Functional electrical therapy: retraining grasping in spinal cord injury

• Published in: Spinal cord 2006-03, Vol.44 (3), p.143-151
• Main Authors: Popovic, M R, Thrasher, T A, Adams, M E, Takes, V, Zivanovic, V, Tonack, M I
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Anatomy; Biological and medical sciences; Biomedical and Life Sciences; Biomedicine; Cerebrospinal fluid. Meninges. Spinal cord; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases; Disability Evaluation; Electric Stimulation Therapy - methods; Hand Strength - physiology; Human Physiology; Humans; Injuries of the nervous system and the skull. Diseases due to physical agents; Male; Medical sciences; Middle Aged; Nervous system (semeiology, syndromes); Neurochemistry; Neurology; Neuropsychology; Neurosciences; Occupational Therapy - methods; original-article; Recovery of Function - physiology; Spinal Cord Injuries - physiopathology; Spinal Cord Injuries - rehabilitation; Statistics, Nonparametric; Time Factors; Traumas. Diseases due to physical agents; Treatment Outcome
• ISSN: 1362-4393; 1476-5624
• DOI: 10.1038/sj.sc.3101822

Objective: To determine the clinical efficacy of functional electrical therapy in the rehabilitation of grasping function for quadriplegics. Study design: Randomized intervention- versus -control trial. Setting: Rehabilitation hospital for spinal cord injury in Toronto, Canada. Methods: A total of 21 people with new spinal cord injuries ranging from C3 to C7 were randomly assigned to two groups: Control ( N =9) and Intervention ( N =12). The intervention was functional electrical therapy, which consisted of repetitive grasping exercises using a neuroprosthesis that applied surface electrical stimulation to the arm to generate and/or assist grasping movements. It was applied by registered Occupational Therapists in a clinical setting. Main outcome measures were: Functional Independence Measure (FIM), Spinal Cord Independence Measure (SCIM), and the Rehabilitation Engineering Laboratory Hand Function Test. Consumer perceptions of functional electrical therapy were assessed via qualitative interviews. Results: Differences between the Control and Intervention groups could be observed although they are not significant due to an insufficient number of participants. Consumer perceptions were positive, including improved Activities of Daily Living and self-satisfaction. Conclusion: Functional electrical therapy has the potential to be an effective treatment modality to restore grasping function in quadriplegia. It can be implemented by occupational therapists in a clinical setting. Further research is required to establish suitable indications for participant selection. In addition, a larger number of participants is needed to demonstrate statistical significance of the Functional Electrical Therapy.