Factors that influence functional ability in individuals with spinal cord injury: A cross-sectional, observational study

South African Journal of Physiotherapy, 2015 · DOI: 10.4102/sajp.v71i1.235 · Published: June 17, 2015

Spinal Cord Injury Participation Rehabilitation

Simple Explanation

Spinal cord injuries (SCIs) can lead to significant physical impairments and functional limitations. This study aimed to identify factors influencing functional ability in individuals with paraplegia after in-patient rehabilitation in Gauteng, South Africa. The study involved 50 participants from private and government spinal rehabilitation units. Researchers collected data on demographic and physical characteristics, neurological injury level, and functional ability using questionnaires and the Spinal Cord Independence Measure III (SCIM III). The results showed that most participants were not functionally independent at discharge. Factors such as patient age, length of rehabilitation stay, pressure sores, spasticity, injury severity, and funding type influenced functional ability.

Study Duration

April 2011 – January 2012

Participants

50 participants with paraplegia

Evidence Level

Cross-sectional, observational study

Key Findings

1
Longer stays at rehabilitation facilities were associated with higher functional independence scores, whereas scores decreased with increasing patient age.
2
Pressure sores and spasticity negatively affected functional independence scores.
3
Government funding was associated with better functional outcomes compared to other funding types.

Research Summary

This study investigated factors influencing functional ability in individuals with spinal cord injuries (SCI) at discharge from in-patient rehabilitation facilities in Gauteng, South Africa. The study found that patient age, length of rehabilitation stay, presence of pressure sores or spasticity, degree of motor ability, location of the injury, and type of funding influenced functional independence scores. Most participants were not functionally independent at discharge, highlighting the need for tailored rehabilitation therapy and consideration of factors influencing functional outcomes.

Practical Implications

Tailored Rehabilitation Therapy

Rehabilitation therapy should be tailored to address factors such as patient age, length of rehabilitation stay, pressure sores, spasticity, degree of motor ability and location of the injury.

Importance of Outpatient Rehabilitation

Emphasize the importance of outpatient rehabilitation after discharge or consider increasing the LOS to help patients reach optimal functional independence.

Close Monitoring for Functional Outcomes

Close monitoring for functional outcomes and more attention during in-patient rehabilitation is warranted for factors such as advanced age, short rehabilitation stays, the presence of pressure sores or spasticity, low ASIA motor scores and high-level SCIs.

Study Limitations

1
The study did not focus on the functional ability of the participants on admission into rehabilitation.
2
Psychosocial factors were not considered.
3
The type and duration of daily therapy sessions or the level and intensity of spasticity were not examined.

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