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  4. Effect of Training Combining Hand-Arm Bimanual Intensive Therapy Concept and Postural Control Elements on Individuals With Chronic Incomplete Cervical Spinal Cord Injury: A Report of Two Cases

Effect of Training Combining Hand-Arm Bimanual Intensive Therapy Concept and Postural Control Elements on Individuals With Chronic Incomplete Cervical Spinal Cord Injury: A Report of Two Cases

Cureus, 2025 · DOI: 10.7759/cureus.79695 · Published: February 26, 2025

Spinal Cord InjuryRehabilitation

Simple Explanation

This study explores a new rehabilitation approach for individuals with incomplete cervical spinal cord injury (ICSCI) that combines intensive hand and arm training with exercises to improve posture and balance. The training, called HABIT-SCI, is based on principles used for cerebral palsy and stroke rehabilitation, adapting them for spinal cord injury to improve both upper limb function and overall stability. Two case studies showed that this combined approach can lead to improvements in upper limb function and balance, suggesting it could be a valuable addition to current rehabilitation methods.

Study Duration
15 days intervention, 3-4 weeks conventional training
Participants
Two men with chronic incomplete cervical spinal cord injury (ICSCI): one in his 30s (NLI C5; AIS grade D) and one in his 50s (NLI C3; AIS grade D)
Evidence Level
Case Report

Key Findings

  • 1
    Both cases demonstrated improvements in upper limb function, as measured by the Capabilities of Upper Extremity Test (CUE-T), after the intensive training period.
  • 2
    Participants also showed enhanced balance ability, indicated by improvements in the Berg Balance Scale (BBS) scores, suggesting better postural control.
  • 3
    The study found that incorporating bimanual movement and postural control into upper limb training can lead to significant functional gains for individuals with ICSCI.

Research Summary

This study investigated the effects of intensive task-oriented training, combining bimanual movement and postural control elements (HABIT-SCI), on individuals with chronic incomplete cervical spinal cord injury (ICSCI). Two case studies involving men with C5 and C3 neurological levels of injury (AIS grade D) participated in 50-hour training sessions over 15 days, along with a diary-based transfer package. The results indicated that HABIT-SCI can improve upper limb function and balance ability in individuals with chronic ICSCI, highlighting the importance of considering both bimanual movement and postural control in rehabilitation interventions.

Practical Implications

Comprehensive Rehabilitation

Interventions for ICSCI should integrate bimanual movement and postural control training.

Task-Oriented Training

Intensive, task-oriented training can be effective for improving functional outcomes in individuals with chronic ICSCI.

Self-Practice and Motivation

The use of transfer packages and regular feedback can help maintain motivation and promote self-practice, leading to sustained improvements.

Study Limitations

  • 1
    Small sample size (two cases) limits generalizability.
  • 2
    The study lacks neurological and physiological evaluations to further explain the mechanisms of improvement.
  • 3
    Initial goal-setting methods need further refinement.

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