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  4. Predicting outdoor walking one-year after spinal cord injury: a retrospective multisite external validation study

Predicting outdoor walking one-year after spinal cord injury: a retrospective multisite external validation study

J Neurol Phys Ther, 2023 · DOI: 10.1097/NPT.0000000000000428 · Published: July 1, 2023

Spinal Cord InjuryRehabilitationResearch Methodology & Design

Simple Explanation

This study validates a tool (a clinical prediction rule or CPR) that helps predict if someone with a spinal cord injury (SCI) will be able to walk outside one year after their injury. The CPR uses scores from a neurological exam (ISNCSCI) taken shortly after the injury to estimate the likelihood of outdoor walking ability. The study found that the CPR is accurate in predicting outdoor walking ability and can help clinicians make better decisions about rehabilitation and care.

Study Duration
Not specified
Participants
3,721 participants
Evidence Level
Not specified

Key Findings

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    The study externally validated a clinical prediction rule (CPR) for predicting outdoor walking ability one year after spinal cord injury (SCI).
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    Using a CPR threshold ≥ 33, the study predicted outdoor walking one year after SCI with high accuracy.
  • 3
    The CPR includes L3 motor score, L5 motor score, and S1 sensory score as predictor variables.

Research Summary

This study externally validated the Canadian 2021 outdoor walking CPR using data from 12 SCIMS centers in the United States. The study found that a CPR threshold of ≥ 33, based on ISNCSCI sensory and motor scores taken within 31 days of injury, accurately predicted outdoor walking one year after SCI. The authors conclude that healthcare teams can have increased confidence in using this 3-variable CPR to predict outdoor walking ability one year post-SCI.

Practical Implications

Clinical Practice

Clinicians can use the CPR (L3/L5 myotome, S1 sensory testing) to estimate the likelihood of a patient recovering outdoor walking ability, informing rehabilitation strategies.

Rehabilitation Strategies

CPR results can help prioritize rehabilitation strategies (intensive locomotor training vs. compensatory strategies like wheelchair skills).

Future Research

The CPR can be used to stratify research participant subgroups for future clinical trials.

Study Limitations

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