Organisation of services and systems of care in paediatric spinal cord injury rehabilitation in seven countries: a survey with a descriptive cross-sectional design

Wiebke Höfers, Vivien Jørgensen, Susanne Sällström, Kristine M. Vege, Mona Strøm, Peter W. New, Tamara Bushnik, Olga Zakharova, Tal Krasovsky, Dafna Guttman, Atheer Ghatasha, Liu Genlin, Chen Yang, Qin Yu-Xi, Kerstin Wahman, Katharina S. Sunnerhagen, Per Ertzgaard, Renat Sukhov, Marika Augutis, Johan K. StanghelleKirsti S. Roaldsen

Research output: Contribution to journalArticlepeer-review


Study design: International multicentre cross-sectional study. Objectives: To describe the organisation and systems of paediatric spinal cord injury (SCI) rehabilitation services in seven countries and compare them with available recommendations and key features of paediatric SCI. Setting: Ten SCI rehabilitation units in seven countries admitting children and adolescents with SCI < 18 years of age. Methods: An online survey reporting data from 2017. Descriptive and qualitative analysis were used to describe the data. Results: The units reported large variations in catchment area, paediatric population and referrals, but similar challenges in discharge policy. Nine of the units were publicly funded. Three units had a paediatric SCI unit. The most frequent causes of traumatic injury were motor vehicle accidents, falls, and sports accidents. Unlike the other units, the Chinese units reported acrobatic dancing as a major cause. Mean length of stay in primary rehabilitation ranged between 18 and 203 days. Seven units offered life-long follow-up. There was a notable variation in staffing between the units; some of the teams were not optimal regarding the interdisciplinary and multiprofessional nature of the field. Eight units followed acknowledged standards and recommendations for specialised paediatric SCI rehabilitation and focused on family-centred care and rehabilitation as a dynamic process adapting to the child and the family. Conclusions: As anticipated, we found differences in the organisation and administration of rehabilitation services for paediatric SCI in the ten rehabilitation units in seven countries. This might indicate a need for internationally approved, evidence-based guidelines for specialised paediatric SCI rehabilitation.

Original languageEnglish
Pages (from-to)339-347
Number of pages9
JournalSpinal Cord
Issue number4
StatePublished - Apr 2022

Bibliographical note

Funding Information:
The authors wish to acknowledge Per-Ola Rike and Kirsti Riiser for their contribution to the study. Special thanks to the following for valuable support: Einar Magnus Strand, Li Jian Jun, Steven Flanegan, Edmund Shehadeh, Arkadi Rutgayzer, Amichai Brezner and Ofer Keren.

Funding Information:
Participating rehabilitation units: Unit for Children and Adolescents, Sunnaas Rehabilitation Hospital, Oslo, Norway (SRH); Rehab Station Stockholm Spinalis, Stockholm, Sweden; HRH Crown Princess Victoria’s Children’s and Youth Hospital, Linköping Hospital, Linköping, Sweden; Institute of Neuroscience and Physiology Rehabilitation Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden; Rusk Rehabilitation Institute, New York, USA; Department of Pediatric Rehabilitation, The Edmond & Lily Safra Children’s Hospital, The Chaim Sheba Medical Center, Tel Hashomer, Israel; China Rehabilitation and Research Center, Beijing, PR China; Bayi Rehabilitation Center, Chengdu, PR China; Rehabilitation Center Children’s City Hospital, Petrozavodsk, Karelian Republic, Russian Federation; Bethlehem Arabic Society Rehabilitation, The Protectorate of Palestine. SCI spinal cord injury. aAdditionally, paediatric SCIs from the whole country are included. bDepends on the cause; car accidents are funded privately, falls from a height are funded by public/government. cReferral from an acute hospital and then early assessment by an ambulatory rehabilitation team from Sunnaas.

Publisher Copyright:
© 2021, The Author(s), under exclusive licence to International Spinal Cord Society.

ASJC Scopus subject areas

  • Rehabilitation
  • Neurology
  • Clinical Neurology


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