Changes of Functional Index according to the Degree of Completeness of Spinal Cord Injury

초록

Introduction: Initial ASIA impairment scale (AIS) in spinal cord injury (SCI) is known as the index that can inform the degree of impairment and predict the prognosis. But there are few articles about the prediction of walking or functional outcome according to initial AIS. To know whether or not initial AIS contributes to predict functional outcome, we analyzed the relationship between the degree of completeness and changes of functional index in spinal cord injured patients. Subject & method: Sixty SCI subjects (male; 47, Age 47 yrs, 5~74, cervical level 31) included. Those had rehabilitative management over 2 months following SCI from 2002 to 2009. All patients evaluated the degree of completeness through initial AIS. Following rehabilitation, several functional indices such as walking index for spinal cord injury (WISCI), spinal cord independence measure (SCIM), Korean Berg balance scale (K-BBS), Korean modified Barthel index (K-MBI) were evaluated each 2 weeks to reach plateau. We got recovery efficiency of each functional index which is divided the difference score between initial and plateau index by elapsed time. We statistically analyzed recovery efficiency of each index according to the degree of completeness. Result: Initial AIS showed A 22, B 8, C 17, D 13, so complete injury group was 22, and incomplete group 38. Recovery efficiency of two functional indices of WISCI and K-BBS revealed a statistically significant difference between completeness and incompleteness of initial SCI (p<0.05). The difference score between initial and plateau point of SCIM showed a significant between completeness and incompleteness, but not significant when the elapsed time was considered. K-MBI was not significant different according to the degree of completeness. Conclusion: To predict the recovery of the walking ability in acute or subacute SCI, the balance and walking indices such as WISCI and K-BBS were better parameters than other functional indices for ADL.