Therapeutic Recreation Outcomes during Inpatient SCI Rehabilitation: Propensity Score Analysis of SCIRehab Data


  • Julie Gassaway Shepherd Center
  • Mark Sweatman Shepherd Center
  • Cecilia Rider Shepherd Center
  • Kelly Edens Shepherd Center
  • Madalyn Weber Shepherd Center



Propensity scores, rehabilitation spinal cord injury, therapeutic recreation


SCIRehab public use datasets were used to compare outcomes based on time spent in therapeutic recreation (TR) during inpatient rehabilitation for persons with spinal cord injury (SCI) (n = 1376). The treatment group consisted of SCIRehab participants who received significant (>20 hours) inpatient TR, n = 476. Propensity score 1-to-1 matching constructed the control group (n = 476) from the remaining SCIRehab participants. Independent means tests were used to identify significant differences in characteristics and outcomes between groups at one and five years post injury; matched pairs means tests compared differences within groups.At one and five years post injury, the treatment group had significantly higher rates of employment/ school, community participation (CHART scores), life satisfaction (satisfaction with life scale score), and greater recreation participation. At one year post injury, the treatment group exhibited more residing at home, less depression (PHQ-9), and less rehospitalization; these differences were neutralized by five years post injury. Both groups saw improvement in most outcomes from one to five years post injury; however, percentage of patients or item scores for treatment group were consistently higher.More time spent in TR during inpatient rehabilitation is associated strongly with improved community participation, health and function, and recreational participation post injury for persons with SCI.Subscribe to TRJ

Author Biographies

Julie Gassaway, Shepherd Center

Julie Gassaway, MS, RN is the Director of Health and Wellness Research at Shepherd Center. She works with CTRS on research projects related to therapuetic recreation.

Mark Sweatman, Shepherd Center

Mark Sweatman, PhD, MBAis a biostatistician and business intelligence analyst at the Virginia C. Crawford Research Institute at Shepherd Center in Atlanta, GA.  Mark has been involved in various types of research and quantitative analyses for over 15 years.  His quantitative analysis experience includes descriptive statistics, bivariate correlations, means comparisons, factor analysis, path analysis, propensity scoring, and predictive modeling including OLS regression, logistic regression, and structural equation modeling.

Cecilia Rider, Shepherd Center

Cecilia Rider, MS, CTRS is a Recreation Therapist in the Spinal Cord Injury Outpatient Day Program and lead therapist for the Recreation Therapy internship program at Shepherd Center. Cecilia has been practicing for 15 years and been involved in various research projects over the past 15 years, including the SCIRehab study.

Kelly Edens, Shepherd Center

Kelly Edens, CTRS, is the Recreation Therapy Manager at the Shepherd Center in Atlanta, GA (  Kelly has been a Recreation Therapist for the past 18 years and was involved in the research of the SCIRehab study.

Madalyn Weber, Shepherd Center

Madalyn Weber, MS, CTRS is a recreation therapist on the Acquired Brain Injury Unit at Shepherd Center in Atlanta, GA. Madalyn has been practicing for 8 years and previously worked in community based programming for brain injury and spinal cord injury rehabilitation.





Research Papers