Rehabilitation and reintegration outcomes following spinal cord injury in the UK

Abstract

Background: Spinal cord injury (SCI) is defined as a low incidence, high cost condition, however there is little information in the UK regarding the incidence, prevalence or associated costs of SCI. Additionally there is little evidence identifying outcomes or issues associated with delays in referral, admission or discharge from an SCIC or the impact of delays in provision of resources on reintegration outcomes. Research Aim: This novel study aims to determine factors and timings which may facilitate or limit successful rehabilitation and community reintegration for individuals with SCI. Map timescales and key indicators in the SCI injury and rehabilitation and reintegration pathways. Establish the impact of delays in provision of required resources on reintegration outcomes. Methods: An observational longitudinal study, collecting data regarding individuals from injury to one year post-discharge. Rehabilitation, reintegration and healthcare systems outcome measures to be evaluated were identified and included: community participation, quality of life, residential situation, readmission rate and vocational activity. Results: Delays in accessing services occur for a variety of issues and can have lasting impact. Many issues can affect progress and may have a more profound effect at particular points of the injury and rehabilitation pathway. At one year post discharge some subjects have fallen short of the identified outcomes; potential reasons for this are discussed in addition to issues that may have facilitated improved outcomes in some subjects. Conclusion: Some assumptions in SCI rehabilitation and reintegration have been challenged and some partially or fully supported. Novel findings have been identified in relation to physical social and psychological barriers or facilitators of outcomes following SCI. Potential areas for further research to increase our knowledge of issues for SCI individuals, SCIC services, acute hospital services and community services are identified.