Assessment of upper limb in tetraplegia: Considerations in evaluation and outcomes research

Mulcahey, M. J.; Hutchinson, Dave; Kozin, Scott H.

doi:10.1682/jrrd.2005.10.0167

Cited by 62 publications

(40 citation statements)

References 83 publications

(96 reference statements)

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“…The International Classification for Surgery of the Hand in Tetraplegia 19 and the MicroFet_2 (Hoggan Health Industries, Salt Lake City, UT, USA) strength measurement were used. 20 The International Classification for Surgery of the Hand in Tetraplegia examines the motor and sensory function and classifies the neurological status.…”

Section: Measurementsmentioning

confidence: 99%

Robot-assisted task-oriented upper extremity skill training in cervical spinal cord injury: a feasibility study

et al. 2015

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Study design: Prospective multiple case study. Objectives: To test (1) the feasibility of haptic robot technology (Haptic Master (HM)) use to improve arm-hand function (AHF) and arm-hand skill performance (AHSP) in persons with a cervical spinal cord injury (C-SCI), (2) inventory participants' motivation and expectation to work with the robot technology used and (3) to descriptively report the results in individual cases. Setting: Rehabilitation Centre. Methods: Five C-SCI patients were trained for 6 weeks, 3 days per week, 60 min per day. Therapists filled out the Usefulness, Satisfaction and Ease-of-use questionnaire (USE). The Intrinsic Motivational Inventory (IMI) and credibility and expectancy questionnaire (CEQ) were filled out by participants. Performance at activity level was gauged using the Van Lieshout test for AHF in Tetraplegia and the Spinal Cord Independence Measure. Function level was gauged using muscle strength testing and the International Classification for Surgery of the Hand in Tetraplegia. Results: As to the feasibility of the application of haptic robot technology, the mean USE score was 65%. Mean IMI and CEQ results were 67% and 60%, respectively. Participants were motivated to train with the HM. All participants rated credibility higher than expectations regarding the improvement. In the current patients, little progress was demonstrated at the International Classification of Functioning, Disability and Health function and the activity level. Conclusion: It is feasible to train C-SCI persons with the HM. Therapists report that working with the HM is easy to learn and easy to perform. Usability of the HM may be improved. Further research is needed to assess in which group of C-SCI and at which stage of rehabilitation HM training may be most beneficial.

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Section: Measurementsmentioning

confidence: 99%

Robot-assisted task-oriented upper extremity skill training in cervical spinal cord injury: a feasibility study

et al. 2015

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“…It allows not only the assessment of the outcome and the progress of upper extremity performance but also the prediction of the outcome, and allows guiding therapists to plan progress in their therapy. In this way, the VLT is different from other instruments measuring upper extremity performances like the Capability Upper Extremity measure (CUE), 13 the Tetraplegia Hand Activity Questionnaire (THAQ) 14 or the Graded and Redefined Assessment of Strength, Sensibility and Prehension (GRASSP). The CUE is a self-reporting questionnaire in which patients rate their abilities to perform functional tasks with their arms; the THAQ focuses on activities that are important to persons with SCI, 15 but has limited clinical application being reported.…”

Section: Discussionmentioning

confidence: 99%

“…The CUE is a self-reporting questionnaire in which patients rate their abilities to perform functional tasks with their arms; the THAQ focuses on activities that are important to persons with SCI, 15 but has limited clinical application being reported. 14 The recently developed GRASSP is a very promising instrument, designed to track the extent of spontaneous recovery or possible outcomes of a surgical or pharmacological intervention 16,17 and combines the evaluation of the impairment level with the evaluation of prehension. In contrast to the VLT, the GRASPP does not include information on the arm performance and it cannot be used as both an assessment tool and therapy guideline.…”

Section: Discussionmentioning

confidence: 99%

Reference values for the transformed Van Lieshout hand function test for tetraplegia

et al. 2013

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Study design: Longitudinal cohort study. Objectives: Previously, the Van Lieshout hand function test for tetraplegia (short form)(VLT-SF) has been transformed into an interval scale (r_VLT-SF) using the Rasch analysis, thereby fulfilling the requirements of an objective measurement. The present study aims (1) to transform r_VLT-SF logit scores (r_VLT-SF logit ) into 0-100 scores (r_VLT-SF 100 ) in order to facilitate communication amongst its users and (2) to describe r_VLT-SF 100 reference values in order to refine the prediction of upper extremity skilled performance in persons with tetraplegia. Setting: Eight Dutch rehabilitation centres. Methods: The VLT-SF data of tetraplegic patients from eight Dutch rehabilitation centres, gathered at the start of the active rehabilitation (t1), 3 months after t1 (t2) and at the time of discharge (t3), have been used. The r_VLT-SF 100 total score for t1 and t3 were computed, anchored on the data for t2. Reference values (medians and interquartiles) for different subgroups were calculated at different moments during the rehabilitation. Results: Data at t1 (n ¼ 64), t2 (n ¼ 73) and t3 (n ¼ 69) were used. The r_VLT-SF logit scores ( À4.78-6.32) were transformed into r_VLT-SF 100 (0-100) at t2. Reference values were established for persons with motor complete or incomplete lesions with either a high (C1-C6) or a low (C7-T1) lesion level at t1, t2 and t3. Significant differences (Po0.025) in r_VLT-SF 100 were found for most subgroups and different time intervals. Conclusions: The r_VLT-SF logit scores were converted into r_VLT-SF 100 scores, and reference values of the r_VLT-SF 100 have been established for different subgroups of tetraplegic patients at different stages during rehabilitation. The r_VLT-SF 100 has been proven to be able to detect improvement over time.

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“…Dynamometry has been demonstrated to be more accurate than MMT 5,6,20 and was also reported to be a better indicator of selfcare independence. 21 In this work, only the elbow flexor strength measured by dynamometry related better to the functional tests than MMT.…”

Section: Discussionmentioning

confidence: 99%

“…4,5 Electromyography (EMG) is commonly used to analyze muscle recruitment during several activities. 6 There are few studies that used the EMG as a predictor of strength in acute and subacute tetraplegia. 7,8,9 Therefore, the purpose of the present study was to analyze the correlations between functional tests, strength and EMG of the upper limb of persons with chronic tetraplegia.…”

Section: Introductionmentioning

confidence: 99%

Relationship between function, strength and electromyography of upper extremities of persons with tetraplegia

et al. 2011

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Study design: Cross-sectional. Objective: To analyze the relationships between functional tests, arm strength and root mean square of surface electromyography (EMG). Setting: Sao Paulo, Brazil. Methods: Twenty-four individuals with chronic tetraplegia participated. Upper extremity motor score (UEMS), functional independence measure (FIM) motor score, spinal cord independence measure III and capabilities of upper extremity (CUE) were performed. Muscle strength of the right elbow flexors-extensors was assessed using dynamometry and manual muscle test (MMT) and EMG of right biceps and triceps brachii were performed. Spearman's rank correlation coefficients and Mann-Whitney's U-test were used. Results: Functional tests and UEMS correlated strongly among them. UEMS highly correlated with triceps dynamometry and EMG. The dynamometry showed a very high correlation with MMT on the extensor group and a moderate correlation with flexor group. Triceps EMG showed moderate correlation with FIM and CUE. High correlations between triceps EMG and elbow extensors dynamometry and MMT were observed. A significant better performance on functional tests was observed on lower ASIA motor levels. The low-tetraplegia group showed a significant higher score on triceps EMG and dynamometry. Conclusion: Arm strength and EMG seem to be related to functional capabilities and independence in chronic tetraplegia.

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Assessment of upper limb in tetraplegia: Considerations in evaluation and outcomes research

Cited by 62 publications

References 83 publications

Robot-assisted task-oriented upper extremity skill training in cervical spinal cord injury: a feasibility study

Robot-assisted task-oriented upper extremity skill training in cervical spinal cord injury: a feasibility study

Reference values for the transformed Van Lieshout hand function test for tetraplegia

Relationship between function, strength and electromyography of upper extremities of persons with tetraplegia

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