Effects of early mobilization within 48 hours of injury in patients with incomplete cervical spinal cord injury.

Abstract

Objective: To investigate the effects of early mobilization within 48 h of injury on motor function and walking ability in patients with incomplete cervical spinal cord injury (SCI).

Design: A retrospective observational study.

Setting: Intensive care unit or high care unit of a university hospital emergency center.

Participants: Of 224 patients with SCI having American Spinal Injury Association impairment scale grades C and D, 158 consecutive patients hospitalized for at least 3 weeks after injury were included.

Interventions: Patients were categorized into two groups: an early mobilization group in which patients were mobilized within 48 h of injury and a delayed mobilization group in which they were mobilized after 48 h of injury.

Outcome measures: The upper extremity motor score (UEMS), lower extremity motor score (LEMS), and Walking Index for Spinal Cord Injury II (WISCI II) were compared using propensity score matching analysis.

Results: Of the 158 patients who met the eligibility criteria, 32 were matched between the groups. There was a significant difference in the change in LEMS from the initial assessment to the assessment 2 weeks postoperatively in the early mobilization group (median 9 points vs. 3 points, p < 0.05). There were no significant differences in UEMS or WISCI II.

Conclusion: Early mobilization within 48 h may improve lower extremity motor function in patients with acute incomplete cervical SCI.