Systematic review of the effects of exercise therapy on the upper extremity of patients with spinal-cord injury

Abstract

Objective: To assess the effects of exercise therapy (ET) on motor control and functional ability of the upper extremity in patients with cervical spinal cord injury (SCI). Methods: An extensive systematic literature search in five databases was performed to identify clinical and (randomized) controlled trials, evaluating the effects of ET on motor control and functional ability in patients with SCI. The methodological quality of the selected studies was systematically assessed by three reviewers. Results: Eight studies were included. Seven had good-to-fair methodological quality, six reported positive effects of ET on motor control (for example, muscle strength or muscle grade) and four also reported positive effects on functional ability. Five of these studies focused on patients with long-lasting SCI. A great variety of therapeutic approaches were applied, even within ET there was a wide range of training characteristics. Conclusion: Although ET is a cornerstone in the treatment of the upper extremity in patients with SCI, only a small number of studies were included in the present review. Most of the included studies reported a positive effect of ET on upper extremity motor control and functional ability in SCI patients. As ET is effective in patients with SCI in the chronic stage, this might have implications for the follow up and further treatment of these patients. Future studies should be more specific in describing the characteristics of ET to verify that the ET is in accordance with the current standards for training and motor relearning.

Is body weight-support treadmill training effective in increasing muscle trophism after traumatic spinal cord injury? A systematic review

“…The remaining two studies by Giangregorio et al 6 and De Abreu et al 28 received scores of VI and III, respectively, indicating fair and good to fair levels of evidence according to Jovell and Navarro-Rubio. 36,37 Patients We found one case report, 27 two case series 5,10 and two nonrandomized clinical trials. 6,28 The samples ranged from 1 to 15 individuals with SCI and an average age of 33 years; most of the individuals were male.…”

Eye-tracking computer systems for inpatients with tetraplegia: findings from a feasibility study

“…[17][18][19] Although improvements in arm and hand function are most likely to be gained during inpatient rehabilitation and the first year post injury, 20 exact individual functional outcomes of the upper extremities remain difficult to predict. These two factors combined encourage patients to attend as many rehabilitation sessions as possible in order to maximize the potential for recovery of arm and hand functions.…”

Spinal cord injury and physical activity: preservation of the body

“…Recent systematic reviews of rehabilitation interventions for improving lower-limb function 118 or upper-limb function 119 after SCI highlight similar issues: the small number of randomized controlled trials (RCT), the relatively small sample sizes in these trials, and the sub-optimal quality of clinical trials in this field. Systematic reviews exclude many studies.…”