Physical function recovery trajectories following spinal cord injury

Model System:

SCI

Reference Type:

Journal article

Accession No.:

J87663

Journal:

Archives of Physical Medicine and Rehabilitation

Year, Volume, Issue, Page(s):

2022 , 103, 2, 215-223

Publication Website:

Abstract:

Study utilized the Spinal Cord Injury-Functional Index (SCI-FI) to explore trajectories of functional recovery that occur during the first two years after spinal cord injury (SCI). The 479 adult participants with SCI, recruited from eight SCI Model System sites, completed four (SCI-FI) item banks within 4 months of injury and again at 2 weeks, 3, 6, 12, and 24 months following baseline assessment. The SCI-FI item banks for SCI-FI Basic Mobility/Capacity (C), Fine Motor Function/C, Self-Care/C, and Wheelchair Mobility/Assistive Technology (AT) were used. Growth mixture modeling was used to identify groups with similar trajectory patterns. For the Basic Mobility/C and Wheelchair Mobility/AT domains, models specifying 2 trajectory groups were selected. For both domains, a majority class exhibited average functional levels and gradual improvement, primarily in the first six months. A smaller group of individuals made gradual improvements but had greater initial functional limitations. The Self Care/C domain exhibited a similar pattern; however, a third, small class emerged that exhibited substantial improvement in the first six months. Finally, for individuals with tetraplegia, trajectories of Fine Motor Function/C scores followed two patterns, with individuals reporting generally low initial scores and then making either modest or large improvements. In individual growth curve models, injury/demographic factors predicted initial functional levels but less so regarding rates of recovery. Trajectories of functional recovery followed a small number of change patterns, though variation around these patterns emerged. During the first two years after initial hospitalization, SCI-FI scores showed modest improvements; however, substantial improvements were noted for a small number of individuals with severe limitations in fine motor and self-care function.

Author(s):