Rehabilitation Outcomes in People with Spinal Cord Disease

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.