Functional independence and health-related functional status following spinal cord injury: a prospective study of the association with physical capacity.

Abstract

OBJECTIVE: To determine changes in functional independence following spinal cord injury and to evaluate the association between functional independence and physical capacity. DESIGN: Multi-centre prospective cohort study. SUBJECTS: Patients with spinal cord injury admitted for initial rehabilitation. METHODS: The motor Functional Independence Measure (FIMmotor) was determined at the start of rehabilitation (n = 176), 3 months later (n = 124), at discharge (n = 160) and one year after discharge from inpatient rehabilitation (n = 133). One year after discharge, physical and social dimensions of health-related functional status (Sickness Impact Profile 68; SIP68) were determined. On each occasion, physical capacity was established by measuring arm muscle strength, peak power output and peak oxygen uptake. RESULTS: Multi-level random coefficient analyses revealed that FIMmotor improved during inpatient rehabilitation, but stabilized thereafter. Changes in FIMmotor were associated with peak power output. Multiple regression models showed that FIMmotor and peak power output at discharge were associated with FIMmotor one year after discharge (R2 = 0.85), and that peak power output at discharge was associated with the social dimension of the SIP68 (R2 = 0.18) one year after discharge. CONCLUSION: Functional independence improves during inpatient rehabilitation, and functional independence is positively associated with peak power output.