Relationship of occupational therapy inpatient rehabilitation interventions and patient characteristics to outcomes following spinal cord injury: The SCIRehab Project

The Journal of Spinal Cord Medicine, 2012 · DOI: 10.1179/2045772312Y.0000000062 · Published: January 1, 2012

Simple Explanation

This study examines how occupational therapy (OT) interventions during inpatient rehabilitation, along with patient characteristics, affect outcomes for individuals with spinal cord injury (SCI) at discharge and one year later. The research looks at the link between OT treatments and results for all SCI patients and then concentrates on specific subgroups with similar needs. The study aims to understand which OT interventions contribute to desired outcomes by analyzing subgroups of patients who had motor complete injuries at both rehabilitation admission and discharge.

Study Duration

2007 to 2009

Participants

1032 patients with traumatic SCI

Evidence Level

Not specified

Key Findings

1
OT treatments, along with patient characteristics, contribute to the explained variance in multiple outcomes, including functional and social participation, after SCI.
2
The impact of OT treatment on functional outcomes is more evident when examining more homogeneous patient groupings and outcomes specific to the groupings.
3
Active patient participation during OT treatment sessions was predictive of FIM and other outcomes, highlighting the importance of patient engagement in therapy.

Research Summary

This study examined associations of occupational therapy (OT) interventions and patient demographic and injury characteristics with outcomes at discharge from inpatient rehabilitation and at 1-year post-SCI for all patients enrolled in the SCIRehab study. The relationship between OT interventions and select functional outcomes within two homogeneous subgroups: motor complete low tetraplegia (C5–C8), and motor complete paraplegia (T1–T9) were examined. OT treatments add to explained variance (in addition to patient characteristics) for multiple outcomes. The impact of OT treatment on functional outcomes is more evident when examining more homogeneous patient groupings and outcomes specific to the groupings.

Practical Implications

Tailored Treatment Plans

Rehabilitation clinicians, including OTs, can use knowledge about injury level and completeness to tailor treatment plans and guide activity selection based on patient needs.

Promote Patient Engagement

OTs should collaborate with patients to create an environment that facilitates full engagement with therapy, given the predictive nature of patient participation on functional outcomes.

Focus on Homogeneous Groupings

Examining functional outcomes within homogeneous subgroups of patients with complete injury provides a stronger understanding of the influence of OT treatments.

Study Limitations

1
The FIM may be insensitive to the small improvements in function that these treatments may achieve.
2
The taxonomy utilized to capture data were developed so that shared activities were described similarly; however, each discipline documented only their work.
3
The centers are not a probability sample, therefore, not representative of the rehabilitation centers that provide care for patients with SCI in the United States.

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