Study Reveals Rehabilitation Gaps for Violence-Related Spinal Cord Injuries
In the United States, violence is a leading cause of spinal cord injuries (SCI), trailing behind only accidents and falls. A recent study explores the rehabilitation experiences of individuals with SCIs caused by violence compared to those whose injuries stem from other traumatic events. The findings indicate that those injured through violence face barriers in accessing and benefiting from outpatient rehabilitation services, which are crucial for their long-term outcomes.
Violence-related SCIs, which make up about 15.2% of all spinal cord injuries in the US from 2015 to 2021, disproportionately affect Black and Hispanic Americans, as well as individuals from lower socioeconomic backgrounds. While those with violence-related and other trauma-related SCI injuries show similar progress immediately after injury, previous research shows a widening gap in outcomes over time. Patients injured in violent incidents fare worse in terms of mobility, job opportunities, and social integration. This study hypothesized that differences in utilization of outpatient rehabilitation services might contribute to this gap in outcomes.
The research focused on a retrospective cohort study, comparing 41 patients with violence-related SCIs to 41 with SCIs from other causes, all treated within the same hospital system. The results showed that after leaving inpatient rehabilitation individuals with violence-related SCIs attended fewer follow-up appointments for physical medicine, physical therapy, occupational therapy, and recreational therapy. Moreover, they were also more likely to miss scheduled appointments, a factor that could significantly impact their rehabilitation outcomes.
Behind these statistics lie deeper issues of access and equity. Factors such as socioeconomic status, insurance coverage limitations, transportation challenges, and the stigma associated with violence-related injuries contribute to the disparities observed. The study calls for targeted interventions to address these barriers, suggesting solutions like care navigators, telehealth services, and specialized programs aimed at supporting individuals with violence-related injuries.
The study was conducted by Heather M. Barnett MD, PhD; Jeanne M. Hoffman, PhD; and Deborah Crane, MD; as well as colleagues from the Department of Surgery and the Department of Anesthesiology & Pain Medicine. The study is online now in PM&R.