The effectiveness of inpatients rehabilitation for spinal cord patients in Siriraj hospital

Abstract

© 2015 International Spinal Cord Society. Study design:Retrospective study.Objectives:To study the effectiveness of inpatient rehabilitation in spinal cord injury (SCI) patients.Setting:Rehabilitation Medicine Department, Faculty of Medicine Siriraj Hospital.Subjects:SCI patients admitted from 2006 to 2010.Methods:Medical records of SCI patients including baseline characteristic, functional score using Barthel index (BI), length of stay (LOS) and complications were reviewed. The effectiveness and efficiency were calculated by difference of BI admission and BI discharge (ΔBI) and ΔBI/LOS, respectively. The factors associated with the effectiveness were then determined by multivariate linear regression analysis.Results:There were 201 admissions with complete data. There were 164 (81.6%) admissions that had objective for intensive rehabilitation. The average LOS was 39.8 days (s.d.=23.6). BI score was significantly increased after inpatient rehabilitation with the effectiveness of 13.0 (s.d.=15.2) and BI efficiency of 0.37 score per day (s.d.=0.47). SCI patients admitted for intensive rehabilitation goal had significantly better BI effectiveness and efficiency compared with other objective group. Only the objective of admission for intensive rehabilitation, the shorter duration of onset before admission, lower BI score on admission and absence of comorbidity were found to associate with the change of BI score.Conclusion:Inpatient rehabilitation is considered as important part for improving SCI patients' functional abilities. The shorter duration between SCI and rehabilitation, a lower BI score on admission, the absence of comorbidity and the ability to undertake an intensive rehabilitation program were positively associated with the effectiveness of rehabilitation. These factors should be taken care during inpatient rehabilitation program.