ICF Based Comprehensive Evaluation for Post-Acute Spinal Cord Injury

OBJECTIVE: To evaluate the feasibility of the ICF for initial comprehensive evaluation of early post-acute spinal cord injury. METHOD: A comprehensive evaluation of 62 early post-acute spinal cord injury (SCI) patients was conducted by rehabilitation team members, such as physicians, physical therapists, occupational therapists, nutritionists, medical social-workers, and nurses. They recorded each of their evaluation according to the ICF first level classification. The contents of the comprehensive evaluation were linked to the ICF second level categories, retrospectively. The linked codes were analyzed descriptively and were also compared with the brief ICF core set for early post-acute SCI. RESULTS: In the evaluation of early post-acute SCI patients based on the ICF first level categories, 19 items from the body functions domain, such as muscle power functions (b730) and urination functions (b620), 15 items from the body structures domain, including spinal cord and related structures (s120), 11 items from the activities and participation domain, such as transferring oneself (d420) and walking (d450), and 9 items from the environmental factors domain, e.g., health professionals (e355), were linked to the ICF second level categories. In total, 82.4% of all contents were linked to the brief ICF core set. Prognosis insight, a personal factor not linkable to an ICF code, was mentioned in 29.0% of all patients. CONCLUSION: First level ICF categories can provide a structural base for a comprehensive evaluation in early post-acute spinal cord injury. However, frequently linked items, including the brief core set, as well as personal factors should be considered via a checklist in order to prevent the omission of significant contents.

Desire for Rehabilitation Services of Patients with Spinal Cord Injury Admitted in Post-acute Rehabilitation Facilities

OBJECTIVE: To determine whether the rehabilitation desire of patients with spinal cord injury (SCI) in post-acute rehabilitation hospitals be suitable to objective parameters, and to figure out the discharge plan after post-acute rehabilitation hospitals. METHOD: 98 patients with SCI in post-acute rehabilitation hospitals were included. In order to identify rehabilitation desire, interviews were conducted among patients or their family members in a direct line. Discharge plans of patients after post-acute rehabilitation hospitals were surveyed. All participants completed demographic measures, Korean Modified Barthel Index (K-MBI) and International Classification of Functioning, Disability and Health (ICF) core-set for patients with neurological problems in post-acute rehabilitation facilities to determine the influences on rehabilitation desire. RESULTS: Most (80.6%) of patients desired more intensive rehabilitation services and 47 patients (48.0%) purposed to get physical therapy focused on motor recovery. Only 15 patients (15.3%) planned to discharge to home. Patients who planned to discharge to home had higher K-MBI score and lower numbers of decreased body functioning, activities and participation in ICF core-set than patients who would admit to another rehabilitation hospitals after discharge. CONCLUSION: Appropriate and intensive educations after spinal cord injury on the recovery process and goal of rehabilitation are required to supply adequate rehabilitation services and to avoid unnecessary admission to rehabilitation hospitals. And the rehabilitation program focusing on functional recovery should be emphasized in patients with SCI.

Desire for Rehabilitation Services of Stroke Patients Admitted in Post-acute Rehabilitation Facilities

OBJECTIVE: To determine whether the rehabilitation desire of stroke patients in post-acute rehabilitation facilities was suitable to objective parameters, and to figure out the discharge plan after post-acute rehabilitation facilities. METHOD: 107 stroke patients in post-acute rehabilitation facilities were included. In order to identify rehabilitation desire, interviews were conducted among patients or their family members in a direct line. Discharge plans of patients after post-acute rehabilitation facilities were surveyed. All participants completed demographic measures, Mini Mental Status Examination (MMSE), Korean Modified Barthel Index (K-MBI) and International Classification of Functioning, Disability and Health (ICF) core set for patients with neurological problems in post-acute rehabilitation facilities to determine the influences on rehabilitation desire. RESULTS: Most (81.3%) of the patients desired more intensive rehabilitation service and 65 patients (60.7%) purposed to get physical therapy focused on motor recovery. Only 24 patients (22.4%) planned home discharge, most (67.3%) of them did re-admission. CONCLUSION: The desire of patients in post-acute rehabilitation facilities would have a tendency of hospital staying for motor recovery in large percentage of patients. Rehabilitation desire and goal were not affected by the affected side and onset duration. Social support and extended educational program for rehabilitation for the patients and their relatives should be performed to overcome these problems.