Spinal cord injury walking measures: charting consistency and community ambulation capacity

Affiliated institutions include: Toronto Rehabilitation Institute (C. Craven, H. Flett), University of Toronto (M. Verrier)Objectives: (1) Determine if physiotherapists are administering walking competency measures during and at discharge from inpatient rehabilitation; (2) assess the walking competency of patients with incomplete spinal cord injury (iSCI) through comparisons with community ambulation requirements. Methods: 180 health records of patients with iSCI were abstracted and analyzed. Data included the frequencies of 7 outcome measures taken and recorded until discharge and the frequency of administration by physiotherapists. The mean score at discharge for each outcome measure was analyzed to determine walking competency. Frequencies of scores attaining community ambulation requirements were analyzed. Results: Manual muscle tests were documented in 89.40%, the timed up and go (TUG) in 23.89%, and the 10-metre walk test (10mWT) in 16.67% of health records. Outcome measures were calculated 97.22% of the time for the assistive device score and 100% of the time for the walking index for spinal cord injury. Community ambulation requirements were met in 37.14% of TUG tests, 48% of 10mWTs, and 40.28% of modified 6-Minute Walk Tests. Conclusion: Physiotherapists are inconsistently administering walking competency outcome measures and do not have a standardized way of assessing safe community ambulation. Missing data could assist the advancement of best practice guidelines and future research