SCI was assessed by neurological examination of level of injury,
and patients were divided into 4 groups by functional prognosis to
allow comparison with the classification of SCI victims of the 2005
Pakistan earthquake used by Rathore (4): cervical (C8–C1); thoracic
(T1–T10); thoracolumbar (T11–L1); and lumbosacral (L2–S5). The
American Spinal Injury Association (ASIA) Impairment Scale (AIS;
5) was used to grade injury severity. Time to rescue, time to surgical
stabilization, and time to rehabilitation intervention were identified
primarily from hospital records.
Functional rehabilitation outcomes were evaluated as follows:
• Ambulation ability was categorized into independent walking (without
an assistive device), walking with ankle-foot orthosis (AFO),
walking with knee-ankle-foot orthosis (KAFO), and wheelchair
dependence (6).
• Wheelchair mobility was dichotomized into independent handling of
a mechanical wheelchair or dependent mechanical handling/powered
propulsion based on performance of weight shifting on wheelchair,
2-way transfer to bed, and propulsion over flat ground skills (7).
• ADL independence was represented by Modified Barthel Index
(MBI; 8) scores: 0–20 indicates total dependence; 21–60: severe
dependence; 61–90: moderate dependence; 91–99: slight dependence,
100 no dependence). (Although MBI dependency scores were
originally established in stroke patients and do not necessarily transfer
to persons with SCI, reliability and validity of the MBI in SCI
patients is good and this application of the instrument is standard
practice in China (9, 10)). ADL independence was assessed at the
beginning and end of rehabilitation programming.
SCI was assessed by neurological examination of level of injury,
and patients were divided into 4 groups by functional prognosis to
allow comparison with the classification of SCI victims of the 2005
Pakistan earthquake used by Rathore (4): cervical (C8–C1); thoracic
(T1–T10); thoracolumbar (T11–L1); and lumbosacral (L2–S5). The
American Spinal Injury Association (ASIA) Impairment Scale (AIS;
5) was used to grade injury severity. Time to rescue, time to surgical
stabilization, and time to rehabilitation intervention were identified
primarily from hospital records.
Functional rehabilitation outcomes were evaluated as follows:
• Ambulation ability was categorized into independent walking (without
an assistive device), walking with ankle-foot orthosis (AFO),
walking with knee-ankle-foot orthosis (KAFO), and wheelchair
dependence (6).
• Wheelchair mobility was dichotomized into independent handling of
a mechanical wheelchair or dependent mechanical handling/powered
propulsion based on performance of weight shifting on wheelchair,
2-way transfer to bed, and propulsion over flat ground skills (7).
• ADL independence was represented by Modified Barthel Index
(MBI; 8) scores: 0–20 indicates total dependence; 21–60: severe
dependence; 61–90: moderate dependence; 91–99: slight dependence,
100 no dependence). (Although MBI dependency scores were
originally established in stroke patients and do not necessarily transfer
to persons with SCI, reliability and validity of the MBI in SCI
patients is good and this application of the instrument is standard
practice in China (9, 10)). ADL independence was assessed at the
beginning and end of rehabilitation programming.
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