Performance assessment system in spinal cord injury



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Health care professionals in the area of rehabilitation of persons with spinal cord injury need an objective, quantitative means to judge functional health status and to assess the behavioral progress of clients. With such tools, clinical treatment teams can plan personalized programs of care more accurately and evaluate the impact of these programs with greater sensitivity. A large archive of data describing the day-to-day molar performances of 15 spinal cord injured patients for the length of their first hospitalizations following trauma was analyzed in order to determine the measures that are essential for describing patients' behavioral change over time. A new correlation-factor-cluster algorithm was employed to map out the domain of patient behavior described in the data archive. The analyses indicate that a three-dimensional, dual-faceted structure is adequate to account for the variance in patient behavior across the period of hospitalization. A dominant facet of behavior centers on how patients execute or transact the routine molar activities of daily living (e.g. with or without assistance). The second facet of behavior, environmental diversity,indicates the extent to which patients are getting around in the hospital and the increasing differentiation in behavior as patients progress through the rehabilitation program. With this information on the key indicators or behavioral vital signs for measuring functional health status and behavioral progress, a clinically useful and practical monitoring system can be established.