China Research Center on Disability, School of Public Health, Fudan University, Shanghai, China.
School of Community and Environmental Health, Old Dominion University, Norfolk, VA, USA.
BMC Health Serv Res. 2020 Apr 15;20(1):298. doi: 10.1186/s12913-020-05181-x.
Specialized Institution-Based Rehabilitation (SIBR) is the cornerstone of care and treatment for individuals with spinal cord injury, but most people with chronic spinal cord injury (CSCI) living in China have no SIBR experience after acute care hospital discharge. In 2009, an SIBR facility was set up in Shanghai (China) to fill this important gap in care. The purpose of the study was to evaluate the effectiveness of an integrated rehabilitation training program among individuals with CSCI living in Shanghai.
A within-subject pre-posttest design was used to evaluate the SIBR. The sample included 455 individuals ≥1 year post-SCI, who were older than 18 years of age and were enrolled in a rehabilitation center in Shanghai, China, between 2013 and 2019. The data included individuals' sociodemographic and injury characteristics, and twenty-three indicators were used as outcome measurements to evaluate basic life skills and their applications in family and social life. Multivariate linear regression was conducted to determine which factors might have influenced the effectiveness of the SIBR.
All basic life skills and their applications in family and social life were improved, but with variations across socio-demographics. Female individuals with CSCI had better outcomes in basic life skills than did males. In terms of basic life skills and their applications in family and social life, individuals with a low level (thoracic or lumbosacral) of injury achieved more significant functional gains than those with a higher level (cervical). The baseline score was also a relevant factor in functional outcome.
Even for individuals with a long SCI history, SIBR training can improve basic life skills and the applications of those skills in family and social life settings.
专门的机构康复（SIBR）是脊髓损伤患者护理和治疗的基石，但大多数在中国生活的慢性脊髓损伤（CSCI）患者在急性医院出院后没有 SIBR 体验。2009 年，在中国上海设立了一个 SIBR 机构，以填补这一重要的护理空白。本研究的目的是评估上海生活的 CSCI 个体综合康复训练计划的有效性。
采用自身前后测试设计来评估 SIBR。该样本包括 455 名 SCI 后≥1 年的个体，年龄大于 18 岁，并于 2013 年至 2019 年期间在中国上海的康复中心登记。数据包括个体的社会人口学和损伤特征，有 23 个指标被用作评估基本生活技能及其在家庭和社会生活中的应用的结果测量。进行多元线性回归以确定哪些因素可能影响 SIBR 的效果。
所有基本生活技能及其在家庭和社会生活中的应用都得到了改善，但在社会人口统计学方面存在差异。CSCI 女性个体的基本生活技能比男性个体更好。在基本生活技能及其在家庭和社会生活中的应用方面，损伤水平较低（胸或腰骶）的个体比损伤水平较高（颈）的个体获得了更显著的功能增益。基线评分也是功能结果的一个相关因素。
即使是脊髓损伤病史较长的个体，SIBR 训练也可以提高基本生活技能及其在家庭和社会生活环境中的应用技能。
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