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The influence of age on functional recovery of adults with spinal cord injury or disease after inpatient rehabilitative care: a pilot study

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Abstract

Background and aims

The impact of age on functional recovery after spinal cord injury/disease (SCI/D) is still unclear. Given this, we sought to examine the potential influence of patient’s age on functional recovery following SCI/D.

Methods

This retrospective cohort study included consecutive adults with SCI/D admitted to a tertiary rehabilitation center from January 2003 to April 2004. The main outcome was functional recovery during inpatient rehabilitation. Functional recovery was assessed using the Spinal Cord Independence Measure (SCIM) and Functional Independence Measure (FIM). FIM and SCIM mean admission scores were subtracted from mean discharge scores and compared to thresholds for minimal clinically important differences. Potential confounders included gender, mechanism of SCI/D, level, and severity of SCI/D.

Results

There were 30 patients (11 females, 19 males; ages 30–83 years) with traumatic (n = 11) or non-traumatic SCI/D (n = 19). Mean baseline SCIM and FIM scores were 55.1 ± 4.3 and 82.7 ± 3.6, respectively. After a mean follow-up time of 71 days, patients achieved a mean SCIM of 70.6 ± 4.2 and mean FIM score of 107.3 ± 2.8. SCIM scores were not associated with age in the analyses either using univariate analysis (p = 0.137) or regression analysis (p = 0.215). FIM scores were not associated with age either using univariate analysis (p = 0.266) or regression analysis (p = 0.551).

Conclusions

Our results indicate that age is not associated with functional recovery after rehabilitation for SCI/D. Clinicians and allied health professionals should have a greater awareness of the potential of adult patients with SCI/D to achieve functional recovery regardless of age.

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References

  1. Dobriansky PJ, Suzman RM, Hodes RJ (2007) Why population aging matters: a global perspective. US Department of State, US Department of Health and Human Services, National Institute on Aging, National Institutes of Health, Washington, DC, USA

  2. Cifu D, Seel R, Kreutzer J, Martwitz J, McKinley W, Wisor D (1999) Age, outcome, and rehabilitation costs after tetraplegia spinal cord injury. NeuroRehabilitation 12:177–185

    Google Scholar 

  3. Cifu DX, Huang ME, Kolakowsky-Hayner SA, Seel RT (1999) Age, outcome, and rehabilitation costs after paraplegia caused by traumatic injury of the thoracic spinal cord, conus medullaris, and cauda equina. J Neurotrauma 16(9):805–815

    Article  PubMed  CAS  Google Scholar 

  4. Cifu DX, Seel RT, Kreutzer JS, McKinley WO (1999) A multicenter investigation of age-related differences in lengths of stay, hospitalization charges, and outcomes for a matched tetraplegia sample. Arch Phys Med Rehabil 80(7):733–740

    Article  PubMed  CAS  Google Scholar 

  5. Seel RT, Huang ME, Cifu DX, Kolakowsky-Hayner SA, McKinley WO (2001) Age-related differences in length of stays, hospitalization costs, and outcomes for an injury-matched sample of adults with paraplegia. J Spinal Cord Med 24(4):241–250

    PubMed  CAS  Google Scholar 

  6. Furlan JC, Bracken MB, Fehlings MG (2010) Is age a key determinant of mortality and neurological outcome after acute traumatic spinal cord injury? Neurobiol Aging 31:434–446

    Article  PubMed  Google Scholar 

  7. McKinley W, Cifu D, Seel R et al (2003) Age-related outcomes in persons with spinal cord injury: a summary paper. NeuroRehabilitation 18(1):83–90

    PubMed  Google Scholar 

  8. Stucki G (2005) International Classification of Functioning, Disability, and Health (ICF): a promising framework and classification for rehabilitation medicine. Am J Phys Med Rehabil 84(10):733–740

    Article  PubMed  Google Scholar 

  9. CIHI (2007) The burden of neurological diseases, disorders and injuries in Canada. Canadian Institute for Health Information (CIHI), Ottawa

    Google Scholar 

  10. Dawson J, Shamley D, Jamous MA (2008) A structured review of outcome measures used for the assessment of rehabilitation interventions for spinal cord injury. Spinal Cord 46(12):768–780

    Article  PubMed  CAS  Google Scholar 

  11. Itzkovich M, Gelernter I, Biering-Sorensen F et al (2007) The Spinal Cord Independence Measure (SCIM) version III: reliability and validity in a multi-center international study. Disabil Rehabil 29(24):1926–1933

    Article  PubMed  CAS  Google Scholar 

  12. Keith RA, Granger CV, Hamilton BB, Sherwin FS (1987) The functional independence measure: a new tool for rehabilitation. Adv Clin Rehabil 1:6–18

    PubMed  CAS  Google Scholar 

  13. Kirshblum S, Millis S, McKinley W, Tulsky D (2004) Late neurologic recovery after traumatic spinal cord injury. Arch Phys Med Rehabil 85(11):1811–1817

    Article  PubMed  Google Scholar 

  14. Dodds TA, Martin DP, Stolov WC, Deyo RA (1993) A validation of the functional independence measurement and its performance among rehabilitation inpatients. Arch Phys Med Rehabil 74(5):531–536

    Article  PubMed  CAS  Google Scholar 

  15. Catz A, Itzkovich M, Agranov E, Ring H, Tamir A (1997) SCIM-spinal cord independence measure: a new disability scale for patients with spinal cord lesions. Spinal Cord 35(12):850–856

    Article  PubMed  CAS  Google Scholar 

  16. Ottenbacher KJ, Hsu Y, Granger CV, Fiedler RC (1996) The reliability of the functional independence measure: a quantitative review. Arch Phys Med Rehabil 77(12):1226–1232

    Article  PubMed  CAS  Google Scholar 

  17. Beninato M, Gill-Body KM, Salles S, Stark PC, Black-Schaffer RM, Stein J (2006) Determination of the minimal clinically important difference in the FIM instrument in patients with stroke. Arch Phys Med Rehabil 87(1):32–39

    Article  PubMed  Google Scholar 

  18. Catz A, Itzkovich M, Steinberg F et al (2001) The Catz-Itzkovich SCIM: a revised version of the Spinal Cord Independence Measure. Disabil Rehabil 23(6):263–268

    Article  PubMed  CAS  Google Scholar 

  19. Catz A, Itzkovich M, Agranov E, Ring H, Tamir A (2001) The spinal cord independence measure (SCIM): sensitivity to functional changes in subgroups of spinal cord lesion patients. Spinal Cord 39(2):97–100

    Article  PubMed  CAS  Google Scholar 

  20. Jakob W, Wirz M, van Hedel HJ, Dietz V (2009) Difficulty of elderly SCI subjects to translate motor recovery—“body function”—into daily living activities. J Neurotrauma 26(11):2037–2044

    Article  PubMed  Google Scholar 

  21. Hall KM, Cohen ME, Wright J, Call M, Werner P (1999) Characteristics of the Functional Independence Measure in traumatic spinal cord injury. Arch Phys Med Rehabil 80(11):1471–1476

    Article  PubMed  CAS  Google Scholar 

  22. Putzke JD, Barrett JJ, Richards JS, DeVivo MJ (2003) Age and spinal cord injury: an emphasis on outcomes among the elderly. J Spinal Cord Med 26(1):37–44

    PubMed  Google Scholar 

  23. Aito S, D’Andrea M, Werhagen L et al (2007) Neurological and functional outcome in traumatic central cord syndrome. Spinal Cord 45(4):292–297

    PubMed  CAS  Google Scholar 

  24. Bracken MB, Shepard MJ, Holford TR et al (1997) Administration of methylprednisolone for 24 or 48 hours or tirilazad mesylate for 48 hours in the treatment of acute spinal cord injury. Results of the Third National Acute Spinal Cord Injury Randomized Controlled Trial. National Acute Spinal Cord Injury Study. JAMA 277(20):1597–1604

    Article  PubMed  CAS  Google Scholar 

  25. Furlan JC, Bracken MB, Fehlings M (2009) The impact of age on mortality, impairment and disability among adults with acute traumatic spinal cord injury. J Neurotrauma 26:1707–1717

    Article  PubMed  Google Scholar 

  26. Pagliacci MC, Celani MG, Zampolini M et al (2003) An Italian survey of traumatic spinal cord injury. The Gruppo Italiano Studio Epidemiologico Mielolesioni study. Arch Phys Med Rehabil 84(9):1266–1275

    Article  PubMed  Google Scholar 

  27. Lawton G, Lundgren-Nilsson A, Biering-Sorensen F et al (2006) Cross-cultural validity of FIM in spinal cord injury. Spinal Cord 44(12):746–752

    Article  PubMed  CAS  Google Scholar 

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Acknowledgments

Dr. J.C. Furlan acknowledges funding support from the Spinal Cord Injury Solutions Network (SCISN). Also, Dr. B.C. Craven acknowledges the support of Toronto Rehabilitation Institute that receives funding under the provincial rehabilitation research program from the Ministry of Health and Long Term Care in Ontario.

Conflict of interest

None.

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Authors and Affiliations

  1. Toronto Western Research Institute, University Health Network, 399 Bathurst Street, McL 12-407, Toronto, ON, M5T 2S8, Canada

    Julio C. Furlan

  2. Lyndhurst Centre, Toronto Rehabilitation Institute, Toronto, ON, Canada

    Julio C. Furlan, Sander L. Hitzig & B. Catharine Craven

  3. Division of Neurology, Department of Medicine, University of Toronto, Toronto, ON, Canada

    Julio C. Furlan

  4. Division of Physical Medicine and Rehabilitation, Department of Medicine, University of Toronto, Toronto, ON, Canada

    B. Catharine Craven

Authors
  1. Julio C. Furlan
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  2. Sander L. Hitzig
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  3. B. Catharine Craven
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Correspondence to Julio C. Furlan.

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Furlan, J.C., Hitzig, S.L. & Craven, B.C. The influence of age on functional recovery of adults with spinal cord injury or disease after inpatient rehabilitative care: a pilot study. Aging Clin Exp Res 25, 463–471 (2013). https://doi.org/10.1007/s40520-013-0066-1

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  • DOI: https://doi.org/10.1007/s40520-013-0066-1

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