Effect of rehabilitation timing on the functional, vocational, and psychological outcomes in patients with paraplegia secondary to traumatic spinal cord injury: a retrospective cohort study
Asian Spine J. 2025 May 30. doi: 10.31616/asj.2024.0132. Online ahead of print.
ABSTRACT
STUDY DESIGN: A retrospective cohort study.
PURPOSE: To study the effect of rehabilitation timing on the functional, psychological, and vocational outcomes of patients with paraplegia secondary to traumatic spinal cord injury (SCI).
OVERVIEW OF LITERATURE: Rehabilitation of patients with SCI is vital for preventing secondary complications and early reintegration into society. However, only few studies have investigated the effects of early rehabilitation.
METHODS: Patients with paraplegia secondary to traumatic SCI (T2-L2) who underwent rehabilitation at our SCI Rehabilitation Center between January 2018 and December 2022 and who were followed up for at least 12 months were included. Patients were divided into three groups based on the rehabilitation timing after SCI: group 1 (early, within 2 weeks); group 2 (subacute, 2-6 weeks); and group 3 (delayed, >6 weeks). The three groups were compared in terms of functional outcomes, psychological status, and socioeconomic status after injury.
RESULTS: A total of 70 patients (62 men and eight women) were included; 30 were in group 1, 18 were in group 2, and 22 were in group 3. Compared with groups 1 and 2, group 3 showed the lowest improvement in mean±standard deviation (SD) Functional Independence Measure score (67.6±14.03 vs. 64.9±8.92 vs. 44.4±12.2, respectively; p<0.05) and significantly higher number of patients with severe (n=10) and extreme depression with suicidal tendency (n=4), with a mean±SD Beck Depression Inventory score of 32.6±8.4. The proportion of unemployed persons was significantly lower in groups 1 and 2 (30% and 27.7%, respectively) than in group 3 (72.2%, 16 of 22).
CONCLUSIONS: Among patients with paraplegia, rehabilitation within 6 weeks after SCI significantly improved their functional outcomes and psychological well-being and increased their chances of employment and reintegration into society.
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