Article

OBJECTIVE: To describe the early active rehabilitation concept developed for
spasticity-correcting surgery in tetraplegia and to report the outcomes in grip
ability and change of performance and satisfaction in patients' prioritized
activities 1 year postoperatively. DESIGN: Retrospective case-control study.
SETTING: Nonprofit rehabilitation unit. PARTICIPANTS:
All patients who underwent
surgeries for correction of spasticity in tetraplegic hands between 2009 and 2013
in the studied unit (N=37). INTERVENTIONS: Spasticity-correcting upper limb
surgery with early active rehabilitation to restore grip ability in tetraplegia.
MAIN OUTCOME MEASURES: Grasp and release test (GRT) and modified Canadian
Occupational Performance Measure (COPM). RESULTS: All patients could accomplish
the early active rehabilitation concept. The complication rate related to the
treatment was low. Compared with preoperatively, all evaluated individuals
experienced improvements in grasp ability and activity performance and
satisfaction at 1-year follow-up. The performance in prioritized activities, as
measured by the COPM, improved by 2.6 scale steps. Satisfaction with performance
improved 3.0 scale steps postoperatively (n=21). The grasp ability, measured by
the GRT, improved significantly, from 80 preoperatively to 111 (n=10).
CONCLUSIONS: The surgery, combined with the early active rehabilitation protocol,
is a reliable and safe procedure. The ability to use the hand improved, and gains
were maintained at least 1 year after surgery in all patients with respect to
both the objective grasp ability and patients' subjective rating of their
performance and satisfaction in their prioritized activities.
The procedure
should therefore be considered as an adjunct to other treatments of upper limb
spasticity in spinal cord injury.
CI - Copyright (c) 2016 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS