Recovery of ambulation in motor-incomplete tetraplegia

Objective: To determine the effect of age and initial neurologic status on recovery of ambulation in patients with motor-incomplete tetraplegia. Study Design: Inception cohort study. Setting: Urban, tertiary care hospital with Regional Spinal Cord Injury Center. Patients: One hundred five patients with American Spinal Injury Association (ASIA) C or D tetraplegia at admission or within 72 hours of injury. Main Outcome Measure: Ambulatory status at time of discharge from inpatient rehabilitation. Results: Ninety-one percent (30/33) of ASIA C patients younger than 50 years of age became ambulatory by discharge, versus 42% (13/31) ASIA C patients age 50 or older (p < .0001), All (41/41) patients initially classified as ASIA D became ambulatory by discharge. Conclusion: For patients with ASIA D tetraplegia, prognosis for recovery of independent ambulation is excellent. For patients with ASIA C tetraplegia, recovery of ambulation is significantly less likely if age is 50 years or older. (C) 1997 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation.