Properties and outcomes of spinal rehabilitation units in four countries

Fromovich-Amit, Y; Biering‐Sørensen, Fin; Baskov,; Juocevičius, Alvydas; Hv, Hansen; Gelernter, Ilana; Hart, Jacob; Baskov, Andrey; Dreval, O N; Terese, P; Catz, Amiram

doi:10.1038/sc.2008.178

Cited by 22 publications

(21 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Ackerman et al 6 showed similar results compared with the present investigation, reporting that tetraplegic patients experienced a mean increase in the outcome-score by 6.3 points, whereas patients with paraplegia experienced a mean increase of 5.75 points. A multicenter study of Fromovich-Amit et al 14 showed that the beginning and length of rehabilitation is important for the outcome of SCI patients. It was shown that patients with a moderately delayed rehabilitation needed a longer rehabilitation than those with a shorter period until rehabilitation.…”

Section: Discussionmentioning

confidence: 99%

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

2012

View full text Add to dashboard Cite

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.

show abstract

Section: Discussionmentioning

confidence: 99%

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

2012

View full text Add to dashboard Cite

show abstract

“…Such an instrument may resemble the combination of lesion level and American Spinal Injury Association impairment scale (AIS) grade, which describes briefly the neurological status and provides abundant information on neurological deficit, its distribution and its prognosis. 1 A similarly concise description of function after SCL may not be feasible because of the large number of possible combinations of task scores. But these combinations are not random, and patterns can be identified.…”

Section: Introductionmentioning

confidence: 99%

A new grading for easy and concise description of functional status after spinal cord lesions

et al. 2011

Self Cite

View full text Add to dashboard Cite

Background: Disability scales do not enable the transmission of concise, meaningful and daily function description for clinical purposes. Study design: Cross-sectional statistical analysis of 328 patients' Spinal Cord Independence Measure (SCIM) III item scores (SIS). Objective: To develop a concise and clinically interpretable data-based characterization of daily task accomplishment for patients with spinal cord lesions (SCLs). Setting: Multi-center study at 13 spinal units in 6 countries. Methods: Patients were grouped into clusters characterized by smaller differences between the patients' SIS within the clusters than between their centers, using the k-medoides algorithm. The number of clusters (k) was chosen according to the percent of SIS variation they explained and the clinical distinction between them. Results: Analysis showed that k ¼ 8 SIS clusters offer a good description of the patient population. The eight functional clusters were designated as A-H, each cluster (grade) representing a combination of task accomplishments. Higher grades were usually (but not always) associated with patients implementing more difficult tasks. Throughout rehabilitation, the patients' functional grade improved and the distribution of patients with similar functional grades within the total SCIM III score deciles remained stable. Conclusions: A new classification based on SIS clusters enables a concise description of overall functioning and task accomplishment distribution in patients with SCL. A software tool is used to identify the patients' functional grade. Findings support the stability and utility of the grades for characterizing the patients' functional status.

show abstract

“…In Japan, for a group of patients with paraplegia injured in 2000-2004, mean rehabilitation LOS was 116 days. 4 In four European countries, rehabilitation LOS in recent years, across all neurological categories of injury, ranged from 47 days in Russia 5 to 240 days in the Netherlands, 6 with 177 days in Denmark 5 and 122 days in Italy. 7 In contrast to the many available citations on overall LOS for SCI rehabilitation admissions, published information on the type and extent of services delivered during rehabilitation is scant.…”

Section: Introductionmentioning

confidence: 99%

Inpatient treatment time across disciplines in spinal cord injury rehabilitation

Whiteneck

Gassaway²,

Dijkers

et al. 2011

The Journal of Spinal Cord Medicine

View full text Add to dashboard Cite

Background/objective: Length of stay (LOS) for rehabilitation treatment after spinal cord injury (SCI) has been documented extensively. However, there is almost no published research on the nature, extent, or intensity of the various treatments patients receive during their stay. This study aims at providing such information on a large sample of patients treated by specialty rehabilitation inpatient programs. Methods: Six hundred patients with traumatic SCI admitted to six rehabilitation centers were enrolled. Time spent on various therapeutic activities was documented by each rehabilitation clinician after each patient encounter. Patients were grouped by neurologic level and completeness of injury. Total time spent by each rehabilitation discipline over a patient's stay and total minutes of treatment per week were calculated. Ordinary least squares stepwise regression models were used to identify patient and injury characteristics associated with time spent in rehabilitation treatment overall and within each discipline. Results: Average LOS was 55 days (standard deviation 37), during which 180 (106) hours of treatment were received, or 24 (5) hours per week. Extensive variation was found in the amount of treatment received, between and within neurologic groups. Total hours of treatment provided throughout a patient's stay were primarily determined by LOS, which in turn was primarily predicted by medical acuity. Variation in minutes per week of treatment delivered by individual disciplines was predicted poorly by patient and injury characteristics. Conclusions: Variations between and within SCI rehabilitation patient groups in LOS, minutes of treatment per week overall, and for each rehabilitation discipline are large. Variation in treatment intensity was not well explained by patient and injury characteristics. In accordance with practice-based evidence methodology, the next step in the SCIRehab study will be to determine which treatment interventions are related with positive outcomes (at 1 year post injury), after controlling for patient and injury differences.

show abstract

Properties and outcomes of spinal rehabilitation units in four countries

Cited by 22 publications

References 19 publications

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

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

A new grading for easy and concise description of functional status after spinal cord lesions

Inpatient treatment time across disciplines in spinal cord injury rehabilitation

Contact Info

Product

Resources

About