Development of Reaching, Grasping & Manipulation indicators to advance the quality of spinal cord injury rehabilitation: SCI-High Project

The Journal of Spinal Cord Medicine, 2021 · DOI: 10.1080/10790268.2021.1961052 · Published: August 2, 2021

Spinal Cord Injury Healthcare Rehabilitation

Simple Explanation

This study focuses on creating ways to measure and improve rehabilitation for people with spinal cord injuries, specifically how they reach, grab, and handle objects. The goal is to set standards and track progress in upper body rehabilitation, making sure patients get the best possible care to regain function and independence. By using these measures, healthcare providers can compare different rehabilitation programs and find ways to enhance the quality of therapy provided.

Study Duration

Not specified

Participants

Upper extremity rehabilitation experts

Evidence Level

Not specified

Key Findings

1
The study identified key indicators to assess the quality of upper extremity rehabilitation, including the expertise of therapists, the amount of therapy provided, and patient outcomes.
2
A structure indicator was selected as the number of occupational and physical therapists with specialized certification.
3
The outcome indicators are the Graded Redefined Assessment of Strength, Sensation and Prehension (GRASSP) strength and Spinal Cord Independence Measure III (SCIM III) Self-Care subscores.

Research Summary

This manuscript describes the context and approach to developing the Reaching, Grasping & Manipulation (RG&M) indicators for application during the first 18 months after SCI/D rehabilitation admission. The RG&M Working Group’s objective was to establish a comprehensive framework of structure, process, and outcome indicators specific to the Domain construct of RG&M for implementation in Canada. The selected indicators align with current practice, will direct the timing of routine assessments, and enhance the volume and quality of RG&M therapy delivered, with the aim to ultimately increase the proportion of individuals with tetraplegia achieving improved upper extremity function by 18 months post-rehabilitation.

Practical Implications

Improved Rehabilitation Programs

The indicators will help rehabilitation centers understand the relationship between therapy intensity and patient outcomes, enabling them to tailor programs for better results.

Standardized Assessment

Routine implementation of these indicators will standardize the assessment of upper extremity function, making it easier to compare outcomes across different rehabilitation sites.

Enhanced Patient Care

By focusing on specific indicators, therapists can better address the needs of individuals with tetraplegia, leading to improved upper extremity function and independence.

Study Limitations

1
The study acknowledges that data collection may miss hours spent with Physical and Occupational Therapy Assistants.
2
The selected indicators do not capture specific upper extremity rehabilitation techniques used.
3
There may be an overlap between the indicator data collected for other Domains of rehabilitation care.

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