Abstract

Although several outcome measures are used to assess various areas of interest regarding spinal cord injuries (SCIs), little is known about the frequency of their use, and the ways in which they transform shared knowledge into implemented practices. Herein, 800 professionals from the International Spinal Cord Society, especially trained for caring in patients with SCI, were invited to respond to an Internet survey collecting information on the use of standardized measures in daily clinical practices. We asked both clinicians and researchers with different areas of interest about their use of functional outcome measures, and, in particular, which scales they habitually use to assess various aspects of clinical practice and rehabilitation. We selected a set of rating scales, which were validated for measuring SCIs (http://www.scireproject.com/outcome-measures). The results show that the areas of interest assessed by most of the participants were neurological status, upper limb, lower limb gait, pain, spasticity, self-care, and daily living. The most widely used rating scales were the spinal cord independence measure, the functional independence measure and the International Standards for Neurological Classification of Spinal Cord Injury. Instead, the majority of respondents did not evaluate the use of assistive technology. Despite the availability of several outcome scales, the practice of evaluating SCIs with standardized measures for assistive technologies and wheelchair mobility is still not widespread, even though it is a high priority in the rehabilitation of SCI patients. The results emphasize the need for a more thorough knowledge and use of outcome scales, thus improving the quality of assistive device evaluation.

Highlights

  • Traumatic spinal cord injury (SCI) is a condition that affects nearly one out of every 1,000 people each year (0.721–0.906 per thousand people in the United States) and represents one of the leading causes of disability worldwide [1]

  • According to the described sorting process, we identified three clusters that had the greatest difference between the responses, and we compared them to the outcome measures identified by Spinal Cord Injury Rehabilitation Evidence (SCIRE): one cluster with three measures had a high consensus, another cluster with six measures had a moderate consensus, and one cluster with three measures had a low consensus

  • Better standardized outcome measures have been selected by the SCIRE in the treatment of SCI patients, a number of the identified areas are under-evaluated with regards to some recommended measures, while other areas are not evaluated at all in rehabilitation centers

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Summary

Introduction

Traumatic spinal cord injury (SCI) is a condition that affects nearly one out of every 1,000 people each year (0.721–0.906 per thousand people in the United States) and represents one of the leading causes of disability worldwide [1]. SCI rehabilitation is complex and resource demanding with a costs that may vary from $53,000–88,000 USD Outcome Measures in Rehabilitation two years after the lesion) or more, depending on the country and the severity of the lesion [4, 5]. Given these high costs, it is necessary to monitor the efficacy and efficiency of rehabilitation with appropriate functional measure outcomes. In the last two decades, research in the field of SCI included more than 900 clinical trials It is clear that the results of these trials need to be assessed with appropriate and validated instruments

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