The Spinal Cord Injury-Interventions Classification System

Translated title of the contribution: The Spinal Cord Injury-Interventions Classification System

A.H.B. van Langeveld

    Research output: ThesisDoctoral thesis 1 (Research UU / Graduation UU)

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    Abstract

    Title: The Spinal Cord Injury-Interventions Classification System: development and evaluation of a documentation tool to record therapy to improve mobility and self-care in people with spinal cord injury. Background: Many rehabilitation researchers have emphasized the need to examine the actual contents of rehabilitation programmes. One key component of these contents is the therapy provided. Mobility and self-care are the main domains of rehabilitation of people with an Spinal Cord Injury (SCI). Physical therapy, occupational therapy, and sports interventions contribute to the improvement of mobility and self-care among people with SCI. To date, the majority of SCI therapy interventions is still based on ‘expert opinion’. To identify effective treatments or to improve the quality of treatments, treatments need to be described in detail by means of uniform concepts and language. Main aims of the thesis: To develop a classification system representing all clinical interventions provided by physical therapists, occupational therapists and sports therapists and aiming at the improvement of mobility and self-care in people with an SCI, which can be used in a valid and reliable way for research and clinical practice, and which is site-neutral and cross-cultural. To describe and compare the contents of treatment in different rehabilitation centres and in different countries. Methods: We developed the Spinal Cord Injury-Interventions Classification System (SCI-ICS) from the ‘International Classification of Functioning, Disability and Health (ICF)’, clinical practice, SCI literature, and stroke literature. To examine the completeness, feasibility, validity, and reliability we performed a consensus procedure, a feasibility, and reliability study involving Dutch therapists from specialized rehabilitation centres. Following these three studies we compared the therapy provided to 79 people with a recent SCI undergoing inpatient treatment in 3 rehabilitation centres in the Netherlands, 1 in Australia and 1 in Norway during the same 4 consecutive weeks. To obtain evidence for the English-language version of the SCI-ICS the Australian and Norwegian therapists repeated the reliability study. Results: The final version of the SCI-ICS comprises a hierarchical structure with 3 levels (body functions, basic activities and complex activities), 25 categories (e.g., muscle power, walking, and dressing) and 139 grouped interventions. We showed that the SCI-ICS is a valid, reliable and feasible instrument to record interventions intended to improve the mobility and self-care of people with SCI by the 3 disciplines in different countries. We reported on the distribution of SCI therapy over different domains of functioning for the first time, especially mobility and self-care, based on direct collection of clinical treatment data in 5 rehabilitation centres, and found mostly similarities between treatment programmes within the Netherlands, but differences in treatment between the Netherlands, Australia and Norway. Conclusions: Using the SCI-ICS allows data on actually provided therapy to be obtained, in clinical practice or for research purposes. These data might enable us to adjust and improve effective and efficient clinical decision making in therapy programmes for people with an SCI, and might facilitate comparisons of therapies between settings and countries
    Translated title of the contributionThe Spinal Cord Injury-Interventions Classification System
    Original languageUndefined/Unknown
    QualificationDoctor of Philosophy
    Awarding Institution
    • Utrecht University
    Supervisors/Advisors
    • Lindeman, E., Primary supervisor, External person
    • Post, Marcel, Co-supervisor
    Award date8 Jul 2010
    Publisher
    Print ISBNs978-90-393-5358-5
    Publication statusPublished - 8 Jul 2010

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