![]() PBE studies also consider the health status of the patient when evaluating relationships between treatments/services and outcomes, since patients' health status may well impact the clinicians' choice of interventions and patients' response to those interventions. 11, 12 In general, the process of PBE involves describing and defining the content and timing of treatments/services provided in the clinical setting in order to determine which of those treatments/services are associated with the best outcomes. ![]() The study design and implementation of its practice-based evidence (PBE) methods have been described previously. This 5-year, multi-center investigation is recording and analyzing the details of the SCI inpatient rehabilitation process for approximately 1400 patients and will relate them to first-year post-injury outcomes. The ongoing SCIRehab project aims at filling the gaps in knowledge about the nature and impact of specific interventions provided in inpatient rehabilitation for traumatic SCI. A better understanding of the nature of interventions delivered in inpatient rehabilitation is critical to assessing how specific interventions relate to rehabilitation outcomes. 8, 9 and others 10 to develop systems for classifying SCI rehabilitation interventions, so that the specific components of rehabilitation programs can be described and studied in detail. In recent years, efforts have been made by van Langeveld et al. As a result, such studies provide little guidance on the interventions that rehabilitation clinicians should select for a given patient and how these interventions should be delivered to maximize positive outcomes. While these studies help build evidence for the importance of specialized inpatient rehabilitation programs for SCI, they are limited in that they provide few details about the specific interventions provided within the rehabilitation package. A number of investigations have examined the impact of the timing, intensity, or duration of inpatient rehabilitation programs on rehabilitation outcomes, and have associated participation in inpatient rehabilitation for SCI with functional gains. For many patients with SCI, the foundation of this process is laid during inpatient rehabilitation where primary goals include maximizing independence with basic skills (bed mobility, wheelchair management, and transfers), progression to ambulation if appropriate, caregiver training, provision of equipment, and education (on topics such as pressure relief, medical complications, etc.). The SCI rehabilitation process typically includes multiple phases that take place over a period of weeks, months, or years. ![]() ![]() Participation refers to activities that contribute to social and leisure skill roles, such as homemaker, sports participant, or college student. Activity limitation refers to deficits in daily tasks such as rolling in bed or propelling a wheelchair. When applying these concepts in the context of rehabilitation following SCI, body function and structure refer to impairments in sensation or motor function, range of motion (ROM) limitations, musculoskeletal pain, etc. 1 These domains include body function and structure, activity limitation, and participation. Physical therapy (PT) is a key component of the rehabilitation process following spinal cord injury (SCI), and includes a variety of interventions that address multiple domains in the International Classification of Functioning, Disability and Health (ICF) adopted by World Health Organization (WHO). ![]()
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