Who wants to walk? Preferences for recovery after SCI: a longitudinal and cross-sectional study

Study design: Cross-sectional and longitudinal direct observation of a constrained consensus-building process in nine consumer panels and three rehabilitation professional panels. Objectives: To illustrate differences among consumer and clinician preferences for the restoration of walking function based on severity of injury, time of injury and age of the individual. Setting: Regional Spinal Cord Center in Philadelphia, USA. Methods: Twelve panels (consumer and clinical) came to independent consensus using the features resource trade-off game. The procedure involves trading imagined levels of independence (resources) across different functional items (features) at different stages of recovery. Results: Walking is given priority early in the game by eight out of nine consumer panels and by two out of three professional panels. The exception consumer panel (ISCI<50) moved walking later in the game, whereas the exception professional panel (rehRx) moved wheelchair early but walking much delayed. Bowel and Bladder was given primary importance in all panels. Conclusions: Walking is a high priority for recovery among consumers with spinal cord injury irrespective of severity of injury, time of injury and age at time of injury. Among professional staff, walking is also of high priority except in rehabilitation professionals.