1645415 · Published: July 1, 2020

Spinal Cord Injury Participation Rehabilitation

Simple Explanation

This review examines research publications related to rehabilitation for individuals with traumatic spinal cord injuries (SCI). It seeks to understand the design of these studies, the clinical settings in which they take place, and the ways in which outcomes are measured. The review categorizes studies based on whether they involve interventions (like treatments or therapies) or are non-interventional. It also looks at the settings where rehabilitation is provided, such as inpatient facilities, outpatient clinics, or transitional programs. The review analyzes the outcome measures used in SCI rehabilitation research. These measures assess various aspects of a patient's recovery and well-being, including impairments, functional abilities, participation in activities, quality of life, and symptoms.

Study Duration

1990–2016

Participants

544 articles

Evidence Level

Scoping review

Key Findings

1
There is a lack of intervention trials and randomized controlled trials (RCTs) in SCI rehabilitation research, particularly for individuals with tetraplegia, indicating a need for more evidence-based practice guidelines.
2
While standard measures of function are frequently used in SCI rehabilitation research, there is a lack of consensus on which specific outcome measures should be used.
3
The Functional Independence Measure (FIM) is the most frequently used functional measure, but it does not adequately measure return to school, work readiness, and employment, which are important for young adults with SCI.

Research Summary

This scoping review aimed to assess clinical rehabilitation research (CRR) publications pertaining to traumatic Spinal Cord Injury (SCI) and determine whether the research performed intervention trials and used function as an outcome. The study revealed a paucity of intervention trials and RCTs, indicating a dearth of knowledge that would be needed to establish evidence-based practice guidelines, especially for tetraplegia. While standard measures of function were frequently used, there is no consensus about what exact outcome measure to use. Gaps remain in SCI research, including few studies reporting interventions, fewer including RCTs and almost none studying tetraplegia; a lack of consensus on which outcome measures to use and which ICF measurement domains are necessary; and few studies measuring return to usual activities and roles.

Practical Implications

Need for More Intervention Trials

The paucity of intervention trials and RCTs highlights the need for more research to establish evidence-based practice guidelines for SCI rehabilitation, especially for tetraplegia.

Consensus on Outcome Measures

The lack of consensus on which outcome measures to use suggests the need for developing standardized and comprehensive measures that capture various aspects of functional recovery and participation.

Focus on Return to Usual Activities

Given the importance of return to school, work readiness, and employment for young adults with SCI, future research should prioritize measuring these outcomes and developing interventions to support them.

Study Limitations

1
The requirement for studies to address function and/or functional limitation as an outcome of the research reduced the total number for inclusion.
2
The decision to exclude studies that measured only symptoms, certainly important to people’s level of functioning, by themselves to do measure function.
3
This scoping review identified the design, clinical setting and outcome measures used in CRR and demonstrates gaps in the literature.

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