Archives of Physical Medicine and Rehabilitation
Volume 85, Issue 11 , Pages 1826-1836, November 2004

Effects of gender on neurologic and functional recovery after spinal cord injury

  • Marca L. Sipski, MD

      Affiliations

    • Center of Excellence in Functional Recovery in Chronic SCI, Veterans Administration Rehabilitation Research and Development, Miami, FL, USA.
    • Department of Rehabilitation Medicine, University of Miami School of Medicine, Miami, FL, USA.
    • Miami Project to Cure Paralysis, University of Miami School of Medicine, Miami, FL, USA.
    • Corresponding Author InformationReprint requests to Marca L. Sipski, MD, Mail Locator (D-461), University of Miami School of Medicine, PO Box 016960, Miami, FL 33101.
    • ,
  • Amie B. Jackson, MD

      Affiliations

    • Department of Rehabilitation Medicine, University of Alabama, Birmingham, AL, USA.
    • ,
  • Orlando Gómez-Marín, MSc, PhD

      Affiliations

    • Center of Excellence in Functional Recovery in Chronic SCI, Veterans Administration Rehabilitation Research and Development, Miami, FL, USA.
    • Department of Epidemiology & Public Health, University of Miami School of Medicine, Miami, FL, USA.
    • ,
  • Irene Estores, MD

      Affiliations

    • Department of Rehabilitation Medicine, University of Miami School of Medicine, Miami, FL, USA.
    • ,
  • Adam Stein, MD

      Affiliations

    • Department of Rehabilitation Medicine, Mount Sinai School of Medicine, New York, NY, USA.

Abstract 

Sipski ML, Jackson AB, Gómez-Marín O, Estores I, Stein A. Effects of gender on neurologic and functional recovery after spinal cord injury. Arch Phys Med Rehabil 2004;85:1826–36.

Objective

To assess gender differences in neurologic and functional outcome measures in persons with spinal cord injury (SCI).

Design

Case series.

Settings

Model Spinal Cord Injury Systems (MSCIS) throughout the United States.

Participants

People (N=14,433) admitted to an MSCIS within 30 days of injury.

Interventions

Not applicable.

Main outcome measures

Improvement in American Spinal Injury Association (ASIA) motor index score, ASIA Impairment Scale, level of injury, and FIM instrument scores after SCI.

Results

When examining subjects grouped by severity of injury, changes in ASIA motor index total scores, from system admission to 1-year anniversary, were significantly greater for women than men with either complete (P=.035) or incomplete (P=.031) injuries. Functional comparison of men and women, using the FIM motor subscale, revealed that men had higher FIM motor scores at rehabilitation discharge among those with motor-complete injuries, except for those with C1-4 and C6 neurologic levels. Women with motor-incomplete high tetraplegia (C1-4 levels) had higher discharge FIM motor scores than did similarly afflicted men. There were no significant differences in FIM motor scores among men and women with other levels of motor incomplete SCI.

Conclusions

Gender differences in SCI were seen in several areas. Women may have more natural neurologic recovery than men; however, for a given level and degree of neurologic injury, men tend to do better functionally than women at time of discharge from rehabilitation. Future prospective study of the effects of estrogen on neurologic recovery and the effects of gender on functional potential are recommended.

Key words:  Gender , Rehabilitation , Spinal cord injuries

 

 Supported by the National Institute on Disability and Rehabilitation Research, Office of Special Education and Rehabilitative Services, US Department of Education (grant no. H133N000017).No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the author(s) or on any organizations with which the author(s) is/are associated.

PII: S0003-9993(04)00626-4

doi:10.1016/j.apmr.2004.04.031

Archives of Physical Medicine and Rehabilitation
Volume 85, Issue 11 , Pages 1826-1836, November 2004

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