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早期痉挛对创伤性脊髓损伤后强化功能康复阶段和社区再融入的影响。

The impact of early spasticity on the intensive functional rehabilitation phase and community reintegration following traumatic spinal cord injury.

机构信息

Department of Medicine, Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada.

Department of Physical Medicine and Rehabilitation, Hôpital du Sacré-Cœur de Montréal, Montreal, Quebec, Canada.

出版信息

J Spinal Cord Med. 2020 Jul;43(4):435-443. doi: 10.1080/10790268.2018.1535638. Epub 2018 Dec 3.

Abstract

To determine the impact of spasticity presenting during the acute care hospitalization on the rehabilitation outcomes following a traumatic spinal cord injury (TSCI). Retrospective cohort study. A single Level 1 trauma center specialized in SCI care. 150 individuals sustaining an acute TSCI. Not applicable. The total inpatient functional rehabilitation length of stay. The occurrence of medical complications and the discharge destination from the inpatient functional rehabilitation facility were also considered. 63.3% of the cohort presented signs and/or symptoms of spasticity during acute care. Individuals with early spasticity developed medical complications during acute care and during intensive functional rehabilitation in a higher proportion. They were also hospitalized significantly longer and were less likely to return home after rehabilitation than individuals without early spasticity. Early spasticity was an independent factor associated with increased total inpatient rehabilitation length of stay. The development of signs and symptoms of spasticity during acute care following a TSCI may impede functional rehabilitation outcomes. In view of its association with the occurrence of early spasticity, higher vigilance towards the prevention of medical complications is recommended. Early assessment of spasticity during acute care is recommended following TSCI.

摘要

目的

确定急性住院期间出现痉挛对创伤性脊髓损伤(TSCI)后的康复结果的影响。 回顾性队列研究。 一家专门从事 SCI 护理的单一 1 级创伤中心。 150 名急性 TSCI 患者。 不适用。 总住院功能康复住院时间。还考虑了医疗并发症的发生和从住院功能康复设施的出院去向。 队列中有 63.3%的人在急性护理期间出现痉挛的迹象和/或症状。早期出现痉挛的患者在急性护理和强化功能康复期间发生医疗并发症的比例更高。他们的住院时间也明显延长,康复后返回家庭的可能性低于没有早期痉挛的患者。早期痉挛是与住院康复时间延长相关的独立因素。TSCI 后急性护理期间出现痉挛的迹象和症状可能会阻碍功能康复结果。鉴于其与早期痉挛的发生有关,建议提高对预防医疗并发症的警惕性。建议在 TSCI 后急性护理期间早期评估痉挛。

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