A comparison of patients' and physiotherapists' expectations about walking post spinal cord injury: a longitudinal cohort study

Study design: A longitudinal cohort study. Objective: The primary objective of this study was to compare the expectations that patients with recent spinal cord injury (SCI) had about walking 1 year from injury with the expectations of their physiotherapists. Setting: Two Sydney SCI units. Methods: A consecutive series of 47 patients admitted to the metropolitan SCI units was recruited. Using the Mobility Scale, expectations of the patients and their physiotherapists about walking at 1 year from SCI were recorded at the time of admission to rehabilitation. Ability to walk was then assessed at 1 year from the SCI. Results: On admission to rehabilitation, 31 patients expected to walk about their homes at 1 year post SCI, but only 18 (58%) of these patients did so. In contrast, physiotherapists expected 21 patients to be able to walk about their homes at 1 year post SCI, with 17 (81%) of these patients doing so. Similarly, whereas 21 patients expected to walk about the community at 1 year post SCI, only 11 (52%) of these patients did so. Physiotherapists expected 8 patients to walk about the community at 1 year post SCI and 7 (88%) of these patients did so. The differences between patients' and physiotherapists' expectations about walking were statistically significant (P<0.001). Conclusion: There is a high degree of disagreement between patients' and physiotherapists' expectations about walking at 1 year post SCI. Differences between patients' and physiotherapists' expectations about walking are potentially problematic and requires research to identify appropriate management strategies. Spinal Cord (2012) 50, 548-552; doi: 10.1038/sc.2012.1; published online 7 February 2012