Международный журнал нейрореабилитации

Functional Outcomes of Patients with Acute Spinal Cord Injury

Abstract

Mohammed Al Hamawi, Wafa Al Yazedi, Amit Ramesh Dhumale, Hani Hassan Al Yahary, Ginny Varghese and Navas Nadukkandiyi

The purpose of this study was to identify relationships between age, length of stay, the American Spinal Injury Association classification (ASIA) with total functional gain during inpatient rehabilitation for patients with Spinal Cord Injury (SCI) with functional independence and rehabilitation outcomes of traumatic spinal cord patients. The data were obtained for 49 patients with traumatic spinal cord lesions admitted to the neuro physical therapy unit from 2006 to 2008. The mean age was 33 ± 10.63 years. Study design: Retrospective observational study. The patient’s characteristics and outcomes were analysed and compared according to the severity of traumatic spinal cord injuries (SCI) and its appearance according to vertebral level correlations of SCI with co-morbidities was analysed. The Functional Independent measure scores of patient at admission (FIMa) on were compared to Functional Independent Measure scores recorded at discharge (FIMd) to get the total gain for each patient. Patients were grouped according to age, level of neurological injury, length of stay to compare with the total gain. The Length of stay was also compared with the American Spinal Injury Association classification (ASIA) at discharge. The author had been observed that there is negative correlation of LOSa with FIMd and Gain (r=-0.507, p=0.00 and r=-0.402, p=0.004), respectively. FIMa is positively correlated with FIMd but negatively correlated to Gain. FIMd is positively related with Gain. The Mean LOSa and LOSr are 44.80 days and 174.37 days, respectively. The Mean FIMa and FIMd are 53.22% and 75.73%, respectively. It revealed that, a significant improvement in FIM at the time of discharge in SCI patients. The differences were found in the extent of functional improvement between subgroups of patients with different levels and extents of lesions. Regarding the outcome of Functional Independent measure better observed in incomplete cervical spinal cord injuries and complete thoracic spinal cord level injuries. Interestingly, independence in bowel management, independent mobility and locomotion were only attained by patients with incomplete lesions. This study provides insight into the functional outcomes of a group of inpatients with traumatic spinal cord injury. More research is needed to determine the specialized rehabilitation program for these patients.