Article

OBJECTIVE: To identify key components of conventional therapy after
brachioradialis (BR) to flexor pollicis longus (FPL) transfer, a common procedure
to restore pinch strength, and evaluate whether any of the key components of
therapy were associated with pinch strength outcomes. DESIGN: Rehabilitation
protocols were surveyed in 7 spinal cord injury (SCI) centers after BR to FPL
tendon transfer. Key components of therapy, including duration of immobilization,
participation, and date of initiating therapy activities (mobilization,
strengthening, muscle reeducation, functional activities, and home exercise),
were recorded by the patient's therapist. Pinch outcomes were recorded with
identical equipment at 1-year follow-up. SETTING: Seven SCI rehabilitation
centers where the BR to FPL surgery is performed on a routine basis.
PARTICIPANTS: Thirty-eight arms from individuals with C5-7 level SCI injury who
underwent BR to FPL transfer surgery (N=34). INTERVENTION: Conventional therapy
according to established protocol in each center. MAIN OUTCOME MEASURES: The
frequency of specific activities and their time of initiation (relative to
surgery) were expressed as means and 95% confidence intervals. Outcome measures
included pinch strength and the Canadian Occupational Performance Measure (COPM).
Spearman rank-order correlations determined significant relations between pinch
strength and components of therapy. RESULTS: There was similarity in the key
components of therapy and in the progression of activities. Early cast removal
was associated with pinch force (Spearman rho=-.40, P=.0269). Pinch force was
associated with improved COPM performance (Spearman rho=.48, P=.0048) and
satisfaction (Spearman rho=.45, P=.0083) scores. CONCLUSIONS: Initiating therapy
early after surgery is beneficial after BR to FPL surgery. Postoperative therapy
protocols have the potential to significantly influence the outcome of tendon
transfers after tetraplegia.
CI - Copyright (c) 2016 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS