Parameters for positive outcome of the in-hospital rehabilitation of spinal cord lesion patients: the Boberg Quality Score.
METHODS
Monocentric Cohort Study.


OBJECTIVE
Development of a multi-dimensional outcome score of the rehabilitation of spinal cord injury (SCI) patients.


METHODS
Level 1 Trauma centre with large spinal unit.


METHODS
During the rehabilitation of 161 patients with SCI between 2005 and 2007 following outcome parameters were assessed at different time points: functional status, pain, emotion, energy, sleep, social isolation, knowledge and self-management attitude. The results for these parameters were statistically evaluated with regard to different grades of paralysis and analyzed for socio-demographic influence factors. Correlation and factor analysis were then applied to evaluate the dependencies of the parameters and the dimensional structure of the applied score.


RESULTS
For all factors a positive trend was found during the course of rehabilitation. Only the functional status is caused by spinal cord lesion. Age, sex and social isolation have no direct influence on the result with regard to functional status. For interactive dependencies of the parameters a three-dimensional structure was found: Success in the parameters, emotion, energy or social status, is independent of success in the parameter functional status. The result of the functional status is, next to the type of spinal injury, mainly influenced by the self-management attitude. The level of knowledge gained during rehabilitation is independent of the success in the other parameters.


CONCLUSIONS
By the combination of functional, psychological and cognitive parameters into a result score it is possible to determine the quality of a rehabilitation process in its multiple dimensions and for different levels and grades of palsy. By this it is possible to analyze and compare the effectiveness and efficiency of rehabilitation on a national and international level. Longitudinal comparison of the long-term effects of rehabilitation after SCI is also possible, for example, in the course of follow-up examinations.


BACKGROUND
Deutsche Gesetzliche Unfallversicherung (German Statutory Occupational Accident Insurance).
Thietje
R
R
Centre for Spinal Injuries, BG Trauma Hospital Hamburg, Hamburg, Germany. r.thietje@buk-hamburg.de
Giese
R
R
Kaphengst
C
C
Runde
P
P
Schulz
A P
AP
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination; D017063:Outcome Assessment, Health Care / Q000379:methods*; D020127:Recovery of Function / Q000502:physiology*; D012047:Rehabilitation Centers; D012189:Retrospective Studies; D013119:Spinal Cord Injuries / Q000503:physiopathology* / Q000523:psychology / Q000534:rehabilitation*; D013997:Time Factors; D055815:Young Adult