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Titre : | Characterizing Natural Recovery of People With Initial Motor Complete Tetraplegia (2022) |
Auteurs : | Steven Kirshblum ; Amanda Botticello ; John Benedetto ; Fatma Eren ; Jayne Donovan ; Ralph J. Marino |
Type de document : | Article |
Dans : | Archives of Physical Medicine and Rehabilitation (Vol. 103, n° 4, 2022) |
Article en page(s) : | p. 649-656 |
Note générale : | https://doi.org/10.1016/j.apmr.2021.09.018 |
Langues: | Anglais |
Descripteurs : |
HE Vinci Réadaptation ; Tétraplégie ; Traumatismes de la moelle épinière |
Résumé : |
Objective
To determine the differences in neurologic recovery in persons with initial cervical American Spinal Cord Injury Association Impairment Scale (AIS) grades A and B over time. Design Retrospective analysis of data from people with traumatic cervical spinal cord injury (SCI) enrolled in the National Spinal Cord Injury Model Systems (SCIMS) database from 2011-2019. Setting SCIMS centers. Participants Individuals (N=187) with traumatic cervical (C1-C7 motor level) SCI admitted with initial AIS grade A and B injuries within 30 days of injury, age 16 years or older, upper extremity motor score (UEMS) ≤20 on both sides, and complete neurologic data at admission and follow-up between 6 months and 2 years. Interventions Not applicable. Main Outcome Measures Conversion in AIS grades, UEMS and lower extremity motor scores (LEMS), and sensory scores. Results Mean time to initial and follow-up examinations were 16.1±7.3 days and 377.5±93.4 days, respectively. Conversion from an initial cervical AIS grades A and B to motor incomplete status was 13.4% and 50.0%, respectively. The mean UEMS change for people with initial AIS grades A and B did not differ (7.8±6.5 and 8.8±6.1; P=.307), but people with AIS grade B experienced significantly higher means of LEMS change (2.3±7.4 and 8.8±13.9 (P≤.001). The increased rate of conversion to motor incomplete status from initial AIS grade B appears to be the primary driving factor of increased overall motor recovery. Individuals with initial AIS grade B had greater improvement in sensory scores. Conclusions While UEMS recovery is similar in persons with initial AIS grades A and B, the rate of conversion to motor incomplete status, LEMS, and sensory recovery are significantly different. This information is important for clinical as well as research considerations. |
Disponible en ligne : | Oui |
En ligne : | https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/article/pii/S0003999321015628#! |