New Approach to Study the Contents and Outcomes of Spinal Cord Injury Rehabilitation: the SCIRehab Project

Overview

Journal J Spinal Cord Med

Date 2009 Oct 9

PMID 19810627

Citations 45

Authors

Gale Whiteneck

Julie Gassaway

Marcel Dijkers

Amitabh Jha

Affiliations

Soon will be listed here.

Abstract

Background/objective: Limited research evidence is available to show the effectiveness of the many specific interventions provided in spinal cord injury (SCI) rehabilitation; what is available typically focuses on effects of the full rehabilitation package but not specific therapy interventions, medical procedures, patient education, or counseling. Given the problems of conducting randomized controlled trials (RCTs) in rehabilitation, practice-based evidence (PBE) research has been suggested as an alternative methodology for identifying which rehabilitation interventions are associated most strongly with positive outcomes, after controlling for patient differences. Using the PBE research methodology, the SCIRehab project attempts to "open the black box" of acute SCI rehabilitation, provide detailed information on treatments delivered by all rehabilitation disciplines, and contribute to outcomes-based guidelines for clinical decision-making.

Methods: The SCIRehab project includes 1,500 patients with acute SCI, consecutively admitted to 1 of 6 US inpatient rehabilitation facilities. Details of the rehabilitation process are captured by clinicians from multiple disciplines documenting their interventions in handheld personal digital assistants after sessions with their patients. Outcome data are abstracted from medical records (clinical outcomes data) and obtained from patient interviews at 6 and 12 months after injury. Extensive patient, injury, and other treatment characteristics are abstracted from medical records. SCIRehab is the first research project to collect detailed information on individual interventions offered by the full rehabilitation team.

Results: SCIRehab is the first research project to collect detailed information on individual interventions offered by the full rehabilitation team. These findings are presented in a series of 9 articles.

Conclusions: To date, SCIRehab's major contribution is a system for categorizing specific contributions of each discipline and a technology for documenting that detail. After data collection is complete, future manuscripts will relate those process elements to outcomes. The SCIRehab Project is an important step toward establishing outcomes-based guidelines for SCI rehabilitation.

Citing Articles

Impact of commonly administered drugs on the progression of spinal cord injury: a systematic review.

Bourguignon L, Lukas L, Kondiles B, Tong B, Lee J, Gomes T Commun Med (Lond). 2024; 4(1):213.

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Reliability of the International Spinal Cord Injury Physical Therapy-Occupational Therapy Basic Data Set.

Field-Fote E, Anderson K, Capron M, Rupp R, Jones L, Schmidt-Read M Neurotrauma Rep. 2024; 5(1):584-591.

PMID: 39036428 PMC: 11257129. DOI: 10.1089/neur.2024.0020.

Classification and Quantification of Physical Therapy Interventions across Multiple Neurological Disorders: An Italian Multicenter Network.

Bowman T, Mestanza Mattos F, Salvalaggio S, Marazzini F, Allera Longo C, Bocini S J Clin Med. 2023; 12(20).

PMID: 37892621 PMC: 10607918. DOI: 10.3390/jcm12206483.

Pharmacological management of acute spinal cord injury: a longitudinal multi-cohort observational study.

Jutzeler C, Bourguignon L, Tong B, Ronca E, Bailey E, Harel N Sci Rep. 2023; 13(1):5434.

PMID: 37012257 PMC: 10070428. DOI: 10.1038/s41598-023-31773-8.

Trans-Spinal Electrical Stimulation Therapy for Functional Rehabilitation after Spinal Cord Injury: Review.

Rahman M, Tharu N, Gustin S, Zheng Y, Alam M J Clin Med. 2022; 11(6).

PMID: 35329875 PMC: 8954138. DOI: 10.3390/jcm11061550.

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