Early versus delayed inpatient spinal cord injury rehabilitation: An Italian study
Early versus delayed inpatient spinal cord injury rehabilitation: An Italian study
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DOI：
10.1016/j.apmr.2004.05.021
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发表时间：
2005-03-01
影响因子：
4.3
通讯作者：
Molinari, M
中科院分区：
文献类型：
--
作者：
Scivoletto, G;Morganti, B;Molinari, M
目的：探讨损伤-康复间隔对脊髓损伤（SCI）康复效果的影响。设计：回顾性研究。地点：某大型康复医院脊柱部。参与者：连续入院的患者根据年龄、性别、美国脊髓损伤协会损伤等级和神经损伤程度分组。对这些变量进行匹配，并根据患者从受伤到进入急性康复的时间间隔进行分组。该方法将150例脊髓损伤患者分为50个比较亚组。干预措施：三个比较组（入院时间短（60d））对康复结果进行评估。主要观察指标：观察Barthel指数、Rivermead活动指数、脊髓损伤步行指数以及入院和出院时的运动评分。评估了这些变化和效率。结果：3组在所有医学和人口学特征以及神经功能恢复方面具有可比性。三个亚组在日常生活活动结果上差异显著，短TTA组表现出更高的Barthel指数原始出院评分、评分增加和评分效率。结论：早期康复似乎是功能预后的相关预后因素。脊髓损伤患者的康复干预应尽早在专门的环境中开始，因为延迟可能会对功能恢复产生不利影响。
Objective: To examine what effect the injury-to-rehabilitation interval has on the outcome of spinal cord injury (SCI) rehabilitation.Design: Retrospective study.Setting: Spinal unit of a large rehabilitation hospital.Participants: Consecutive admissions were divided into groups according to age, sex, and American Spinal Injury Association impairment grade and neurologic level of injury. The patients were matched for these variables and divided into groups according to the interval from injury to admission into acute rehabilitation. This approach resulted in 150 patients with SCI grouped into 50 comparison subgroupings. Interventions: Three comparison groups-short (60d) time to admission (TTA)-were evaluated for rehabilitation outcomes.Main Outcome Measures: Barthel Index, Rivermead Mobility Index, Walking Index for Spinal Cord Injury, and motor scores at admission and discharge were examined. The changes and efficiencies were evaluated.Results: The 3 groups were comparable for all medical and demographic characteristics as well as neurologic recovery. The 3 subgroups differed significantly in activity of daily living outcomes, with the short TTA group exhibiting higher Barthel Index raw discharge scores, score increases, and score efficiencies.Conclusions: Early rehabilitation seems to be a relevant prognostic factor of functional outcome. Rehabilitation intervention in patients with SCI should begin as soon as possible, in a specialized setting, because delay may adversely affect functional recovery.