Do improvements in upper extremity motor function affect changes in bladder management after cervical spinal cord...

Area of Science:

• Neuroscience
• Rehabilitation Medicine
• Urology

Background:

• Upper extremity (UE) motor function at discharge is a key predictor of clean intermittent catheterization (CIC) adoption in spinal cord injury (SCI) patients.
• The impact of post-discharge improvements in UE motor function on bladder management choices remains unclear.

Purpose of the Study:

• To investigate whether improvements in UE motor function after rehabilitation discharge influence bladder management decisions in individuals with cervical SCI.
• To analyze the relationship between changes in predicted CIC ability and actual CIC adoption or discontinuation.

Main Methods:

• Analysis of the National Spinal Cord Injury Dataset (2000-2016) for individuals with cervical SCI.
• Stratification of patients based on UE motor scores to predict CIC independence at discharge and 1-year follow-up.
• Evaluation of CIC adoption and dropout rates in relation to motor function improvements.

Main Results:

• Despite 15% of the cohort improving their predicted ability to independently perform CIC, overall CIC dropout (27.2%) exceeded adoption (12.4%).
• For those initially unable to self-catheterize, CIC adoption rates at 1 year did not differ significantly whether or not motor function improved (12.7% vs. 9.2%).
• CIC dropout rates were also similar between these groups (34.3% vs. 30.0%).

Conclusions:

• In the first year post-rehabilitation, more individuals with SCI transition away from CIC than adopt it.
• Significant improvements in UE motor function during the first year after discharge do not appear to alter bladder management decisions regarding CIC.