Civelek Gul M, Tulunoglu Selen, Ozisler Zuhal
From the Health Sciences University, Ankara City Hospital, Physical Therapy and Rehabilitation Hospital, Ankara, Turkey.
Neurosciences (Riyadh). 2025 Jul;30(3):201-208. doi: 10.17712/nsj.2025.3.20240085.
To investigate the factors affecting participation in rehabilitation in patients with spinal cord injury.
Our prospective clinical follow-up study included 87 patients with spinal cord injuries who were hospitalized in a tertiary Physical Therapy and Rehabilitation Hospital. General characteristics of the patients were noted. Depression, neuropathic pain, independence in activities of daily living, and participation in the rehabilitation program were assessed using the Beck Depression Scale, DN-4 score, Spinal Cord Injury Independence Measure (SCIM), and Pittsburgh Rehabilitation Participation Scale, respectively.
Nearly one-third of patients (31%) showed low participation. The frequency of tetraplegics was higher, the median motor score was statistically lower, the rate of training in the locomat and mechanical balance devices was lower, and the median Beck Depression Scale score was higher in the lower participation group (=0.043, <0.001, =0.007 and <0.001, =0.019, respectively). The determinant factors for low participation in rehabilitation were low motor score <0.001, not receiving locomat training =0.006, presence of neuropathic pain =0.016, and high Beck Depression Scale scores =0.040. Patients with high participation showed greater improvement in SCIM scores (=0.030).
Our results confirm the importance of rehabilitation participation. Patients should be encouraged to participate in rehabilitation and problems such as neuropathic pain and depression should be appropriately addressed and solved. Intensive rehabilitation including locomat and mechanical balance training is recommended.
探讨影响脊髓损伤患者参与康复治疗的因素。
我们的前瞻性临床随访研究纳入了87例在三级物理治疗与康复医院住院的脊髓损伤患者。记录患者的一般特征。分别使用贝克抑郁量表、DN-4评分、脊髓损伤独立测量量表（SCIM）和匹兹堡康复参与量表评估患者的抑郁、神经性疼痛、日常生活活动独立性以及参与康复项目的情况。
近三分之一的患者（31%）参与度较低。四肢瘫痪患者的比例更高，运动评分中位数在统计学上更低，在运动训练和机械平衡设备上的训练率更低，且在参与度较低的组中，贝克抑郁量表评分中位数更高（分别为P = 0.043、P < 0.001、P = 0.007和P < 0.001、P = 0.019）。康复参与度低的决定性因素为运动评分低（P < 0.001）、未接受运动训练（P = 0.006）、存在神经性疼痛（P = 0.016）以及贝克抑郁量表评分高（P = 0.040）。参与度高的患者在SCIM评分上有更大改善（P = 0.030）。
我们的结果证实了康复参与的重要性。应鼓励患者参与康复治疗，神经性疼痛和抑郁等问题应得到妥善处理和解决。建议进行包括运动训练和机械平衡训练在内的强化康复治疗。
