Table 6.
Characteristics of Studies Reporting Patient or Injury Factors Affecting Outcome Following Rehabilitation.
| Investigator (Year) | Study Design, Funding | Demographics | Predictive Factors Assessed | Outcome Measures |
|---|---|---|---|---|
| Abdul-Sattar (2014) | Single center prospective cohort study Funding NR | N = 90 Mean age: 38.1 ± 18.3 years Males: 82.2% (74/90) Follow-up: 123 ± 45 days (% NR) | Patient factors Age Gender Marital status Education level Presence of family caregiver during inpatient rehabilitation SCI factors Etiology of injury Time from injury to admission Length of stay Level of SCI injury Severity of injury/ASIA score at admission Motor FIM score at admission Depression Anxiety Urinary tract infection Spasticity Pressure ulcer Pain Destination at discharge |
|
| Cifu (1999) | Multicenter (n = 16) retrospective cohort study (SCI Model Systems Project) Study was supported in part by a grant from NIDRR. No funds were provided by a commercial party with direct financial interest in the results of this study | N = 300 Mean age: NR Males: 79.7% (239/300) Follow-up: At discharge (80.0%) | Patient factors Age |
|
| Coleman (2004) | Multicenter (n = 28) retrospective cohort study (GM-1 ganglioside drug study) Nothing of value received from a commercial entity related to this research | N = 760 Mean age: NR Males: NR Follow-up: 26 weeks postinjury (94.2%) | SCI factors Anatomical region of injury |
|
| Daverat (1990) | Single center prospective study Funding NR | N = 99 Mean age: 41 (12-84) years Males: 78% (n/N NR) Follow-up: 18 months (94.9%) | Patient factors Age SCI factors Initial conscious level Level of lesion Yale Scale score |
|
| DeJong (2013) | Multicenter (n = 6) retrospective study (used SCIRehab dataset) No commercial party with direct financial interest in the results of this research has or will confer a benefit on the authors or on any organization with which the authors are associated Likely overlap in patient population with other SCIRehab studies; extent of overlap unknown | N = 1032 Mean age: 37.9 ±16.5 years Males: 81.3% (836/951) Follow-up: 12 months postinjury (79.1%) | Patient factors Age BMI Education Employment status (admission) Marital status Primary language Primary payer Race Sex SCI factors CMG-TW CSI (admission) FIM Cognitive score (admission)b FIM Motor score (admission)b |
|
| Furlan (2009) | Multicenter retrospective study (used NASCIS-3 database) Authors disclose no conflicting financial interests | N = 499 Mean age: NR Males: 89.8% (448/499) Follow-up: 12 months postinjury (79.3%) | Patient factors Age BAC Ethnicity Sex SCI factors Cause of SCI Complete/incomplete injury (severity of SCI) Level of injury Glasgow Coma Scale (admission) |
|
| Horn (2013) CoE: II | Multicenter (n = 6) retrospective cohort (used SCIRehab dataset) No commercial party with direct financial interest in the results of this research has or will confer a benefit on the authors or on any organization with which the authors are associated Likely overlap in patient population with other SCIRehab studies; extent of overlap unknown | N = 1031 Mean age: 37.7 ± 16.7 years Males: 81.2% Follow-up: 12 months postinjury (83.3%) | SCI factors CCI CMG-TW CSI (admission, maximum) | Motor FIM scoreb Hospitalization by 1 year postinjury |
| Iseli (1999) Abstraction of traumatic only patients | Prospective cohort study Study was supported by the Swiss National Science Foundation and the International Research Institute for Paraplegia | N = 39 Mean age: 40±16.8 years Males: 76.9% (30/39) Follow-up: 6 months (100%) | Patient factors Age SCI factors Complete/incomplete injury (severity of SCI) Initial ASIA motor score Initial ASIA sensory score SSEP recordings (tibial, pudendal) |
|
| Kay (2007) CoE: II | Retrospective cohort study No funds were provided by a commercial party with direct financial interest in the results of this study | N = 343 Mean age: 42.1 ± 18.8 years Males: 79.9% Follow-up: 60.4 ± 32.5 days (96%) | Patient factors Age SCI factors AIS Central cord syndrome Completeness of neurologic impairment |
|
| Putzke (2003) | Multicenter (n = 18) retrospective cohort study (used NSCISC data of patients admitted to Department of Education–funded MSCIS centers) Resources for the production of this manuscript were provided by the University of Alabama at Birmingham Model Spinal Cord Injury System of Care Grant from the NIDRR, OSERS, and Department of Education | N = 6128 Mean age: 39.0±13.3 years Males: 80% (4913/6128) Follow-up: 12 months (79.4%) | Patient factors Age |
|
| Sipski (2004) | Multicenter (n = 20) retrospective cohort study (used data of patients admitted to MSCIS centers) No funds were provided by a commercial party with direct financial interest in the results of this study | N = 14 433 Mean age: 31.8 ± 15.0 years Males: 81.5% Follow-up: 12 months postinjury (83.7%) | Patient factors Age Sex |
|
| Teeter (2012) | Multicenter (n = 6) retrospective cohort study (used SCIRehab dataset and NSCISC database) No commercial party with direct financial interest in the results of this research has or will confer a benefit on the authors or on any organization with which the authors are associated Likely overlap in patient population with other SCIRehab studies; extent of overlap unknown | N = 1032 Mean age: 37.7 ± 16.7 years Males: 81.2% Follow-up: 12 months postinjury (80.4%) | Patient factors Age BMI Education Employment status (admission) Marital status Primary language Primary payer Race/ethnic group Sex SCI factors AIS Cause of SCI CSI (admission) FIM cognitive score (admission)b FIM motor score (admission)b Time from injury to admission |
|
| Tian (2013) | Multicenter (n = 6) retrospective cohort study (used SCIRehab dataset and NSCISC database) No commercial party with direct financial interest in the results of this research has or will confer a benefit on the authors or on any organization with which the authors are associated Likely overlap in patient population with other SCIRehab studies; extent of overlap unknown | N = 1032 Mean age: 37.7 ± 16.7 years Males: 80.9% Follow-up: 12 months postinjury (85.2%) | Patient factors BMI |
|
| Whiteneck (2012) | Multicenter (n = 6) retrospective cohort study (used SCIRehab dataset and NSCISC database) The contents of this article were developed under grants provided to the Craig Hospital, the Mount Sinai School of Medicine, and the Rehabilitation Institute of Chicago from the NIDRR, Office of Rehabilitative Services and US Department of Education Likely overlap in patient population with other SCIRehab studies, extent of overlap unknown | N = 1032 Mean age: 37.7 ± 16.7 years Males: 81% Follow-up: 12 months postinjury (83.2%) | Patient factors Age BMI Education Employment status (admission) Marital status Primary language Primary payer Race/ethnic group Sex SCI factors AIS Cause of SCI CSI (admission) FIM cognitive score (admission)b FIM motor score (admission)b Time from injury to admission |
|
Abbreviations: AIS, ASIA Impairment Scale; ASIA, American Spinal Injury Association; BAC, blood alcohol concentration; BMI, body mass index; CCI, Charlston Comorbidity Index; CMG-TW, case-mix group-tier weight; CoE, class of evidence; CSI, comprehensive severity index; FIM, Functional Independence Measure; MSCIS, Model Spinal Cord Injury Systems; NASCIS, National Acute Spinal Cord Injury Study; NIDRR, National Institute on Disability and Rehabilitation Research; NR, not reported; NSCISC, National Spinal Cord Injury Statistical Center; OSERS, Office of Special Education and Rehabilitation Services; PHQ, patient health questionnaire; SCI, spinal cord injury; SF-12, Short Form-12; SSEP, somatosensory-evoked potentials; SWLS, Satisfaction With Life Scale.
ASIA grade/AIS: categorizes motor and sensory impairment in patients with SCI: (A) complete—no sensory or motor function is preserved in sacral segments S4-S5; (B) incomplete—sensory, but not motor, function is preserved below the neurologic level and extends through sacral segments S4-S5; (C) incomplete—motor function is preserved below the neurologic level, and most key muscles below the neurologic level have muscle grades less than 3; (D) incomplete—motor function is preserved below the neurologic level, and most key muscles below the neurologic level have muscle gradess greater than or equal to 3; (E) normal—sensory and motor functions are normal.
ASIA Motor Score: sum of strength grades for all 10 key muscles bilaterally; scores range from 0 – 100, with lower scores indicating greater disability.
Barthel Scale Independence: Independent if patient can perform basic self-care activities such as feeding, dressing, washing, toileting, transferring, and moving (in wheelchair or walking) without the presence of a helping individual, but perhaps with assistive devices. In this sense, independence corresponds to a Barthel index of more than 60.
FIM score: a clinician-reported measure for the level of a patient’s disability; indicates how much assistance is required for the individual to carry out activities of daily living; scores range from 18 to 126, with lower scores indicating greater disability. In Cifu et al (1999), motor scores range from 13 to 91 and cognitive scores range from 5 to 35 (higher scores denoting greater levels of independence).
Level of preserved neurological function: Improvement was defined as a dichotomous (0 to 1) variable for left side, right side, either side, and both sides. For left-side improvement, a score of 1 was assigned to patients whose left level of preserved neurologic function was 1 or more levels greater at 1-year than at MSCIS admission; a score of 0 was assigned in all other cases. Right-side improvement was likewise defined. Patients with improvement on either side were given a score of 1 for “either side improvement” and 0 otherwise. Bilateral improvement was defined as improvement in both the left and the right side.
NASCIS motor score: Motor scores included assessment of 14 muscle segments from each body side. Each segment was scored 0 (no contraction), 1 (reduced contraction), 2 (active movement without gravity), 3 (active movement with resistance), 4 (function reduced but active movement against resistance), or 5 (normal function). Unilateral expanded motor scores varied from 0 (no contraction in any muscle) to 70 (normal motor function in 14 muscles).
PHQ-9: Contains nine questions about the frequency of depression symptoms. A higher score indicates greater symptomatology; proxy responses were not allowed.
SWLS: Life satisfaction based on responses to 5 questions addressing global life satisfaction: 5 statements on a 7-point Likert-type scale (1: completely disagree, 7: completely agree). Scores range from 7 to 35, with higher scores indicating greater life satisfaction.
a Coleman’s “marked recovery” was defined as improvement of at least 2 grades on the Modified Benzel Scale at week 26.
b FIM motor and transfer scores were Rasch-transformed.