Key result
Standardized rehabilitation in patients with spinal tetraplegia yielded functional improvements of 19 points on the VLT scale and 14 points on the FIMm scale over 5-7 years.
Why the study?
The prevalence of severe spine and spinal cord injuries is increasing worldwide, but the structure and nature of functional recovery remain poorly understood.
Does a standardized rehabilitation program improve functional activities in patients with C4-D1 spinal tetraplegia?
Observational (n=190)
Does a standardized rehabilitation program improve functional activities in patients with C4-D1 spinal tetraplegia?
In patients with spinal tetraplegia, the most significant functional recovery occurs in self-care, transfer activities, and hand/pinch grasping, predominantly during the first rehabilitation cycle.
Answers are grounded in this paper and cite their sources.
Associated with sustained gains in tetraplegia; extends observational data but leaves open need for RCTs.
INTRODUCTION. The prevalence of severe spine and spinal cord injuries worldwide is increasing, while the structure and nature of recovery of lost functions remain poorly understood. AIM. To study the variability of functional activities during continued rehabilitation to distinguish pure rehabilitation goals MATERIAL AND METHODS. 190 patients with C4D1 tetraplegia 1860 years old whose were under clinical and functional follow up over a period for 57 years after spinal cord injury were examined. They were examed using the motor section of the FIM scale (FIMm), the VLT scale. The rehabilitation program was standardized and based on the National Clinical Guidelines for physical rehabilitation in spinal cord injured patients. RESULTS. At admission, the age of the patients was 31 (24.0; 43.0) years, the proportion of patients with DU C4C6 was 117 (62 %), with complete damage types A and B was 134 (70 %) patients, men 151 (79 %). Functional improvement was 19 (12.0; 28.0) points on the VLT scale; 14 (5.0; 21.0) points on the FIMm scale over the entire observation period, and was predominantly noted in the first rehabilitation cycle. The proportion of patients completely independent increased on FIMm activities: eating by 25 %, dressing the upper body by 33 %, dressing the lower body by 20 %, self-care domain by +34 %, wheelchair transfer by 21 %, walking by 5 %, and the proportion of patients completely dependent decreased: eating by 9 %, upper dressing by 13 %, lower dressing by 12 %, self-care domain by 7 %, wheelchair transfer by 21 %, wheelchair mobility by 11 %, and walking by 4.5 %. Changes on the VLT scale domains were balance domain 14 %, 1 finger 18 %, hand 26 %, and manipulation 11 %. The gain in food intake activity (FIM) was higher in patients with DU C6C8 (4050 %) and incomplete motor damage (43 %), on the VLT scale domains similar to C6C8 (1218 %), and incomplete motor damage (20 %). CONCLUSION. The most significant functional recovery occurred in self-care and transfer activities, as well as hand and pinch grasping.
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Bushkov et al. (2023) conducted an observational in Spinal tetraplegia (n=190). Standardized rehabilitation program was evaluated on Functional improvement on the VLT and FIMm scales. Standardized rehabilitation in patients with spinal tetraplegia yielded functional improvements of 19 points on the VLT scale and 14 points on the FIMm scale over 5-7 years.
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