Outcome Evaluation and Spinal Cord Injury 1

Abstract

The evaluation of spinal cord injury outcomes can be approached from several perspectives, with each strategy emphasizing different outcomes, different evaluation instruments, different assessment timetables, and different analytic techniques. A synthesis of various conceptual models of spinal cord injury, including the World Health Organization’s model of disablement, the medical model, the psychosocial model, and the economic model, results in the identification of six primary outcomes of spinal cord injury: impairment, disability, handicap, health, life satisfaction, and cost. Methods of measuring each of these outcomes are reviewed and the interrelationships among them and the many predictive factors which influence them are explored. A comprehensive outcome evaluation model is proposed which combines selected evaluation tools to assess the primary outcomes in a practical but thorough approach. The need for such a broad-based evaluation plan to capture the complexity of spinal cord injury outcomes is emphasized.