Document Type
Article
Publication Date
4-2022
Publisher
Elsevier (WB Saunders)
Source Publication
Archives of Physical Medicine and Rehabilitation
Source ISSN
0003-9993
Abstract
Objective
To characterize individuals with spinal cord injuries (SCI) who use outpatient physical therapy or community wellness services for locomotor training and predict the duration of services, controlling for demographic, injury, quality of life, and service and financial characteristics. We explore how the duration of services is related to locomotor strategy.
Design
Observational study of participants at 4 SCI Model Systems centers with survival. Weibull regression model to predict the duration of services.
Setting
Rehabilitation and community wellness facilities at 4 SCI Model Systems centers.
Participants
Eligibility criteria were SCI or dysfunction resulting in motor impairment and the use of physical therapy or community wellness programs for locomotor/gait training. We excluded those who did not complete training or who experienced a disruption in training greater than 45 days. Our sample included 62 participants in conventional therapy and 37 participants in robotic exoskeleton training.
Interventions
Outpatient physical therapy or community wellness services for locomotor/gait training.
Main Outcome Measures
SCI characteristics (level and completeness of injury) and the duration of services from medical records. Self-reported perceptions of SCI consequences using the SCI-Functional Index for basic mobility and SCI-Quality of Life measurement system for bowel difficulties, bladder difficulties, and pain interference.
Results
After controlling for predictors, the duration of services for the conventional therapy group was an average of 63% longer than for the robotic exoskeleton group, however each visit was 50% shorter in total time. Men had an 11% longer duration of services than women had. Participants with complete injuries had a duration of services that was approximately 1.72 times longer than participants with incomplete injuries. Perceived improvement was larger in the conventional group.
Conclusions
Locomotor/gait training strategies are distinctive for individuals with SCI using a robotic exoskeleton in a community wellness facility as episodes are shorter but individual sessions are longer. Participants’ preferences and the ability to pay for ongoing services may be critical factors associated with the duration of outpatient services.
Recommended Citation
Garnier-Villarreal, Mauricio; Pinto, Daniel; Mummidisetty, Chaithanya K.; Jayaraman, Arun; Tefertiller, Candy; Charlifue, Susan; Tayler, Heather B.; Chang, Shuo-Hsiu; McCombs, Nicholas; Furbish, Catherine L.; Field-Fote, Edelle C.; and Heinemann, Allen W., "Predicting Duration of Outpatient Physical Therapy Episodes for Individuals with Spinal Cord Injury Based on Locomotor Training Strategy" (2022). Physical Therapy Faculty Research and Publications. 190.
https://epublications.marquette.edu/phys_therapy_fac/190
Comments
Accepted version. Archives of Physical Medicine and Rehabilitation, Vol. 103, No. 4 (April 2022): 665-675. DOI. © 2022 Elsevier (WB Saunders). Used with permission.