Martina Franz1, Lea Richner2, Markus Wirz3, Anne von Reumont4,5, Ulla Bergner5,6, Tanja Herzog2, Werner Popp2, Kathrin Bach4,5, Norbert Weidner4,5, Armin Curt2,5. 1. University Hospital Balgrist, Spinal Cord Injury Center, Forchstrasse, Zurich, Switzerland. martina.franz@balgrist.ch. 2. University Hospital Balgrist, Spinal Cord Injury Center, Forchstrasse, Zurich, Switzerland. 3. Zurich University of Applied Sciences, Winterthur, Switzerland. 4. Spinal Cord Injury Center, Heidelberg University Hospital, Heidelberg, Germany. 5. European Multi-Center Study in Spinal Cord Injury (EMSCI), Zurich, Switzerland. 6. BG Hospital, Center for Spinal Cord Injuries, Murnau am Staffelsee, Germany.
Abstract
STUDY DESIGN: Prospective observational multicenter study. OBJECTIVES: Investigation of content, duration and adjustment of physical therapy for the rehabilitation of ambulation in acute spinal cord injury (SCI). SETTING: European Multicenter Study of SCI (EMSCI). METHODS: Physical therapy interventions during acute in-patient rehabilitation of eighty incomplete SCI patients (AIS B, C, D all lesion levels) were recorded using the SCI - Intervention Classification System. Mobility was documented using the Spinal Cord Independence Measurement (SCIM III), demographics and clinical data were retrieved from the EMSCI database. RESULTS: Overall recovery of locomotor function was categorized into three outcome groups (G1-G3). Of 76 initial wheelchair-using patients, 53.9% remained wheelchair user (G1), 25% regained moderate (G2) and 21.1% good walking (G3) capability. Strength training was the most frequently applied intervention of body function/-structure across all outcome groups (about 30% of all interventions), while interventions focusing on muscle tone and respiration were predominantly applied in wheelchair-dependent patients. Activity-focused interventions of transfer, transition, sitting were trained most intensively in outcome group G1, while walking and swimming were increasingly trained in patients with moderate and good walking outcomes. Physical therapy interventions of assistive and active trainings as well as corresponding training environments changed with the recovery of locomotor function. CONCLUSIONS: Physical therapy of locomotor function is targeted to individual patients' conditions and becomes adjusted to the progress of ambulation. Although the involved clinical sites were not following explicitly standardized rehabilitation programs, common patterns can be discerned which may form the basis of prospective standardized programs.
STUDY DESIGN: Prospective observational multicenter study. OBJECTIVES: Investigation of content, duration and adjustment of physical therapy for the rehabilitation of ambulation in acute spinal cord injury (SCI). SETTING: European Multicenter Study of SCI (EMSCI). METHODS: Physical therapy interventions during acute in-patient rehabilitation of eighty incomplete SCI patients (AIS B, C, D all lesion levels) were recorded using the SCI - Intervention Classification System. Mobility was documented using the Spinal Cord Independence Measurement (SCIM III), demographics and clinical data were retrieved from the EMSCI database. RESULTS: Overall recovery of locomotor function was categorized into three outcome groups (G1-G3). Of 76 initial wheelchair-using patients, 53.9% remained wheelchair user (G1), 25% regained moderate (G2) and 21.1% good walking (G3) capability. Strength training was the most frequently applied intervention of body function/-structure across all outcome groups (about 30% of all interventions), while interventions focusing on muscle tone and respiration were predominantly applied in wheelchair-dependent patients. Activity-focused interventions of transfer, transition, sitting were trained most intensively in outcome group G1, while walking and swimming were increasingly trained in patients with moderate and good walking outcomes. Physical therapy interventions of assistive and active trainings as well as corresponding training environments changed with the recovery of locomotor function. CONCLUSIONS: Physical therapy of locomotor function is targeted to individual patients' conditions and becomes adjusted to the progress of ambulation. Although the involved clinical sites were not following explicitly standardized rehabilitation programs, common patterns can be discerned which may form the basis of prospective standardized programs.
Authors: Steven C Kirshblum; Stephen P Burns; Fin Biering-Sorensen; William Donovan; Daniel E Graves; Amitabh Jha; Mark Johansen; Linda Jones; Andrei Krassioukov; M J Mulcahey; Mary Schmidt-Read; William Waring Journal: J Spinal Cord Med Date: 2011-11 Impact factor: 1.985
Authors: Sacha A van Langeveld; Marcel W Post; Floris W van Asbeck; Karin Postma; Jacqueline Leenders; Kees Pons Journal: Arch Phys Med Rehabil Date: 2008-08 Impact factor: 3.966
Authors: Sacha A van Langeveld; Marcel W Post; Floris W van Asbeck; Paul Ter Horst; Jacqueline Leenders; Karin Postma; Eline Lindeman Journal: Arch Phys Med Rehabil Date: 2009-07 Impact factor: 3.966