Individual-level therapist and patient characteristics and evaluations of rehabilitative interventions used to assess the reliability of the International Spinal Cord Injury Physical Therapy-Occupational Therapy Basic Data Set

STUDY PURPOSE: In interventional clinical trials for people with spinal cord injury (SCI), the influence of experimental biological, pharmacological, or device-related interventions must be differentiated from that of physical and occupational therapy interventions, as rehabilitation influences motor-related outcomes. The International Spinal Cord Injury (ISCI) Physical Therapy–Occupational Therapy Basic Data Set (PT-OT BDS) was developed with the intent to track the content and time of rehabilitation interventions that are delivered concurrently with experimental interventions. The overall purpose of this study was to assess the interrater reliability of the PT-OT BDS.

At each of 10 centers across 7 countries, pairs of therapists (a treating therapist and an observing therapist; PT/PT, OT/OT, or PT/OT) used the PT-OT BDS to record the content and time of therapy sessions for 20 individuals with SCI. Interrater reliability of documentation collected by paired therapists was assessed. As differences in therapists (discipline, years of experience), person with SCI (degree of impairment), setting (inpatient vs. outpatient, US based vs. non-US based) may impact therapy documentation these data were collected and analyzed.

The PT-OT BDS aims to provide a method to standardize documentation of PT and OT interventions delivered as part of a controlled clinical trial. Understanding the level of agreement between therapists is needed to validate the reliability of this tool and help identify potential areas requiring refinement. DATA COLLECTED: At each of the 10 centers, data were collected for 20 individuals with SCI (>18 years of age, any post-injury timepoint) with varying levels of impairment (motor-incomplete paraplegia to motor-complete tetraplegia). Therapists assessed the amount of time spent in rehabilitative interventions classified as activity-directed interventions (bed/seated mobility, standing activities, walking/stairs, gross motor upper extremity, fine motor upper extremity) and impairment-directed interventions (strength training, endurance training). Evaluation date and start time, therapist designation (PT or OT), therapist role (treating or observing), therapist years of experience, SCI classification (motor-incomplete paraplegia; motor-incomplete tetraplegia; motor-complete paraplegia; motor-complete tetraplegia), evaluation setting (inpatient or outpatient rehabilitation), amount of time during therapy session (in 15 minute increments) spent on the interventions within the PT-OT BDS, and total intervention time were also recorded. DATA USAGE NOTES: