F - SPECIALIZED REHAB
F.1.1
Specialized interdisciplinary spinal cord rehabilitation services should be integrated into and between primary, secondary, and tertiary levels of health systems with established referral pathways and mechanisms to ensure transition of care. (Adapted from WHO 2017, p.13; Level C)
F.1.2
Tertiary specialized rehabilitation services should be available to all individuals with SCI. Both community and hospital rehabilitation services should be available according to the clinical needs of the individual. (WHO 2017, p.17; Level C)
F.1.3
SCI-specific inpatient and outpatient rehabilitation should be offered to individuals with acute SCI when they are medically stable and can tolerate required rehabilitation intensity to address achievable physical, vocational, and life-quality rehabilitation goals. (Adapted from TIME 2017, p.233S; Level C)
F.1.4
Rehabilitation length of stay should be based on individualized achievable rehabilitation goals in addition to spinal cord impairment (level and severity of injury). (CAN-SCIP 2020; Level C)
F.1.5
SCI-specific rehabilitation should be offered to individuals living with chronic SCI when new achievable rehabilitation goals are identified. (CAN-SCIP 2020; Level C)
F.1.6
Timely access to the full continuum of intensity-appropriate specialized care at transition points (i.e., acute to inpatient post-acute, inpatient to outpatient) is recommeded. If insufficient time has been allowed in specialized rehabilitation care, the impact on the family/caregivers and health care costs are significant. (CAN-SCIP 2020; Level C)
F.1.7
Wherever possible, interdisciplinary teams led by a physiatrist should be utilized in specialized rehabilitation care; including, but not limited to psychologists, respiratory therapists, sexual health specialists, nursing, social workers, recreational therapists, speech therapists, peer mentors, specialized physiotherapists, and occupational therapists. (CAN-SCIP 2020; Level C)
F.2.1
The Spinal Cord Independence Measure IV (SCIM IV) is recommended as the preferred functional outcome assessment tool for clinicians involved in the assessment, care, and follow-up of patients with SCI. (Adapted from CNS-ASSESS 2013; p.40; Level A)
F.2.2
The SCIM IV should be completed on admission and discharge from acute care or rehabilitation into the community. (CAN-SCIP 2020; Level C)
F.3.1
Individuals with SCI should have timely access to local peer support services and community-based programs to increase the quality of life and community participation after injury across their lifespan. (CAN-SCIP 2020; Level C)
F.3.2
Family and caregivers should be screened at follow-up for evidence of excess stress and burnout and provided with support as needed. (CAN-SCIP 2020; Level C)