Rehabilitation outcomes in patients with complete thoracic spinal cord injury.

This paper describes the functional outcomes and lengths of stay of 184 patients discharged from comprehensive rehabilitation with complete thoracic traumatic spinal cord injuries. The 100-point modified Barthel Index (MBI) was used to assess functional abilities. There were statistically significant improvements in the mean total MBI score for the entire sample from 35.2 at rehabilitation admission to 71.0 at discharge. The mean lengths of stay were 46 days in acute care and 84 days in the rehabilitation facility. There were 79 patients with lesions between T1 and T6 ("high paraplegics") and 105 patients with lesions between T7 and T12 ("low paraplegics"). There were no significant differences in the mean MBI scores, self-care subscores, mobility subscores, acute lengths of stay or rehabilitation lengths of stay between high and low paraplegic patients. However, low paraplegic patients were more likely to walk than were the high paraplegic patients. Surgical stabilization was performed on 36% of the sample; total MBI scores were similar for surgically stabilized and nonsurgically stabilized patients. High and low thoracic paraplegic patients achieved significant functional gains during rehabilitation. These functional gains occurred in a setting which provided for the vocational, psychosocial and recreational needs of the individual, and which fostered independence, community participation and a return to a healthy and active lifestyle.