Benefits of rehabilitation for traumatic spinal cord injury. Multivariate analysis in 711 patients

Rehabilitation outcomes in C6 tetraplegia

This study reports on the rehabilitation outcome of 69 C6 tetraplegic patients admitted to the Rehabilitation Institute of Chicago during an 8 year period. All patients' last normal level was C6 bilaterally. A 100-point modified Barthel Index was used to obtain measures of functional independence in 15 self-care and mobility tasks. The population consisted of 54 males and 15 females with an average age of 29.2 years. The average number of days from injury to admission to the rehabilitation unit was 58.6 and the average length of rehabilitation stay was 108.4 days. The average Modified Barthel Index score increased from 16.6 on admission to 50.1 on discharge. The Self-Care Subscore increased from 12.8 to 32.2 and the Mobility subscore from 3.7 to 17.9. There were statistically significant increases in the number of patients able to perform all tasks except ability to don an orthosis and ability to walk 50 yards. This study documents a significant increase in function of C6 spinal cord injured patients during rehabilitation.

Spinal cord injury rehabilitation outcome: the impact of age

The effect of age on self-care and mobility skill performance after spinal cord injury was studied using a 15-task modified Barthel Index (MBI) to score functional abilities for 708 patients aged 6 through 88 years. Analysis of covariance showed no relationship between age and discharge MBI score; however, patients with paraplegia, incomplete lesions, and greater admission functional ratings had greater discharge functional scores than did those with quadriplegia, complete lesions, and lower admission scores, respectively. Advancing age was associated with increased dependence in only seven functional skills (bathing, upper and lower body dressing, stair climbing, and transfers to chair, toilet and bath) and only for patients with complete paraplegia. Other MBI component tasks and patients with complete quadriplegia, incomplete paraplegia and incomplete quadriplegia demonstrated no relationship between age and skill performance. Results of this study support the practice of providing comprehensive rehabilitation services to all patients following spinal cord injury regardless of age.