Development and validation of prognostic models designed to predict wheelchair skills at discharge from spinal cord injury rehabilitation

Clin Rehabil. 2010 Feb;24(2):168-80. doi: 10.1177/0269215509343248. Epub 2009 Nov 19.

Abstract

Objective: To develop and validate a statistical model to predict wheelchair skills at discharge (t(2)) from personal and lesion characteristics and wheelchair skills at the start of spinal cord injury inpatient rehabilitation (t(1)).

Design: Prospective cohort study.

Setting: Eight Dutch rehabilitation centres.

Subjects: One hundred and forty-two patients with a spinal cord injury.

Main measures: Models were developed with the performance time and ability score at t(2) as dependent variables and t(1) scores of performance time and ability score, age, gender, body mass index, level and completeness of the lesion as independent variables. The statistical models were evaluated by comparing individual estimated scores with actual measured scores.

Results: The main independent variables to predict wheelchair skills at discharge were the t(1) performance time and ability score, age, gender and lesion level. The intraclass correlation coefficient between the estimated and actual ability score was 0.79 and for the performance time 0.86. However, the 95% limits of agreement and their confidence intervals were relatively wide for both ability score (-2.3 to 3.4, range 0-8) and performance time (-12.5 to 8.2, range 11-40 seconds).

Conclusion: The prognostic models developed in this study to predict future wheelchair skills might help planning the course of rehabilitation. The models should be used with caution in daily clinical practice, but may add useful information to clinical expertise and knowledge of the individual patient.

Publication types

  • Multicenter Study

MeSH terms

  • Activities of Daily Living
  • Adult
  • Female
  • Humans
  • Male
  • Models, Statistical
  • Oxygen Consumption
  • Patient Discharge*
  • Predictive Value of Tests
  • Prognosis
  • Prospective Studies
  • Regression Analysis
  • Rehabilitation Centers
  • Reproducibility of Results
  • Spinal Cord Injuries / rehabilitation*
  • Task Performance and Analysis*
  • Wheelchairs*