Physical Capacity and Complications During and After Inpatient Rehabilitation for Spinal Cord Injury

A spinal cord injury (SCI) is an interruption of the neural pathways in the spinal canal and is characterized by muscle weakness, loss of sensation and autonomic dysfunction below the level of the lesion. The extent of these neurological deficits is determined by both the level and completeness of the lesion. A complete lesion results in loss of motor function and sensation in the lowest sacral segment whereas, following an incomplete lesion function in this segment is maintained.1 The SCI can either have a traumatic or a non-traumatic cause. In traumatic cases, injury is typically the result of a traffic or sporting accident, but an increasing number of injuries result from a low impact fall, for example, in those with osteoporosis.2,3 A non-traumatic SCI may be caused by metastasis, infection and spinal haemorrhage or infarction.3,4 An estimated 183 new traumatic SCI occur in The Netherlands per year, of whom 154 survive hospitalization, which corresponds to an incidence of over 10 per 1,000,000 per year.2 The incidence of non-traumatic SCI is easily underestimated because many are not registered as SCI, but this incidence largely exceeds the incidence of traumatic injuries.2,4‑6 As compared to the able-bodied population, the life expectancy of those with SCI is reduced. For example, a 20-year-old man with a traumatic paraplegia has an estimated life expectancy of 46 years, whereas an able-bodied man the same age, will have another 58 years to live.3,7 However, because the treatment of complications has improved over the past decades, the life expectancy following SCI has increased.2 Although the life expectancy may have improved, many patients report a low level of functioning and well-being.8‑10 Functioning following SCI may be threatened because most patients have complications, have a low physical capacity, and depend on others for daily activities.6,9,11,12 Therefore, it is important to investigate opportunities to optimize functioning following SCI.

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