Rule Predicts Ability to Walk After Spinal Cord Injury

New prediction rule gives accurate early prognosis of ability to walk after spinal cord injury

FRIDAY, March 4 (HealthDay News) -- A new clinical prediction rule, which accounts for age and four neurological variables, can predict independent walking one year following traumatic spinal cord injury, according to a study published online March 4 in The Lancet.

Joost J. van Middendorp, M.D., from the Radboud University Nijmegen Medical Centre in the Netherlands, and colleagues studied outcome measures of 492 patients with traumatic spinal cord injury who were admitted to one of 19 centers in Europe between 2001 and 2008. Patients underwent clinical examinations within 15 days of injury and follow-up one year later. Using a multivariate analysis, a clinical prediction rule, including age and neurological variables, was determined based on the international standards for neurological classification of spinal cord injury. The primary outcome was independent indoor walking ability one year after injury, according to the Spinal Cord Independence Measure. The predictive power of the models was quantified.

The researchers found that the model that used a combination of age, motor scores of the quadriceps femoris (L3) and gastrocsoleus (S1), and light touch sensation of dermatomes L3 and S1, displayed very strong discrimination in differentiating independent walkers from nonwalkers or dependent walkers. In 99 patients, the temporal validation confirmed the discerning ability of the prediction rule.

"We have developed a simple clinical prediction rule derived from data from a large prospective European database that can be used by physicians to counsel patients with traumatic spinal cord injury and their families during the initial phase after injury," the authors write.

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