The effect of age alone, and age combined with pinprick, on recovery of walking function in motor complete, sensory incomplete spinal cord injury

Publication date: Available online 18 February 2016
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Christina V. Oleson, Ralph J. Marino, Benjamin E. Leiby, John F. Ditunno
ObjectiveTo determine if age, pinprick scores in the lower extremities, and neurological severity of injury influence recovery of ambulation in persons with motor complete, sensory incomplete (AIS B), spinal cord injury (SCI) one year after initial injury.DesignThis retrospective analysis examined AIS B subjects from the Spinal Cord Injury Model System Database (SCIMSDB) from 2006 to 2015. The baseline neurological examination upon rehabilitation admission (2-4 weeks post-injury) was used for comparison with one-year outcome measures of locomotion.SettingFifteen acute inpatient rehabilitation centers (participants in the SCIMSDB).ParticipantsParticipants with AIS B SCI (249) were enrolled in SCIMSDB in 2 cycles (2006-2010 and 2011-2015).InterventionsNot applicable.Main Outcome MeasuresHousehold ambulation at one year by Fone-FIM and by direct interview, as part of the annual neurological exam; change in ASIA score one-year post-injury.ResultsFindings demonstrate a statistically non-significant increase in likelihood of walking for those age <50 compared with >50 years (RR=1.99 with 95% CI: [0.80, 3.04]). Presence of pinprick in at least one-half of the lower extremity dermatomes L2-S1 was associated with higher likelihood of walking (RR=5.57; p=0.0023). Pinprick was significant for patients <age 50 (RR 4.58, p=0.0090) but not for those >50 (p=0.15).ConclusionCompared with younger individuals, participants >age 50 with AIS B SCI are less likely to achieve walking function one-year post-injury. Likewise, preservation of pinprick sensation post-injury in the majority of lower extremity dermatomes L2-S1 increases the chances of walking in individuals <age 50.



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