| Titre : | Rehabilitation After Spasticity-Correcting Upper Limb Surgery in Tetraplegia (2016) |
| Auteurs : | Johanna Wangdell ; Jan Fridén |
| Type de document : | Article |
| Dans : | Archives of Physical Medicine and Rehabilitation (2016/6 supp., 2016) |
| Article en page(s) : | pp. S136–S143 |
| Langues: | Anglais |
| Descripteurs : |
HE Vinci Membre supérieur ; Procédures de chirurgie reconstructive ; Rééducation et réadaptation ; Tétraplégie ; Traumatismes de la moelle épinière |
| Mots-clés: | Muscle spasticity ; Spasticité musculaire ; Quadriplegia ; Reconstructive surgical procedures ; Spinal cord injuries ; Tendon transfer ; Transposition tendineuse ; Upper extremity |
| Résumé : |
Objective To describe the early active rehabilitation concept developed for spasticity-correcting surgery in tetraplegia and to report the outcomes in grip ability and change of performance and satisfaction in patients' prioritized activities 1 year postoperatively. Design Retrospective case-control study. Setting Nonprofit rehabilitation unit. Participants All patients who underwent surgeries for correction of spasticity in tetraplegic hands between 2009 and 2013 in the studied unit (N=37). Interventions Spasticity-correcting upper limb surgery with early active rehabilitation to restore grip ability in tetraplegia. Main Outcome Measures Grasp and release test (GRT) and modified Canadian Occupational Performance Measure (COPM). Results All patients could accomplish the early active rehabilitation concept. The complication rate related to the treatment was low. Compared with preoperatively, all evaluated individuals experienced improvements in grasp ability and activity performance and satisfaction at 1-year follow-up. The performance in prioritized activities, as measured by the COPM, improved by 2.6 scale steps. Satisfaction with performance improved 3.0 scale steps postoperatively (n=21). The grasp ability, measured by the GRT, improved significantly, from 80 preoperatively to 111 (n=10). Conclusions The surgery, combined with the early active rehabilitation protocol, is a reliable and safe procedure. The ability to use the hand improved, and gains were maintained at least 1 year after surgery in all patients with respect to both the objective grasp ability and patients' subjective rating of their performance and satisfaction in their prioritized activities. The procedure should therefore be considered as an adjunct to other treatments of upper limb spasticity in spinal cord injury. |
| Disponible en ligne : | Oui |
| En ligne : | https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/article/pii/S0003999316001866 |
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