In Spinal Cord Rehab, Timing Matters

Early rehabilitation after traumatic spinal cord injury can have long-term positive effects

(RxWiki News) The human brain and nervous system have considerable healing abilities. And that is critically important for patients with spinal cord injuries.

Now, a group of researchers from several universities have looked at how early rehabilitation affects outcomes for patients with traumatic spinal cord injuries.

When these researchers used patient records to determine how the timing of rehabilitation affects disability, they found that patients who received early rehab had higher levels of function and independence.

Lead investigator Kurt Herzer, MSc, said in a press release, "In other areas of medicine, we tend to recognize that the time between an acute health event and treatment matters. Our study is interested in a similar type of relationship between time and outcomes, but extending to the ... the time from spinal cord injury to rehabilitation."

Herzer is a fellow in the Medical Scientist Training Program at Johns Hopkins University.

The brain and nervous system are neuroplastic, meaning that they can easily adapt to change. After a spinal cord injury, there's a narrow window of opportunity to take advantage of this neuroplasticity.

Rehab programs are designed to help patients learn how to manage after an injury. However, traumatic spinal cord injuries often come along with other injuries that may delay the rehab process.

Herzer and team used data from the Spinal Cord Injury Model Systems (SCIMS), which is a network of facilities that has collected data on spinal cord injury patients since 1973.

The team focused on 3,937 patients who sustained a spinal cord injury between 2000 and 2014. Most of these patients were white men, with an average age of 41. All had been admitted to a SCIMS facility within 24 hours of their injuries. The average rehab time was 19 days.

Herzer and team looked at several areas to determine each patient's outcome. These included physical disability, independence and mobility one year post-injury.

Patients who began rehab earlier had modest improvements in function and physical independence.

"This study shows that, following spinal cord injury, patients might benefit from entering inpatient rehabilitation at the earliest, clinically appropriate opportunity," Herzer said. "Patients and caregivers can discuss with their medical teams the plan and timing for transfer to rehabilitation and any concerns they may have about delays. Healthcare providers could similarly consider the value of additional days in the hospital as it relates to their treatment plans."

This study was presented Feb. 23 at the Association of Academic Physiatrists' Annual Meeting. Research presented at conferences may not have been peer-reviewed.

Information on funding sources and conflicts of interest was not available.

Review Date: 
February 21, 2016