Using “functional hand” protocol to improve hand function following a spinal cord injury: An explorative study

Acta Biomed, 2023 · DOI: 10.23750/abm.v94i5.14408 · Published: May 1, 2023

Spinal Cord Injury Neurology Rehabilitation

Simple Explanation

A cervical spinal cord injury often impairs hand function, affecting grasping and independence. This study explores the "functional hand" protocol, a physiotherapy approach, for improving hand recovery. The "functional hand" protocol aims to develop a structured shortening of finger and thumb flexor muscles, enabling functional grips with wrist stabilization. The study compared patients who underwent the "functional hand" protocol with those who did not, assessing hand function using the Action Research Arm Test (ARAT).

Study Duration

Not specified

Participants

6 patients with C5-C7 spinal cord injury

Evidence Level

Longitudinal-single cohort study

Key Findings

1
Patients who underwent the functional hand protocol demonstrated lower impairment and better ability to produce cylindrical and cuboid sockets compared to those who did not.
2
ARAT scores showed higher performance in treated patients, indicating the effectiveness of the procedure to restore hand ability compared to exercise alone.
3
The study suggests that the functional hand protocol is an effective tool to restore and preserve hand function even after many years by SCI occurrence.

Research Summary

This study investigates the effectiveness of the "functional hand" protocol, a physiotherapy approach, in improving hand function for tetraplegic patients following a spinal cord injury. The study found that patients who underwent the functional hand protocol showed better hand function, particularly in grasping and gripping abilities, compared to those who did not. The authors conclude that the functional hand protocol appears to be an effective tool for restoring and preserving hand function in tetraplegic patients and suggest further research on larger samples and in combination with other treatments.

Practical Implications

Rehabilitation Strategy

The functional hand protocol can be considered as a valuable rehabilitation strategy for improving hand function in tetraplegic patients.

Multidisciplinary Approach

Highlights the importance of a multidisciplinary approach in tetraplegic hand management involving doctors, physiotherapists, occupational therapists, nurses, and patients.

Personalized Treatment

Treatment needs to be personalized and consider factors like the patient’s general medical condition, motor abilities, and self-efficacy.

Study Limitations

1
Small sample size, limiting the generalizability of the findings.
2
ARAT scale may not be fully suitable to explore functional hand principle, since pinch subscale is not applicable.
3
Lack of a control group and randomization limits the ability to establish causality.

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