Document Detail


Problems of adaptation to wheelchair in early stage rehabilitation after spinal cord trauma.
MedLine Citation:
PMID:  17581519     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine main obstacles delaying adaptation to sitting during initial phase of rehabilitation after SCT.
SUBJECTS: 100 patients admitted with SCT (21 women, 79 men)aged between 15 and 74 years (mean age 33,5 years) observed during first hospital stay after SCT. There were 68 patients with a complete neural deficite and 32 persons with incomplete deficite. Lesion localization: C1-C7 - 63 cases; D1-D11 - 23 cases; D12-L1 - 11 cases; below L1 - 3 cases.
METHODS: Measurement of time relapsing between trauma and wheelchair adaptation. An analysis of reasons adaptation delay was performed.
RESULTS AND DICUSSION: Time of adaptation ranged from 7 to 187 (mean 40,6) days. There were no significant differences in adaption time between groups of cervical, thoracic and lumbar spine injury (Kruskall-Wallis test). Patients with incomplete neural deficite adapted to wheelchair earlier (mean time 26,9 days) than ones with plegia (mean time 45,8 days) (p<0,05) The most common reason for adaptation delay was orthostatic hypotension (68 cases). Statistically significant relation between length of intensive care related to cardio-pulmonary insufficiency and adaptation delay was observed (p=0). Among other factors responsible for adaptation delay we identified sepsis (41 cases, mean adaptation time: 52,02 days, p<0,001), lack of stabile spine fusionresulting in necessity of external trunk support , concomittant extremity injury (32 cases, mean adaptation time: 54,88 days, p<0,01), deep venous thrombosis (11 cases, mean adaptation time: 49,64 days, p<0,05), bed sores (8 cases, mean adaptation time: 49,64 days, p<0,05), psychiatic disorders (7 cases, mean adaptation time: 58,29 days, p<0,05) and heterogenic ossification (7 cases, mean adaptation time: 63,67 days, p<0,05).
CONCLUSIONS: 1. Orthostatic hypotension is the most common reason for delay of adaptation to sitting position in patient after SCT. 2. Other factors resulting in wheelchair adaptation delay incude: concomittant limb inuries, sepsis, psychiatric disorders, heterotopic ossification and decubitus ulcers. 3. Level of injury sex and age do not affect time of wheelchair adaptation. 4. Patients with an incomplete neural have adapt faster to wheelchair than ones with a complete neural deficite.
Authors:
Piotr Tederko; Halina Limanowska; Marek Krasuski; Jerzy Kiwerski
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Ortopedia, traumatologia, rehabilitacja     Volume:  8     ISSN:  1509-3492     ISO Abbreviation:  Ortop Traumatol Rehabil     Publication Date:  2006 Dec 
Date Detail:
Created Date:  2007-06-21     Completed Date:  2012-10-02     Revised Date:  2013-11-06    
Medline Journal Info:
Nlm Unique ID:  101240146     Medline TA:  Ortop Traumatol Rehabil     Country:  Poland    
Other Details:
Languages:  eng     Pagination:  672-9     Citation Subset:  -    
Affiliation:
Klinika Rehabilitacji Akademii Medycznej , Oddział II Rehabilitacji Schorzeń Narzadu Ruchu Centrum Rehabilitacji STOCER.
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