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Early rehabilitation effect for traumatic spinal cord injury
M Sumida1, M Fujimoto, A Tokuhiro
1Department of Rehabilitation Medicine, Kansai Rosai Hospital, Amagasaki City, Japan.
Objective:
To determine the natural course of traumatic spinal cord injury (SCI) and the effect of early rehabilitation on it.
Design:
A retrospective, multicenter study.
Setting:
Sixteen Rosai hospitals and 1 medical school.
Participants:
One hundred twenty-three SCI patients (104 men, 19 women; mean age, 48.8 +/- 17.7yr) enrolled.
Interventions:
Dividing the subjects into an early rehabilitation group and a delayed group; differences were ensured by international classification of SCI.
Main Outcome Measures:
Using the American Spinal Injury Association (ASIA) classifications, the motor recovery rate (MRR) was defined as (ASIA motor score at discharge - ASIA motor score at admission)/(100 - ASIA motor score at admission). The regression lines for FIM instrument score and ASIA motor score were determined for 6 subgroups (early or delayed tetraplegia, central cord injury, paraplegia) by the MRR staging. The regression lines for physical or cognitive FIM score and ASIA motor score were also determined for 6 subgroups.
Results:
Three stages were obtained: acute stage: 2 weeks postinjury; recovery stage: 2 weeks to 6 months postinjury; and chronic stage: more than 6 months postinjury. Regression lines showed that rehabilitation improved physical functional independence for ASIA motor score, especially in the early rehabilitation subgroups. There was no correlation between cognitive FIM score and ASIA motor score in 6 subgroups.
Conclusion:
Early SCI rehabilitation contributes to good physical activities of daily living for motor function.