Abstract
In order to overcome activity limitations, prevent secondarycomplications and early death and achieve community integration comprehensiverehabilitation post spinal cord injury (SCI), is essential. The aim ofthe study was to evaluate outcomes of patients with complete paraplegia whoreceived rehabilitation at a private rehabilitation hospital.A quantitative, descriptive methodology was implemented. All patientswith complete, traumatic, thoracic spinal cord injuries, admitted to the studyhospital in the study period, were consecutively sampled. Thirty five patientswere identified of whom16 adhered to the inclusion criteria. The FunctionalIndependence Measure (FIM ) and Needs Assessment Checklist (NAC) wereused as measuring instruments.The mean length of stay was 95 days. Discharge FIM motor scores ranged from 72 to 83 with a mean of 79.3. Themean gain in FIM motor score was 55 and varied from 45 to 61. Discharge NAC scores ranged from 264 to 340 with amean of 300 out of a possible 347. A correlation between length of stay and discharge FIM scores (p = 0.05) were found.Both NAC and FIM scores indicated high levels of physical independence. According to NAC scores patients wereeducated on the prevention of secondary complications and received psychological counselling. Discharge planningand community integration scored lower with means of 80% and 61% respectively. Community based completionof rehabilitation programmes, the incorporation of the NAC, or another participation outcome measure and implementationof on-going programme monitoring and assessment strategies is recommended.
Highlights
Spinal Cord Injury (SCI) is a relatively uncommon yet devastating cause of dis ability (McKinley et al, 2007)
Functional recovery can be measured by various out come measures including the Modified Bartel Index (MBI), the Quadriplegia index of function (QIF), the Functional Independence Measure (FIM) and the Spinal cord independence measure (SCOM) (Anderson et al, 2008) to name but a few
The study population consisted of a consecutive sample of all patients admitted to the study hospital with a complete, trau matic, thoracic spinal cord injury, classi fied as ASIA A, by a the medical doctor at the study hospital, during the period; 1 April 2004 to 31 December 2007
Summary
Spinal Cord Injury (SCI) is a relatively uncommon yet devastating cause of dis ability (McKinley et al, 2007). Comprehensive rehabilitation post spinal cord injury is crucial to prevent complications such as pressure ulcers and early mortality (Krause et al, 2008), to improve function and to assist with community reintegration and economic self sufficiency (Schönherr et al 1999). The above measures are objec tive tools that do not take into considera tion the patient’s opinion and needs In addition they measure activity and do not include participation measures such as community integration and employ ment. It is clear from the International Classification of Function, Disability and Health’s (ICF) definition that rehabilitation should encompass all measures necessary to maximize physi cal and psychological health, including social, economic and vocational aspects and that the person and his/her opinion plays an important role in determin ing outcomes (WHO 2000). Subjective tools that take the patient’s opinion into account and participation measures must be included in outcome measurement studies and practices
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