Comparison of patients managed in specialised spinal rehabilitation units with those managed in non-specialised rehabilitation units

New, Peter W; Simmonds, Frances D; Stevermuer, Tara

doi:10.1038/sc.2011.29

Cited by 42 publications

(43 citation statements)

References 21 publications

(25 reference statements)

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“…Patients with non-traumatic injuries, however, often receive rehabilitation in non-specialised settings despite a wealth of research suggesting that both the groups should be rehabilitated in a SIC or a specialised neurological rehabilitation team. [19][20][21] It has been stated that 'patients not cared for in specialised units may have worse outcomes, such as greater disability at discharge, longer hospital admission, higher rates of discharge to nursing homes and more preventable complications (p. 34)' . 29 Furthermore, a survey of physicians found that 85% believed NT-SCI patients should be rehabilitated in an SIC or a neurological rehabilitation unit specialising in NT-SCI.…”

Section: Discussionmentioning

confidence: 99%

“…19 The first study to examine patient outcomes in varied rehabilitation settings in the UK found that individuals who completed their rehabilitation at a SIC, as opposed to a non-spinal setting, presented with significantly better results in 10 out of 18 health outcomes, 16 out of 18 functional outcomes and 5 out of 10 social outcomes. 20 Recent work by New et al 21 found that patients with non-traumatic injuries were less likely to be admitted to a SIC than those with traumatic injuries. Importantly, patients with non-traumatic injuries who were admitted and treated in a SIC had greater functional gains during rehabilitation than those who were not, a finding that interestingly was not evident in patients with traumatic injuries.…”

Section: Introductionmentioning

confidence: 99%

“…It has, therefore, been recommended that patients with NT-SCI should receive rehabilitation in a SIC or a specialised neurological rehabilitation team. [19][20][21] The majority of studies examining the rehabilitation outcomes of NT-SCI patients have utilised only length of stay, discharge destination and FIM scores as measurement, 22 and, therefore, there is a need to examine in greater detail the full range of rehabilitation outcomes. The Needs Assessment Checklist (NAC) 23 is a clinical assessment tool that comprehensively measures patients' needs, abilities and rehabilitation outcomes.…”

Section: Introductionmentioning

confidence: 99%

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Traumatic versus non-traumatic spinal cord injuries: are there differential rehabilitation outcomes?

Kennedy

Chessell

2013

Spinal Cord

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Study design: Retrospective case review. Objectives: To compare the rehabilitation outcomes between patients with traumatic spinal cord injuries and patients with nontraumatic spinal cord injuries, using The Needs Assessment Checklist (NAC), to observe if both the groups benefit from the same rehabilitation programme. Setting: Tertiary care, spinal cord injury rehabilitation unit (National Spinal Injuries Centre), Stoke Mandeville Hospital, UK. Methods: Information obtained with the NAC at two time points during patients' rehabilitation was examined. Statistical analysis investigated the rehabilitation outcomes both between and within groups. Results: Initial differences were observed on admission between patients with traumatic and non-traumatic spinal cord injuries in five of the ten rehabilitation domains measured, with patients with non-traumatic injuries presenting with better outcomes. At a later stage in patients' rehabilitation, however, differences between the groups had lessened. Furthermore, the results demonstrated that the whole cohort made significant improvements in all the ten rehabilitation domains, with the same finding evident for both patients with traumatic and patients with non-traumatic spinal cord injuries. Conclusion: Patients with traumatic spinal cord injuries and patients with non-traumatic spinal cord injuries benefitted from the same rehabilitation programme in a spinal injury centre, making significant improvements in all ten rehabilitation domains measured, suggesting that it is effective to admit and rehabilitate patients with injuries resulting from both traumatic and non-traumatic aetiologies in the same specialised setting.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Traumatic versus non-traumatic spinal cord injuries: are there differential rehabilitation outcomes?

Kennedy

Chessell

2013

Spinal Cord

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“…Rehabilitation outcome in traumatic and non-traumatic SCI has also been examined as a function of whether patients were admitted to specialist or non-specialist spinal injury centers. 15 After controlling for demographic variables, it was found that patients in specialist spinal injury centers made greater progress in rehabilitation in terms of functional outcome, but this difference was only the case for those with traumatic injury etiology.…”

Section: Introductionmentioning

confidence: 99%

Spinal cord injuries as a consequence of falls: are there differential rehabilitation outcomes?

2012

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Study design: Case series, consecutive sample, survey. Objectives: To examine the incidence of spinal cord injuries sustained as a result of falls compared with other causes, and to investigate rehabilitation outcomes between these two groups. Settings: Tertiary care, spinal cord injury rehabilitation unit (National Spinal Injuries Center), Stoke Mandeville Hospital, UK. Methods: Demographic information and descriptive statistics were examined for individuals sustaining their injury via falls vs non-falls. Statistical analysis investigated rehabilitation outcomes between the groups. Results: The etiology of spinal cord injury (SCI) reported is similar to previous findings. Individuals who sustained their SCI as a result of falls and other causes made equal improvements from the start to end of rehabilitation, according to the Needs Assessment Checklist, a clinical measure of individual rehabilitation needs in 10 domains. However, those in the falls group achieved less overall throughout rehabilitation, and this was significant at pre-discharge for the areas of bladder management, mobility and discharge. Conclusion: Results highlight the need for specific consideration to be made of the rehabilitation needs of individuals who sustain SCI as a result of a fall, and for these to be addressed in rehabilitation programming.

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“…Patients have improved outcomes with a specialised and systematic approach to their care. 12,13 A number of studies have highlighted the problem faced by some patients with SCD who have barriers for admission into a specialised spinal rehabilitation unit (SRU), 5,6,14,15 and this has been highlighted as an international issue. 16 We have recently reported the duration of process barriers for patients with SCD in acute hospital, the variables that influenced them, along with the impact on a range of outcomes.…”

Section: Introductionmentioning

confidence: 99%

Time-series analysis of the barriers for admission into a spinal rehabilitation unit

New

Akram

2015

Spinal Cord

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Study design: This is a prospective open-cohort case series. Objectives: The objective of this study was to assess changes over time in the duration of key acute hospital process barriers for patients with spinal cord damage (SCD) from admission until transfer into spinal rehabilitation unit (SRU) or other destinations. Setting: The study was conducted in Acute hospitals, Victoria, Australia (2006. Methods: Duration of the following discrete sequential processes was measured: acute hospital admission until referral to SRU, referral until SRU assessment, SRU assessment until ready for SRU transfer and ready for transfer until SRU admission. Time-series analysis was performed using a generalised additive model (GAM). Seasonality of non-traumatic spinal cord dysfunction (SCDys) was examined.Results: GAM analysis shows that the waiting time for admission into SRU was significantly (Po0.001) longer for patients who were female, who had tetraplegia, who were motor complete, had a pelvic pressure ulcer and who were referred from another health network. Age had a non-linear effect on the duration of waiting for transfer from acute hospital to SRU and both the acute hospital and SRU length of stay (LOS). The duration patients spent waiting for SRU admission increased over the study period. There was an increase in the number of referrals over the study period and an increase in the number of patients accepted but not admitted into the SRU. There was no notable seasonal influence on the referral of patients with SCDys. Conclusions: Time-series analysis provides additional insights into changes in the waiting times for SRU admission and the LOS in hospital for patients with SCD.

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Comparison of patients managed in specialised spinal rehabilitation units with those managed in non-specialised rehabilitation units

Cited by 42 publications

References 21 publications

Traumatic versus non-traumatic spinal cord injuries: are there differential rehabilitation outcomes?

Traumatic versus non-traumatic spinal cord injuries: are there differential rehabilitation outcomes?

Spinal cord injuries as a consequence of falls: are there differential rehabilitation outcomes?

Time-series analysis of the barriers for admission into a spinal rehabilitation unit

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