Andréane Richard-Denis, Antoine Dionne, Pascal Mputu Mputu, Jean-Marc Mac-Thiong
{"title":"是否所有功能性运动不全（AIS-D）创伤性脊髓损伤患者都需要专门的住院功能康复治疗？一项前瞻性观察性队列研究提出了急性护理后居家康复的临床标准。","authors":"Andréane Richard-Denis, Antoine Dionne, Pascal Mputu Mputu, Jean-Marc Mac-Thiong","doi":"10.1080/10790268.2023.2200354","DOIUrl":null,"url":null,"abstract":"<p><strong>Context/objective: </strong>Functional motor-incomplete AIS-D traumatic spinal cord injury (tSCI) represents an important growing population in neuro-traumatology. There is thus an important need for establishing strategies to optimize SCI rehabilitation resources. This study aims at proposing eligibility criteria to select individuals who could be discharged home (home-based rehabilitation) after acute care following an AIS-D tSCI and investigate its impact on the long-term functional status and quality of life (QOL), as compared to transfer to inpatient functional rehabilitation (IFR) resources.</p><p><strong>Design: </strong>An observational prospective cohort study.</p><p><strong>Setting: </strong>A single Level-1 specialized trauma center.</p><p><strong>Participants: </strong>213 individuals sustaining an AIS-D tSCI.</p><p><strong>Interventions: </strong>Home-based rehabilitation based on clinical specific criteria to be assessed by the acute care team.</p><p><strong>Outcome measures: </strong>Functional status and QOL as assessed by the Spinal Cord Independence Measure version 3 and WHOQOL-BREF questionnaire one year following the injury, respectively.</p><p><strong>Results: </strong>A total 37.9% of individuals fulfilled proposed criteria for home-based rehabilitation after acute care. As expected, this group was significantly younger, experienced lesser comorbidities and acute complications, and showed higher motor and sensory function compared to the IFR group. Home-rehabilitation was associated with a higher long-term functional status, physical and psychological QOL, when accounting for relevant confounding factors after an acute AIS-D tSCI<i>.</i> There was no readmission due to failure of home-based rehabilitation.</p><p><strong>Conclusion: </strong>Home-based rehabilitation in selected individuals sustaining an acute AIS-D tSCI is a safe and interesting strategy to optimize the long-term outcome in terms of functional recovery, physical and psychological QOL, as well as to optimize inpatient rehabilitation resources. The proposed eligibility criteria can be used by the acute care team to select the optimal discharge orientation in this important subpopulation.</p>","PeriodicalId":50044,"journal":{"name":"Journal of Spinal Cord Medicine","volume":" ","pages":"753-764"},"PeriodicalIF":1.8000,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11378677/pdf/","citationCount":"0","resultStr":"{\"title\":\"Do all patients with functional motor-incomplete (AIS-D) traumatic spinal cord injury need specialized inpatient functional rehabilitation? <i>A prospective observational cohort study proposing clinical criteria for home-based rehabilitation after acute care</i>.\",\"authors\":\"Andréane Richard-Denis, Antoine Dionne, Pascal Mputu Mputu, Jean-Marc Mac-Thiong\",\"doi\":\"10.1080/10790268.2023.2200354\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Context/objective: </strong>Functional motor-incomplete AIS-D traumatic spinal cord injury (tSCI) represents an important growing population in neuro-traumatology. There is thus an important need for establishing strategies to optimize SCI rehabilitation resources. This study aims at proposing eligibility criteria to select individuals who could be discharged home (home-based rehabilitation) after acute care following an AIS-D tSCI and investigate its impact on the long-term functional status and quality of life (QOL), as compared to transfer to inpatient functional rehabilitation (IFR) resources.</p><p><strong>Design: </strong>An observational prospective cohort study.</p><p><strong>Setting: </strong>A single Level-1 specialized trauma center.</p><p><strong>Participants: </strong>213 individuals sustaining an AIS-D tSCI.</p><p><strong>Interventions: </strong>Home-based rehabilitation based on clinical specific criteria to be assessed by the acute care team.</p><p><strong>Outcome measures: </strong>Functional status and QOL as assessed by the Spinal Cord Independence Measure version 3 and WHOQOL-BREF questionnaire one year following the injury, respectively.</p><p><strong>Results: </strong>A total 37.9% of individuals fulfilled proposed criteria for home-based rehabilitation after acute care. As expected, this group was significantly younger, experienced lesser comorbidities and acute complications, and showed higher motor and sensory function compared to the IFR group. Home-rehabilitation was associated with a higher long-term functional status, physical and psychological QOL, when accounting for relevant confounding factors after an acute AIS-D tSCI<i>.</i> There was no readmission due to failure of home-based rehabilitation.</p><p><strong>Conclusion: </strong>Home-based rehabilitation in selected individuals sustaining an acute AIS-D tSCI is a safe and interesting strategy to optimize the long-term outcome in terms of functional recovery, physical and psychological QOL, as well as to optimize inpatient rehabilitation resources. The proposed eligibility criteria can be used by the acute care team to select the optimal discharge orientation in this important subpopulation.</p>\",\"PeriodicalId\":50044,\"journal\":{\"name\":\"Journal of Spinal Cord Medicine\",\"volume\":\" \",\"pages\":\"753-764\"},\"PeriodicalIF\":1.8000,\"publicationDate\":\"2024-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11378677/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Spinal Cord Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1080/10790268.2023.2200354\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2023/4/21 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q3\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Spinal Cord Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/10790268.2023.2200354","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/4/21 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Do all patients with functional motor-incomplete (AIS-D) traumatic spinal cord injury need specialized inpatient functional rehabilitation? A prospective observational cohort study proposing clinical criteria for home-based rehabilitation after acute care.
Context/objective: Functional motor-incomplete AIS-D traumatic spinal cord injury (tSCI) represents an important growing population in neuro-traumatology. There is thus an important need for establishing strategies to optimize SCI rehabilitation resources. This study aims at proposing eligibility criteria to select individuals who could be discharged home (home-based rehabilitation) after acute care following an AIS-D tSCI and investigate its impact on the long-term functional status and quality of life (QOL), as compared to transfer to inpatient functional rehabilitation (IFR) resources.
Design: An observational prospective cohort study.
Setting: A single Level-1 specialized trauma center.
Participants: 213 individuals sustaining an AIS-D tSCI.
Interventions: Home-based rehabilitation based on clinical specific criteria to be assessed by the acute care team.
Outcome measures: Functional status and QOL as assessed by the Spinal Cord Independence Measure version 3 and WHOQOL-BREF questionnaire one year following the injury, respectively.
Results: A total 37.9% of individuals fulfilled proposed criteria for home-based rehabilitation after acute care. As expected, this group was significantly younger, experienced lesser comorbidities and acute complications, and showed higher motor and sensory function compared to the IFR group. Home-rehabilitation was associated with a higher long-term functional status, physical and psychological QOL, when accounting for relevant confounding factors after an acute AIS-D tSCI. There was no readmission due to failure of home-based rehabilitation.
Conclusion: Home-based rehabilitation in selected individuals sustaining an acute AIS-D tSCI is a safe and interesting strategy to optimize the long-term outcome in terms of functional recovery, physical and psychological QOL, as well as to optimize inpatient rehabilitation resources. The proposed eligibility criteria can be used by the acute care team to select the optimal discharge orientation in this important subpopulation.
期刊介绍：
For more than three decades, The Journal of Spinal Cord Medicine has reflected the evolution of the field of spinal cord medicine. From its inception as a newsletter for physicians striving to provide the best of care, JSCM has matured into an international journal that serves professionals from all disciplines—medicine, nursing, therapy, engineering, psychology and social work.
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