Identiﬁcation of Classes of Functioning Trajectories and Their Predictors in Individuals With Spinal Cord Injury Attending Initial Rehabilitation in Switzerland

Archives of Rehabilitation Research and Clinical Translation, 2021 · DOI: https://doi.org/10.1016/j.arrct.2021.100121 · Published: January 1, 2021

Spinal Cord Injury Rehabilitation Research Methodology & Design

Simple Explanation

Spinal cord injury (SCI) can significantly impact an individual's ability to perform daily activities and participate in life. Rehabilitation is crucial to help individuals optimize their functioning after SCI. This study aimed to identify different patterns of functional recovery during initial rehabilitation after SCI and the factors that predict these patterns. The findings can help tailor rehabilitation programs to individual needs and improve clinical planning.

Study Duration

May 2013 and September 2019

Participants

748 individuals with newly acquired SCI

Evidence Level

Not specified

Key Findings

1
Four distinct classes of functioning trajectories were identified: stable high functioning, early functioning improvement, moderate functioning improvement, and slow functioning improvement.
2
Age, injury level, injury severity, and ventilator assistance were identified as robust predictors of class membership.
3
Individuals in the 'stable high functioning' class showed consistently high levels of independence, while those in the 'slow functioning improvement' class demonstrated slower progress.

Research Summary

This study aimed to identify classes of functioning trajectories in individuals with SCI undergoing initial rehabilitation in Switzerland and to examine predictors of class membership. Latent process mixed model analysis revealed four distinct classes of functioning trajectories: stable high functioning, early functioning improvement, moderate functioning improvement, and slow functioning improvement. Age, injury level, injury severity, and ventilator assistance were identified as significant predictors of the identified trajectory classes, which can inform tailored rehabilitation programs.

Practical Implications

Tailored Rehabilitation Programs

The identification of distinct functioning trajectory classes allows for the development of specifically tailored rehabilitation programs to address the unique needs of individuals with SCI.

Clinical Prediction Models

The study's findings can be used to develop clinical prediction models to assign newly injured individuals to a specific class of functioning trajectories, aiding in early intervention planning.

Improved Patient Outcomes

By understanding patient trajectories and associated factors, rehabilitation practices can be adjusted to improve patient outcomes and support more effective rehabilitation planning and management.

Study Limitations

1
The study is limited by the use of existing data for secondary analysis, restricting influence on initial data collection.
2
The Spinal Cord Independence Measure (SCIM) focuses on independence in activities of daily living and does not fully capture restrictions in 'activities and participation'.
3
Country-specific differences in clinical rehabilitation practice might limit the generalizability of the results.

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