LONG-TERM FUNCTION FOLLOWING THE CENTRAL CORD SYNDROME

Follow-up visits were made to persons with central spinal cord injury in order to assess long term functional outcomes. An occupational therapist conducted in-home evaluations of 18 randomly selected subjects at an average time of 4 years 8 months since injury. Evaluation instruments included: the ASIA Motor Index; the Jebsen Hand Function Test; the Klein-Bell Activities of Daily Living Scale; the Feeling Tone Checklist; the Multidimensional Pain Inventory (MPI) and the Occupational Performance History Interview (OPHI)—Research Version. Spontaneous improvement in bowel and bladder function and ambulation was observed in all subjects. Despite poor hand function, subjects compensated through use of adaptive equipment to perform activities of daily living well. Most subjects reported experiencing pain and fatigue, many of them on a daily basis. A statistically significant difference was found between males and females (with females performing better) on the MPI’s scales measuring interference of pain with household chores (p < 0.005) and general activity level (p < 0.05). A statistically significant difference (p < 0.005) was also noted in adaptation to daily life before and after injury, as measured by the OPHI. The study results suggest that: (1) the problems of pain, fatigue and environmental barriers may not be recognised until patients have been living at home for some time; (2) central cord injured persons may benefit from training in pain management and energy conservation techniques subsequent to discharge from their inpatient rehabilitation programme; (3) visits should be made to the homes and work sites of central cord injured persons subsequent to their discharge to assess and alleviate environmental barriers. © 1990 International Medical Society of Paraplegia.