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Feasibility of predicting improvements in motor function following SCI using the SCAR outcome measure: a retrospective study

Abstract

Study design

A retrospective study.

Objectives

To assess improvement in volitional motor function after SCI, using The Spinal Cord Ability Ruler (SCAR) as a metric and investigate participant characteristics and recovery of motor functioning.

Setting

A highly-specialized SCI rehabilitation unit (Spinal Cord Injury Centre of Western Denmark, SCIWDK).

Methods

Retrospectively, data on all SCI patients admitted to SCIWDK between 1 January 1997 and 1 November 2018 were extracted from a database. The SCAR score (range: 0–100) was calculated by combining items from ISNCSCI and SCIM.

Results

Mean (95%CI) improvement in volitional motor function was of 17.2 (CI: 14.5–19.9) equal to an improvement of 43% from baseline after median 155 days in-hospital rehabilitation. Individuals with tetraplegia exerted larger improvement (mean difference of 8.9 (CI: 3.6–14.2) points) as compared to paraplegia. Male gender predicted better improvement (p < 0.03), as did no need for mechanical ventilation with a gain of 8.5 (CI: 1.8–15.3) points as compared to those in need.

Conclusions

Overall mean improvement of 43% in volitional motor function was found in 84 in-hospitalized patients using SCAR as a metric at a highly-specialized SCI unit. Following factors; level-of-injury, gender, age, need of ventilation support predicted improvement in volitional motor function after a rehabilitation period. Results should be cautiously interpreted as a majority of hospitalized patients did not fulfill criteria for SCAR scoring. Prospectively designed studies with better internal validation and external validations are needed to confirm these findings.

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Data archiving

The datasets generated and analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgements

We would like to thank Prof. John Steeves at The University of British Columbia and Vancouver Coastal Health, for his assistance in the conversion of raw SCAR data.

Funding

This work was funded by Health Research Fund of Central Denmark Region.

Author information

ABJ was responsible for conducting literature search, data entry, extracting and analyzing data, interpreting results, creating figures and tables, writing the report. MT was responsible for data entry and provided feedback on the report. SKJ was responsible for data entry and provided feedback on the report. HK contributed to the design of the retrospective study, interpreting results, writing and provided feedback on the report.

Correspondence to Helge Kasch.

Ethics declarations

Statement of ethics

We certify that all applicable institutional and governmental regulations concerning the ethical use of human volunteers were followed during the course of this study.

Conflict of interest

The authors declare that they have no conflict of interest.

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