Factors that influence functional ability in individuals with spinal cord injury: A cross-sectional, observational study

Background: Spinal cord injuries result in devastating impairments that can produce severe functional limitations. However, few documented studies have investigated the levels of function and factors that influence functional ability at discharge from in-patient rehabilitation facilities in Gauteng following such injuries. This necessitated further investigation. Method: Fifty participants were recruited for this cross-sectional, observational study. Participants were recruited from one private and one government spinal rehabilitation unit in Gauteng. A custom-developed questionnaire was used to establish the physical and demographic characteristics of the sample, whilst existing classification scales and measures were used to establish the degree of a lesion and a patient's associated functional ability. Data were analysed using descriptive statistics. Multiple regression analysis was performed to determine factors that influenced the level of functional ability. Results: Patients achieved an average functional independence score of 64.6 (+/- 27.6) at discharge according to the Spinal Cord Independence Measure III. Longer stays at rehabilitation facilities were associated with higher scores, whereas scores decreased with increasing patient age. Pressure sores and spasticity affected scores negatively. The type of funding also influenced patients' scores, with government funding being associated with the best outcome. Both the degree and the level at which the injury occurred could be considered predictive measures that influenced functional independence scores. Conclusion: Most participants were not functionally independent at discharge. Factors such as patient age, length of rehabilitation, presence of pressure sores or spasticity, degree of motor ability and location of the injury should be considered in tailoring rehabilitation therapy.