Life care planning projections for individuals with motor incomplete spinal cord injury before and after locomotor training intervention: A case series

BACKGROUND/PURPOSE:: We present a retrospective case series of 2 individuals with motor-incomplete spinal cord injury (SCI) to examine differences in lifetime cost estimates before and after participation in an intensive locomotor training (LT) program. Sections of a life care plan (LCP) were used to determine the financial implications associated with equipment, home renovations, and transportation for patients who receive LT. An LCP is a viable method of quantifying outcomes following any therapeutic intervention. CASE DESCRIPTION:: The LCP cases analyzed were a 61-year-old woman and a 41/2-year-old boy with motor-incomplete SCI and impairments classified by the American Spinal Injury Association Impairment Scale (AIS) as AIS D and AIS C, respectively. INTERVENTIONS:: Each patient received an intensive outpatient LT program 3 to 5 days per week. The 61-year-old woman received 198 sessions over 57 weeks and the 41/2-year-old boy received 76 sessions over 16 weeks. OUTCOMES:: The equipment, home renovation, and transportation costs of an LCP were calculated before and after LT. Prior to the implementation of LT, the 61-year-old woman had estimated lifetime costs between $150 247.00 and $199 654.00. Following LT, the estimated costs decreased to between $2010.00 and $2446.00 (a decrease of $148 237.00 and $197 208.00). Similarly, the 4-year-old boy had estimated lifetime costs for equipment, home renovation, and transportation between $535 050.00 and $771 665.00 prior to LT. However, the estimated costs decreased to between $97 260.00 and $200 047.00 (a decrease of $437 790.00 and $571 618.00) following LT. DISCUSSION:: The lifetime financial costs associated with equipment, home renovations, and transportation following a motor-incomplete SCI were decreased following an intensive LT program for the 2 cases presented in this article. The LCP, including costs of rehabilitation and long-term medical and personal care costs, may be an effective tool to discern cost benefit of rehabilitation interventions.