Functional Evolution of Spinal Cord Injury Patients Followed by the Rehabilitation Team Residing Outside the Capital of Antananarivo

Abstract

Spinal cord injury rehabilitation is a complex and continuous process aimed at improving patients' functional capacity and quality of life. The objective of this study was to assess the progress of spinal cord injury patients followed by the rehabilitation team residing outside Antananarivo. A prospective descriptive cross-sectional study was conducted over a period of seven years, from 2015 to 2022, involving all patients who had previously consulted the Rehabilitation Department at CHU-JRA. Follow-up through telephone calls and/or during follow-up consultations was carried out. Of the 50 included patients, a male predominance of 76% was observed, with a mean age of 46 years. The majority were paraplegic (84%), with an ASIA classification predominantly in category A. Only 16% benefited from rehabilitation sessions in a specialized center, while 84% practiced exercises at home. Only 10% of patients achieved a high level of functional independence. However, 62% developed pressure ulcers, and the mortality rate was 28%. The study highlights the urgent need to improve accessibility to rehabilitation services in rural areas and outside the capital, as well as the importance of mastering self-rehabilitation exercises to maintain the autonomy acquired during rehabilitation sessions at the rehabilitation center.