Article

OBJECTIVE: To examine the amount and type of therapy services received in
inpatient and postdischarge settings during the first year after spinal cord
injury (SCI). DESIGN: Prospective observational longitudinal cohort design. Data
were obtained from systematic recording of interventions by clinicians and from
patient interview. SETTING: Inpatient and postdischarge rehabilitation programs.
PARTICIPANTS: Patients (N=493) with traumatic SCI admitted to 6 rehabilitation
centers participating in the SCIRehab study. INTERVENTIONS: Not applicable. MAIN
OUTCOME MEASURES: Hours of therapy by physical therapy (PT), occupational therapy
(OT), speech therapy, recreation therapy, psychology, social work/case
management, and nursing education during initial inpatient rehabilitation and
postdischarge up to the first anniversary of injury. Inpatient data were
collected prospectively by the treating clinicians; postdischarge service data
were collected by patient self-report during follow-up interviews. RESULTS: Of
the total hours spent on these rehabilitation interventions during the first year
after injury, 44% occurred after discharge from inpatient rehabilitation.
Participants received 56% of their PT hours after discharge and 52% of their OT
hours, but only a minority received any postdischarge services from other
rehabilitation disciplines. While wide variation was found in the total hours of
inpatient treatment across all disciplines, the variation in the total hours of
postdischarge services was greater, with the interquartile range of postdischarge
services being twice that of the inpatient services. CONCLUSIONS: SCI
rehabilitation is often given in a care continuum, with inpatient rehabilitation
being only the beginning. Reductions in inpatient SCI rehabilitation length of
stay are well documented, but the postdischarge services that may replace some
inpatient treatment appear to be greater than previously reported. The
availability and impact of postdischarge care should be studied in greater detail
to capture the wide array of postdischarge services and outcomes.
CI - Copyright (c) 2011 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS