Article

Scientific advances are increasing the options for improved upper limb function
in people with cervical level spinal cord injury (SCI).
Some of these
interventions rely on identifying an aspect of paralysis that is not uniformly
assessed in SCI: the integrity of the lower motor neuron (LMN). SCI can damage
both the upper motor neuron and LMN causing muscle paralysis. Differentiation
between these causes of paralysis is not typically believed to be important
during SCI rehabilitation because, regardless of the cause, the muscles are no
longer under voluntary control by the patient. Emerging treatments designed to
restore upper extremity function (eg, rescue microsurgical nerve transfers, motor
learning-based interventions, functional electrical stimulation) all require
knowledge of LMN status. The LMN is easily evaluated using surface electrical
stimulation and does not add significant time to the standard clinical assessment
of SCI. This noninvasive evaluation yields information that contributes to the
development of a lifetime upper extremity care plan for maximizing function and
quality of life. Given the relative simplicity of this assessment and the
far-reaching implications for treatment and function, we propose that this
assessment should be adopted as standard practice for acute cervical SCI.
CI - Copyright (c) 2016 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS