You are not logged in. Press here to login.

Content

List volumes - List articles in this issue

Review article

Outcome of motor training programmes on arm and hand functioning in patients with cervical spinal cord injury according to different levels of the ICF: A systematic review

doi: 10.2340/16501977-0387

Open access

Abstract:

OBJECTIVE: To investigate the outcome of motor training programmes on arm and hand functioning in patients with
cervical spinal cord injury according to different levels of
the International Classification of Functioning, Disability and Health (ICF).
DESIGN: Systematic review.
METHODS: A search of the following databases: Medline,
Cochrane, Cumulative Index to Nursing and Allied Health Literature (CINAHL), EMBASE, Physiotherapy Evidence Database (PEDro) and Database of Abstracts of Reviews of Effects (DARE) from 1976 to August 2008 was performed using the following MeSH terms: Spinal Cord Injuries, Quadriplegia, Rehabilitation, Physical Education and Training, Exercise, Patient-Centered Care, Upper Extremity, Activities of Daily Living, Motor Skills, Motor Activity, Intervention Studies, Clinical Trial. The methodological quality of the selected articles was scored with the Van Tulder Checklist. Descriptive analyses were performed using the PICO principle (Patient characteristics, Intervention, Comparison, Outcome & results) along the ICF function and activity level.
RESULTS: Twelve studies were included in the analyses. Overall, the methodological quality of the studies was acceptable, with a mean Van Tulder score of 9.58. Interventions included motor training programmes at the level of function, activity or a combined programme. Most studies reported improvements in arm and hand functioning at the level that was trained for.
CONCLUSION: Motor training programmes may improve arm and hand functioning at function and/or activity level in cervical spinal cord injured patients. However, no general conclusion based on a meta-analysis can be drawn due to the wide variety of approaches.

Authors:

Annemie I.F. Spooren, Yvonne J.M. Janssen-Potten, Eric Kerckhofs, Henk A.M. Seelen

References

  1. Hanson RW, Franklin MR. Sexual loss in relation to other functional losses for spinal cord injured males. Arch Phys Med Rehabil 1976; 57: 291–293.
  2. Snoek GJ, Ijzerman MJ, Hermens HJ, Maxwell D, Biering-Sorensen F. Survey of the needs of patients with spinal cord injury: impact and priority for improvement in hand function in tetraplegics. Spinal Cord 2004; 42: 526–532.
  3. Snoek GJ, Ijzerman MJ, Post MW, Stiggelbout AM, Roach MJ, Zilvold G. Choice-based evaluation for the improvement of upper-extremity function compared with other impairments in tetraplegia. Arch Phys Med Rehabil 2005; 86: 1623–1630.
  4. World Health Organization. ICF: International classification of functioning, disability and health. Geneva: WHO; 2001.
  5. Ditunno JF Jr, Cohen ME, Hauck WW, Jackson AB, Sipski ML. Recovery of upper-extremity strength in complete and incomplete tetraplegia: a multicenter study. Arch Phys Med Rehabil 2000; 81: 389–393.
  6. Beekhuizen KS. New perspectives on improving upper extremity function after spinal cord injury. J Neurol Phys Ther 2005; 29: 157–162.
  7. Waters RL, Adkins RH, Yakura JS, Sie I. Motor and sensory recovery following complete tetraplegia. Arch Phys Med Rehabil 1993; 74: 242–247.
  8. Waters RL, Adkins RH, Yakura JS, Sie I. Motor and sensory recovery following incomplete tetraplegia. Arch Phys Med Rehabil 1994; 75: 306–311.
  9. Marino RJ, Ditunno JF Jr, Donovan WH, Maynard F, Jr. Neurologic recovery after traumatic spinal cord injury: data from the Model Spinal Cord Injury Systems. Arch Phys Med Rehabil 1999; 80: 1391–1396.
  10. Kirshblum S, Millis S, McKinley W, Tulsky D. Late neurologic recovery after traumatic spinal cord injury. Arch Phys Med Rehabil 2004; 85: 1811–1817.
  11. Ditunno JF, Burns AS, Marino RJ. Neurological and functional capacity outcome measures: essential to spinal cord injury clinical trials. J Rehabil Res Dev 2005; 42 Suppl 1: 35–42.
  12. Spooren AI, Janssen-Potten YJ, Post MW, Kerckhofs E, Nene A, Seelen HA. Measuring change in arm hand skilled performance in persons with a cervical spinal cord injury: responsiveness of the Van Lieshout Test. Spinal Cord 2006; 44: 772–779.
  13. Spooren AIF, Janssen-Potten YJM, Snoek GJ, Ijzerman MJ, Kerckhofs E, Seelen H. Rehabilitation outcome of upper extremity skilled performance in persons with cervical spinal cord injuries. J Rehabil Med 2008; 40: 637–644.
  14. van Tuijl JH, Janssen-Potten YJ, Seele HA. Evaluation of upper extremity motor function tests in tetraplegics. Spinal Cord 2002; 40: 51–64.
  15. Yarkony GM, Roth EJ, Heinemann AW, Wu YC, Katz RT, Lovell L. Benefits of rehabilitation for traumatic spinal cord injury. Multivariate analysis in 711 patients. Arch Neurol 1987; 44: 93–96.
  16. Wirth B, van Hedel HJ, Kometer B, Dietz V, Curt A. Changes in activity after a complete spinal cord injury as measured by the Spinal Cord Independence Measure II (SCIM II). Neurorehabil Neural Repair 2008; 22: 145–153.
  17. Ota T, Akaboshi K, Nagata M, Sonoda S, Domen K, Seki M, et al. Functional assessment of patients with spinal cord injury: measured by the motor score and the Functional Independence Measure. Spinal Cord 1996; 34: 531–535.
  18. Schonherr MC, Groothoff JW, Mulder GA, Eisma WH. Functional outcome of patients with spinal cord injury: rehabilitation outcome study. Clin Rehabil 1999; 13: 457–463.
  19. Yarkony GM, Roth EJ, Heinemann AW, Lovell L, Wu YC. Functional skills after spinal cord injury rehabilitation: three-year longitudinal follow-up. Arch Phys Med Rehabil 1988; 69: 111–114.
  20. Post MWM, Van Lieshout G, Seelen HAM, Snoek GJ, IJzerman M, Pons C. Measurement properties of the short version of the van Lieshout Test (VLT-SF). Spinal Cord 2006; 44: 763–771.
  21. Mulcahey MJ, Hutchinson D, Kozin S. Assessment of upper limb in tetraplegia: considerations in evaluation and outcomes research. J Rehabil Res Dev 2007; 44: 91–102.
  22. Harvey LA, Batty J, Jones R, Crosbie J. Hand function of C6 and C7 tetraplegics 1–16 years following injury. Spinal Cord 2001; 39: 37–43.
  23. Mulcahey MJ, Smith BT, Betz RR. Psychometric rigor of the Grasp and Release Test for measuring functional limitation of persons with tetraplegia: a preliminary analysis. J Spinal Cord Med 2004; 27: 41–46.
  24. Ginis KA, Hicks AL. Exercise research issues in the spinal cord injured population. Exerc Sport Sci Rev 2005: 33; 49–53.
  25. Welch RD, Lobley SJ, O’Sullivan SB, Freed MM. Functional independence in quadriplegia: critical levels. Arch Phys Med Rehabil 1986; 67: 235–240.
  26. Daly JJ, Ruff RL. Construction of efficacious gait and upper limb functional interventions based on brain plasticity evidence and model-based measures for stroke patients. Scientific World J 2007; 7: 2031–2045.
  27. Dromerick AW, Lum PS, Hidler J. Activity-based therapies. NeuroRx 2006; 3: 428–438.
  28. Magill R, editor. Motor learning: concepts and application. New York: McGraw-Hill; 1998.
  29. Valent L, Dallmeijer A, Houdijk H, Talsma E, van der Woude L. The effects of upper body exercise on the physical capacity of people with a spinal cord injury: a systematic review. Clin Rehabil 2007; 21: 315–330.
  30. Dallmeijer AJ, Hopman MT, van der Woude LH. Lipid, lipoprotein, and apolipoprotein profiles in active and sedentary men with tetraplegia. Arch Phys Med Rehabil 1997; 78: 1173–1176.
  31. Devillard X, Rimaud D, Roche F, Calmels P. Effects of training programs for spinal cord injury. Ann Readapt Med Phys 2007; 50: 480–498.
  32. de Groot PC, Hjeltnes N, Heijboer AC, Stal W, Birkeland K. Effect of training intensity on physical capacity, lipid profile and insulin sensitivity in early rehabilitation of spinal cord injured individuals. Spinal Cord 2003; 41: 673–679.
  33. Rimaud D, Calmels P, Devillard X. Réentraînement a léffort chez le blesse médullaire. Ann Readapt Med Phys 2005; 48: 259–269.
  34. Nash MS. Exercise as a health-promoting activity following spinal cord injury. J Neurol Phys Ther 2005; 29: 87–103, 106.
  35. Jacobs PL, Nash MS. Exercise recommendations for individuals with spinal cord injury. Sports Med 2004; 34: 727–751.
  36. Bryden AM, Wuolle KS, Murray PK, Peckham PH. Perceived outcomes and utilization of upper extremity surgical reconstruction in individuals with tetraplegia at model spinal cord injury systems. Spinal Cord 2004; 42: 169–176.
  37. Snoek GJ, van Til JA, Krabbe PF, Ijzerman MJ. Decision for reconstructive interventions of the upper limb in individuals with tetraplegia: the effect of treatment characteristics. Spinal Cord 2008; 46: 228–233.
  38. Murray WM, Hentz VR, Friden J, Lieber RL. Variability in surgical technique for brachioradialis tendon transfer. Evidence and implications. J Bone Joint Surg Am 2006; 88: 2009–2016.
  39. Wuolle KS, Bryden AM, Peckham PH, Murray PK, Keith M. Satisfaction with upper-extremity surgery in individuals with tetraplegia. Arch Phys Med Rehabil 2003; 84: 1145–1149.
  40. Kilgore KL, Hart RL, Montague FW, Bryden AM, Keith MW, Hoyen HA, et al. An implanted myoelectrically-controlled neuroprosthesis for upper extremity function in spinal cord injury. Conf Proc IEEE Eng Med Biol Soc 2006; 1: 1630–1633.
  41. Popovic MR, Popovic DB, Keller T. Neuroprostheses for grasping. Neurol Res 2002; 24: 443–452.
  42. Giuffrida JP, Crago PE. Functional restoration of elbow extension after spinal-cord injury using a neural network-based synergistic FES controller. IEEE Trans Neural Syst Rehabil Eng 2005; 13: 147–152.
  43. Inmann A, Haugland M. Functional evaluation of natural sensory feedback incorporated in a hand grasp neuroprosthesis. Med Eng Phys 2004; 26: 439–447.
  44. Rupp R, Gerner HJ. Neuroprosthetics of the upper extremity – clinical application in spinal cord injury and challenges for the future. Acta Neurochir Suppl 2007; 97: 419–426.
  45. Knutson JS, Hoyen HA, Kilgore KL, Peckham PH. Simulated neuroprosthesis state activation and hand-position control using myoelectric signals from wrist muscles. J Rehabil Res Dev 2004; 41: 461–472.
  46. DiPasquale-Lehnerz P. Orthotic intervention for development of hand function with C-6 quadriplegia. Am J Occup Ther 1994; 48: 138–144.
  47. Paternostro Sluga T, Stieger M. Hand splints in rehabilitation. Crit Rev Phys Rehabil Med 2004; 16: 233–256.
  48. Shepherd RB. Exercise and training to optimize functional motor performance in stroke: driving neural reorganization? Neural Plast 2001; 8: 121–129.
  49. Carr J, Shepherd RB. A motor learning model for rehabilitation. In: Carr J, Shepherd RB, editors. Movements Science.Foundation for Physical Therapy in Rehabilitation. 2nd edn. Gaithersburg: Aspen Publishers; 2000, p. 33–111.
  50. Richardson W, Wilson M, Nishikawa J, Hayward R. The well-built clinical question: a key to evidence-based decisions. ACP J Club 1995; 123: A12–A13.
  51. van Tulder MW, Assendelft WJ, Koes BW, Bouter LM. Method guidelines for systematic reviews in the Cochrane Collaboration Back Review Group for Spinal Disorders. Spine 1997; 22: 2323–2330.
  52. van Tulder M, Furlan A, Bombardier C, Bouter L. Updated method guidelines for systematic reviews in the Cochrane collaboration back review group. Spine 2003; 28: 1290–1299.
  53. Marino RJ, Barros T, Biering-Sorensen F, Burns SP, Donovan WH, Graves DE, et al. International standards for neurological classification of spinal cord injury. J Spinal Cord Med 2003; 26 Suppl 1: S50–S56.
  54. Beekhuizen KS, Field-Fote EC. Massed practice versus massed practice with stimulation: effects on upper extremity function and cortical plasticity in individuals with incomplete cervical spinal cord injury. Neurorehabil Neural Repair 2005; 19: 33–45.
  55. Beekhuizen KS, Field-Fote EC. Sensory stimulation augments the effects of massed practice training in persons with tetraplegia. Arch Phys Med Rehabil 2008; 89: 602–608.
  56. Hicks AL, Martin KA, Ditor DS, Latimer AE, Craven C, Bugaresti J, et al. Long-term exercise training in persons with spinal cord injury: effects on strength, arm ergometry performance and psychological well-being. Spinal Cord 2003; 41: 34–43.
  57. Klose KJ, Schmidt DL, Needham BM, Brucker BS, Green BA, Ayyar DR. Rehabilitation therapy for patients with long-term spinal cord injuries. Arch Phys Med Rehabil 1990; 71: 659–662.
  58. Nawoczenski DA, Ritter-Soronen JM, Wilson CM, Howe BA, Ludewig PM. Clinical trial of exercise for shoulder pain in chronic spinal injury. Phys Ther 2006; 86: 1604–1618.
  59. Needham-Shropshire BM, Broton JG, Cameron TL, Klose KJ. Improved motor function in tetraplegics following neuromuscular stimulation-assisted arm ergometry. J Spinal Cord Med 1997; 20: 49–55.
  60. Kohlmeyer KM, Hill JP, Yarkony GM, Jaeger RJ. Electrical stimulation and biofeedback effect on recovery of tenodesis grasp: a controlled study. Arch Phys Med Rehabil 1996; 77: 702–706.
  61. Popovic MR, Thrasher TA, Adams ME, Takes V, Zivanovic V, Tonack MI. Functional electrical therapy: retraining grasping in spinal cord injury. Spinal Cord 2006; 44: 143–151.
  62. Curtis KA, Tyner TM, Zachary L, Lentell G, Brink D, Didyk T, et al. Effect of a standard exercise protocol on shoulder pain in long-term wheelchair users. Spinal Cord 1999; 37: 421–429.
  63. Seeger BR, Law D, Creswell JE, Stern LM, Potter G. Functional electrical stimulation for upper limb strengthening in traumatic quadriplegia. Arch Phys Med Rehabil 1989; 70: 663–667.
  64. Lugo LH, Salinas F, Garcia HI. Out-patient rehabilitation programme for spinal cord injured patients: evaluation of the results on motor FIM score. Disabil Rehabil 2007; 29: 873–881.
  65. Hoffman LR, Field-Fote EC. Cortical reorganization following bimanual training and somatosensory stimulation in cervical spinal cord injury: a case report. Phys Ther 2007; 87: 208–223.
  66. Guzelkucuk U, Duman I, Taskaynatan MA, Dincer K. Comparison of therapeutic activities with therapeutic exercises in the rehabilitation of young adult patients with hand injuries. J Hand Surg [Am] 2007; 32: 1429–1435.
  67. Plautz EJ, Milliken GW, Nudo RJ. Effects of repetitive motor training on movement representations in adult squirrel monkeys: role of use versus learning. Neurobiol Learn Mem 2000; 74: 27–55.
  68. Donnelly C, Eng JJ, Hall J, Alford L, Giachino R, Norton K, et al. Client-centred assessment and the identification of meaningful treatment goals for individuals with a spinal cord injury. Spinal Cord 2004; 42: 302–307.
  69. Wressle E, Eeg-Olofsson AM, Marcusson J, Henriksson C. Imp- roved client participation in the rehabilitation process using a client-centred goal formulation structure. J Rehabil Med 2002; 34: 5–11.

    Appendix I. Levels of evidence and conclusion according to the Dutch CBO guidelines

    Levels of evidence according to the Dutch CBO guidelines

    A1

    Systematic review containing at least 2 independent trials of level A2

    A2

    Randomized comparative double-blind study of good quality and sufficient size

    B

    Comparative trials, but not all characteristic of A2 (also patient control studies and cohort studies)

    C

    Non-comparative trials

    D

    Expert opinion

    Level of conclusion according to the Dutch CBO guidelines

    Conclusion based on:

    1

    Research on level A1 of at least 2 independent trials of level A2

    2

    1 trial of level A2 of at least 2 independent trials of level B

    3

    1 trial of level B or C

    4

    Expert opinion

    CBO: Institute for Healthcare Improvement.



Related articles

There are no related articles.


Actions


Abstract

Full text

PDF

Supplementary


There is no supplementary for this article.

Related articles


Click here to show related articles

Print information


Volume 41, Issue 7

DOI: 10.2340/16501977-0387

Pages: 497-505

View at PubMed