Assessments and interventions on body functions, structures and activity to prepare adults with acute spinal cord injury or disease for participation: a scoping review

Front. Rehabil. Sci., 2024 · DOI: 10.3389/fresc.2024.1272682 · Published: March 27, 2024

Simple Explanation

This review examines assessments and treatments for adults with recent spinal cord injuries (SCI/D) within the first two weeks. It focuses on restoring body structures and functions to help patients participate in activities. The review looks at physiotherapy and occupational therapy approaches used early after SCI/D. It aims to identify effective strategies for improving patients' ability to engage in daily life. By identifying useful assessments and therapies, the review hopes to standardize rehabilitation during the acute phase. This could improve care quality and life quality for people with SCI/D.

Study Duration

Not specified

Participants

Adults (≥18 years) with acute (until 14 days after the onset of the injury) spinal cord injury/disease

Evidence Level

Systematic reviews, randomized controlled trials, observational studies, clinical practice guidelines

Key Findings

1
SCIM III, ISNCSCI, and GRASSP version 2 can be used as assessments in the early phase after SCI/D.
2
Therapies in the first 14 days after SCI/D are important to avoid complications and to support functioning.
3
Due to the low quality and heterogeneity of studies, no specific and patient-tailored recommendation can be made.

Research Summary

This scoping review aimed to identify and evaluate the available evidence on assessments and interventions for body functions and structures to prepare adults with acute spinal cord SCI/D for activity and participation during the ﬁrst 14 days. The review included twelve publications, namely three systematic reviews, two randomized controlled trials, two observational studies and ﬁve clinical practice guidelines. The review concludes that early assessments and therapeutic interventions during the acute phase after SCI/D are safe and can be integrated in the clinical management of any trauma center in the acute phase.

Practical Implications

Early Assessment Implementation

Implement SCIM III, ISNCSCI and GRASSP early to establish baselines.

Acute Phase Therapy Focus

Prioritize therapies in the first 14 days to prevent complications and support function.

Future Research Directions

Conduct observational studies to substantiate therapeutic interventions in the acute phase.

Study Limitations

1
Limited to German- and English-language studies.
2
Methodological quality of the studies varied greatly.
3
Varying deﬁnitions of the acute phase after a SCI/D posed challenges in the evaluation of the studies.

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