4.3 Article

Feasibility of predicting improvements in motor function following SCI using the SCAR outcome measure: a retrospective study

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SPINAL CORD
卷 57, 期 11, 页码 966-971

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NATURE PUBLISHING GROUP
DOI: 10.1038/s41393-019-0307-z

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  1. Health Research Fund of Central Denmark Region

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Study design A retrospective study. Objectives To assess improvement in volitional motor function after SCI, using The Spinal Cord Ability Ruler (SCAR) as a metric and investigate participant characteristics and recovery of motor functioning. Setting A highly-specialized SCI rehabilitation unit (Spinal Cord Injury Centre of Western Denmark, SCIWDK). Methods Retrospectively, data on all SCI patients admitted to SCIWDK between 1 January 1997 and 1 November 2018 were extracted from a database. The SCAR score (range: 0-100) was calculated by combining items from ISNCSCI and SCIM. Results Mean (95%CI) improvement in volitional motor function was of 17.2 (CI: 14.5-19.9) equal to an improvement of 43% from baseline after median 155 days in-hospital rehabilitation. Individuals with tetraplegia exerted larger improvement (mean difference of 8.9 (CI: 3.6-14.2) points) as compared to paraplegia. Male gender predicted better improvement (p < 0.03), as did no need for mechanical ventilation with a gain of 8.5 (CI: 1.8-15.3) points as compared to those in need. Conclusions Overall mean improvement of 43% in volitional motor function was found in 84 in-hospitalized patients using SCAR as a metric at a highly-specialized SCI unit. Following factors; level-of-injury, gender, age, need of ventilation support predicted improvement in volitional motor function after a rehabilitation period. Results should be cautiously interpreted as a majority of hospitalized patients did not fulfill criteria for SCAR scoring. Prospectively designed studies with better internal validation and external validations are needed to confirm these findings.

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