Predicting Walking at Discharge From Inpatient Rehabilitation After a Traumatic Spinal Cord Injury
Presented in part to the 5th Conference of the Asian Spinal Cord Network, December 2005, Ho Chi Minh City, Vietnam.
Abstract
Kay ED, Deutsch A, Wuermser LA. Predicting walking at discharge from inpatient rehabilitation after a traumatic spinal cord injury.
Objective
To investigate how injury level and American Spinal Injury Association Impairment Scale (AIS) grade at rehabilitation admission are related to walking at discharge after traumatic spinal cord injury (SCI).
Design
Retrospective study.
Setting
Comprehensive rehabilitation hospital.
Participants
A total of 343 adult inpatients with traumatic SCI.
Interventions
Not applicable.
Main Outcome Measure
FIM instrument walking rating of 3 (moderate assistance) or higher at discharge.
Results
Significantly more subjects admitted with AIS grade C (28.3%) than AIS grade A or B injuries (0.9%) walked at discharge. Significantly more subjects admitted with AIS grade D (67.2%) than AIS grade C (28.3%) injuries walked at discharge. Level of injury did not significantly affect walking after AIS grade C or D injuries. Being 50 years or older had a significant negative affect on walking in subjects with AIS grade D but not AIS grade C injuries.
Conclusions
Admission AIS grades give information about walking for treatment and discharge planning during acute inpatient rehabilitation, including the following: (1) patients admitted with AIS grade C injuries should not be considered functionally complete when predicting walking (FIM score ≥3; no more than moderate assistance) at discharge, (2) level of injury does not affect walking for those with AIS grade C or D injuries, and (3) being 50 years or older has a significant negative affect on walking in subjects with AIS grade D but not AIS grade C injuries.
aSpinal Cord Injury Program, Rehabilitation Institute of Chicago, Chicago, IL
bCenter for Rehabilitation Outcomes Research, Rehabilitation Institute of Chicago, Chicago, IL
cDepartment of Physical Medicine and Rehabilitation, Northwestern University, Feinberg School of Medicine, Chicago, IL
dAcute Spinal Cord Injury Program, Northwestern Memorial Hospital, Chicago, IL.
Correspondence to Anne Deutsch, RN, PhD, CRRN, Center for Rehabilitation Outcomes Research, Rehabilitation Institute of Chicago, 345 E Superior St, Onterie Center, Chicago, IL 60611-4496
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated.
ABSTRACT