A comparison of one year outcomes between standardized locomotor training and usual care after motor incomplete spinal cord injury: Community participation, quality of life and re-hospitalization

Abstract

Context/Objective:

Spinal cord injury (SCI) often results in a significant loss of mobility and independence coinciding with reports of decreased quality of life (QOL), community participation, and medical complications often requiring re-hospitalization. Locomotor training (LT), the repetition of stepping-like patterning has shown beneficial effects for improving walking ability after motor incomplete SCI, but the potential impact of LT on psychosocial outcomes has not been well-established. The purpose of this study was to evaluate one year QOL, community participation and re-hospitalization outcomes between individuals who participated in a standardized LT program and those who received usual care (UC).

Design/Setting/Participants:

A retrospective (nested case/control) analysis was completed using SCI Model Systems (SCIMS) data comparing one year post-injury outcomes between individuals with traumatic motor incomplete SCI who participated in standardized LT to those who received UC.

Outcome Measures:

Outcomes compared include the following: Satisfaction with Life Scale (SWLS™), Craig Handicap Assessment and Reporting Technique-Short Form (CHART-SF™), and whether or not an individual was re-hospitalized during the first year of injury.

Results:

Statistically significant improvements for the LT group were found in the following outcomes: SWLS (P = 0.019); and CHART subscales [mobility (P = <0.001)]; occupation (P = 0.028); with small to medium effects sizes.

Conclusion:

Individuals who completed a standardized LT intervention reported greater improvements in satisfaction with life, community participation, and fewer re-hospitalizations at one year post-injury in comparison to those who received UC. Future randomized controlled trials are needed to verify these findings.

Keywords:

• Locomotor training
• Spinal cord injury
• Community participation
• Quality of life

Acknowledgements

The following centers provided data for this analysis: Craig Hospital, Denver CO; Frazier Rehabilitation, Louisville, KY; Magee Rehabilitation, Philadelphia PA; Shepherd Center, Atlanta, GA; Kessler Rehabilitation Institute, West Orange, NJ; and TIRR Memorial Hermann, Houston, TX. Thank you to the following centers for providing data for this analysis: Craig Hospital, Denver CO; Frazier Rehabilitation, Louisville, KY; Magee Rehabilitation, Philadelphia PA; Kessler Rehabilitation Institute, West Orange NJ; Shepherd Center, Atlanta, GA; and The Institute for Rehabilitation and Research (TIRR) Memorial Hermann, Houston, TX.

Disclaimer statements

Contributors None.

Conflicts of interest Authors have no conflict of interests to declare.

Additional information

Funding

None.