Non-traumatic spinal cord injury: what is the ideal setting for rehabilitation?
OBJECTIVE
To survey rehabilitation physicians about management of patients with non-traumatic spinal cord injury (NTSCI).


METHODS
Postal and email survey of Australian physicians treating adult inpatients in neurological rehabilitation or Spinal Injury Units (SIUs). 59/69 returned surveys met inclusion criteria. 75% (44) of respondents were from neurological rehabilitation units (response rate 72%) and 25% (15) were from SIUs (response rate 94%). Outcomes were: incidence of NTSCI, opinion regarding ideal setting for NTSCI inpatient rehabilitation, and availability of key services for NTSCI patients in neurological rehabilitation units.


RESULTS
Estimated incidence of NTSCI was 26/million adults/year. 60% of NTSCI patients were managed in general neurological rehabilitation units. The majority of respondents (85% (50/59); 95% CI, 73%-92%) believed that the most appropriate setting for NTSCI rehabilitation was either an SIU or a neurological team that specialises in NTSCI patients. Neurological rehabilitation units offered NTSCI patients the following services: education regarding coping with NTSCI and preventing complications (55% [18/33]); specialised wheelchair and seating prescription (85% [28/33]); Environmental Control Unit training (36% [12/33]); and bladder training (97% [32/33]).


CONCLUSIONS
The most appropriate setting for rehabilitation of NTSCI patients is either a dedicated SIU or a neurological rehabilitation team that specialises in NTSCI. The organisation of inpatient rehabilitation services for NTSCI patients in Australia should be improved.
New
Peter W
PW
Department of Rehabilitation, Caulfield General Medical Centre, 260 Kooyong Rd, Melbourne, VIC 3162, Australia. p.new@cgmc.org.au
D000328:Adult; D001291:Attitude of Health Personnel; D001315:Australia / Q000453:epidemiology; D019538:Health Care Surveys; D006757:Hospital Units / Q000706:statistics & numerical data*; D006801:Humans; D009313:National Health Programs; D010348:Patient Care Team; D010820:Physicians / Q000523:psychology*; D012047:Rehabilitation Centers / Q000706:statistics & numerical data*; D012656:Self-Help Devices / Q000600:supply & distribution; D013119:Spinal Cord Injuries / Q000453:epidemiology / Q000534:rehabilitation*