Abstract
The purpose of this study was to investigate the changes in the activity limitations of patients following in-patient rehabilitation and the factors influencing functional ability as measured by the Spinal Cord independence measure III (SCIM III). A longitudinal study design was utilised to study the change in functional abilities of patients with spinal cord injury between admission and discharge. A convenient sampling strategy was employed, in which every consecutive patient admitted to the rehabilitation centre within a three-month period was eligible for the study. Demographic-, medical, and process of rehabilitation data were collected and collated from the patients’ medical records using a data gathering sheet that was validated and tested for reliability. functional abilities were measured by the SCIM III. Seventy-six patients met the inclusion criteria, consisting of 58 paraplegics and 18 tetraplegics. The mean age of this cohort was 34.14 years. A significant difference (p<0.001) in functional ability was detected for the total sample, with only 12.5% of patients independent in walking ability and 28.12% in stair management. four (4) factors were found to be predictors of functional outcomes on bivariate analysis, but when considered together in a multiple regression model, only functional status on admission remained correlated to functional outcomes. Conclusion and implication for practice: Significant improvement in functional abilities of persons with spinal cord injury following in-patient rehabilitation was observed. however, mobility and stair-management limitations were the most prevalent at discharge. lastly, a lower functional status should be better targeted to optimise functional ability in the future. future research should be directed towards illuminating whether personal factors or rehabilitation inefficiencies are responsible for the limitations observed at discharge.
Highlights
Spinal cord injury (SCI) is a condition that has the potential to result in severe impairments, difficulties to perform functional tasks and a compromise in quality of life (De Vivo et al, 1999)
Recruitment of participants Patients with spinal cord injury accounted for 40% of the total admis sions to the WCRC for the period of November 01, 2010 to January 31, 2011
Of the 93 patients with spinal cord injury, nine patients were under the age of 18 years old, two declined consent, five subjects presented with missing data and one presented with a mental illness as co-morbidities, which was considered as part of the exclusion criteria
Summary
Spinal cord injury (SCI) is a condition that has the potential to result in severe impairments, difficulties to perform functional tasks and a compromise in quality of life (De Vivo et al, 1999). Since the First World War, there has been a dra matic improvement in the management of patients with SCI in both the medi cal and rehabilitation spheres. To date, there is still no good scientific evidence for treatments conducted on patients showing an improvement in neurological impairment after acute SCI (Anderberg et al, 2007). There is high level evidence indicating that rehabilitation strategies could result in optimal functional outcomes (Foy et al, 2011). Despite these advancements centred towards longevity, the function ing of persons with spinal cord injury is still significantly lower than that of the rest of the population (Post et al, 1995)
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