Practice-Based Evidence In Spinal Cord Injury Rehabilitation

Main Category: Neurology / Neuroscience
Also Included In: Rehabilitation / Physical Therapy
Article Date: 08 Feb 2013 - 0:00 PST


The final phase of the SCIRehab Project (Phase 3) was published in the November 2012 issue of the Journal of Spinal Cord Medicine (JSCM). Nine papers comprised the Special Issue: Relationship of Inpatient Rehabilitation Interventions to Outcomes Following Spinal Cord Injury. Guest editors: J. Scott Richards, Gale Whiteneck, Daniel Lammertse, Marcel Dijkers, and Julie Gassaway. Key article available for free download via ingentaconnect.com: Whiteneck G, Gassaway J. The SCIRehab Project: What rehabilitation interventions are most strongly associated with positive outcomes after spinal cord injury? Journal of Spinal Cord Medicine 2012;35(6): 482-483.

The SCIRehab Project Phase 1 and Phase 2 articles were published in JSCM in June 2009 and March 2011, respectively. The Project was funded by the National Institute on Disability and Rehabilitation, Research Office of Rehabilitative Services, US Department of Education, to Craig Hospital (H133A060103 and H133N060005), The Mount Sinai School of Medicine (H133N060027), the National Rehabilitation Hospital (H133N060028), Rehabilitation Institute of Chicago (H133N060014) and to Shepherd Center (H133N060009), and Carolinas Rehabilitation.

The SCIRehab Project used practice-based evidence research methodology to investigate inpatient rehabilitation practices for acute spinal cord injury. The objective was to inform clinical decision-making by determining what interventions are associated with positive outcomes at discharge and one-year followup. More than 1000 clinicians collected detailed data on 460,000 interventions for 1376 patients at six sites in the US. Seven components of SCI rehabilitation were studied: psychology, nursing, physical, occupational and recreational therapy, speech-language pathology, and social work/case management. Each was defined and classified in Phase 1; treatment times were analyzed in Phase 2. Phase 3 details the associations between the interventions and patient outcomes at discharge and one-year post injury. The results provide an in-depth look at practice-based rehabilitation practices that can inform the direction of further research and guide clinicians in selecting interventions for patients with acute SCI.

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