Abstract
Background Research reports have described the contents of therapy in spinal cord injury (SCI) rehabilitation only as the total number of therapy hours. We developed the Spinal Cord Injury–Interventions Classification System (SCI-ICS) as a tool to classify therapy to improve mobility and self-care into 3 levels (body functions, basic activities, and complex activities) and 25 categories.
Objective The purposes of this study were: (1) to compare specific contents and amount of therapy provided, with the aim of improving mobility and self-care for people with SCI in Australia, Norway, and the Netherlands and (2) to evaluate the use of the SCI-ICS outside the Netherlands.
Design This was a prospective, descriptive study.
Methods Physical therapists, occupational therapists, and sports therapists in 6 centers recorded all therapy provided to all people with a recent SCI in inpatient rehabilitation during 4 designated weeks. Each treatment session was classified using 1 or more SCI-ICS codes. Duration of each intervention was specified.
Results Seventy-three therapists recorded 2,526 treatments of 79 people with SCI (Netherlands, 48; Australia, 20; Norway, 11). Most therapy time was spent on exercises (overall mean=84%) and on categories at body function and basic activity level of the SCI-ICS. Therapy time significantly differed among countries for 13 of 25 categories. Mean time in minutes per treatment (Netherlands, 28; Australia, 43; Norway, 39) and in hours per patient per week (Netherlands, 4.3; Australia, 5.8; Norway, 6.2) differed significantly.
Limitations The short period and small number of patients may have influenced the results.
Conclusions Therapy in inpatient SCI rehabilitation in all 3 countries focused on mobility and self-care exercises at body function and basic activity level, but differences were present in focus on the various categories and therapy time. The SCI-ICS can be used reliably to describe therapy in different countries.
Footnotes
Mrs van Langeveld, Dr Post, Dr van Asbeck, Dr Halvorsen, Ms Leenders, Ms Postma, and Dr Lindeman provided concept/idea/research design. Mrs van Langeveld, Dr Post, Mr Gregory, Dr Halvorsen, Ms Leenders, Ms Postma, and Dr Lindeman provided writing. Ms van Langeveld, Mr Gregory, Ms Rijken, and Ms Leenders provided data collection. Mrs van Langeveld, Dr Post, and Ms Postma provided data analysis. Mrs van Langeveld, Dr Post, Mr Gregory, Dr Halvorsen, and Dr Lindeman provided project management. Dr Lindeman provided fund procurement. Mr Gregory, Dr Halvorsen, and Ms Rijken provided participants and facilities/equipment. Dr van Asbeck, Mr Gregory, Dr Halvorsen, and Ms Postma provided institutional liaisons. Mr Gregory and Ms Rijken provided clerical support. Dr van Asbeck, Mr Gregory, Dr Halvorsen, Ms Rijken, Ms Postma, and Dr Lindeman provided consultation (including review of manuscript before submission).
The authors thank all of the therapists and other team members from the participating centers for their enthusiastic participation in this research. They also thank Dr Lisa Harvey and Dr Annelies de Wolf for their corrections in the Dutch- and English-language versions of the SCI-ICS manual and the video clips.
The study was funded by the Rehabilitation Centre De Hoogstraat, Utrecht, the Netherlands.
- Received December 18, 2009.
- Accepted September 20, 2010.
