Restoring Voluntary Grasping Function in Individuals with Incomplete Chronic Spinal Cord Injury: Pilot Study

Top Spinal Cord Inj Rehabil, 2013 · DOI: 10.1310/sci1904-279 · Published: October 1, 2013

Spinal Cord Injury Neurology Rehabilitation

Simple Explanation

This pilot study investigates whether functional electrical stimulation (FES) therapy can improve voluntary hand function in individuals with chronic, incomplete spinal cord injury (SCI). FES therapy involves using electrical stimulation to activate muscles and help individuals regain movement. Eight participants with chronic incomplete SCI were divided into two groups: one receiving FES therapy and the other receiving conventional occupational therapy (COT). Both groups received 39 hours of therapy over 13 to 16 weeks. The study found that the FES therapy group showed greater improvements in hand function compared to the COT group, particularly in object manipulation and self-care activities. These results suggest that FES therapy may be a promising approach for restoring hand function in individuals with chronic incomplete SCI.

Study Duration

13 to 16 weeks

Participants

8 male participants with chronic (≥24 months post injury), incomplete (AIS B-D), C4 to C7 SCI

Evidence Level

Pilot RCT

Key Findings

1
The intervention group improved by 5.8 points on the TRI-HFT’s Object Manipulation Task, whereas the control group changed by only 1.17 points.
2
The intervention group improved by 4.6 points on the FIM self-care subscore, whereas the control group did not change at all.
3
The results of the pilot data justify a clinical trial to compare FES therapy and COT alone to improve voluntary hand function in individuals with chronic incomplete tetraplegia.

Research Summary

This pilot study aimed to determine the effectiveness of FES therapy compared to conventional occupational therapy (COT) in improving voluntary hand function in individuals with chronic incomplete SCI. Eight participants were randomized to either FES therapy or COT, receiving 39 hours of therapy over 13-16 weeks. Outcome measures included the TRI-HFT, GRASSP, FIM, and SCIM self-care subscores. The FES therapy group showed greater improvements in object manipulation and FIM self-care subscores compared to the COT group, suggesting that FES therapy may be beneficial for restoring hand function in chronic incomplete tetraplegia.

Practical Implications

Clinical Trial Justification

The study provides justification for a larger clinical trial comparing FES therapy and COT for improving voluntary hand function in chronic incomplete tetraplegia.

Therapeutic Potential

Repetitive FES therapy designed to improve hand function may promote recovery of voluntary grasping function in persons with chronic incomplete SCI.

Individualized FES Protocols

Applying individualized FES protocols monitored and adjusted by an occupational therapist, combined with regular occupational therapy and incorporation with functional tasks, maximizes recovery.

Study Limitations

1
The study had a small sample size, prohibiting statistical analysis.
2
Challenges with recruitment limited the ability to provide solid evidence regarding benefits of one type of therapy over the other.
3
The data represent only pilot data of insufficient quantity to test scientific hypotheses.

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