title: Functional impact of multidisciplinary outpatient program on patients with chronic complete spinal cord injury.
abstract: METHODS
  Prospective study.
  
  
  OBJECTIVE
  The objective of this study was to determine whether an integrated and an intensive outpatient program would result in functional improvement of spinal cord injury (SCI) patients with American Spinal Injury Association Impairment Scale (AIS) A injuries as measured by the Spinal Cord Independence Measure (SCIM III).
  
  
  METHODS
  Patient recruitment and evaluations were conducted at the Brain and Spinal Injury Repair Research Centre (BASIR), Tehran, Iran.
  
  
  METHODS
  Observed SCIM III scores and SCI Ability Realization Measurement Index changes were used to measure the change in 134 patients with complete SCI (AIS A), after participation in an outpatient rehabilitation program consisting of a bimonthly multidisciplinary education program, combined with a twice-weekly occupational therapy, physical therapy and home nursing as a rehabilitation package for a 6-month period.
  
  
  RESULTS
  A significant increase in median total SCIM III scores following comparison of 'pre-treatment' scores and final 'post-treatment' scores (9.5 score, P<0.001) was found. The increase in final SCIM III scores was highest in lower cervical (8.75 scores) and thoracic cases (13.5 scores). With the exception of high cervical patients, all subgroups had a significant SCIM III score improvement.
  
  
  CONCLUSIONS
  Multidisciplinary, outpatient rehabilitation programs are recommended as a safe and an effective post-injury rehabilitation for AIS A SCI patients. Such programs may complement inpatient rehabilitation and promote functional recovery. Multidisciplinary outpatient programs are effective in achieving long-term independence in SCI patients and reducing the cost of care for developing countries. This study suggests that high cervical injuries benefit more from inpatient programs.
authors.affiliation: Brain and Spinal Injury Repair Research Center (BASIR), Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: N
authors.initials: N
authors.lastname: Derakhshanrad
authors.affiliation: Brain and Spinal Injury Repair Research Center (BASIR), Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: F
authors.initials: F
authors.lastname: Vosoughi
authors.affiliation: Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: M S
authors.initials: MS
authors.lastname: Yekaninejad
authors.affiliation: Department of Neurology, UCLA, Los Angeles, CA, USA.
authors.forename: P
authors.initials: P
authors.lastname: Moshayedi
authors.affiliation: Brain and Spinal Injury Repair Research Center (BASIR), Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.|Department of Neurosurgery, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: H
authors.initials: H
authors.lastname: Saberi
mesh_terms: D000293:Adolescent; D000328:Adult; D016009:Chi-Square Distribution; D002908:Chronic Disease; D004185:Disability Evaluation; D005260:Female; D006701:Home Nursing / Q000379:methods*; D006801:Humans; D007492:Iran; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009788:Occupational Therapy / Q000379:methods*; D010045:Outpatients; D026741:Physical Therapy Modalities; D011446:Prospective Studies; D012047:Rehabilitation Centers / Q000706:statistics & numerical data; D013119:Spinal Cord Injuries / Q000534:rehabilitation*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult