Comparison of rehabilitation outcomes following vascular-related and traumatic spinal cord injury

McKinley, William; Sinha, Amit; Ketchum, Jessica M.; Deng, Xiaoyan

doi:10.1179/2045772311y.0000000016

Cited by 18 publications

(15 citation statements)

References 17 publications

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“…Despite the differences in the systems of care, our patient population reached and even exceeded their potential motor FIM change by specific injury level according to the expected functional scores published by the Paralyzed Veterans of America. 26 As a result of the long LOS in our data, however, the motor FIM efficiency in our study was quite low (0.43 for all patients) compared with other recent SCI studies that reported a motor FIM efficiency of 0.7 ( n = 30, rehabilitation LOS = 36 days) 27 and 0.95 ( n = 775, rehabilitation LOS = 51 days). 28 …”

Section: Discussioncontrasting

confidence: 63%

Impact of Therapy on Recovery during Rehabilitation in Patients with Traumatic Spinal Cord Injury

Truchon

Fallah

Santos

et al. 2017

Journal of Neurotrauma

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Evidence-based planning of rehabilitation interventions is important to improving cost efficiency while maintaining patient and system outcomes. This article aims to explore the relationship between rehabilitation therapy, functional outcome, bed utilization, and care costs after traumatic spinal cord injury (tSCI). A retrospective review of 262 persons with tSCI admitted to an inpatient rehabilitation facility from 2005–2012 was conducted. Treatment variables and outcome measures included rehabilitation length of stay (LOS), days to rehabilitation (onset), hours and intensity of therapy, and Functional Independence Measure (FIM). Polynomial regression models and generalized additive models were applied to explore the relationship between therapy hours and motor FIM change. Simulation modeling was used to assess the impact of hypothetically increasing therapy intensity. Patients were grouped by injury as: C1–4 American Spinal Injury Association (ASIA) Impairment Scale (AIS) A,B,C; C5–8 AIS A,B,C; T1–S5 AIS A,B,C; and AIS D. The sample was 85% male, mean age 45.9, median LOS 102 days, and mean therapy intensity 5.7 h/week. Motor FIM change was positively associated with total hours of therapy (β = 0.40, p < 0.0001) up to a certain time point, adjusted for age, gender, injury, complications, and rehabilitation onset. Hypothetically increasing therapy intensity by 50% and 100% resulted in average motor FIM efficiency gain ranging between 0.04–0.07 and 0.1–0.17, respectively, across injury groups. The hypothetical changes resulted in reductions in the average LOS and bed utilization rate, translating to cost savings of $20,000 and $50,000 (2011 CAD) for the +50% and +100% scenarios, respectively. The results highlight the importance of monitoring functional change throughout rehabilitation after tSCI and the need for customized therapeutic strategies.

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Section: Discussioncontrasting

confidence: 63%

Impact of Therapy on Recovery during Rehabilitation in Patients with Traumatic Spinal Cord Injury

Truchon

Fallah

Santos

et al. 2017

Journal of Neurotrauma

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“…In one study, Jellema et al 22 found 11 cases of SDAVF out of 1429 patients admitted to SCI ward of a rehabilitation center in 24 years. In another study examining the rehabilitation outcome of vascular-related SCI, 23 5 (17%) patients out of 30 patients had SDAVF in 10 years. It seems that the majority of patients with SDAVF do not require inpatient rehabilitation treatment.…”

Section: Discussionmentioning

confidence: 98%

Correlation between time to diagnosis and rehabilitation outcomes in patients with spinal dural arteriovenous fistula

Ofran

Yovchev

Hiller

et al. 2013

The Journal of Spinal Cord Medicine

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“…In the present study neurogenic bladder patterns showed no co-relation with demographic parameters like age, length of stay in rehabilitation and duration of neurological insult like some earlier studies. [ 8 9 10 ]…”

Section: Discussionmentioning

confidence: 99%

Neurogenic bladder following myelopathies: Has it any correlation with neurological and functional recovery?

Menon

Gupta

Taly

et al. 2014

Journal of Neurosciences in Rural Practice

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Objectives:To observe neurogenic bladder pattern in patients with myelopathy by performing urodynamic study (UDS) and to observe whether it has any correlation with functional and neurological recovery.Patients and Methods:This prospective study was conducted with 90 patients with myelopathy, both traumatic and non-traumatic (males = 65) in a university tertiary research hospital in India between January 2011 and December 2013. Mean age was 33.5 ± 13.2 years (range 15-65 years), mean duration of injury was 82.63 ± 88.3 days (range 14-365 days) and mean length of stay (LOS) in the rehabilitation unit 42.5 ± 23.3 days (range 14-130 days). The urodynamic study was performed in all the patients to assess the neurogenic bladder pattern. Management was based on the UDS findings. Functional recovery was assessed using Barthel index (BI) scores and spinal cord independence measures (SCIM) scores. Neurological recovery was assessed using ASIA impairment scale (AIS). We tried to correlate neurogenic bladder patterns with recovery.Results:Fifty patients (55.6%) had overactive detrusor with 25 each had detrusor sphincter dyssynergia (DSD) and synergic sphincter. Thirty-eight patients had hypoactive/acontractile detrusor and two had normal studies. No significant correlation observed between neurogenic bladder pattern and change in BI scores (P = 0.696), SCIM scores (P = 0.135) or change in ASIA status (P = 0.841) in the study.Conclusions:More than half of the patients with myelopathies had overactive detrusor with or without dyssynergic sphincter according to the urodynamic study. Neurogenic bladder patterns had no significant correlation with functional and neurological recovery in these patients.

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Comparison of rehabilitation outcomes following vascular-related and traumatic spinal cord injury

Cited by 18 publications

References 17 publications

Impact of Therapy on Recovery during Rehabilitation in Patients with Traumatic Spinal Cord Injury

Impact of Therapy on Recovery during Rehabilitation in Patients with Traumatic Spinal Cord Injury

Correlation between time to diagnosis and rehabilitation outcomes in patients with spinal dural arteriovenous fistula

Neurogenic bladder following myelopathies: Has it any correlation with neurological and functional recovery?

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