Monitoring Upper limb recovery after cervical spinal cord injury: insights beyond assessment scores

Frontiers in Neurology, 2016 · DOI: 10.3389/fneur.2016.00142 · Published: August 31, 2016

Spinal Cord Injury Assistive Technology Rehabilitation

Simple Explanation

This study uses wearable sensors to objectively measure upper limb (UL) activity in patients with spinal cord injury (SCI) during acute rehabilitation. The study tracked UL activity and wheeling kinematics in 12 thoracic and 19 cervical SCI patients for up to seven consecutive days, correlating these measurements with standard clinical assessments. The findings suggest that wearable sensors can provide valuable insights into UL recovery, potentially enabling better control and adjustment of activity-based rehabilitative therapies.

Study Duration

6 Months

Participants

31 SCI patients (19 cervical, 12 thoracic)

Evidence Level

Not specified

Key Findings

1
Tetraplegic patients showed a significant increase in overall UL activity and active distance wheeled during acute rehabilitation, while paraplegic patients remained constant.
2
In the later stages of acute rehabilitation, tetraplegic individuals matched the quantity of UL activity of their paraplegic counterparts, despite greater motor impairments.
3
Both subject groups showed higher UL activity during therapy time compared to leisure time.

Research Summary

The study examined changes in upper limb (UL) activity using wearable sensors in spinal cord injury (SCI) patients during acute rehabilitation, comparing tetraplegic and paraplegic subjects over a 6-month period. Results indicated that tetraplegic patients significantly improved UL activity during rehabilitation, eventually reaching similar levels to paraplegic patients, despite greater motor impairments. The study suggests that wearable sensors can provide valuable insights into UL recovery and inform the tailoring of rehabilitative therapies.

Practical Implications

Personalized Rehabilitation

Wearable sensor data can be used to tailor rehabilitative therapies to specific patient needs and track progress objectively.

Improved Monitoring

Continuous monitoring of UL activity can provide a more accurate understanding of a patient’s impairment impact and response to therapy.

Enhanced Clinical Trials

The methodology can be used to reliably control and adjust activity-based rehabilitative therapies and evaluate the progress of UL rehabilitation in clinical trials.

Study Limitations

1
The study may have a low stratification of included patients due to a low number of patients with high tetraplegia.
2
The study could not control for certain cofounders, e.g., the prevalence of ambulatory bouts of mobility, which limits the interpretation of global kinematics metrics.
3
The interpretation of global kinematic metrics such as active wheeling distance is limited.

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