Iyer R Dinesh, Palaninathan Pranavakumar, Suresh Prashasth Belludi, Gunasekaran Vignesh, Periyaswamy Sathiyamoorthi, Shetty Ajoy Prasad, Sri Vijayanand K S, Kanna Rishi Mugesh, Shanmuganathan Rajasekaran
Department of Orthopaedics and Spine Surgery, Ganga Medical Centre and Hospitals Pvt. Ltd., Coimbatore, India.
Ganga Spine Injury Rehabilitation Centre, Coimbatore, India.
Asian Spine J. 2025 Aug;19(4):535-544. doi: 10.31616/asj.2024.0132. Epub 2025 May 30.
A retrospective cohort study.
To study the effect of rehabilitation timing on the functional, psychological, and vocational outcomes of patients with paraplegia secondary to traumatic spinal cord injury (SCI).
Rehabilitation of patients with SCI is vital for preventing secondary complications and early reintegration into society. However, only few studies have investigated the effects of early rehabilitation.
Patients with paraplegia secondary to traumatic SCI (T2-L2) who underwent rehabilitation at our SCI Rehabilitation Center between January 2018 and December 2022 and who were followed up for at least 12 months were included. Patients were divided into three groups based on the rehabilitation timing after SCI: group 1 (early, within 2 weeks); group 2 (subacute, 2-6 weeks); and group 3 (delayed, >6 weeks). The three groups were compared in terms of functional outcomes, psychological status, and socioeconomic status after injury.
A total of 70 patients (62 men and eight women) were included; 30 were in group 1, 18 were in group 2, and 22 were in group 3. Compared with groups 1 and 2, group 3 showed the lowest improvement in mean±standard deviation (SD) Functional Independence Measure score (67.6±14.03 vs. 64.9±8.92 vs. 44.4±12.2, respectively; p<0.05) and significantly higher number of patients with severe (n=10) and extreme depression with suicidal tendency (n=4), with a mean±SD Beck Depression Inventory score of 32.6±8.4. The proportion of unemployed persons was significantly lower in groups 1 and 2 (30% and 27.7%, respectively) than in group 3 (72.2%, 16 of 22).
Among patients with paraplegia, rehabilitation within 6 weeks after SCI significantly improved their functional outcomes and psychological well-being and increased their chances of employment and reintegration into society.
一项回顾性队列研究。
研究康复时机对创伤性脊髓损伤（SCI）所致截瘫患者功能、心理和职业结局的影响。
SCI患者的康复对于预防继发性并发症和早期重新融入社会至关重要。然而，仅有少数研究调查了早期康复的效果。
纳入2018年1月至2022年12月期间在我们的SCI康复中心接受康复治疗且随访至少12个月的创伤性SCI（T2-L2）所致截瘫患者。根据SCI后的康复时机将患者分为三组：第1组（早期，2周内）；第2组（亚急性，2 - 6周）；第3组（延迟，>6周）。比较三组损伤后的功能结局、心理状态和社会经济状况。
共纳入70例患者（62例男性和8例女性）；第1组30例，第2组18例，第3组22例。与第1组和第2组相比，第3组的平均±标准差（SD）功能独立性测量得分改善最低（分别为67.6±14.03、64.9±8.92和44.4±12.2；p<0.05），重度（n = 10）和有自杀倾向的极度抑郁患者数量显著更多（n = 4），贝克抑郁量表平均±SD得分为32.6±8.4。第1组和第2组的失业人员比例（分别为30%和27.7%）显著低于第3组（72.2%，22例中的16例）。
在截瘫患者中，SCI后6周内进行康复显著改善了他们的功能结局和心理健康，并增加了他们就业和重新融入社会的机会。
