Sumida M, Fujimoto M, Tokuhiro A, Tominaga T, Magara A, Uchida R
Department of Rehabilitation Medicine, Kansai Rosai Hospital, Amagasaki City, Japan.
Arch Phys Med Rehabil. 2001 Mar;82(3):391-5. doi: 10.1053/apmr.2001.19780.
To determine the natural course of traumatic spinal cord injury (SCI) and the effect of early rehabilitation on it.
A retrospective, multicenter study.
Sixteen Rosai hospitals and 1 medical school.
One hundred twenty-three SCI patients (104 men, 19 women; mean age, 48.8 +/- 17.7yr) enrolled.
Dividing the subjects into an early rehabilitation group and a delayed group; differences were ensured by international classification of SCI.
Using the American Spinal Injury Association (ASIA) classifications, the motor recovery rate (MRR) was defined as (ASIA motor score at discharge - ASIA motor score at admission)/(100 - ASIA motor score at admission). The regression lines for FIM instrument score and ASIA motor score were determined for 6 subgroups (early or delayed tetraplegia, central cord injury, paraplegia) by the MRR staging. The regression lines for physical or cognitive FIM score and ASIA motor score were also determined for 6 subgroups.
Three stages were obtained: acute stage: 2 weeks postinjury; recovery stage: 2 weeks to 6 months postinjury; and chronic stage: more than 6 months postinjury. Regression lines showed that rehabilitation improved physical functional independence for ASIA motor score, especially in the early rehabilitation subgroups. There was no correlation between cognitive FIM score and ASIA motor score in 6 subgroups.
Early SCI rehabilitation contributes to good physical activities of daily living for motor function.
确定创伤性脊髓损伤（SCI）的自然病程以及早期康复对其的影响。
一项回顾性多中心研究。
16家罗赛医院和1所医学院。
纳入123例SCI患者（104例男性，19例女性；平均年龄48.8±17.7岁）。
将受试者分为早期康复组和延迟康复组；通过SCI国际分类确保两组差异。
采用美国脊髓损伤协会（ASIA）分级，运动恢复率（MRR）定义为（出院时ASIA运动评分 - 入院时ASIA运动评分）/（100 - 入院时ASIA运动评分）。根据MRR分期，为6个亚组（早期或延迟性四肢瘫、中央脊髓损伤、截瘫）确定FIM工具评分和ASIA运动评分的回归线。还为6个亚组确定了身体或认知FIM评分与ASIA运动评分的回归线。
得到三个阶段：急性期：伤后2周；恢复期：伤后2周～6个月；慢性期：伤后6个月以上。回归线显示康复改善了ASIA运动评分的身体功能独立性，尤其是在早期康复亚组中。6个亚组的认知FIM评分与ASIA运动评分之间无相关性。
早期SCI康复有助于改善运动功能的日常生活身体活动。
