Background and purpose: The purpose of this study was to determine the amount and type of equipment prescribed to aid mobility and self-care for patients with spinal cord injuries (SCI) in Australia and to determine how frequently the equipment is used 1 year later and whether patients are satisfied with it. Methods: A consecutive series of 61 patients admitted for rehabilitation to two Sydney SCI units were recruited. All mobility and self-care equipment worth more than $AU50 prescribed by therapists before patients' discharge was recorded. This included wheelchairs, commodes, shower chairs, hoists, electric beds, pressure-relieving cushions, bed mattresses, slideboards, walking aids, orthoses, electrical stimulation systems and other pieces of notable exercise equipment. Patients were interviewed 1 year later and asked about each piece of equipment they had been prescribed. Specifically, they were asked about how frequently they had used each piece of equipment and whether they were satisfied with it. Data were analysed using descriptive statistics. Results: Three hundred and fourteen pieces of equipment, including 68 wheelchairs, were prescribed for the 61 patients. Most of the equipment (226/314) was used more than 20 times in the 2 months preceding the 1-year review. Most patients were satisfied or highly satisfied with the majority of equipment prescribed, although patients were very dissatisfied or only partly dissatisfied with 18/314 pieces of equipment. Discussion: Patients were generally satisfied with the equipment they were prescribed. There was a small amount of equipment prescribed that was not used 1 year later or with which patients were dissatisfied.

Study design: A longitudinal cohort study. Objective: The primary objective of this study was to compare the expectations that patients with recent spinal cord injury (SCI) had about walking 1 year from injury with the expectations of their physiotherapists. Setting: Two Sydney SCI units. Methods: A consecutive series of 47 patients admitted to the metropolitan SCI units was recruited. Using the Mobility Scale, expectations of the patients and their physiotherapists about walking at 1 year from SCI were recorded at the time of admission to rehabilitation. Ability to walk was then assessed at 1 year from the SCI. Results: On admission to rehabilitation, 31 patients expected to walk about their homes at 1 year post SCI, but only 18 (58%) of these patients did so. In contrast, physiotherapists expected 21 patients to be able to walk about their homes at 1 year post SCI, with 17 (81%) of these patients doing so. Similarly, whereas 21 patients expected to walk about the community at 1 year post SCI, only 11 (52%) of these patients did so. Physiotherapists expected 8 patients to walk about the community at 1 year post SCI and 7 (88%) of these patients did so. The differences between patients' and physiotherapists' expectations about walking were statistically significant (Po0.001). Conclusion: There is a high degree of disagreement between patients' and physiotherapists' expectations about walking at 1 year post SCI. Differences between patients' and physiotherapists' expectations about walking are potentially problematic and requires research to identify appropriate management strategies.

Study design: A cross-sectional descriptive study was undertaken. Objectives: The overall objective was to explore the potential usefulness of clinicians' and patients' impressions of change in motor performance for clinical trials. Specifically, the aim was to compare clinicians' and patients' impressions of change in motor performance with standardized outcome measures in people with spinal cord injury (SCI). Setting: Spinal injury units, Sydney, Australia. Methods: Thirty people undergoing rehabilitation after recent SCI were recruited. They were assessed on two occasions separated by between 1 and 5 months. On both occasions, patients were assessed sitting unsupported (n ¼ 25), transferring (n ¼ 23) and walking (n ¼ 12) using standardized outcome measures. On the second occasion, patients rated their impressions of change in each of the three motor tasks since their initial assessment. A 15-point scale was used. In addition, patients were videoed performing the three motor tasks on the two occasions. Two clinicians with SCI experience independently viewed the pairs of videos and rated their impressions of change using the same 15-point scale. Clinicians' and patients' impressions of change were compared with each other and to the standardized objective measures. Results: Clinicians' and patients' impressions of change were greater than change measured with standardized objective measures for all three motor tasks (Po0.01). In addition, patients' impressions of change were greater than clinicians' impressions of change for transferring, but comparable for unsupported sitting and walking. Conclusion: Clinicians' and patients' impressions of change in motor performance may have potential for evaluating treatment effectiveness in clinical trials.

Study design: A within-participant, double-blind, cross-over, randomised control trial. Objectives: To determine the short-term effects of bronchodilator therapy on respiratory function in people with recently acquired motor complete tetraplegia. Setting: Hospital, Australia. Methods: A total of 12 people with recently acquired tetraplegia were randomised to receive either a one-off dose of a bronchodilator followed by an equivalent dose of a placebo propellant between 1 day and 1 week later or visa versa. The three outcomes were forced expiratory volume in 1 s (FEV1), peak expiratory flow rate (PEF) and forced vital capacity (FVC). These were measured while supine by a blinded assessor 10 and 30 min after treatment. Data were analysed on 11 participants and reported as percentage of predicted. Results: The FEV1, FVC and PEF mean between-group differences (95% confidence interval) at 10 min post treatment were 7.3% (2.7-11.9%; P ¼ 0.003), 5.5% (1.6-9.4%; P ¼ 0.008) and 20.1% (1.1-40.4%; P ¼ 0.039). Similar effects were observed at 30 min for FVC and FEV1 but not for PEF. Conclusion: Bronchodilator therapy has a beneficial effect on FEV1, FVC and PEF in participants with recently acquired tetraplegia.