Lampart Patricia, Gemperli Armin, Baumberger Michael, Bersch Ines, Prodinger Birgit, Schmitt Klaus, Scheel-Sailer Anke
Swiss Paraplegic Centre (SPC), Nottwil, Switzerland.
Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland.
Spinal Cord. 2018 Apr;56(4):322-331. doi: 10.1038/s41393-017-0039-x. Epub 2017 Dec 20.
Retrospective chart analysis.
To examine which professionals administered which assessment instruments in which patient in clinical practice during first rehabilitation after newly acquired spinal cord injury (SCI) and the differences in the frequencies of different assessments between patient groups.
Specialized SCI acute care and rehabilitation clinic.
Patients after SCI, aged 18 years and above, admitted for first rehabilitation between December 2014 and December 2015 were analyzed. Descriptive statistics of 54 selected assessments. p values based on the χ test were calculated for assessments used in both paraplegic and tetraplegic patients.
One hundred and nineteen patients were screened. Forty-one assessments were administered, of which 10 on average more than once per patient. The most frequently used assessments were Spinal Cord Independence Measure III (7.7 times per patient), Skin Assessment (3.6 times), and Manual Muscle Test (3.2 times for Lower Extremities; 2.5 times for Upper Extremities). The American Spinal Injury Association Impairment Scale was administered on average 1.9 times per patient. More variation in the number of assessments per patient was observed in patients with complete and incomplete lesions compared to patients with paraplegia and tetraplegia.
Assessments covering neurological functioning, mobility, and self-care are used in clinical practice during first rehabilitation of patients with SCI, while others covering autonomic functioning, pain, participation, or quality of life are still missing. Based on these observations and national and international requirements, a meaningful standard for an assessment toolkit, applicable in general and in specific subgroups, needs to be defined and implemented.
回顾性图表分析。
探讨在新发生脊髓损伤（SCI）后的首次康复期间，临床实践中哪些专业人员对哪些患者使用了哪些评估工具，以及不同患者组之间不同评估频率的差异。
专门的SCI急性护理和康复诊所。
分析2014年12月至2015年12月期间因首次康复入院的18岁及以上SCI患者。对54项选定评估进行描述性统计。对截瘫和四肢瘫患者都使用的评估，计算基于χ检验的p值。
筛查了119名患者。进行了41项评估，其中平均每位患者进行超过10项评估。最常用的评估是脊髓独立测量量表III（每位患者7.7次）、皮肤评估（3.6次）和徒手肌力测试（下肢3.2次；上肢2.5次）。美国脊髓损伤协会损伤量表平均每位患者使用1.9次。与截瘫和四肢瘫患者相比，完全性和不完全性损伤患者的每位患者评估次数变化更大。
在SCI患者首次康复期间的临床实践中，使用了涵盖神经功能、活动能力和自我护理的评估，而其他涵盖自主神经功能、疼痛、参与或生活质量的评估仍然缺失。基于这些观察结果以及国家和国际要求，需要定义并实施一个适用于一般情况和特定亚组的有意义的评估工具包标准。
