Abstract
Study design
Population cohort study.Objectives
Propose a new paradigm of using a descriptive approach - rather than a predictive tool - to estimate the ambulation potential after traumatic spinal cord injury (TSCI).Setting
30 trauma and rehabilitation centers across Canada participating in the Rick Hansen SCI Registry.Methods
A retrospective study of 1209 patients from the Rick Hansen Spinal Cord Injury Registry was conducted. The outcome was the level of outdoor walking 12 months following the SCI: dependent vs. limited vs. independent community ambulators. The actual ambulation outcomes were stratified by AIS severity grade, and by main phenotypes of individuals sharing similar baseline characteristics determined by classification tree analysis.Results
The proportion of participants achieving dependent, limited and independent community ambulation were respectively 94, 4.7 and 1.6% for AIS grade A SCI; 72, 16 and 12% for AIS grade B; 50, 23 and 28% for AIS grade C; and 11, 24 and 65% for AIS grade D. In addition to AIS grade, main phenotypes for ambulation outcomes were associated with lower extremity motor score (LEMS) and mechanism of injury for AIS grade B SCI, as well as LEMS and age for AIS grade C and D SCI.Conclusions
This study proposes a paradigm shift to describe rather than predict ambulation outcomes after TSCI, using a descriptive chart characterizing the potential for recovering community ambulation based on real outcomes observed in the general TSCI population, in order to facilitate estimating the ambulation potential early after TSCI.