Abdul-Sattar Amal B
Department of Rehabilitation and physical medicine, Zagazig University, Zagazig, Egypt.
NeuroRehabilitation. 2014 Jan 1;35(2):341-7. doi: 10.3233/NRE-141111.
To identify the possible factors influencing motor functional outcome of patients with traumatic spinal cord injury (T-SCI) after inpatient rehabilitation.
90 patients with T-SCI consecutively admitted for inpatient SCI rehabilitation unit was studied. Demographic characteristics, level and completeness of SC injury using American Spinal Injury Association (ASIA) Impairment Scale, disability level using Functional Independence Measure (FIM), psychological state using Hospital Anxiety and Depression Scale (HADS), and SCI-related medical complications were assessed and recorded at admission. The main measure of functional outcome was the motor FIM gain score at discharge. The univariate and multiple linear regression analyses were performed.
The Mean admission motor FIM score was 35.3 (20.1), the mean discharge motor FIM score was 65.3 (22.5), and the mean motor FIM gain score was 30.0 (20.9). Univariate analyses indicated that the significant factors influencing motor functional outcome included age, motor FIM score at admission, level and severity of injury, anxiety/depression score, time between injury and admission to rehabilitation, length of stay, destination at discharge, and family caregiver. However, in multiple linear regression analyses, age, destination at discharge, family caregiver were not significant predictors.
Age was not predictor of motor functional outcome and rehabilitation can be effective in elderly SCI patients. Rehabilitation intervention should begin as soon as possible. The admission motor FIM score, level and severity of injury, interval between onset and admission, anxiety/depression score, and length of stay can be used to predict functional outcomes of rehabilitation in SCI patients.
确定影响创伤性脊髓损伤(T-SCI)患者住院康复后运动功能结局的可能因素。
对90例连续入住脊髓损伤康复单元的T-SCI患者进行研究。在入院时评估并记录人口统计学特征、使用美国脊髓损伤协会(ASIA)损伤量表评估的脊髓损伤水平和完整性、使用功能独立性测量(FIM)评估的残疾水平、使用医院焦虑抑郁量表(HADS)评估的心理状态以及与脊髓损伤相关的医疗并发症。功能结局的主要测量指标是出院时的运动FIM得分增益。进行单因素和多因素线性回归分析。
入院时运动FIM平均得分为35.3(20.1),出院时运动FIM平均得分为65.3(22.5),运动FIM得分增益平均为30.0(20.9)。单因素分析表明,影响运动功能结局的显著因素包括年龄、入院时运动FIM得分、损伤水平和严重程度、焦虑/抑郁得分、受伤至入院康复的时间、住院时间、出院目的地以及家庭照顾者。然而,在多因素线性回归分析中,年龄、出院目的地、家庭照顾者不是显著的预测因素。
年龄不是运动功能结局的预测因素,康复对老年脊髓损伤患者有效。康复干预应尽早开始。入院时运动FIM得分、损伤水平和严重程度、发病至入院间隔、焦虑/抑郁得分以及住院时间可用于预测脊髓损伤患者康复的功能结局。