Symposium

Application of Clinical Prediction Rules to Guide Physical Therapists’ Clinical Decision Making in Gait Rehabilitation During the Early Recovery Stages Following Spinal Cord Injury 9621

Corresponding Presenter(s)

• 

  Dannae Arnold, PT, DPT, ATP

  Research Physical Therapist
  Baylor Scott & White Institute for Rehabilitation
  Dallas, United States, International, Texas, United States

  Slides
• 

  Jillian Campbell, PT, DPT (she/her/hers)

  Physical Therapist
  Baylor Scott & White Institute for Rehabilitation
  Dallas, TX, United States

Non-Presenting Contributor(s)

• 

  Lindsey Wynne, PT, DPT, NCS (she/her/hers)

  Research Physical Therapist
  Baylor Scott & white Institute for Rehabilitation- Dallas
  Dallas, Texas, United States
• AT

  Ashley D. Taylor, PT, MPT, NCS

  Physical Therapist
  Baylor Scott & White Institute for Rehabilitation
  Dallas, United States, International, TX, United States
• 

  Christa Ochoa, MPH

  Analytics Developer
  Baylor Scott & White Research Institute
  dallas, Texas, United States
• 

  Chad Swank, PT, PhD

  Research Investigator
  Baylor Scott & White Research Institute
  Dallas, Texas, United States

Spinal cord injury (SCI) significantly impacts an individual’s functional mobility. This presentation addresses the challenges associated with predicting walking recovery in the early stages following SCI. Clinical prediction rules (CPRs) have been developed using age, motor, and sensory exam scores to predict independent walking potential at 1-year post-SCI. CPRs were integrated within a clinical model of care to prioritize gait interventions for those with higher walking potential. Data from a clinical trial at our inpatient rehabilitation hospital comparing overground exoskeleton gait training (OEGT) intervention versus usual care (UC) were analyzed to assess the use of our model and impact of intervention. Preliminary results suggest our model integrating CPRs through a clinical decision tree appears to differentiate those with higher versus lower walking potential and may guide therapists to better prioritize gait interventions earlier in recovery.

Learning Objectives:

• Discuss published clinical prediction rules for assessing likelihood of independent ambulation after spinal cord injury.
• Apply the clinical prediction rules to clinical cases guided by a clinical decision tree.
• Describe how the application of the clinical prediction rules will guide clinical research efforts.