Factors affecting rehabilitation participation in patients with spinal cord injury

To investigate the factors affecting participation in rehabilitation in patients with spinal cord injury.

Our prospective clinical follow-up study included 87 patients with spinal cord injuries who were hospitalized in a tertiary Physical Therapy and Rehabilitation Hospital. General characteristics of the patients were noted. Depression, neuropathic pain, independence in activities of daily living, and participation in the rehabilitation program were assessed using the Beck Depression Scale, DN-4 score, Spinal Cord Injury Independence Measure (SCIM), and Pittsburgh Rehabilitation Participation Scale, respectively.

Nearly one-third of patients (31%) showed low participation. The frequency of tetraplegics was higher, the median motor score was statistically lower, the rate of training in the locomat and mechanical balance devices was lower, and the median Beck Depression Scale score was higher in the lower participation group (p=0.043, p<0.001, p=0.007 and p<0.001, p=0.019, respectively). The determinant factors for low participation in rehabilitation were low motor score p<0.001, not receiving locomat training p=0.006, presence of neuropathic pain p=0.016, and high Beck Depression Scale scores p=0.040. Patients with high participation showed greater improvement in SCIM scores (p=0.030).

Our results confirm the importance of rehabilitation participation. Patients should be encouraged to participate in rehabilitation and problems such as neuropathic pain and depression should be appropriately addressed and solved. Intensive rehabilitation including locomat and mechanical balance training is recommended.