Difficulty of elderly SCI subjects to translate motor recovery--"body function"--into daily living activities

The objective of this retrospective analysis was to determine whether outcome of body functions and activities as well as length of stay of inpatient rehabilitation is related to age in patients with traumatic spinal cord injury (SCI). Data were collected from a European network of 17 SCI rehabilitation centers (EM-SCI); a total of 237 traumatic SCI subjects were included. Assessments were performed at 1, 6, and 12 months after SCI. The measures analyzed were motor score according to the American Spinal Injury Association, Spinal Cord Independence Measure (SCIM), gait speed, and length of stay. Correlation analysis was applied to quantify the association between age and change in the outcome measures. A positive relationship was found between age and neurological recovery in both the first and second 6-month periods of assessment. A negative relationship was found between age and change in SCIM in the second 6-month period after SCI. A negative relationship between age and gait speed was observed in the first half year. Length of stay was not associated with age. It was concluded that age is an important determining factor for functional outcome after SCI and that elderly patients have difficulties in translating an improvement in neurological outcome into functional changes. Therefore, rehabilitation approaches in elderly subjects should focus on functional training.