Irrgang Sophie, Himmelhaus Sandra, Allek Kirstin, Debecker Isabelle, Gemperli Armin, Kynast Karen, von Reumont Anne, Scheel-Sailer Anke
Health Services and Clinical Care Group, Swiss Paraplegic Research, Nottwil, Switzerland.
Faculty of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland.
Front Rehabil Sci. 2024 Mar 27;5:1272682. doi: 10.3389/fresc.2024.1272682. eCollection 2024.
In the acute phase after a spinal cord injury or disease (SCI/D), various therapeutic assessments and interventions are applied with the goal of restoring structures, preventing complications and preparing the patient as best as possible for further activity and finally participation. The goal was to identify and evaluate the available evidence on assessments and interventions for body functions and structures to prepare adults with acute spinal cord SCI/D for activity and participation during the first 14 days.
A scoping review was conducted. The search was performed on June 19, 2023 using the databases PubMed, PEDro, Cochrane library and Embase. These were screened for studies including patients with acute SCI/D and physiotherapeutic or occupational therapy assessments and interventions. Only studies in English or German published between 2012 and 2023 were included.
Twelve publications met the inclusion criteria, namely three systematic reviews, two randomized controlled trials, two observational studies and five clinical practice guidelines. Assessments as the Spinal Cord Independence Measure, as well as exercises such as daily passive mobilization of body structures against contractures were used in the entire population, while others were only applied in subgroups of SCI/D such as the Graded Redefined Assessment of Strength, Sensation and Prehension or functional electrical stimulation with and without additional movements. The methodological quality of the studies found varied greatly from good to very poor.
Heterogeneity in research design and study population as well as lack of high-quality studies do not cover the standard of clinical management in the acute phase and further comprehensive research is needed.
在脊髓损伤或疾病（SCI/D）后的急性期，会采用各种治疗评估和干预措施，目的是恢复身体结构、预防并发症，并尽可能让患者为进一步活动乃至最终参与做好准备。目标是识别和评估关于身体功能和结构评估及干预措施的现有证据，以便让急性脊髓SCI/D的成年人在最初14天内为活动和参与做好准备。
进行了一项范围综述。于2023年6月19日使用PubMed、PEDro、Cochrane图书馆和Embase数据库进行检索。筛选了包括急性SCI/D患者以及物理治疗或职业治疗评估与干预措施的研究。仅纳入2012年至2023年间发表的英文或德文研究。
12篇出版物符合纳入标准，即3篇系统综述、2篇随机对照试验、2篇观察性研究和5篇临床实践指南。在所有人群中都使用了诸如脊髓独立测量等评估方法，以及诸如针对挛缩进行身体结构的每日被动活动等锻炼方法，而其他一些方法仅应用于SCI/D的亚组，如力量、感觉和抓握能力的分级重新定义评估，或有和没有额外动作的功能性电刺激。所发现研究的方法学质量差异很大，从良好到非常差不等。
研究设计和研究人群的异质性以及缺乏高质量研究并未涵盖急性期临床管理的标准，需要进一步开展全面研究。
