Associations between upper extremity functioning and kinematics in people with spinal cord injury

J NeuroEngineering Rehabil, 2021 · DOI: https://doi.org/10.1186/s12984-021-00938-9 · Published: September 8, 2021

Spinal Cord Injury Neurology Biomechanics

Simple Explanation

This study examines the relationship between how well people with spinal cord injuries (SCI) can use their arms and hands, and the way their movements look during a simple task. The research looks at specific movements, like reaching and drinking, and connects them to scores from standard clinical tests. This helps understand how these tests reflect real-world movement quality in people with SCI. The findings highlight the importance of wrist movement, speed, and smoothness in arm function for individuals with SCI, particularly those with injuries in the neck area. The results suggest all three assessments are appropriate for SCI.

Study Duration

Not specified

Participants

25 individuals with chronic cervical or thoracic SCI

Evidence Level

Cross-sectional study

Key Findings

1
Wrist angle combined with movement time or smoothness explained a large portion of the variance in ARAT and SHFT scores.
2
Wrist angle alone explained a significant portion of the variance in ISCI-Hand scores.
3
The proprioception of the hand increased the explanatory power in the models of ARAT and SHFT.

Research Summary

This study aimed to determine which kinematic variables obtained during a drinking task were associated with three clinical assessments of upper extremity functioning (ARAT, SHFT, ISCI-Hand) in people with cervical or thoracic spinal cord injury. The multiple regression analysis showed that as for the whole group the wrist angle combined with movement time or movement smoothness explained 82% and 77% or more of the total variance in ARAT and SHFT, respectively. The findings show that all three clinical assessments, included in this study, reflected well the quality of movement measured with kinematics in individuals with SCI and particularly in those with cervical spinal SCI.

Practical Implications

Clinical Assessment

ARAT, SHFT and ISCI-Hand are valid for assessing upper extremity function after SCI.

Rehabilitation Focus

Rehabilitation programs should focus on improving wrist angle, movement time and smoothness.

Proprioception Importance

Clinical examination should consider proprioception of the hand as an important factor in upper extremity function.

Study Limitations

1
The sample size of thoracic SCI subgroup was small.
2
The results are most applicable for people with cervical SCI.
3
The study is only applicable for individuals with SCI who have some limitations in arm functioning but are able to use their upper extremity for drinking from a glass or drinking cup.

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