PMID- 34800478
OWN - NLM
STAT- MEDLINE
DCOM- 20220405
LR  - 20220511
IS  - 1532-821X (Electronic)
IS  - 0003-9993 (Linking)
VI  - 103
IP  - 4
DP  - 2022 Apr
TI  - Rehabilitation Length of Stay, Body Mass Index, and Functional Improvement Among 
      Adults With Traumatic Spinal Cord Injury.
PG  - 657-664
LID - S0003-9993(21)01560-4 [pii]
LID - 10.1016/j.apmr.2021.09.017 [doi]
AB  - OBJECTIVE: To examine the modifying effect of body mass index (BMI) on the 
      association between rehabilitation length of stay (LOS), severity of injury, and 
      motor FIM (mFIM) improvement in patients with traumatic spinal cord injury 
      (TSCI). DESIGN: Retrospective cohort study. SETTING: Seventeen SCI Model Systems 
      (SCIMS) centers in the United States. PARTICIPANTS: A total of 3413 patients 
      (N=3413) who had a TSCI were admitted to an SCIMS between October 2011 and August 
      2018. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: The mFIM (12 items) 
      improvement by discharge. Four rehabilitation LOS groups split by quartiles were 
      created for each neurologic severity of injury group (C1-C4 level with American 
      Spinal Injury Association Impairment Scale [AIS] ABC, C5-C8 AIS ABC, T1-S3 AIS 
      ABC, AIS DE). The interrelationship among rehabilitation LOS, BMI, and mFIM 
      improvement were examined using multivariate linear regressions. A stratified 
      analysis was performed to examine the association between rehabilitation LOS and 
      mFIM improvement by BMI status (underweight or normal weight, overweight, 
      obesity) and neurologic groups. RESULTS: A total of 1099 (32.2%) and 821 (24.1%) 
      patients were overweight and had obesity, respectively. Patients with obesity had 
      less improvement in mFIM than those who were underweight or normal weight (unit 
      of mFIM improvement, -3.71). After stratifying by BMI status, among patients with 
      obesity, those with the longest rehabilitation LOS showed greater improvement in 
      mFIM than those in the shortest LOS (unit of mFIM improvement=4.78). CONCLUSIONS: 
      Longer inpatient rehabilitation LOS may benefit patients with TSCI by increasing 
      mFIM improvement by discharge. Obesity is negatively associated with mFIM 
      improvement.
CI  - Published by Elsevier Inc.
FAU - Kao, Yu-Hsiang
AU  - Kao YH
AD  - Behavioral and Community Health Sciences, School of Public Health, Louisiana 
      State University Health Sciences Center-New Orleans, New Orleans, LA.
FAU - Chen, Yuying
AU  - Chen Y
AD  - Department of Physical Medicine and Rehabilitation, School of Medicine, 
      University of Alabama at Birmingham, Birmingham, AL.
FAU - Deutsch, Anne
AU  - Deutsch A
AD  - The Shirley Ryan Ability Lab, Chicago, IL; Department of Physical Medicine and 
      Rehabilitation, Feinberg School of Medicine, Northwestern University, Chicago, 
      IL; RTI International, Chicago, IL.
FAU - Wen, Huacong
AU  - Wen H
AD  - Department of Physical Medicine and Rehabilitation, School of Medicine, 
      University of Alabama at Birmingham, Birmingham, AL.
FAU - Tseng, Tung-Sung
AU  - Tseng TS
AD  - Behavioral and Community Health Sciences, School of Public Health, Louisiana 
      State University Health Sciences Center-New Orleans, New Orleans, LA. Electronic 
      address: ttseng@lsuhsc.edu.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Research Support, U.S. Gov't, Non-P.H.S.
DEP - 20211117
PL  - United States
TA  - Arch Phys Med Rehabil
JT  - Archives of physical medicine and rehabilitation
JID - 2985158R
SB  - IM
MH  - Adult
MH  - Body Mass Index
MH  - Humans
MH  - Length of Stay
MH  - Recovery of Function
MH  - Retrospective Studies
MH  - *Spinal Cord Injuries/rehabilitation
MH  - *Spinal Injuries
MH  - Treatment Outcome
MH  - United States
OTO - NOTNLM
OT  - Body mass index
OT  - Length of stay
OT  - Rehabilitation
OT  - Spinal cord injuries
EDAT- 2021/11/21 06:00
MHDA- 2022/04/06 06:00
CRDT- 2021/11/20 20:10
PHST- 2021/04/13 00:00 [received]
PHST- 2021/09/12 00:00 [revised]
PHST- 2021/09/20 00:00 [accepted]
PHST- 2021/11/21 06:00 [pubmed]
PHST- 2022/04/06 06:00 [medline]
PHST- 2021/11/20 20:10 [entrez]
AID - S0003-9993(21)01560-4 [pii]
AID - 10.1016/j.apmr.2021.09.017 [doi]
PST - ppublish
SO  - Arch Phys Med Rehabil. 2022 Apr;103(4):657-664. doi: 10.1016/j.apmr.2021.09.017. 
      Epub 2021 Nov 17.