Motor, sensory and functional recovery in patients with spinal cord lesions

Abstract

The aim of this study is to evaluate the sensory, motor and functional improvement in patients with a Spinal Cord Lesion (SCL) by recording at admission, discharge and at 12 months after discharge. Fifty-five patients (29 with paraplegia and 26 with tetraplegia) admitted to our departments of Physical Medicine and Rehabilitation between December 1992-1995. Three patients were excluded as they did not give their consent. Each patient was evaluated at admission, before discharge and at 12 months after discharge. Motor status was evaluated by the motor score (MS), sensory status by the light touch score (LTS), and functional status by the Functional Independence Measure (FIM) score. Each patient was asked to complete a patient questionnaire which was developed according to the standards of the American Spinal Injury Association (ASIA) scale. Twelve patients (10 with paraplegia and two with tetraplegia) were evaluated at 12 months after discharge. Paired samples t-test was used for statistical analysis, The mean age of the patients group was 36.42 +/- 17.70 years, the mean duration of inpatient rehabilitation was 93.87 +/- 44.95 days. The SCL was due to trauma in 45 patients, 86.50% of the cases and was complete in nine patients (17.30%) and incomplete in (36.53%) with paraplegia. Six tetraplegic patients (11.53%) had complete and 18 (34.61%) incomplete lesions. The evaluation of MS, LTS and FIM scores at admission and discharge showed significant improvement in the MS and LTS in all of the patients with incomplete lesions (P < 0.001). FIM scores showed significant improvement only in those with complete or incomplete paraplegia (P < 0.05). At 12 months follow-up there was no significant change in the MS and the LTS whereas a significant change was noted in the FIM scores (P < 0.05) in 10 paraplegic patients. In summary, the results of this study indicate that rehabilitation was effective in our SCL series although the significant gain may also be attributed to the fact that 71.1% of the study group had incomplete neurological lesions.