Changes in functional independence after inpatient rehabilitation in patients with spinal cord injury: A simultaneous evaluation of prognostic factors

Abstract

Objective

This study aimed to investigate the improvements of functional independence following inpatient rehabilitation and compare those improvements between different levels and severities of Spinal Cord Injury (SCI). Prognostic factors affecting the patient’s outcomes were also studied.

Settings

Rofeideh Rehabilitation Hospital.

Outcome Measures

Spinal Cord Independence Measure version III (SCIM III), and Functional Independence Measure (FIM).

Method

In this retrospective cohort study, 180 patients with SCI were enrolled to record their functional independence upon admission and discharge, and the changes were compared between different levels and severities of injury using non-parametric tests. The prognostic factors of outcomes were studied by generalized estimating equation (GEE) analysis.

Results

The independence changes were significant for all the severities (American Spinal Injury Association Impairment Scale (AIS)) and levels of injury except for the patients with AIS A and B at upper cervical levels (P < 0.05). The level of injury, AIS, Length of Stay (LOS), and pressure ulcer had a significant prognostic value on patient’s outcomes. Furthermore, there was a significant difference between different levels of injury with the same AIS grade in functional improvement (P < 0.05), while there was a significant difference between AIS groups with the same level of injury only at upper and middle cervical lesions (P < 0.05).

Conclusion

Recording the values of functional independence before and after rehabilitation in individuals with SCI can help clinicians approximately expect the outcomes of future patients. Moreover, a deeper study of the prognostic factors can provide a more logical expectation of rehabilitation outcomes.

Keywords:

• Spinal cord injury
• Functional independence measure
• Spinal cord independence measure
• Rehabilitation
• Prognostic factors

Acknowledgements

The authors sincerely thank the study participants, the authorities, and staff as well as the Clinical Research Development center of the Rofeideh Rehabilitation Hospital for their cooperation and assistance.

Disclaimer statements

Contributors None.

Funding None.

Compliance with Ethical Standards The present study protocol was reviewed and approved by the Research Ethics Committee of the University of Social Welfare and Rehabilitation Sciences with the ethical code of IR.USWR.REC.1400.196.

Conflict of Interests Authors have no conflict of interests to declare.