Upper Limb Capabilities, Self-Care and Fine Motor Activities with and Without Equipment in Persons with Cervical Spinal Cord Injury at Discharge from Rehabilitation and 1 Year Post-Injury

Abstract

Introduction: There is little information on the impact of assistive technology or devices (AT) on function. The purpose of this project was to explore the impact of AT on self-care (SC) and fine motor (FM) function in persons with cervical SCI, and to examine the functional capabilities of those who benefit from AT. Methods: Persons with acute cervical SCI, all levels and AIS grades, with an upper extremity motor score (UEMS) \u3e 0 were enrolled. At discharge from rehabilitation and 1 year post-injury we collected the Capabilities of Upper Extremity questionnaire (CUE-Q), and the combined SC and FM questions of the SCI Functional Index (SCI-FI) and SCI-FI/AT short forms. The arm with the highest CUE-Q side score was designated the better side. The impact of AT on SC and FM function was evaluated by looking at the difference in SCI-FI and SCI-FI/AT scores, and changes over time. Results: There were 67 participants with data at rehab discharge and 1-year post-injury, 50 male and 17 female, average age 43.3 ± 15.6 years. Median scores by neurologic groupings are shown in the table. All groups demonstrated improvements in CUE-Q and SCI-FI scores from discharge to 1 year post-injury (table and radar charts). By neurologic group, AT was useful for the greatest percentage of persons classified as C4-C5 AB for FM and C6-T1 AB for SC), least useful for C6-T1 CD (charts at right). AT was helpful for the greatest number of items for SC in the C4-C5 CD group at discharge (bolded numbers in table). There tended to be less use of AT for tasks at 1 year compared to rehab discharge. For example, the percentage of persons using AT for brushing teeth at discharge was 48%, while at 1 year it was only 25%. Conclusion: Many persons with tetraplegia are able to perform self-care and fine motor tasks easier using AT, but the benefit depends on the level and severity of injury. There is a decreased reliance on AT over time, which may in part be due to continued recovery after rehabilitation discharge.https://jdc.jefferson.edu/rmposters/1013/thumbnail.jp