In:
Physical Therapy, Oxford University Press (OUP)
Abstract:
The Standing and Walking Assessment Tool (SWAT) standardizes the timing and content of walking assessments during inpatient rehabilitation by combining 12 stages ranging from lowest to highest function (0, 0.5, 1A, 1B, 1C, 2A, 2B, 2C, 3A, 3B, 3C, and 4) with 5 standard measures: the Berg Balance Scale, the modified Timed “Up & Go” test, the Activities-specific Balance Confidence Scale, the modified 6-Minute Walk Test, and the 10-Meter Walk Test. This study aimed to determine if the SWAT at rehabilitation discharge could predict outdoor walking capacity 1-year after discharge in people with traumatic spinal cord injury. Methods This retrospective study used data obtained from the Rick Hansen Spinal Cord Injury Registry from 2014 to 2020. Community outdoor walking capacity was measured using the Spinal Cord Independence Measure III (SCIM III) outdoor mobility score obtained 12 (4) months after discharge. Of 206 study participants, 90 were community nonwalkers (i.e., SCIM III score 0–3), 41 were community walkers with aids (i.e., SCIM III score 4–6), and 75 were independent community walkers (i.e., SCIM III score 7–8). Bivariate, multivariable regression, and an area under the receiver operating characteristic curve analyses were performed. Results At rehabilitation discharge 3 significant SWAT associations were confirmed: 0-3A with community nonwalkers, 3B/higher with community walkers with and without an aid, and 4 with independent community walkers. Moreover, at discharge, a higher (Berg Balance Scale, Activities-specific Balance Confidence scale), faster (modified Timed “Up & Go,” 10-Meter Walk Test), or further (10-Meter Walk Test) SWAT measure was significantly associated with independent community walking. Multivariable analysis indicated that all SWAT measures, except the 10-Meter Walk Test, were significant predictors of independent community walking. Further, the Activities-specific Balance Confidence scale had the highest area under the receiver operating characteristic score (0.91), demonstrating an excellent ability to distinguish community walkers with aids from independent community walkers. Conclusion The SWAT stage and measures at discharge can predict community outdoor walking capacity in persons with traumatic spinal cord injury. Notably, a patient’s confidence in performing activities plays an important part in achieving walking ability in the community. Impact The discharge SWAT is useful to optimize discharge planning.
Type of Medium:
Online Resource
ISSN:
0031-9023
,
1538-6724
Language:
English
Publisher:
Oxford University Press (OUP)
Publication Date:
2023
detail.hit.zdb_id:
2008745-7
Bookmarklink