Functional outcome of patients with spinal cord injury: rehabilitation outcome study.

OBJECTIVE To increase our knowledge of neurological recovery and functional outcome of patients with spinal cord injuries in order to make more successful rehabilitation programmes based on realistic goals. DESIGN Descriptive analysis of data gathered in an information system. SETTING Rehabilitation centre in The Netherlands with special department for patients with spinal cord injuries. SUBJECTS Fifty-five patients with traumatic spinal cord lesions admitted to the rehabilitation centre from 1988 to 1994. MAIN OUTCOME MEASURES The functional improvement was presented in terms of progress in independence in nine daily activity skills. Independence was rated on a four-point scale. RESULTS From admission to discharge, lesions in 100% of patients with tetraplegia and 96% of patients with paraplegia remained complete. Significant progress in independence was made in self-care, ambulation and bladder and bowel care. Differences were found in the extent of functional improvement between subgroups of patients with different levels and extent of lesion. Contrary to expectations based on theoretical models, patients with complete paraplegia did not achieve maximal independence in self-care. Independent walking was only attained by patients with incomplete lesions. Regarding outcome of bladder and bowel care, poor results were found, especially the independence in defaecation and toilet transfers. CONCLUSIONS The results of this study provided more insight into the functional outcome of a group of patients with traumatic spinal cord injury. More research is needed to evaluate the rehabilitation programmes for these patients.