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马尾感觉保留对运动完全性脊髓损伤的影响。

The impact of sacral sensory sparing in motor complete spinal cord injury.

机构信息

Spinal Cord Injury Program, Kessler Institute for Rehabilitation, West Orange, NJ, USA.

出版信息

Arch Phys Med Rehabil. 2011 Mar;92(3):376-83. doi: 10.1016/j.apmr.2010.07.242.

Abstract

OBJECTIVE

To determine the effect of sensory sparing in motor complete persons with spinal cord injury (SCI) on completion of rehabilitation on neurologic, functional, and social outcomes reported at 1 year.

DESIGN

Secondary analysis of longitudinal data collected by using prospective survey-based methods.

SETTING

Data submitted to the National SCI Statistical Center Database.

PARTICIPANTS

Of persons (N=4106) enrolled in the model system with a motor complete injury (American Spinal Injury Association Impairment Scale [AIS] grade A or B) at the time of discharge between 1997 and 2007, a total of 2331 (56.8%) completed a 1-year follow-up interview (Form II) and 1284 (31.3%) had complete data for neurologic (eg, AIS grade, injury level) variables at 1 year.

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

AIS grade (A vs B) at 1 year, bladder management, hospitalizations, perceived health status, motor FIM items, Satisfaction With Life Scale, depressive symptoms, and social participation.

RESULTS

Compared with persons with AIS grade A at discharge, persons with AIS grade B were less likely to require indwelling catheterization and be hospitalized and more likely to perceive better health, report greater functional independence (ie, self-care, sphincter control, mobility, locomotion), and report social participation in the first year postinjury. A greater portion of individuals with AIS grade B at discharge had improved neurologic recovery at 1 year postinjury than those with AIS grade A. Significant AIS group differences in 1-year outcomes related to physical health were maintained after excluding persons who improved to motor incomplete status for only bladder management and change in perceived health status. This recognition of differences between persons with motor complete injuries (AIS grade A vs B) has important ramifications for the field of SCI rehabilitation and research.

摘要

目的

确定脊髓损伤(SCI)完全运动损伤患者感觉保留对康复完成情况的影响,以报告 1 年后的神经、功能和社会结局。

设计

使用前瞻性基于调查的方法收集的纵向数据的二次分析。

设置

数据提交给国家 SCI 统计中心数据库。

参与者

在 1997 年至 2007 年期间出院时患有完全运动损伤(美国脊髓损伤协会损伤量表 [AIS] 等级 A 或 B)的模型系统中登记的 4106 人中,共有 2331 人(56.8%)完成了 1 年随访访谈(表格 II),1284 人(31.3%)在 1 年内有完整的神经(例如,AIS 等级、损伤水平)变量数据。

干预措施

不适用。

主要观察指标

1 年后的 AIS 等级(A 与 B)、膀胱管理、住院、健康感知、运动 FIM 项目、生活满意度量表、抑郁症状和社会参与。

结果

与出院时 AIS 等级 A 的患者相比,AIS 等级 B 的患者不太可能需要留置导尿管和住院,更有可能感知到更好的健康状况,报告更高的功能独立性(即自我护理、括约肌控制、移动、运动),并报告受伤后第一年的社会参与。出院时 AIS 等级 B 的患者中,有更大比例的患者在 1 年后的神经恢复情况得到改善,而非 AIS 等级 A 的患者。在排除仅因膀胱管理和健康感知变化而改善为不完全运动状态的患者后,与身体健康相关的 1 年结局的 AIS 组间差异仍然显著。对具有完全运动损伤(AIS 等级 A 与 B)的患者之间差异的认识对 SCI 康复和研究领域具有重要意义。

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