RESEARCH PAPER
Adherence to prescriptions of therapeutic exercises in patients with traumatic spinal cord injury
 
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1
Medical University, Warsaw, Poland
2
National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland
3
Mazovian Rehabilitation Center STOCER, Konstancin-Jeziorna, Poland
CORRESPONDING AUTHOR
Justyna Frasuńska   

Medical University of Warsaw, Poland
 
 
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Spinal cord injury (SCI), which disrupts motor, sensory and autonomic functions, causes significant changes in the functioning of an individual. It is believed that most of the conditions secondary to SCI, i.e. osteoporosis, spasticity or cardiopulmonary diseases, are associated with immobility. The aim of the study is to assess the adherence to prescriptions of therapeutic exercises (APTE) in patients with SCI after acute phases of rehabilitation.

Material and methods:
The criterionfor APTE recognition was the performance at least twice a week for a minimum of 30 minutes of active exercises with resistance, and exercises maintaining the range of movement of the joints The research tools were own questionnaire and the WHOQOL-BREF scale.

Results:
46 subjects (63.9%) met the APTE criteria. The most frequent place for performing the exercises was the subject’s home with 43 subjects (93.5%) with APTE performed the exercises in their homes. 17 subjects (36.9%) with APTE performed exercises during stays at various rehabilitation centres. The main cause for the lack of APTE was the limited availability of facilities considered necessary by the respondents to adhere to the instructions. In statistical analysis, the level of neurological injury correlated with meeting the APTE criteria. It was discovered that a subjective assessment of the exercise dose correlated with the place where the exercises were performed, but did not correlate with meeting the APTE criteria.

Conclusions:
The basic place for performing exercises (as instructed in hospital) was the subject’s home. Limited access to reimbursed environmental therapy resulted in an increased cost of exercises supervised by commercially-employed physiotherapists. The current gaps in the system of supervision and counselling of subjects post-SCI necessitate changes in the Polish health care system.

 
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