Relationship of therapeutic recreation inpatient rehabilitation interventions and patient characteristics to outcomes following spinal cord injury: The SCIRehab project

Objective To investigate associations of therapeutic recreation (TR) interventions during inpatient rehabilitation for patients with traumatic spinal cord injury (SCI) with functional, participation, and quality of life outcomes. Methods In this prospective observational study, data were obtained fr...

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Bibliographic Details
Published in:The journal of spinal cord medicine 2012-11, Vol.35 (6), p.547-564
Main Authors: Cahow, Claire, Gassaway, Julie, Rider, Cecilia, Joyce, Joan P., Bogenschutz, Andrew, Edens, Kelly, Kreider, Scott E. D., Whiteneck, Gale
Format: Article
Language:English
Subjects:
Activities of Daily Living
Disability Evaluation
Evidence-Based Medicine
Female
Follow-Up Studies
Hospitalization
Humans
Leisure Activities
Length of Stay
Male
Observation
Outcomes
Paraplegia
Practice-based evidence
Recreation Therapy - methods
Rehabilitation
Severity of Illness Index
Social Participation
Special Issue
Spinal cord injuries
Spinal Cord Injuries - complications
Spinal Cord Injuries - psychology
Spinal Cord Injuries - rehabilitation
Tetraplegia
Therapeutic recreation
Treatment Outcome
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Summary:Objective To investigate associations of therapeutic recreation (TR) interventions during inpatient rehabilitation for patients with traumatic spinal cord injury (SCI) with functional, participation, and quality of life outcomes. Methods In this prospective observational study, data were obtained from systematic recording of TR services by certified TR specialists, chart review, and patient interview. Results TR interventions, including exposure to community settings and leisure activities, add to the variance explained (in addition to the strong predictors of injury classification, admission motor Functional Independence Measure (FIM), and other patient characteristics) in outcomes at the time of rehabilitation discharge (FIM, discharge to home) and at the 1-year injury anniversary (FIM, working or being in school, residing at home, and societal participation as measured by the Craig Handicap Assessment and Reporting Technique (CHART)). They also are associated with less rehospitalization and less pressure development after discharge. In addition, more time spent in specific TR activities during rehabilitation is associated with more participation in the same type of activities at the 1-year injury anniversary. Conclusion(s) Greater participation in TR-led leisure skill and community activities during rehabilitation is a positive predictor of multiple outcomes at rehabilitation discharge and the 1-year injury anniversary demonstrating that TR activities are associated with a return to a productive and healthy life after SCI. Further research should focus on the impact of TR on longer-term outcomes to determine whether relationships continue or change as persons continue to adapt to their life after SCI. Note This is the fourth of nine articles in the SCIRehab series.
ISSN:1079-0268
2045-7723
DOI:10.1179/2045772312Y.0000000066