Study design: Systematic review. Objectives: To provide a quantitative analysis of all randomized controlled trials designed to determine the effectiveness of physical interventions for people with spinal cord injury (SCI). Setting: Sydney, Australia. Methods: A search was conducted for randomized controlled trials involving physical interventions for people with SCI. Two reviewers independently rated methodological quality using the PEDro scale and extracted key findings from the trials. Results: Four thousand five hundred and forty three abstracts were identified of which 31 trials met the inclusion criteria. Trials examined the effectiveness of fitness and strength training (n ¼ 7), gait training (n ¼ 5), hand therapy (n ¼ 3), stretch (n ¼ 4), acupuncture (n ¼ 3), hand splinting (n ¼ 2) and other related therapies (n ¼ 7). Six trials reported a between-group mean difference with a clearly important treatment effect on at least one outcome measure. These trials supported the use of fitness, strength and gait training as well as acupuncture. Conclusion: There is initial evidence supporting the effectiveness of some physical interventions for people with SCI. However, there is a pressing need for high-quality trials to determine the effectiveness of all physical interventions commonly administered in clinical practice.
BackgroundWe sought to identify the role of pre-injury socio-demographic and health characteristics, and injury severity in determining health-related quality-of-life outcomes for mild to moderate injuries 2 months after a motor vehicle crash in a compensable setting.MethodsPeople aged 17 years and older, injured with a New Injury Severity Score of 8 or less, in a motor vehicle crash in New South Wales and who had registered a claim with the Compulsory Third Party Insurance scheme from March to December 2010 were contacted to participate in the study. Information for 364 eligible participants was primarily collected through telephone interview, approximately 2 months after injury.ResultsSubstantial proportions of participants continued to have adverse outcomes approximately 2 months after their injury with mean Short Form Health Survey (SF-12) physical component score of 36.7 (SD ±10.3), SF-12 mental component score of 46.6 (SD ±11), Euro Qol (EQ) analogue scale score of 65.8 (SD ±18) and Euro Qol five dimension (EQ-5D) summary score of 0.70 (SD ±10). Key factors predicting adverse outcomes were prior chronic illness, obesity, hospitalisation and self-perceived threat to life due to injury.ConclusionsThis study highlights the substantial impact of apparently “minor” motor vehicle crash injuries in a compensable setting and suggests targets for studies of tertiary prevention to improve health-related quality-of-life outcomes.Electronic supplementary materialThe online version of this article (doi:10.1186/s40621-015-0042-7) contains supplementary material, which is available to authorized users.
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