ABSTRACT
There are many scales and methods for evaluation of spinal cord disability. Only few data are reported about the effect of either early or delayed rehabilitation programs. This study used a simple and reproducible index [Modified Barthel Index] to evaluate patients of spinal cord injury in different stages of their rehabilitation within one year. Forty patients with spinal cord injury were evaluated in this study to find the functional outcomes from rehabilitation program using the 100 point modified Barthel Index [MBI]. Also a comparative study was done between the functional outcome and the level of sensory and motor recovery using Sensory Index Score [SIS] and Motor Index Score [MIS]. Twenty patients had spinal cord injury at the level of cervical spine [tetraplegic] and the other twenty patients were paraplegic [lumbar cord injury]. Serial clinical assessment was done at admission, one month, three months, six months and one year for muscle power, sensation, self care and mobility activities. For the tetraplegic patients, our results showed significant improvement in the self care subscore assessed after six months [P<0.005] and one year [P<0.05] of rehabilitation while the mobility subscore was insignificant in the first 6 months [P> 0.05] and became significant after one year [P<0.02] of training program . The mean MIS showed insignificant improvement during the same period [P>0.05] while the Mean SIS was significantly increased [P<0.05]. A good positive correlation was found between MIS and SIS as well as between them and self care and mobility subscores. The paraplegic patients showed a significant improvement in the self care subscore in the first six months and while the mobility subscore showed a significant increase during the total rehabilitation course [P<0.05], the mean MIS and SIS was insignificantly increased. Correlation studies found a good positive association between MIS and SIS as well as between them and the self care subscore but no correlation was found between the MIS and the mobility subscore. In tetraplegic patients, improvement in self care started after 6 months, while mobility did not improve until 1 year of rehabilitation. Sensory scores improved significantly, but not mobility scores in those patients. Paraplegic patients had early mobility improvement, but the motor and sensory scores did not. Positive correlations were detected between MIS, SIS, self care and mobility in tetraplegics and the same was found in paraplegic patients with the exception of mobility subscores