[以色列住院康复治疗对改善脊髓损伤后日常功能的贡献]。

Harefuah Pub Date : 2024-09-01
Yaron Watts, Lilach Front, Dianne Michaeli, Elena Aidinoff, Amiram Catz, Vadim Bluvshtein
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引用次数: 0

摘要

简介脊髓损伤(SCL)后通常会出现神经和功能的改善。神经功能的改善是自然的,它提高了患者的功能潜能,而康复治疗则提高了这种潜能的实现。功能变化取决于神经系统的变化,通常并不代表康复治疗本身对功能改善的贡献。目的:评估以色列住院康复治疗对 SCL 后功能的净贡献,以及预测这种贡献的能力,这反映了康复治疗的成功与否:方法:回顾性收集2011年至2020年间接受康复治疗的SCL患者的人口统计学和临床数据。数据用于计算脊髓损伤能力实现测量指数(SCI-ARMI)得分,分离出神经系统状态对功能的影响、其在康复过程中的变化以及影响因素。数据分析采用t检验、皮尔逊相关、方差分析和方差分析:研究共纳入 1,433 名患者。他们的年龄为(54±17)岁,32%为女性,37.2%有外伤。美国脊柱损伤协会损伤量表(AIS)分级为A级的患者占11%,B级占4.8%,C级占17.3%,D级占65.9%。入院康复时 SCI-ARMI 为 52±24,出院时 SCI-ARMI 为 73.5±19(改善了 41%,p 结论:以色列的住院康复对功能改善做出了重大贡献。入院康复时的功能潜能实现率较低,这预示着 SCL 康复过程会取得更大的成功。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[THE CONTRIBUTION OF INPATIENT REHABILITATION IN ISRAEL TO THE IMPROVEMENT OF DAILY FUNCTIONING AFTER SPINAL CORD LESIONS].

Introduction: Spinal cord lesions (SCL) are usually followed by neurological and functional improvement. The neurological improvement is natural and improves the functional potential of the patients, while rehabilitation improves the realization of that potential. The functional change depends on the neurological change, and usually does not represent the contribution of rehabilitation alone to the functional improvement.

Aims: To evaluate the net contribution of inpatient rehabilitation in Israel to functioning after SCL, and the ability to predict this contribution, which reflects the success of rehabilitation.

Methods: Demographic and clinical data of SCL patients admitted to rehabilitation between 2011 and 2020 were collected retrospectively. The data were used to calculate Spinal Cord Injury Ability Realization Measurement Index (SCI-ARMI) scores, isolating the effect of neurologic status on functioning, its change during rehabilitation, and factors affecting it. Data were analyzed using t-tests, Pearson correlations, ANOVA, and ANCOVA.

Results: A total of 1,433 patients were included in the study. Their age was 54±17 years, 32% were females, and 37.2% had traumatic injuries. American Spinal Injury Association Impairment Scale (AIS) grades were A in 11% of the patients, B in 4.8%, C in 17.3% and D in 65.9%. SCI-ARMI was 52±24 at admission to rehabilitation, and 73.5±19 at discharge (41% improvement, p<0.001). Likewise, the neurological motor status and function significantly improved. SCI-ARMI improvement increased with lower admission SCI-ARMI values (r=-0.654, p<0.001) and younger age (r=-0.122, p<0.001), and correlated with longer stay in rehabilitation (r=0.261, p<0.001).

Conclusions: Inpatient rehabilitation in Israel made a substantial contribution to functional improvement. Lower realization of the functional potential at admission to rehabilitation predicted greater success in the process of SCL rehabilitation.

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