Identification of Classes of Functioning Trajectories and Their Predictors in Individuals With Spinal Cord Injury Attending Initial Rehabilitation in Switzerland
Objectives: To identify classes of functioning trajectories in individuals with spinal cord injury (SCI) undergoing initial rehabilitation after injury and to examine potential predictors of class membership to inform clinical planning of the rehabilitation process. Design: Longitudinal analysis of...
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| Format: | Article |
| Language: | English |
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Elsevier
2021-06-01
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| Series: | Archives of Rehabilitation Research and Clinical Translation |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2590109521000252 |
| _version_ | 1818668383244124160 |
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| author | Jsabel Hodel, MSc Cristina Ehrmann, PhD Anke Scheel-Sailer, MD Gerold Stucki, MD, MS Jerome E. Bickenbach, PhD, LLB Birgit Prodinger, PhD |
| author_facet | Jsabel Hodel, MSc Cristina Ehrmann, PhD Anke Scheel-Sailer, MD Gerold Stucki, MD, MS Jerome E. Bickenbach, PhD, LLB Birgit Prodinger, PhD |
| author_sort | Jsabel Hodel, MSc |
| collection | DOAJ |
| description | Objectives: To identify classes of functioning trajectories in individuals with spinal cord injury (SCI) undergoing initial rehabilitation after injury and to examine potential predictors of class membership to inform clinical planning of the rehabilitation process. Design: Longitudinal analysis of the individual's rehabilitation stay using data from the Inception Cohort of the Swiss Spinal Cord Injury Cohort Study (SwiSCI). Setting: Initial rehabilitation in specialized centers in Switzerland. Participants: Individuals with newly acquired SCI (N=748; mean age, 54.66±18.38y) who completed initial rehabilitation between May 2013 and September 2019. The cohort was primarily composed of men (67.51%), persons with paraplegia (56.15%), incomplete injuries (67.51%), and traumatic etiologies (55.48%). Interventions: Not applicable. Main Outcome Measures: Functioning was operationalized with the interval-based sum score of the Spinal Cord Independence Measure version III (SCIM III). For each individual, the SCIM III sum score was assessed at up to 4 time points during rehabilitation stay. The corresponding time of assessment was recorded by the difference in days between the SCIM III assessment and admission to the rehabilitation program. Results: Latent process mixed model analysis revealed 4 classes of functioning trajectories within the present sample. Class-specific predicted mean functioning trajectories describe stable high functioning (n=307; 41.04%), early functioning improvement (n=39; 5.21%), moderate functioning improvement (n=287; 38.37%), and slow functioning improvement (n=115; 15.37%), respectively. Out of 12 tested factors, multinomial logistic regression showed that age, injury level, injury severity, and ventilator assistance were robust predictors that could distinguish between identified classes of functioning trajectories in the present sample. Conclusions: The current study establishes a foundation for future research on the course of functioning of individuals with SCI in initial rehabilitation by identifying classes of functioning trajectories. This supports the development of specifically tailored rehabilitation programs and prediction models, which can be integrated into clinical rehabilitation planning. |
| first_indexed | 2024-12-17T06:35:27Z |
| format | Article |
| id | doaj.art-3718ac0cad6d456ea258d3cb739f96d5 |
| institution | Directory Open Access Journal |
| issn | 2590-1095 |
| language | English |
| last_indexed | 2024-12-17T06:35:27Z |
| publishDate | 2021-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Archives of Rehabilitation Research and Clinical Translation |
| spelling | doaj.art-3718ac0cad6d456ea258d3cb739f96d52022-12-21T22:00:01ZengElsevierArchives of Rehabilitation Research and Clinical Translation2590-10952021-06-0132100121Identification of Classes of Functioning Trajectories and Their Predictors in Individuals With Spinal Cord Injury Attending Initial Rehabilitation in SwitzerlandJsabel Hodel, MSc0Cristina Ehrmann, PhD1Anke Scheel-Sailer, MD2Gerold Stucki, MD, MS3Jerome E. Bickenbach, PhD, LLB4Birgit Prodinger, PhD5Swiss Paraplegic Research, Nottwil, Switzerland; Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland; Corresponding author Jsabel Hodel, MSc, Swiss Paraplegic Research, Guido A. Zäch Strasse 4, Nottwil, Lucerne CH-6207, Switzerland.Swiss Paraplegic Research, Nottwil, Switzerland; Department of Health Sciences and Medicine, University of Lucerne, Lucerne, SwitzerlandDepartment of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland; Swiss Paraplegic Centre, Nottwil, SwitzerlandSwiss Paraplegic Research, Nottwil, Switzerland; Center for Rehabilitation in Global Health Systems, University of Lucerne, Lucerne, SwitzerlandSwiss Paraplegic Research, Nottwil, Switzerland; Department of Health Sciences and Medicine, University of Lucerne, Lucerne, SwitzerlandSwiss Paraplegic Research, Nottwil, Switzerland; Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland; Faculty of Applied Health and Social Sciences, Technical University of Applied Sciences Rosenheim, Rosenheim, GermanyObjectives: To identify classes of functioning trajectories in individuals with spinal cord injury (SCI) undergoing initial rehabilitation after injury and to examine potential predictors of class membership to inform clinical planning of the rehabilitation process. Design: Longitudinal analysis of the individual's rehabilitation stay using data from the Inception Cohort of the Swiss Spinal Cord Injury Cohort Study (SwiSCI). Setting: Initial rehabilitation in specialized centers in Switzerland. Participants: Individuals with newly acquired SCI (N=748; mean age, 54.66±18.38y) who completed initial rehabilitation between May 2013 and September 2019. The cohort was primarily composed of men (67.51%), persons with paraplegia (56.15%), incomplete injuries (67.51%), and traumatic etiologies (55.48%). Interventions: Not applicable. Main Outcome Measures: Functioning was operationalized with the interval-based sum score of the Spinal Cord Independence Measure version III (SCIM III). For each individual, the SCIM III sum score was assessed at up to 4 time points during rehabilitation stay. The corresponding time of assessment was recorded by the difference in days between the SCIM III assessment and admission to the rehabilitation program. Results: Latent process mixed model analysis revealed 4 classes of functioning trajectories within the present sample. Class-specific predicted mean functioning trajectories describe stable high functioning (n=307; 41.04%), early functioning improvement (n=39; 5.21%), moderate functioning improvement (n=287; 38.37%), and slow functioning improvement (n=115; 15.37%), respectively. Out of 12 tested factors, multinomial logistic regression showed that age, injury level, injury severity, and ventilator assistance were robust predictors that could distinguish between identified classes of functioning trajectories in the present sample. Conclusions: The current study establishes a foundation for future research on the course of functioning of individuals with SCI in initial rehabilitation by identifying classes of functioning trajectories. This supports the development of specifically tailored rehabilitation programs and prediction models, which can be integrated into clinical rehabilitation planning.http://www.sciencedirect.com/science/article/pii/S2590109521000252Latent class analysisLogistic modelsLongitudinal studiesObservational studyRehabilitationSpinal cord injuries |
| spellingShingle | Jsabel Hodel, MSc Cristina Ehrmann, PhD Anke Scheel-Sailer, MD Gerold Stucki, MD, MS Jerome E. Bickenbach, PhD, LLB Birgit Prodinger, PhD Identification of Classes of Functioning Trajectories and Their Predictors in Individuals With Spinal Cord Injury Attending Initial Rehabilitation in Switzerland Archives of Rehabilitation Research and Clinical Translation Latent class analysis Logistic models Longitudinal studies Observational study Rehabilitation Spinal cord injuries |
| title | Identification of Classes of Functioning Trajectories and Their Predictors in Individuals With Spinal Cord Injury Attending Initial Rehabilitation in Switzerland |
| title_full | Identification of Classes of Functioning Trajectories and Their Predictors in Individuals With Spinal Cord Injury Attending Initial Rehabilitation in Switzerland |
| title_fullStr | Identification of Classes of Functioning Trajectories and Their Predictors in Individuals With Spinal Cord Injury Attending Initial Rehabilitation in Switzerland |
| title_full_unstemmed | Identification of Classes of Functioning Trajectories and Their Predictors in Individuals With Spinal Cord Injury Attending Initial Rehabilitation in Switzerland |
| title_short | Identification of Classes of Functioning Trajectories and Their Predictors in Individuals With Spinal Cord Injury Attending Initial Rehabilitation in Switzerland |
| title_sort | identification of classes of functioning trajectories and their predictors in individuals with spinal cord injury attending initial rehabilitation in switzerland |
| topic | Latent class analysis Logistic models Longitudinal studies Observational study Rehabilitation Spinal cord injuries |
| url | http://www.sciencedirect.com/science/article/pii/S2590109521000252 |
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