Relationship of Exercise and Hospital Readmission After Spinal Cord Injury: A Secondary Analysis

Abstract

Importance: After spinal cord injury (SCI), as many as 45% of people experience at least one hospital readmission within 1 yr. Identification of feasible low-cost interventions to reduce hospital readmissions after SCI is needed. Objective: To explore whether a relationship exists between routine exercise and hospital readmission rates 1 yr after SCI. Design: We conducted a secondary analysis of data from the SCIRehab Project, a prospective cohort study. Setting: Five SCI inpatient rehabilitation facilities across the United States. Participants: Participants were people age 12 yr and older who had sustained an SCI, were admitted to a participating inpatient rehabilitation facility, completed the 12-mo postinjury interview, and reported exercising either monthly or not at all since discharge (N = 520). Outcomes and Measures: The SCIRehab Project conducted 12-mo post–inpatient rehabilitation discharge interviews. As part of the interviews, self-reported hospital readmissions and exercise frequencies since discharge (self-reported number of months, average days per week, and average minutes per day of exercise participation) were collected and analyzed. Results: A χ2 analysis determined that a significant correlation (φ = −.091, p = .038) exists between monthly exercise and hospital readmissions 1 yr postinjury. Compared with those who did not exercise, participants who exercised monthly had 8.4% fewer hospital readmissions. Conclusions and Relevance: A relationship exists between exercise and hospital readmission, but follow-up research is needed to determine whether regular exercise reduces hospital readmissions among this population. What This Article Adds: After discharge, 44% of the participants did not exercise during the first year after injury. Identifying or implementing accessible community exercise programs is an area of opportunity for occupational therapy practitioners and future researchers to explore.

Health Services Research and Occupational Therapy: Ensuring Quality and Cost-Effectiveness

“…These reviews found mixed evidence for readmission prevention across chronic conditions (Molitor et al, 2022) and low strength of evidence to support occupational therapy interventions to reduce pressure ulcers or promote skin integrity (Feldhacker et al, 2022) This special issue also includes three articles consisting of secondary data analyses to examine relationships between occupational therapy care and quality outcomes. Kubiak and Sklar (2022) found that clients with spinal cord injury who exercised monthly had fewer hospital readmissions during the first year after discharge from inpatient rehabilitation than those who did not exercise. Malcolm et al (2022) found that clients who received occupational therapy services in the neurological critical care unit had a higher likelihood of noncommunity discharge than those who did not receive occupational therapy.…”