Abstract:Objective: To provide an overview of arm±hand function tests useful in tetraplegic subjects. Considerations for selection of an appropriate test are also provided. Data sources: A Medline literature search was conducted covering the period from 1967 to March 2001. Relevant references cited in the selected papers were also considered, regardless of the year of publication. Study selection: This review was restricted to strength tests, functional and ADL tests. Only general tests and tests designed speci®cally t… Show more
“…4 The GRT was designed to assess use of the Freehand system, but the test is used in other tetraplegic populations as well. 7 Validity and some evidence of sensitivity to change were established. 17 The test contains three objects to be handled (eg grasp, move, and release) with the lateral grasp and three objects to be handled with the palmar grasp.…”
Section: Methodsmentioning
confidence: 99%
“…5,6 At the moment, there is no superior test available that has been developed for people with tetraplegia, which is valid within the range of C5 to T1 spinal cord lesions. 7 …”
“…4 The GRT was designed to assess use of the Freehand system, but the test is used in other tetraplegic populations as well. 7 Validity and some evidence of sensitivity to change were established. 17 The test contains three objects to be handled (eg grasp, move, and release) with the lateral grasp and three objects to be handled with the palmar grasp.…”
Section: Methodsmentioning
confidence: 99%
“…5,6 At the moment, there is no superior test available that has been developed for people with tetraplegia, which is valid within the range of C5 to T1 spinal cord lesions. 7 …”
“…49,52,[77][78][79] Fourthly, it seems less valid, because it has a limited correlation with isokinetic dynamometry, which is often regarded the gold standard for the assessment of muscle strength, but is not manageable in use. 44,77,80 The HHD score has shown to be valid, and has a good reliability in SCI, both with experienced and inexperienced examiners. 44,47,49 Muscle strength is an important component of physical capacity, and is related to functioning.…”
Section: Measuring Muscle Strength Of the Upper Extremitymentioning
Study design: Review of publications. Objective: To assess the level of physical capacity (peak oxygen uptake, peak power output, muscle strength of the upper extremity and respiratory function) in wheelchair-dependent persons with a spinal cord injury (SCI). Setting: Erasmus MC, University Medical Centre Rotterdam, The Netherlands. Methods: Pubmed (Medline) search of publications from 1980 onwards. Studies were systematically assessed. Weighted means were calculated for baseline values. Results: In tetraplegia, the weighted mean for peak oxygen uptake was 0.89 l/min for the wheelchair exercise test (WCE) and 0.87 l/min for arm-cranking or hand-cycling (ACE). The peak power output was 26 W (WCE) and 40 W (ACE). In paraplegia, the peak oxygen uptake was 2.10 l/min (WCE) and 1.51 l/min (ACE), whereas the peak power output was 74 W (ACE) and 85 W (WCE). In paraplegia, muscle strength of the upper extremity and respiratory function were comparable to that in the able-bodied population. In tetraplegia muscle strength varied greatly, and respiratory function was reduced to 55-59% of the predicted values for an age-, gender-and height-matched able-bodied population. Conclusions: Physical capacity is reduced and varies in SCI. The variation between results is caused by population and methodological differences. Standardized measurement of physical capacity is needed to further develop comparative values for clinical practice and rehabilitation research.
“…Although the ARAT was originally used as a measure of arm and hand function after stroke,[13] it has been successfully used in a trial similar to this one conducted in people with established SCI [personal communication; Prochazka A, 2009]. The ARAT has excellent reliability and has been validated against a number of other upper limb function tests [14-17]. It also has good face validity, assessing a range of functional hand tasks.…”
BackgroundLoss of hand function is one of the most devastating consequences of spinal cord injury. Intensive hand training provided on an instrumented exercise workstation in conjunction with functional electrical stimulation may enhance neural recovery and hand function. The aim of this trial is to compare usual care with an 8-week program of intensive hand training and functional electrical stimulation.Methods/designA multicentre randomised controlled trial will be undertaken. Seventy-eight participants with recent tetraplegia (C2 to T1 motor complete or incomplete) undergoing inpatient rehabilitation will be recruited from seven spinal cord injury units in Australia and New Zealand and will be randomised to a control or experimental group. Control participants will receive usual care. Experimental participants will receive usual care and an 8-week program of intensive unilateral hand training using an instrumented exercise workstation and functional electrical stimulation. Participants will drive the functional electrical stimulation of their target hands via a behind-the-ear bluetooth device, which is sensitive to tooth clicks. The bluetooth device will enable the use of various manipulanda to practice functional activities embedded within computer-based games and activities. Training will be provided for one hour, 5 days per week, during the 8-week intervention period. The primary outcome is the Action Research Arm Test. Secondary outcomes include measurements of strength, sensation, function, quality of life and cost effectiveness. All outcomes will be taken at baseline, 8 weeks, 6 months and 12 months by assessors blinded to group allocation. Recruitment commenced in December 2009.DiscussionThe results of this trial will determine the effectiveness of an 8-week program of intensive hand training with functional electrical stimulation.Trial registrationNCT01086930 (12th March 2010)ACTRN12609000695202 (12th August 2009)
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