title: Using Rasch motor FIM individual growth curves to inform clinical decisions for persons with paraplegia.
abstract: METHODS
  A longitudinal retrospective study.
  
  
  OBJECTIVE
  To better understand individual-level temporal change in functional status for participants with paraplegia in the National Spinal Cord Injury Database (NSCID), as measured by Rasch Transformed Motor Functional Indepedence Measure (FIM) scores.
  
  
  METHODS
  Multicenter/Multistate longitudinal study across the United States.
  
  
  METHODS
  Non-linear random effects modeling, that is, individual growth curve analysis of retrospective data obtained from the National Institute on Disability and Rehabilitation Research (NIDRR) NSCID.
  
  
  RESULTS
  We generated non-linear individual level trajectories of recovery for Rasch Transformed Motor FIM scores that rise rapidly from inpatient rehabilitation admission to a plateau. Trajectories are based on relationships between growth parameters and patient and injury factors: race, gender, level of education at admission, age at injury, neurological level at discharge, American Spinal Injury Association Impairment Scale (AIS) at discharge, days from injury to first system inpatient rehabilitation admission, rehabilitation length of stay, marital status and etiology. On the basis of study results, an interactive tool was developed to represent individual level longitudinal outcomes as trajectories based upon an individual's given baseline characteristics, that is, information supplied by the covariates and provides a robust description of temporal change for those with paraplegia within the NSCID.
  
  
  CONCLUSIONS
  This methodology allows researchers and clinicians to generate and better understand patient-specific trajectories through the use of an automated interactive tool where a nearly countless number of longitudinal paths of recovery can be explored. Projected trajectories holds promise in facilitating planning for inpatient and outpatient services, which could positively impact long term outcomes.
authors.affiliation: 1] Research Department, Craig Hospital, Englewood, CO, USA [2] Traumatic Brain Injury National Data and Statistical Center, Englewood, CO, USA.
authors.forename: C R
authors.initials: CR
authors.lastname: Pretz
authors.affiliation: Icahn School of Medicine at Mount Sinai, New York, NY, USA.
authors.forename: A J
authors.initials: AJ
authors.lastname: Kozlowski
authors.affiliation: Research Department, Craig Hospital, Englewood, CO, USA.
authors.forename: S
authors.initials: S
authors.lastname: Charlifue
authors.affiliation: National Spinal Cord Injury Statistical Center at the University of Alabama at Birmingham, Birmingham, AL, USA.
authors.forename: Y
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Rehabilitation Institute of Chicago and Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
authors.forename: A W
authors.initials: AW
authors.lastname: Heinemann
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D003657:Decision Making; D003710:Demography; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010264:Paraplegia / Q000503:physiopathology / Q000534:rehabilitation*; D012189:Retrospective Studies; D014481:United States