Relationship between neurological and functional status after acute spinal cord injury: An epidemiological study

Abstract

This paper examines the relationships between motor and sensory neurological function and functional status as defined by four activities of daily living (ADLs) after acute spinalcord injury. Patients ( n = 192) were from a 5-yr prospective study in Connecticut. Motor function improved significantly during hospitalization ( p < 0.0001), and between discharge and 1 yr follow-up ( p = 0.002). Improvement in sensory function occurred equally during treatment and rehabilitation but was only significant when considered over the entire first post-injury year ( p = 0.01). Sensory loss was three times more common than motor loss after hospital discharge. Even using a highly sensitive neurological measure 45% of patients were unchanged on motor function during hospitalization; this figure rose to 65.5% using a more traditional four-point scale. Motor and sensory function were highly correlated and this increased from hospital admission to discharge to 1 yr follow-up due principally to relatively greater improvement in motor vs sensory function. Four ADL scores all showed significant improvement ( p < 0.0001) between discharge and 1 yr. Walking and selfcare activities depended on both the independent and the additive effects of motor and sensory function. Movement of limbs and transfer ability depended more on motor function alone and on its combined effect with sensory function.