In an accompanying commentary, Dr. Wagih Shafik El Masri and Dr. Naveen Kumar applauded the rule’s development, but cautioned that other factors, which the rule cannot address, play an important part in spinal cord injury recovery (Lancet 2011 [doi:10.1016/S0140-6736(11)60248-1]).
"Early prediction of ambulation outcome is important to patients," wrote the authors, both of whom are at the Robert Jones and Agnes Hunt Orthopaedic Hospital in Staffordshire, England. "However, several variables exist that affect the achievability and quality of such predictors," such as the patient’s preexisting health, associated comorbidities, quality of rehabilitation, and neurologic progress. "[Neurologic] and functional recovery should be thought of as two essential, distinct entities in the assessment of traumatic spinal cord injury outcomes."
Further studies are necessary to assess the individual prognostic components of the rule and assess their value at different times during recovery, as are more studies of interventions that can help not only with ambulation, neurologic recovery, and functional recovery, but also with autonomic functions that can impact quality of life, including bladder, bowel, cardiorespiratory, vasomotor, erectile, and reproductive problems, Dr. El Masri and Dr. Kumar wrote.
Neither the authors of the study nor those of the commentary declared any conflicts of interest. The study was funded by the Internationale Stiftung für Forschung in Paraplegie.