Factors associated with upper extremity contractures after cervical spinal cord injury: A pilot study

The Journal of Spinal Cord Medicine, 2018 · DOI: 10.1080/10790268.2017.1331894 · Published: May 1, 2018

Spinal Cord Injury Rehabilitation Musculoskeletal Medicine

Simple Explanation

This study looks at how common joint contractures are in the upper limbs of people with cervical spinal cord injuries. It examines the relationship between these contractures and factors like muscle strength, nerve function, overall functional ability, and demographic information. The findings highlight the need for regular monitoring of joint health throughout the lives of individuals with tetraplegia.

Study Duration

November 2012 and January 2014

Participants

Thirty-eight participants with cervical level spinal cord injury

Evidence Level

Cross-sectional convenience sampled pilot study

Key Findings

1
Every participant tested had multiple joints with contractures and, on average, participants were unable to achieve the normative values of passive movement in 52% of the joints tested.
2
There was a strong negative correlation between SCIM-III score and percentage of contractures.
3
Individuals with paralyzed or weak voluntary triceps are at greater risk for developing elbow flexion contracture.

Research Summary

Joint contractures were found to be a common problem after cervical level SCI based on our convenience sample of 38 subjects. Joint contractures are negatively correlated to functional ability, as measured by the SCIM III. This pilot study points to the need for larger studies that follow a large group of participants longitudinally are needed to elucidate the contributing factors to joint contractures

Practical Implications

Early Evaluation

Detailed evaluation of the arm and hand early after injury is crucial.

Continued Monitoring

Continued monitoring of joint characteristics throughout the life course of individuals with tetraplegia is necessary.

Preventive Interventions

Better preventive interventions need to be developed to address joint contractures.

Study Limitations

1
Sample comprised of male veteran participants from a single geographical region of the United States, limiting generalizability of the results.
2
Cross-sectional design limits inferences about causation.
3
Surface electrical stimulation is a measurement of functional denervation, as true denervation determination requires electrodiagnostic testing.

Your Feedback

Was this summary helpful?

Back to Spinal Cord Injury