Development of Walking indicators to advance the quality of spinal cord injury rehabilitation: SCI-High Project

The Journal of Spinal Cord Medicine, 2019 · DOI: 10.1080/10790268.2019.1647385 · Published: January 1, 2019

Spinal Cord Injury Healthcare Rehabilitation

Simple Explanation

This research focuses on creating ways to measure and improve how people with spinal cord injuries or diseases (SCI/D) regain their ability to walk in Canada by 2020. Experts developed a system to evaluate walking rehabilitation quality, reviewing studies and analyzing factors that affect walking outcomes. The study defined specific indicators to track the structure, process, and outcomes of walking rehabilitation, aligning with current practices in Canada to enhance walking therapy and patient potential.

Study Duration

Not specified

Participants

Experts in walking after SCI/D

Evidence Level

Not specified

Key Findings

1
The structure indicator is the number of physical therapists using evidence-based walking interventions per number of ambulatory individuals with SCI/D.
2
The process indicator is the number of received hours of walking interventions during inpatient rehabilitation per number of ambulatory individuals with SCI/D.
3
The outcome indicators are the modified Timed Up and Go or the 10-Meter Walk Test at discharge, and the Spinal Cord Independence Measure III-Mobility subscale at 18 months post-discharge.

Research Summary

This study describes the development of structure, process and outcome indicators to improve walking rehabilitation for Canadians with SCI/D by 2020. The indicators aim to direct the timing and enhance the volume of walking therapy delivered, increasing the proportion of patients achieving their walking potential by 18 months post-rehabilitation. The selected indicators align with current clinical practice in Canada and include measures of therapist expertise, therapy hours, and patient mobility outcomes.

Practical Implications

Improved Rehabilitation Practices

The indicators will provide site-specific metrics to modify practices and inform funding policies.

Objective Outcome Measurement

The indicators will provide objective data on the amount of evidence-based walking interventions received.

Trajectory of Walking Recovery

The indicators will offer insight into whether the duration of inpatient rehabilitation is optimal for addressing walking deficits.

Study Limitations

1
The generalizability of the framework may be limited outside of Canada due to differences in healthcare practices.
2
The burden of documentation requirements for the Walking indicators has not yet been evaluated.
3
Barriers to implementation may include a perceived lack of confidence in using outcome measures and constraints of the clinical environment.

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