Relationship between motor FIM and muscle strength in lower cervical-level spinal cord injuries (original) (raw)
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Correlation among lesion level, muscle strength and hand function in cervical spinal cord injury
European Journal of Physical and Rehabilitation Medicine, 2013
Correlation among lesion level, muscle strength and hand function in cervical spinal cord injury rately predict residual hand function from the level of lesion obtained from the clinical records, or from an ICSHT evaluation. Clinical rehabilitation impact. The results of our work show that a large number of patients with cervical spinal cord lesion have impaired hand function. Residual hand function must be assessed with specific functional tests; it cannot be derived simply from a lesion's neurological level.
Neurorehabilitation and Neural Repair, 2012
Background. For therapeutics directed to the injured spinal cord, a change in neurological impairment has been proposed as a relevant acute clinical study end point. However, changes in neurological function, even if statistically significant, may not be associated with a functional impact, such as a meaningful improvement in items within the self-care subscore of the Spinal Cord Independence Measure (SCIM). Objective. The authors examined the functional significance associated with spontaneously recovering upper-extremity motor function after sensorimotor-complete cervical spinal cord injury (SCI). Methods. Using the European Multi-center Study about Spinal Cord Injury (EMSCI) data set, a retrospective analysis was undertaken of individuals with cervical sensorimotor-complete SCI (initial motor level, C4-C7). Specifically, changes in upper-extremity motor score (UEMS), motor level, and SCIM (total and self-care subscore) were assessed between approximately 1 and 48 weeks after inju...
Spinal Cord, 2016
Background: Automated sensor-based assessments of upper extremity (UE) function after cervical spinal cord injury (SCI) could provide more detailed tracking of individual recovery profiles than is possible with existing assessments, and optimize the delivery and assessment of new interventions. The design of reliable automated assessments requires identifying the key variables that need to be measured to meaningfully quantify UE function. An unanswered question is to what extent measures of sensorimotor impairment can quantitatively predict performance on functional tasks. Objective: The objective was to define the predictive value of impairment measures for concurrent functional task performance in traumatic cervical SCI, as measured by the Graded Redefined Assessment of Strength, Sensibility and Prehension (GRASSP). Setting: Retrospective analysis. Methods: A data set of 138 GRASSP assessments was analyzed. The Strength and Sensation modules were used as measures of impairment, whereas the concurrent Prehension Performance module was used as the surrogate measure of function. Classifiers were trained to predict the scores on each of the six individual tasks in the Prehension Performance module. The six scores were added to obtain a total score. Results: The Spearman's ρ between predicted and actual total Prehension Performance scores was 0.84. Predictions using both the Strength and Sensation scores were not found to be superior to predictions using the Strength scores alone. Conclusions: Measures of UE motor impairment are highly predictive of functional task performance after cervical SCI. Automated sensor-based assessments of UE motor function after SCI can rely on measuring only impairment and estimating functional performance accordingly.
Analysis of the Factors Influencing Functional Outcomes in Patients with Spinal Cord Injury
Journal of Physical Therapy Science, 2014
The extent of functional independence ultimately achieved by an individual patient will be influenced by a variety of medical and non-medical factors. [Subjects and Methods] this study included 419 patients with spinal cord lesions treated in the Clinic for Rehabilitation "Dr M. Zotovic", Belgrade, Serbia, from January 2000 to December 2009. The patients were divided in two groups according to achievement of increase in Functional Independence Measure (FIM) score of more than 13 at discharge compared to admission. A variety of clinical variables were followed in both groups. [Results] one hundred twenty-one patients (28.9%) showed improvements in FIM score of ≤13, while 298 (71.1%) patients showed an increases in FIM score of >13 at discharge compared to admission. Better functional recovery was observed in patients with non-traumatic spinal cord lesions, lower neurological levels of the lesion (OR = 6.07), and in patients treated surgically, but the level of the spinal cord lesion was the most influential factor affecting outcome. [Conclusion] the patients with spinal cord lesions should not only be grouped by traumatic and non-traumatic lesions only, but also subcategorized , according to the etiology, level of injury and treatment method.
Journal of Rehabilitation Medicine, 2008
To determine changes in functional independence following spinal cord injury and to evaluate the association between functional independence and physical capacity. Design: Multi-centre prospective cohort study. Subjects: Patients with spinal cord injury admitted for initial rehabilitation. Methods: The motor Functional Independence Measure (FIMmotor) was determined at the start of rehabilitation (n = 176), 3 months later (n = 124), at discharge (n = 160) and one year after discharge from inpatient rehabilitation (n = 133). One year after discharge, physical and social dimensions of health-related functional status (Sickness Impact Profile 68; SIP68) were determined. On each occasion, physical capacity was established by measuring arm muscle strength, peak power output and peak oxygen uptake. Results: Multi-level random coefficient analyses revealed that FIMmotor improved during inpatient rehabilitation, but stabilized thereafter. Changes in FIMmotor were associated with peak power output. Multiple regression models showed that FIMmotor and peak power output at discharge were associated with FIMmotor one year after discharge (R 2 = 0.85), and that peak power output at discharge was associated with the social dimension of the SIP68 (R 2 = 0.18) one year after discharge. Conclusion: Functional independence improves during inpatient rehabilitation, and functional independence is positively associated with peak power output.
Türkiye Fiziksel Tıp ve Rehabilitasyon Dergisi, 2017
Objectives: This study aims to analyze the demographic and clinical properties of patients with spinal cord injury (SCI) and to investigate the functional outcomes after rehabilitation. Patients and methods: In this retrospective and descriptive study, we investigated a total of 118 SCI patients (74 males, 44 females; mean age 41±16 years; range 13 to 74 years) with full records who were admitted to our rehabilitation program between January 2005 and December 2010. Demographic characteristics of the patients, etiological factors, time since injury, length of hospital stay, level of injury, as assessed by the American Spinal Injury Association (ASIA) Impairment Scale and functional status, as assessed by the Functional Independence Measure (FIM TM) on admission and discharge were analyzed. Complications related to SCI were also noted. Characteristic features of the patients', frequency of complications, and functional and neurological recovery were evaluated. Results: Of the patients, 70% were tetraplegic. The median time since injury was four months (IQR: 1 to 15 months), while the median length of stay was 76 days (IQR: 46 to 104 days). Four of 47 patients (8%) with Grade A (complete) according to the ASIA Impairment Scale on admission progressed to Grade B on discharge. Functional independence measure motor scores showed significant improvements at discharge (p<0.0001). The most common complications were urinary tract infections (70%), pressure ulcers (31%), and pain (28%). Conclusion: Inpatient rehabilitation in a tertiary referral hospital appears to provide substantial functional and motor gains in patients with SCI. Based on our study results, considerable improvement in the activities of daily living, as assessed by FIM motor scores, can be achieved with rehabilitation.
Reduced Muscle Activity of the Upper Extremity in Individuals with Spinal Cord Injuries
International Journal of Environmental Research and Public Health
Compromised physical ability due to musculoskeletal impairment among spinal cord injury (SCI) patients is known to negatively affect their quality of life. It is essential to comprehensively understand the muscle strength of the upper extremity among patients with SCI to enhance muscle function and capacity to engage in an active lifestyle. The objective of this study was to evaluate the muscle strength of 15 upper extremity muscles among patients with SCI and compare the relative weakness of individual muscles to the control group. Seven male patients with SCI with ASIA impairment scale D and E and 33 males in the control group participated in this study. Each participant performed maximal voluntary contraction of individual muscles, and the electromyography data were recorded. The results showed that the majority of the upper extremity muscles (12 out of 15) showed considerable weakness (24 to 53%) relative to the control group. Furthermore, the relative strength (ranking) of indi...
https://ijshr.com/IJSHR\_Vol.7\_Issue.3\_July2022/IJSHR-Abstract33.html, 2022
Background: Spinal cord injury (SCI) refers to a physical injury to the spinal cord that distorts normal spinal cord function. The sudden occurrence of SCI leading to paralysis of the muscles below the level of injury leads to major functional limitations. Thus, the Spinal Cord Injury-Ability Realization Measurement Index (SCI-ARMI) tool was developed that evaluates functional recovery quantitatively. Purpose: To assess changes in quantitative functional recovery before and after rehabilitation of spinal cord injury by using Quadric Formula of SCI-ARMI. Methodology: SCI-ARMI was used as an outcome measure. Participants followed a routine conventional approach. They were assessed before starting inpatient rehabilitation and after 4 weeks of inpatient rehabilitation by taking Spinal Cord Independence Measure version III (SCIM-III) and AIS motor score (AMS) along with age and gender as a factor for calculation of SCI-ARMI. Results: A highly significant difference was found with a p-value of <0.001. That is suggestive of significant changes in SCI-ARMI scores before and after conventional rehabilitation. Change in this score and improvement in functional performance was influenced by the conventional approach of inpatient rehabilitation. Conclusion: The present study concludes that SCI ARMI is useful and effective tool that monitors achievement of rehabilitation potential and helps to observe changes in quantitative functional recovery in individuals with SCI. Clinical Implication: SCI-ARMI is valid and reliable tool and also takes less time for calculation that can be incorporated into routine clinical assessment for the evaluation of functional performance and rehabilitation potential in SCI population.
Archives of Physical Medicine and Rehabilitation, 2012
Objective: To assess how frequently subjects with spinal cord injuries (SCIs) classified as American Spinal Injury Association Impairment Scale (AIS) grade A have substantial preserved motor function below the neurologic level of injury, despite having no preserved sensory or motor function at the S4-5 spinal cord segment. Design: Analysis of the European Multicenter Study about Spinal Cord Injury database to determine how frequently subjects assessed as AIS A would have been AIS D based on motor scores alone (ie, had scores of Ն3 in at least half of the International Standards for Neurological Classification of Spinal Cord Injury [ISNCSCI] key muscles below the neurologic level of injury, despite having no sacral sparing). Setting: Eighteen European centers. Participants: Individuals with traumatic SCI at any level (total of 2557 assessments). Interventions: Not applicable. Main Outcome Measure: ISNCSCI assessments. Results: Over the first year after SCI (with assessments at approximately 1, 4, 12, 24, and 48wk) and for all rostrocaudal levels of injury, only 3.2% of AIS A assessments were found to meet the AIS D motor score criteria. The percentage was highest for lumbar (16.3%) and lower thoracic (4.4%) SCI. No trends were observed across time points. Conclusions: These results suggest that the low frequency of individuals with an AIS A classification and high levels of motor function are not a significant concern in subject recruitment for clinical trials, unless the level of SCI is within the lumbar cord.