Recovery Trajectories of Lower Limb Motor Function After Cervical Spinal Cord Injury: A Latent Class Mixed Model Analysis
In brief
Five distinct patterns of leg-strength recovery emerge after cervical spinal cord injury
In a Japanese cohort of 516 patients, latent class modeling revealed five separate trajectories of lower-extremity motor score over the first year, ranging from early high recovery to slow sustained gains. Admission motor score, age, injury severity and bony injury predicted class membership, suggesting trajectory-based prognostication could refine patient counseling, though external validation is needed.
- Journal
- Archives of physical medicine and rehabilitation (Q1)
- Published
- 20 September 2026
- Study design
- Retrospective cohort
- Evidence level
- Level 3, Low (CEBM 3b)
- Authors
- Atsushi Sugyo, Ryosuke Ideta, Yuto Ariji, Ryuichiro Koga, Satoshi Murai, Ryusei Ifuku, et al.
- PMID
- 42764049
- DOI
- 10.1016/j.apmr.2026.09.012
Why clinicians should know about it
- Picked for Rehabilitation (paper of the day, 22 September 2026): Multiple lower‑limb recovery trajectories, prognostic for SCI rehab
Abstract
OBJECTIVE: To identify the latent recovery trajectories of lower limb motor function after cervical spinal cord injury using a latent class mixed model (LCMM) and to examine clinical factors associated with trajectory class membership. DESIGN: Retrospective longitudinal cohort study. SETTING: A single specialized spinal cord injury center in Japan. PARTICIPANTS: A total of 516 participants and 4,040 longitudinal observations were included. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Longitudinal Lower Extremity Motor Score (LEMS) data within one year of injury were analyzed using the LCMM. Candidate models with one to five latent classes were evaluated using information criteria and clinical interpretability. Factors associated with trajectory class membership were identified using multinomial logistic regression with Firth correction. RESULTS: The LCMM identified five distinct recovery trajectory classes: early high recovery, steep nonlinear recovery, moderate recovery with early plateau, low recovery, and slow sustained recovery. The mean posterior probabilities were 0.91-0.98, supporting the validity of the classification. LEMS at admission was consistently associated with trajectory class membership across all comparisons. Age, ASIA Impairment Scale classification, and bony injury were associated with specific trajectory classes. CONCLUSIONS: Lower limb motor function recovery after cervical spinal cord injury can be classified into multiple longitudinal trajectories. Trajectory-based analysis may contribute to understanding heterogeneous recovery patterns and support prognostic assessment in clinical practice.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.