Abstract
Objective
To describe the early active rehabilitation concept developed for spasticity-correcting
surgery in tetraplegia and to report the outcomes in grip ability and change of performance
and satisfaction in patients' prioritized activities 1 year postoperatively.
Design
Retrospective case-control study.
Setting
Nonprofit rehabilitation unit.
Participants
All patients who underwent surgeries for correction of spasticity in tetraplegic hands
between 2009 and 2013 in the studied unit (N=37).
Interventions
Spasticity-correcting upper limb surgery with early active rehabilitation to restore
grip ability in tetraplegia.
Main Outcome Measures
Grasp and release test (GRT) and modified Canadian Occupational Performance Measure
(COPM).
Results
All patients could accomplish the early active rehabilitation concept. The complication
rate related to the treatment was low. Compared with preoperatively, all evaluated
individuals experienced improvements in grasp ability and activity performance and
satisfaction at 1-year follow-up. The performance in prioritized activities, as measured
by the COPM, improved by 2.6 scale steps. Satisfaction with performance improved 3.0
scale steps postoperatively (n=21). The grasp ability, measured by the GRT, improved
significantly, from 80 preoperatively to 111 (n=10).
Conclusions
The surgery, combined with the early active rehabilitation protocol, is a reliable
and safe procedure. The ability to use the hand improved, and gains were maintained
at least 1 year after surgery in all patients with respect to both the objective grasp
ability and patients' subjective rating of their performance and satisfaction in their
prioritized activities. The procedure should therefore be considered as an adjunct
to other treatments of upper limb spasticity in spinal cord injury.
Keywords
List of abbreviations:
ASIA (American Spinal Injury Association), COPM (Canadian Occupational Performance Measure), GRT (grasp and release test), SCI (spinal cord injury)To read this article in full you will need to make a payment
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Article Info
Footnotes
Supported by the Swedish Research Council (grant no. 11200), Göteborg University, and Sahlgrenska University Hospital.
Publication of this article was supported by the American Congress of Rehabilitation Medicine.
Disclosures: none.
Identification
Copyright
© 2016 by the American Congress of Rehabilitation Medicine
