MODEL OF REHABILITATION ASSESSMENT OF PATIENTS AFTER SPINAL CORD INJURY

Abstract

Objective. To develop and substantiate a model of rehabilitation assessment for patients after spinal cord injury, taking into account modern international approaches to evaluating functional status, activity, and participation. The structural-logical model integrates functional and occupational therapy assessment in accordance with the concept of the International Classification of Functioning, Disability and Health (ICF). The proposed model includes a multilevel assessment system: neurological (ASIA/ISNCSCI), functional (SCIM III), kinematic, sensorimotor, and psycho-emotional components, as well as an analysis of personal and contextual factors. Materials and methods. The model was developed through the analysis and synthesis of domestic and international scientific and methodological sources, as well as the legislative and regulatory framework of Ukraine. This made it possible to review and generalize various perspectives and approaches to selecting rehabilitation assessment tools, and to identify underexplored issues in assessing the functional state of patients with spinal cord injury. Results. The developed rehabilitation assessment model is based on a structural and logical sequence of collecting information and assessing patient functioning according to ICF domains. The model includes four interrelated levels: medical-biological level: determines neurological status (ASIA/ISNCSCI), sensorimotor function, muscle tone (Modified Ashworth Scale), spasticity, and pain (VAS). Functional level: assesses mobility, self-care, respiratory function, transfers, and activity (SCIM III, FIM, 10MWT, 6MWT, WISCI II). Psychosocial level: evaluates quality of life (WHOQOL-BREF). Contextual level: examines environmental factors, family support, adaptation of living space, barriers, and resources. Based on the model, rehabilitation goals, intervention priorities, and monitoring of recovery dynamics are determined using key indicators. Conclusions. The proposed model enables a comprehensive assessment of the patient’s condition, determination of rehabilitation potential and prognosis of functional recovery, and provides a unified framework for intervention planning by a multidisciplinary team. Implementation of the model promotes improved quality of the rehabilitation process, continuity between stages of medical and physical rehabilitation, and monitoring of intervention effectiveness from the acute to the chronic phase after injury.