Archives of physical medicine and rehabilitation
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Arch Phys Med Rehabil · Nov 2004
Metric properties of the ASIA motor score: subscales improve correlation with functional activities.
To apply item response theory (IRT) methods to neurologic and functional scales to determine the value of using American Spinal Injury Association (ASIA) motor subscores and ability estimates, rather than total ASIA motor scores, to predict motor FIM instrument scores. ⋯ Consistent with the metric properties of the ASIA motor score, and with recent models of disablement, impairment in SCI is more accurately characterized by using separate ASIA upper- and lower-extremity motor scores than by using a single motor score. Use of subscores for impairment should improve prediction of functional abilities and enhance more complex models of disability.
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Arch Phys Med Rehabil · Nov 2004
Comparative StudyEffects of gender on neurologic and functional recovery after spinal cord injury.
To assess gender differences in neurologic and functional outcome measures in persons with spinal cord injury (SCI). ⋯ Gender differences in SCI were seen in several areas. Women may have more natural neurologic recovery than men; however, for a given level and degree of neurologic injury, men tend to do better functionally than women at time of discharge from rehabilitation. Future prospective study of the effects of estrogen on neurologic recovery and the effects of gender on functional potential are recommended.
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To present Model Spinal Cord Injury System (MSCIS) data on late neurologic recovery after 1 year after spinal cord injury (SCI). ⋯ There was a small degree of neurologic recovery (between 1 and 5 y postinjury) after a traumatic SCI. Late conversion, between 1 and 5 years, from a neurologically complete to an incomplete injury occurred in 5.6% of cases, but in only up to 2.1% was there a conversion from motor complete to motor incomplete status. Limitations of this study included changes in the ASIA classification during the study and in the intra- and interrater reliability typically seen in longitudinal studies of the ASIA standards. Functional changes were not studied. Knowledge of the degree of late recovery may help in analyzing newer interventions to enhance recovery.
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Arch Phys Med Rehabil · Nov 2004
Comparative StudyGender and minority differences in the pain experience of people with spinal cord injury.
To examine gender and minority differences in the prevalence and severity of pain in people with traumatic-onset spinal cord injury (SCI) during follow-up, and to determine the relation of those differences to demographic characteristics, etiology of injury, and level and extent of the lesion. ⋯ Pain is a common and significant problem for the majority of people with SCI. It may interfere less frequently with work over time, which suggests that an adaptive process may be occurring. Gender differences in the pain experience did not emerge, but nonwhites tended to have a lower prevalence of pain. If pain was present, nonwhites tended to report more severe pain than did whites. Further research is needed to delineate the possible psychosocial and biomedical causes of these findings.
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Arch Phys Med Rehabil · Nov 2004
Etiology and incidence of rehospitalization after traumatic spinal cord injury: a multicenter analysis.
To examine the frequency and reasons for rehospitalization in persons with acute traumatic spinal cord injury (SCI) during follow-up years and to examine the association between rehospitalization and demographics, neurologic category, payer sources, length of stay (LOS), discharge motor FIM instrument score, and discharge residence. ⋯ Despite improvements in SCI medical management, rehospitalization rates remain high, with an increased incidence in conditions associated with the genitourinary system (including UTIs), respiratory complications (including pneumonia), and diseases of the skin (including pressure ulcers). Acutely injured patients need close follow-up to reduce morbidity and rehospitalizations.