How do we know if a new treatment really improves recovery? In the world of SCI recovery research, one of the challenges of conducting clinical trials is being able to tell whether any improvement in function was caused by the experimental treatment, or if the patient would have improved anyway, since most people with SCI have some natural recovery in the first year after injury.
The researchers looked at the changes in motor function that naturally occurred during the first year after injury in 1,436 individuals with tetraplegia (quadriplegia). They found that people with initially complete injuries converted to incomplete injuries at a somewhat higher rate (30%) than was previously thought, including 7.1% converting to ASIA Impairment Scale grade D. They identified neurological measures that would be appropriate outcome measures for future clinical trials. (Marino RJ, Burns S, Graves DE, et al. Upper- and lower-extremity motor recovery after traumatic cervical spinal cord injury: an update from the national spinal cord injury database. Arch Phys Med Rehabil. 2011 Mar;92(3):369-75.)