240193 Rehabilitation Outcomes in People with Spinal Cord Disease

Sunday, October 30, 2011

C. Jean Hsieh, PhD , Center for Post-acute Innovation & Research, National Rehabilitation Hospital, Washington, DC
Suzanne Groah, MD, MSPH , National Rehabilitation Hospital, Washington, DC
Inger Ljungberg, MPH , SCI Research Center, National Rehabilitation Hospital, Washington, DC
Gerben DeJong, PhD , National Rehabilitation Hospital, Washington, DC
Objective: Compare demographic characteristics, rehabilitation processes, and outcomes between SCD and SCI.

Design: Prospective observational cohort.

Participants/methods: Patients who had a diagnosis of SCI or SCD, and were ≥16 years, were eligible for enrollment. Study obtained data from medical records on patient demographics, injury and impairment levels functional status (Functional Independence Measure), and rehabilitation outcomes. Physical and occupational therapy (PT/OT) data were collected by therapists.

Results: 58 SCD and 54 SCI patients were enrolled. Patients with SCD were more likely to be older, female, and have a higher level of education. There were more Medicare beneficiaries in the SCD and more Medicaid beneficiaries in the SCI group. The top 3 etiologies for SCD were spondylosis, cancer, and inflammation (98.3%). The top 3 etiologies for SCI were vehicular collisions, falls, and gunshot wounds (91.1%). At admission, SCD group had a higher percentage (>90%) of incomplete injuries and higher motor FIM scores. The SCD group had shorter rehabilitation stays and received less weekly therapy. The SCD patients spent a higher proportion of PT on gait training, whereas SCI patients spent more on stretching regimens and transfers. The SCD group spent more OT on education; the SCI group spent more on therapeutic activities. At discharge, the SCD group had higher functional scores and efficiency. The majority of both groups were discharged to community.

Conclusion: This study characterizes the differing demographic and impairment profiles, and functional outcomes between SCI and SCD. These characterizations help define and refine rehabilitation regimens to optimize outcomes and efficiency.

Learning Areas:
Public health or related laws, regulations, standards, or guidelines
Public health or related research

Learning Objectives:
Upon completion of this course, participants will be able to: 1.Compare the demographic profiles, impairment status, and functional recoveries of patients with spinal cord disease (SCD) and those with traumatic spinal cord injury (SCI). 2.Identify the differences and similarities in the use of physical and occupational therapy among SCD and SCI patient groups in an inpatient rehabilitation facility. 3.Identify differences in rehabilitation outcomes between SCD and SCI groups.

Keywords: Outcomes Research, Disability

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I oversee the study and intimately involve in the conduct of the research study.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.