Physical Therapists' Ability to Predict Future Mobility After Spinal Cord Injury

Chu, Jackie BAppSc (Physiotherapy); Harvey, Lisa A. BAppSc (Physiotherapy), GradDipAppSc (ExSpSc), MAppSc, PhD; Ben, Marsha BAppSc (Physiotherapy), MScMed; Batty, Julia BAppSc (Physiotherapy); Avis, Alexandra BAppSc (Physiotherapy); Adams, Roger PhD

Journal of Neurologic Physical Therapy:
doi: 10.1097/NPT.0b013e3182462f4f
Research Articles
Abstract

Background and Purpose: Goal setting is an important aspect of any physical therapy program. It not only determines the focus of therapy but also determines discharge planning and equipment prescription. The effectiveness of goal setting is dependent on therapists' ability to predict patients' future mobility. The purpose of this study was to determine how accurately physical therapists can predict the future mobility of people with spinal cord injuries (SCI) at the time of admission to rehabilitation.

Methods: A cohort observational study was undertaken in 2 SCI units in Sydney, Australia, where a consecutive series of 50 patients admitted for rehabilitation was recruited. At the time of admission to rehabilitation, treating therapists predicted each patient's likely future mobility. Therapists used standardized assessment scales that captured ability to mobilize in a wheelchair, transfer, move in bed, and walk. After 3 months of standard in-patient rehabilitation, patients were reassessed by blinded assessors using the same scales. Therapists' predictions on admission were compared with patients' outcomes at 3 months.

Results: There was a strong positive correlation between therapists' predictions on admission and patients' outcomes at 3 months (r = 0.53–0.92). Therapists' predictions were within 1 point of patient outcomes between 60% and 78% of the time.

Discussion and Conclusion: Physical therapists are able to accurately predict future mobility of people with SCI at the time of admission to rehabilitation. Ability to accurately predict future mobility is necessary for goal setting and for ensuring that therapy, discharge planning, and equipment prescription are appropriate. These findings are important because they indicate how much confidence patients, funders, policy makers, and administrators can have in therapists' ability to predict patients' future mobility.

Author Information

Rehabilitation Studies Unit, Northern Clinical School, Sydney School of Medicine (J.C., L.A.H) University of Sydney, Sydney, Australia; and Discipline of Physiotherapy, Faculty of Health Sciences (R.A.), University of Sydney, Sydney, Australia; Moorong Spinal Unit, Royal Rehabilitation Centre Sydney (M.B.), Sydney, Australia; Spinal Unit, Prince of Wales Hospital (J.B.), Sydney, Australia; and Spinal Unit, Royal North Shore Hospital (A.A.), Sydney, Australia.

Correspondence: Lisa A. Harvey, PhD, Rehabilitation Studies Unit, Royal Rehabilitation Centre Sydney, PO Box 6, Ryde, NSW 1680, Australia (lisa.harvey@sydney.edu.au)

This study was funded by the Rehabilitation and Disability Research Foundation.

The authors declare no conflict of interest.

© 2012 Neurology Section, APTA