Impact of Patient Counseling and Socioeconomic Factors on Initiation of Rehabilitation Program in Spinal Cord Injury Patients Presenting to a Tertiary Spine Unit in India

Overview

Journal Asian Spine J

Date 2020 Sep 3

PMID 32872761

Citations 1

Authors

Siddharth Narasimhan Aiyer

Vignesh Gunasekaran

Latha Mani

Sri Vijay Anand K S

Shanmuganathan Rajasekaran

Ajoy Prasad Shetty

Affiliations

Soon will be listed here.

Abstract

Study Design: Prospective case series.

Purpose: This study aimed to investigate the impact of education, financial income, occupation, and patient counseling on the timing of enrolment in a spinal cord injury (SCI) rehabilitation program.

Overview Of Literature: A rehabilitation program following SCI is essential to improve functional outcomes. Socioeconomic factors can affect the timing of enrolment to a rehabilitation program. Literature on the effects of socioeconomic factors among patients with SCI in the Indian scenario is limited.

Methods: A prospective, consecutive analysis of patients with SCI was performed with 1-year follow-up. Assessment of the timing of enrolment to a rehabilitation program was performed using the modified Kuppuswamy socioeconomic scores (MKSS). Patients admitted to the SCI unit (group A), underwent intensive individual, group, and family counseling sessions to encourage early enrolment into a rehabilitation program. Patients presenting directly for rehabilitation (group B) were analyzed for comparison.

Results: A total of 153 patients were recruited. Group A was composed of 122 patients who started the rehabilitation program after a mean of 28 days, compared with a mean of 149 days for 31 patients in group B. In group A, 104 patients (85%; mean MKSS, 14.02) and 18 patients (15%; mean MKSS, 15.61) enrolled for rehabilitation <6 weeks and ≥6 weeks, respectively. In group B, 12 patients (39%; mean MKSS, 13.69) and 19 patients (61%; mean MKSS, 12.10) enrolled for rehabilitation <6 weeks and ≥6 weeks, respectively. The total MKSS and scores for education, income, and occupation did not show a significant difference between the two both groups (p>0.05).

Conclusions: Early patient counseling in the acute care unit helps in the early enrolment of patients with poor socioeconomic demographic profile to a rehabilitation program.

Citing Articles

Therapeutic potential of small extracellular vesicles derived from mesenchymal stem cells for spinal cord and nerve injury.

Lim Y, Jung G, Park W, Seo M, Lee G Front Cell Dev Biol. 2023; 11:1151357.

PMID: 37035240 PMC: 10073723. DOI: 10.3389/fcell.2023.1151357.

References

DeVivo M . Causes and costs of spinal cord injury in the United States. Spinal Cord. 1998; 35(12):809-13. DOI: 10.1038/sj.sc.3100501. View

Chhabra H, Arora M . Demographic profile of traumatic spinal cord injuries admitted at Indian Spinal Injuries Centre with special emphasis on mode of injury: a retrospective study. Spinal Cord. 2012; 50(10):745-54. DOI: 10.1038/sc.2012.45. View

Chacko V, Joseph B, Mohanty S, Jacob T . Management of spinal cord injury in a general hospital in rural India. Paraplegia. 1986; 24(5):330-5. DOI: 10.1038/sc.1986.48. View

New P . Functional outcomes and disability after nontraumatic spinal cord injury rehabilitation: Results from a retrospective study. Arch Phys Med Rehabil. 2005; 86(2):250-61. DOI: 10.1016/j.apmr.2004.04.028. View

Fitzharris M, Cripps R, Lee B . Estimating the global incidence of traumatic spinal cord injury. Spinal Cord. 2013; 52(2):117-22. DOI: 10.1038/sc.2013.135. View

Chhabra H, Bhalla A . Influence of socio-economic status on access to different components of SCI management across Indian population. Spinal Cord. 2015; 53(11):816-20. DOI: 10.1038/sc.2015.80. View

Selvarajah S, Hammond E, Haider A, Abularrage C, Becker D, Dhiman N . The burden of acute traumatic spinal cord injury among adults in the united states: an update. J Neurotrauma. 2013; 31(3):228-38. DOI: 10.1089/neu.2013.3098. View

Lalwani S, Singh V, Trikha V, Sharma V, Kumar S, Bagla R . Mortality profile of patients with traumatic spinal injuries at a level I trauma care centre in India. Indian J Med Res. 2014; 140(1):40-5. PMC: 4181158. View

Singh A, Tetreault L, Kalsi-Ryan S, Nouri A, Fehlings M . Global prevalence and incidence of traumatic spinal cord injury. Clin Epidemiol. 2014; 6:309-31. PMC: 4179833. DOI: 10.2147/CLEP.S68889. View

10.

Bairwa M, Rajput M, Sachdeva S . Modified Kuppuswamy's Socioeconomic Scale: Social Researcher Should Include Updated Income Criteria, 2012. Indian J Community Med. 2013; 38(3):185-6. PMC: 3760330. DOI: 10.4103/0970-0218.116358. View

11.

Mathur N, Jain S, Kumar N, Srivastava A, Purohit N, Patni A . Spinal cord injury: scenario in an Indian state. Spinal Cord. 2014; 53(5):349-52. DOI: 10.1038/sc.2014.153. View

12.

Webster B, Giunti G, Young A, Pransky G, Nesathurai S . Work-related tetraplegia: cause of injury and annual medical costs. Spinal Cord. 2004; 42(4):240-7. DOI: 10.1038/sj.sc.3101526. View

13.

DeVivo M . Epidemiology of traumatic spinal cord injury: trends and future implications. Spinal Cord. 2012; 50(5):365-72. DOI: 10.1038/sc.2011.178. View

14.

. SCI facts and figures 2016. J Spinal Cord Med. 2016; 39(6):737-738. PMC: 5137566. DOI: 10.1080/10790268.2016.1253912. View

15.

Wyndaele M, Wyndaele J . Incidence, prevalence and epidemiology of spinal cord injury: what learns a worldwide literature survey?. Spinal Cord. 2006; 44(9):523-9. DOI: 10.1038/sj.sc.3101893. View

16.

Gupta N, Solomon J, Raja K . Employment after paraplegia in India: a postal survey. Spinal Cord. 2011; 49(7):806-11. DOI: 10.1038/sc.2011.1. View

17.

Cifu D, Huang M, Kolakowsky-Hayner S, Seel R . Age, outcome, and rehabilitation costs after paraplegia caused by traumatic injury of the thoracic spinal cord, conus medullaris, and cauda equina. J Neurotrauma. 1999; 16(9):805-15. DOI: 10.1089/neu.1999.16.805. View

18.

Lee B, Cripps R, Fitzharris M, Wing P . The global map for traumatic spinal cord injury epidemiology: update 2011, global incidence rate. Spinal Cord. 2013; 52(2):110-6. DOI: 10.1038/sc.2012.158. View

19.

Margolis J, Juneau P, Sadosky A, Cappelleri J, Bryce T, Nieshoff E . Health care resource utilization and medical costs of spinal cord injury with neuropathic pain in a commercially insured population in the United States. Arch Phys Med Rehabil. 2014; 95(12):2279-87. DOI: 10.1016/j.apmr.2014.07.416. View

20.

Hollingworth W, Relyea-Chew A, Comstock B, Overstreet J, Jarvik J . The risk of bankruptcy before and after brain or spinal cord injury: a glimpse of the iceberg's tip. Med Care. 2007; 45(8):702-11. DOI: 10.1097/MLR.0b013e318041f765. View