Article

Clinical intervention study. Arm hand skilled performance
(AHSP) has a major role in the rehabilitation of persons with cervical spinal
cord injury (C-SCI). A task-oriented client-centered upper extremity skilled
performance-training (ToCUEST) module was developed. The present study aims to
evaluate effects of ToCUEST on specific and general AHSP in C-SCI, during and
after rehabilitation.Setting:Adelante Rehabilitation Centre (The
Netherlands).Methods:C-SCI persons, either during or after rehabilitation,
completed the ToCUEST training; a control group of patients during rehabilitation
received standard rehabilitation. The training module was focused on patient's
individual needs, combining principles of motor learning and training physiology.
Three self-selected goals were trained 3 days per week, in three sessions of 30
min per day for 8 weeks. Measures were taken at 3 months after the start of the
active rehabilitation (T0), before training (T1), after training (T2), at
follow-up (3 months post-training; T3) and at discharge.Results:For both ToCUEST
groups during (n=11) and after (n=12) rehabilitation, an improvement (P<0.001) on
specific AHSP (using the Goal Attainment Scale and the Canadian Occupational
Performance Measure (satisfaction and performance)) was found between T1-T2 and
T1-T3. Also an improvement (P<0.02) in general AHSP (using the Van Lieshout Test,
the QIF and the motor FIM) was found in the total ToCUEST group between T1-T2 and
T1-T3. No significant difference in improvement of general AHSP was found between
the ToCUEST rehab and control group.Conclusion:The ToCUEST module leads to
improvement in AHSP, not only persons with C-SCI during rehabilitation, but also
after finishing rehabilitation. These effects remain at follow-up.

Langue : ANGLAIS