Early predictors of functional independence 2 years after spinal cord injury.
OBJECTIVE
To determine: (1) how well factors measured at admission to an acute care facility predict functional independence measure (FIM) scores, use of personal care assistance, and wheelchair ownership 2 years after traumatic spinal cord injury (SCI); (2) the extent that factors measured during inpatient stay add to these predictions; and (3) if FIM scores differ through use of assistance and wheelchair ownership 2 years after SCI.


METHODS
Prospective, longitudinal.


METHODS
Tertiary care acute, rehabilitation hospitals and home settings.


METHODS
One hundred sixty SCI admissions.


METHODS
FIM, use of personal care assistance (yes/no), and wheelchair ownership (manual/electric/none) 2 years after SCI.


RESULTS
Year 2 FIM scores were highly correlated (> or = .68) to the ASIA admission and discharge light touch, pin prick, and motor scores. Admission neurological status and age accounted for 65% of year 2 FIM score variance. Adding hospital events and the discharge ASIA motor score increased prediction to 76% of the variance. A separate regression model using only year 2 neurological scores and age accounted for 73% of the total FIM variance. Discriminant function analysis indicated 86% correct classification regarding use of personal care assistance and 88% correct classification of wheelchair ownership. Using a separate cross-validation sample, overall classification accuracy for assistance was 80% and wheelchair ownership 67%. FIM scores were significantly lower in assistance users (78 +/- 24) than nonusers (120 +/- 8) and were significantly different between wheelchair ownership groups: manual (103 +/- 21), electric (61 +/- 15), and none (125 +/- 2).


CONCLUSIONS
Late disability can be predicted using early impairment measures. The FIM prediction from variables measured during the early treatment phase was as good as prediction based on concurrent measures.
Saboe
L A
LA
Physical Therapy Services, Glenrose Rehabilitation Hospital, Edmonton, Alberta, Canada.
Darrah
J M
JM
Pain
K S
KS
Guthrie
J
J
D000203:Activities of Daily Living; D000328:Adult; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008137:Longitudinal Studies; D008297:Male; D009048:Motor Skills; D011237:Predictive Value of Tests; D012047:Rehabilitation Centers; D013119:Spinal Cord Injuries / Q000534:rehabilitation*; D014910:Wheelchairs