Functional outcome of patients 12 and 48 weeks after acute traumatic tetraplegia and paraplegia: data analysis from 2004–2009

Abstract

Objectives: During the first rehabilitation of patients with traumatic spinal cord injuries (SCIs), professional skills are learned, which can be objectified in an independent measurement score. The aims of this study were to record the skills of patients 12 and 48 weeks after acute trauma and perform an analysis of the data to identify provisions of importance. Methods: All patients from 2004 to 2009 who experienced traumatic SCI were included in this investigation. Data recording were accomplished by the European Multi-centre Study about Spinal Cord Injury (EMSCI) databank. Patients were divided into tetraplegia and paraplegia groups. Parameters were age at injury, the American Spinal Injury Association-Score, level of lesion and Spinal Cord Independence Measure (SCIM-Score) 12 and 48 weeks after traumatic spinal cord lesion. A questionnaire was also added to help clarify where deficiencies were prevalent. Results: Data analysis of 103 tetraplegic and 110 paraplegic patients showed no correlation between the ASIA score, level of lesion, age and SCIM score. On average, tetraplegic patients had a SCIM score of 43 points 12 weeks after treatment, with 81% showing an increase to 58 points after 48 weeks. Paraplegic patients showed an average SCIM score of 60 points after 12 weeks, with 71% experiencing an increase to 71 points after 48 weeks. In all, 9% of tetraplegic patients and 19% of paraplegic patients experienced a decrease of SCIM points after 48 weeks, which occurred mainly in the bladder and intestinal control subgroups. Results of the questionnaire were not helpful for clarifying the location of the deficiencies. Conclusion: Most of the patients experienced an increase of SCIM points 48 weeks after traumatic SCI. However, data also showed that, especially in paraplegic patients, special attention must be given to bladder and intestinal management to avoid negative lateterm consequences.

Patterns and predictors of functional recovery from the subacute to the chronic phase following a traumatic spinal cord injury: a prospective study

“…Although this difference was statistically significant, it did not reach a clinically significant level of 4 points. While this increase is in accordance with previous work [13,15], this study is the first to have accounted for the clinical significance of this result.…”

“…Hogel et al [13] observed that the majority of individuals with tetraplegia and paraplegia had a significant increase in functional performance from 3 to 12 months after TSCI, regardless of the initial neurological status. However, they did study the pattern of improvement during this period, particularly after 6 months where the intensive functional rehabilitation (IFR) process is generally completed [14].…”

Determining Complete Functional Independence in Patients with a Traumatic Cervical Spinal Cord Injury: Proposal of a Two-Level Scale Based on the Spinal Cord Independence Measure

“…It is well known that functional recovery differs between cervical, thoracic and thoracolumbar injuries [19][20][21]. Unfortunately, there is no specific study in the literature that has specifically compared the FI between low and high cervical injuries.…”

Is comorbidity related to the independence of patients with spinal cord injury?

“…These patients may have had existing illnesses before getting an SCI. Moreover, being in such a chronic condition, in the long term, they may face numerous health problems that may develop due to the injury, addiction, or aging [2,3]. SCI is associated with numerous factors, such as current risk factors, genetic predisposition, daily life activities, and predisposing factors associated linked with the injury.…”