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Spinal cord injury: time out of bed during rehabilitation.

Preliminary experience in applying unobtrusive instrumentation to monitor selected patient activities over extended periods of time has shown this procedure to be both feasible and useful. The target activity studied was time out of bed (TOB) for 36 spinal cord injury patients undergoing comprehensive rehabilitation. Measurements were made with a rest-time monitor (RTM), which provides an objective daily record of how often and for how long a patient is out of bed. During the initial week of mobilization, paraplegic patients (n = 14) were out of bed for an average of 1.7 hours and quadriplegic patients (n = 22) for an average of 1.5 hours. Maximum TOB in each group was 8.7 and 9.2 hours, respectively, which dropped to 7.2 and 7.8 hours at time of discharge. Based on this experience, a standard activity curve has been developed which is used as a reference in assessing the weekly progress of individual patients. Distinctive types of activity patterns are described in relation to clinical and functional outcomes during hospitalization and 12 months after discharge.