Article

OBJECTIVE: To examine the association between body weight, therapy participation,
and functional outcomes among people with spinal cord injury (SCI). DESIGN:
Multisite prospective observational cohort study. SETTING: Six acute
rehabilitation facilities. PARTICIPANTS: Patients (N=1017) aged >/= 12 years
admitted for their initial rehabilitation after SCI. MAIN OUTCOME MEASURE: Motor FIM at inpatient rehabilitation discharge
and 1 year postinjury. RESULTS: Underweight and overweight/obese patients
consisted of 2 different clusters of SCI patients. Underweight patients were more
likely to be younger, black, less educated, single, have Medicaid as a primary
payer, and more likely to have had a cervical level injury because of violence
and vehicular-related events than their overweight and obese counterparts. We
found few significant differences in hours of therapy during inpatient
rehabilitation across weight groups. Among patients with C5-8 ASIA Impairment
Scale (AIS) grades A, B, and C injuries, underweight patients received fewer
hours of physical therapy per week than patients with a healthy weight (P=.028).
Obese patients with paraplegia AIS grades A, B, and C received more hours of
occupational therapy during their rehabilitation stay (P<.001) than other weight
groups. A higher percentage of underweight patients had pressure ulcers during
inpatient rehabilitation in C5-8 AIS grades A, B, and C and paraplegia AIS grades
A, B, and C groups. Only in the paraplegia AIS grades A, B, and C group did we
find a significant association between weight groups and discharge motor FIM
score. Regression models showed that among C1-4 AIS grades A, B, and C patients,
the overweight group had better 1-year follow-up motor FIM scores than other
weight groups. CONCLUSIONS: Patients who had an unhealthy body weight, that is,
being underweight or obese, often have therapy participation and profiles
different from those deemed healthy, or just overweight. For patients with
paraplegia AIS grades A, B, and C, being overweight or obese was associated with
diminished motor FIM outcomes at discharge from rehabilitation. The relation
between body weight status, therapy participation, and outcomes are not
consistent among study group participants.
CI - Copyright (c) 2013 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS