Abstract
Objective: To examine associations of patient characteristics and treatment quantity delivered during inpatient spinal cord injury (SCI) rehabilitation with outcomes at 5 years post-injury and compare them to the associations found at 1 year post-injury. Design: Observational study using Practice-Based Evidence research methodology in which clinicians documented treatment details. Regression modeling was used to predict outcomes. Setting: Five inpatient SCI rehabilitation centers in the US. Participants: Participants were 792 SCIRehab participants who were >12 years of age, gave informed consent, and completed both a 1-year and 5-year post-injury interview. Outcome Measures: Outcome data were derived from Spinal Cord Injury Model Systems (SCIMS) follow-up interviews at 5 years post-injury and, similar to the 1-year SCIMS outcomes, included measures of physical independence, societal participation, life satisfaction, and depressive symptoms, as well as place of residence, school/work attendance, rehospitalization, and presence of pressure ulcers. Results: Consistent with 1-year findings, patient characteristics continue to be strong predictors of outcomes 5-years post-injury, although several variables add to the prediction of some of the outcomes. More time in physical therapy and therapeutic recreation were positive predictors of 1-year outcomes, which held less true at 5 years. Greater time spent with psychology and social work/case management predicted greater depressive symptomatology 5-years post-injury. Greater clinician experience was a predictor at both 1- and 5 -years, although the related positive outcomes varied across years. Conclusion: Various outcomes 5-years post-injury were primarily explained by pre-and post-injury characteristics, with little additional variance offered by the quantity of treatment received during inpatient rehabilitation.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 870-885 |
| Number of pages | 16 |
| Journal | Journal of Spinal Cord Medicine |
| Volume | 44 |
| Issue number | 6 |
| DOIs | |
| State | Published - 2021 |
Bibliographical note
Funding Information:Contributors None. Funding The data were collected and analyzed under grants from the National Institute on Disability, Independent Living, and Rehabilitation Research (formerly NIDRR), grant numbers H133A060103, H133N060005, 90SI5003 (formerly H133N11000), and 90SI5015 to Craig Hospital; H133N060027 and 90SI5017 to Icahn School of Medicine at Mount Sinai; H133A21943016 to Carolinas Rehabilitation; H133N060009 and 90SI5002 (formerly H133N110005) to Shepherd Center; and H133N060014 and 90SI5009 (formerly H133N110014) to the Rehabilitation Institute of Chicago (now the Shirley Ryan Ability Lab). Conflicts of interest There are no conflicts of interest to declare. Data availability statement The data that support the findings of this study are available from the corresponding author, KRM, upon reasonable request.
Publisher Copyright:
© The Academy of Spinal Cord Injury Professionals, Inc. 2021.
Keywords
- Practice-based evidence
- Rehabilitation
- Spinal cord injury
- Spinal cord injury model systems