Model System:

SCI

Reference Type:

Journal article

Accession No.:

J79386

Journal:

Archives of Physical Medicine and Rehabilitation

Year, Volume, Issue, Page(s):

, 99, 8, 1591-1598

Publication Website:

Abstract:

Study investigated the amount and impact of gait training (GT) during inpatient rehabilitation (IPR) for non-ambulatory people with traumatic spinal cord injury (SCI) using data from the SCIRehab database. A total of 1,376 patients with new SCI receiving initial rehabilitation were divided into groups consisting of those who did and did not receive GT. Patients were further subdivided based on their primary mode of mobility as measured by the Functional Independence Measure. Outcome measures assessed at 1 year after discharge from IPR included: pain rating scales, Patient Health Questionnaire Mood Subscale, Satisfaction With Life Scale, and Craig Handicap Assessment and Reporting Technique (CHART). Nearly 58 percent of all patients received GT, including 33.3 percent of patients who were primarily using a wheelchair 1 year after discharge from IPR. Those who used a wheelchair and received GT, received significantly less transfer and wheeled mobility training. CHART physical independence, mobility, and occupation scores were significantly worse in patients who used a wheelchair at 1 year and received GT, compared with those who used a wheelchair and did not receive GT in IPR. Older age was also a significant predictor of worse participation as measured by the CHART. Findings suggest that a significant percentage of individuals who are not likely to become functional ambulators are spending portions of their IPR stays performing GT, which is associated with less time allotted for other functional interventions. GT in IPR was also associated with participation deficits at 1 year for those who used a wheelchair, implying the potential consequences of opportunity costs, pain, and psychological difficulties of receiving unsuccessful GT. Clinicians should consider these data when deciding to implement GT during initial IPR.

Author(s):

Rigot, Stephanie|Worobey, Lynn|Boninger, Michael L.|

Participating Centers: