Development and validation of prognostic models designed to predict wheelchair skills at discharge from spinal cord injury rehabilitation.
OBJECTIVE
To develop and validate a statistical model to predict wheelchair skills at discharge (t(2)) from personal and lesion characteristics and wheelchair skills at the start of spinal cord injury inpatient rehabilitation (t(1)).


METHODS
Prospective cohort study.


METHODS
Eight Dutch rehabilitation centres.


METHODS
One hundred and forty-two patients with a spinal cord injury.


METHODS
Models were developed with the performance time and ability score at t(2) as dependent variables and t(1) scores of performance time and ability score, age, gender, body mass index, level and completeness of the lesion as independent variables. The statistical models were evaluated by comparing individual estimated scores with actual measured scores.


RESULTS
The main independent variables to predict wheelchair skills at discharge were the t(1) performance time and ability score, age, gender and lesion level. The intraclass correlation coefficient between the estimated and actual ability score was 0.79 and for the performance time 0.86. However, the 95% limits of agreement and their confidence intervals were relatively wide for both ability score (-2.3 to 3.4, range 0-8) and performance time (-12.5 to 8.2, range 11-40 seconds).


CONCLUSIONS
The prognostic models developed in this study to predict future wheelchair skills might help planning the course of rehabilitation. The models should be used with caution in daily clinical practice, but may add useful information to clinical expertise and knowledge of the individual patient.
de Groot
S
S
Rehabilitation Center Amsterdam and Centre for Human Movement Sciences, University Medical Centre Groningen, University of Groningen, The Netherlands. s.d.groot@rcamsterdam.nl
Bevers
G E
GE
Dallmeijer
A J
AJ
Post
M W M
MW
van Kuppevelt
H J M
HJ
van der Woude
L H V
LH
D000203:Activities of Daily Living; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D015233:Models, Statistical; D010101:Oxygen Consumption; D010351:Patient Discharge; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012044:Regression Analysis; D012047:Rehabilitation Centers; D015203:Reproducibility of Results; D013119:Spinal Cord Injuries / Q000534:rehabilitation*; D013647:Task Performance and Analysis; D014910:Wheelchairs