Feasibility of Predicting Improvements in Motor Function Following SCI Using the SCAR Outcome Measure: a Retrospective Study

Study design A retrospective study. Objectives To assess improvement in volitional motor function after SCI, using The Spinal Cord Ability Ruler (SCAR) as a metric and investigate participant characteristics and recovery of motor functioning. Setting A highly-specialized SCI rehabilitation unit (Spinal Cord Injury Centre of Western Denmark, SCIWDK). Methods Retrospectively, data on all SCI patients admitted to SCIWDK between 1 January 1997 and 1 November 2018 were extracted from a database. The SCAR score (range: 0–100) was calculated by combining items from ISNCSCI and SCIM. Results Mean (95%CI) improvement in volitional motor function was of 17.2 (CI: 14.5–19.9) equal to an improvement of 43% from baseline after median 155 days in-hospital rehabilitation. Individuals with tetraplegia exerted larger improvement (mean difference of 8.9 (CI: 3.6–14.2) points) as compared to paraplegia. Male gender predicted better improvement ( p < 0.03), as did no need for mechanical ventilation with a gain of 8.5 (CI: 1.8–15.3) points as compared to those in need. Conclusions Overall mean improvement of 43% in volitional motor function was found in 84 in-hospitalized patients using SCAR as a metric at a highly-specialized SCI unit. Following factors; level-of-injury, gender, age, need of ventilation support predicted improvement in volitional motor function after a rehabilitation period. Results should be cautiously interpreted as a majority of hospitalized patients did not fulfill criteria for SCAR scoring. Prospectively designed studies with better internal validation and external validations are needed to confirm these findings.