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Motor scores on the functional independence measure after pediatric spinal cord injury
D D Allen1, M J Mulcahey, S M Haley
1Graduate Program in Physical Therapy, University of California San Francisco/San Francisco State University, San Francisco, CA 94306, USA.
Insights
Children with spinal cord injury (SCI) show improved motor function with intervention, even years post-injury. Functional Independence Measure (FIM) scores depend on injury level and type.
Area of Science:
- Pediatric rehabilitation
- Neuroscience
- Clinical outcomes
Background:
- Pediatric spinal cord injury (SCI) significantly impacts functional ability.
- Assessing motor function is crucial for rehabilitation planning and outcome prediction.
- The Functional Independence Measure (FIM) is a standard tool for evaluating functional status.
Purpose of the Study:
- To report the functional ability of children with SCI using FIM motor scores.
- To identify factors associated with FIM motor admission and post-discharge gain scores.
- To analyze the relationship between injury characteristics and functional recovery in pediatric SCI.
Main Methods:
- Retrospective descriptive analysis of 941 children with SCI (ages 0-21).
- Analysis of FIM motor item scores at admission and discharge.
- Examination of factors including neurological level, injury completeness, age, etiology, and time intervals.
Main Results:
- FIM motor scores at admission negatively correlated with age, neurological level, and injury completeness.
- Significant FIM motor score gains observed across neurological levels.
- Gains associated with lower admission scores, lower neurological level, incomplete and traumatic injuries, and shorter pre-admission interval.
Conclusions:
- Motor function in pediatric SCI is influenced by neurological level and injury completeness.
- FIM motor scores can improve with therapeutic interventions, regardless of time elapsed since injury.
- Early intervention and addressing specific injury characteristics may optimize functional recovery.
Study Design:
Retrospective descriptive analysis.
Objectives:
The purpose of this study was to report the functional ability of children with spinal cord injury (SCI) as recorded on motor items of the functional independence measure (FIM) and to examine the factors associated with FIM motor admission and post-discharge gain scores.
Methods:
Scores on FIM motor items were analyzed from 941 children (age range: 0-21 years; mean: 13 years 4 months; s.d.: 4 years 8 months) admitted in acute-to-chronic time periods post-SCI to Shriners Hospitals for Children (USA). FIM motor scores at admission and gains at discharge were examined along with neurological level, completeness of injury, age, etiology of injury, and length of time between injury and admission and admission and discharge.
Results:
The FIM motor scores at admission were negatively correlated with age, neurological level and completeness of injury. Gain in FIM motor scores was significant across neurological levels, and was associated with lower admission FIM motor scores, lower neurological level, incomplete injury, traumatic injury and less time between injury and admission.
Conclusions:
The motor function of children after pediatric SCI depends on neurological level and completeness of injury, among other factors. FIM motor scores can improve with intervention even several years after the injury.
