Risk-beneﬁt value of upper extremity function by an implanted electrical stimulation device targeting chronic cervical spinal cord injury

Spinal Cord Series and Cases, 2019 · DOI: https://doi.org/10.1038/s41394-019-0213-9 · Published: July 9, 2019

Spinal Cord Injury Patient Experience Neurology

Simple Explanation

This study investigates how people with tetraplegia value improvements in arm and hand function that could be achieved with a new implanted device. The survey explored how much importance individuals placed on different potential benefits, as well as their tolerance for possible risks associated with the device. The findings suggest that people with tetraplegia are generally very interested in regaining arm and hand function and are willing to accept certain risks to achieve this.

Study Duration

August to November 2017

Participants

408 adults living with tetraplegia

Evidence Level

Not specified

Key Findings

1
More than 70% of participants rated improvements in arm/hand function as “very important” to regain.
2
Over 64% of responders were interested in getting the NNP with a success rate threshold as low as 50%, regardless of time post-injury.
3
Females and people injured 16 or more years were more conservative in their definition of success and risk tolerance.

Research Summary

This study used a survey to assess the value people with tetraplegia place on potential benefits and risks of an implanted neuroprosthetic device (NNP) for upper extremity function. The results indicated a high level of interest in regaining arm and hand function, with participants showing tolerance for potential risks associated with the device. The study highlights the importance of considering patient preferences when designing and evaluating new neuroprosthetic interventions.

Practical Implications

Device Design

Prioritize features that restore meaningful upper extremity function, as these are highly valued by individuals with tetraplegia.

Clinical Trial Design

Recognize that individuals with tetraplegia may have a high tolerance for risk when it comes to interventions that improve arm and hand function.

Patient Education

Provide clear and comprehensive information about the potential benefits and risks of neuroprosthetic devices to allow for informed decision-making.

Study Limitations

1
The survey was administered primarily online, which may introduce bias.
2
The choices presented in the survey were hypothetical.
3
Participants responded to each attribute individually, not to a proﬁle of attributes.

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