Article

OBJECTIVE: To describe and evaluate the concept of early active rehabilitation
after tendon transfer to restore grip function in tetraplegia. DESIGN:
Retrospective cohort study. SETTING: Two nonprofit rehabilitation units in Sweden
and Switzerland. PARTICIPANTS: All patients with tetraplegia who underwent tendon
transfer to restore grip ability during 2009 to 2013 (N=49). INTERVENTION:
Reconstructive tendon transfer surgery with early active rehabilitation to
restore grip ability in tetraplegia. MAIN OUTCOME MEASURES: Grip and pinch
strength, grip ability test, and outcome of prioritized activities. RESULTS: In
the 49 surgeries performed, postoperative complications included 2 patients with
bleeding and 2 infections related to the surgery. There were no reported ruptures
or lengthening of transferred tendons. Within 24 hours after surgery, all 47
patients (100%) with finger flexion reconstruction succeeded to activate their
finger flexion. All but 1 patient with reconstructed thumb flexion sucessfully
activated their thumb flexion (n=40). Three weeks after surgery, all patients
(100%) were able to perform basic activities of daily living, and instrumental
activities of daily living were achieved by 74%. One year after surgery, the
maximum grip strength in restored finger flexion was on average 6.9kg (range,
1.5-15kg; n=29). The maximum pinch strength in restored thumb flexion was on
average 3.7kg (range, 1-20; n=29). On average, grip ability improved from 33 to
101 (n=19) according to the COPM. Prioritized activity limitations, as measured
with the COPM, equated to an average of 3.5 steps (2.5 steps preoperatively to 6
steps postoperatively). Patients' perceived satisfaction with this improvement
was 4 steps (increasing from 2 steps preoperatively to 6 steps postoperatively).
CONCLUSIONS: Grip reconstructive surgery followed by early active rehabilitation
can be considered a reliable procedure that leads to substantial improvements in
grip and pinch strength and activity performance among patients with tetraplegia.
CI - Copyright (c) 2016 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.
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Langue : ANGLAIS