scholarly journals FUNCTIONAL UTILITY OF WEARING A MYOELECTRIC ORTHOSIS FOR UPPER EXTREMITY PARALYSIS DUE TO SPINAL CORD INJURY

Author(s):  
Lauren Wengerd

INTRODUCTION Spinal cord injury (SCI) remains a leading cause of long-term disability in the United States with the majority of injuries resulting in incomplete quadriplegia due to cervical lesions.1 This leads to significant neurological impairment including upper extremity (UE) weakness and decreased independence with self-care activities of daily living (ADLs). Previous work demonstrated that using a myoelectric elbow-wrist-hand orthosis as a therapeutic adjunct to a multi-week rehabilitation regimen resulted in decreased UE motor impairment and increased function in stroke survivors with moderate UE hemiparesis.2 The purpose of this case study was to determine if wearing a myoelectric elbow-wrist-hand orthosis reduces upper extremity motor impairment and increases functional ability in an individual with chronic, incomplete spinal cord injury and resultant quadriplegia. Abstract PDF  Link: https://jps.library.utoronto.ca/index.php/cpoj/article/view/32021/24439 How to cite: Wengerd L. FUNCTIONAL UTILITY OF WEARING A MYOELECTRIC ORTHOSIS FOR UPPER EXTREMITY PARALYSIS DUE TO SPINAL CORD INJURY. CANADIAN PROSTHETICS & ORTHOTICS JOURNAL, VOLUME 1, ISSUE 2, 2018; ABSTRACT, POSTER PRESENTATION AT THE AOPA’S 101ST NATIONAL ASSEMBLY, SEPT. 26-29, VANCOUVER, CANADA, 2018. DOI: https://doi.org/10.33137/cpoj.v1i2.32021 Abstracts were Peer-reviewed by the American Orthotic Prosthetic Association (AOPA) 101st National Assembly Scientific Committee.  http://www.aopanet.org/

2021 ◽  
pp. 1-7
Author(s):  
Allan D. Levi ◽  
Jan M. Schwab

The corticospinal tract (CST) is the preeminent voluntary motor pathway that controls human movements. Consequently, long-standing interest has focused on CST location and function in order to understand both loss and recovery of neurological function after incomplete cervical spinal cord injury, such as traumatic central cord syndrome. The hallmark clinical finding is paresis of the hands and upper-extremity function with retention of lower-extremity movements, which has been attributed to injury and the sparing of specific CST fibers. In contrast to historical concepts that proposed somatotopic (laminar) CST organization, the current narrative summarizes the accumulated evidence that 1) there is no somatotopic organization of the corticospinal tract within the spinal cord in humans and 2) the CST is critically important for hand function. The evidence includes data from 1) tract-tracing studies of the central nervous system and in vivo MRI studies of both humans and nonhuman primates, 2) selective ablative studies of the CST in primates, 3) evolutionary assessments of the CST in mammals, and 4) neuropathological examinations of patients after incomplete cervical spinal cord injury involving the CST and prominent arm and hand dysfunction. Acute traumatic central cord syndrome is characterized by prominent upper-extremity dysfunction, which has been falsely predicated on pinpoint injury to an assumed CST layer that specifically innervates the hand muscles. Given the evidence surveyed herein, the pathophysiological mechanism is most likely related to diffuse injury to the CST that plays a critically important role in hand function.


2018 ◽  
Author(s):  
Ryan Martin ◽  
Lara Zimmermann ◽  
Kee D. Kim ◽  
Marike Zwienenberg ◽  
Kiarash Shahlaie

Traumatic spinal cord injury currently affects approximately 285,000 persons in the United States and carries with it significant morbidity and cost. Early management focuses on adequate ventilation and hemodynamic resuscitation of the patient and limiting motion of the spine to prevent a second injury. Medical management targets maintenance of adequate blood flow to the spinal cord, whereas surgical management focuses on decompression, realignment, and stabilization of the vertebral column. In this chapter, we discuss the approach to the patient with traumatic spinal cord injury, injury types, and medical and surgical management. This review contains 9 figures, 4 tables and 30 references Key Words: American Spinal Injury Association score, burst fracture, Chance fracture, compression fracture, hangman, mean arterial pressure therapy, odontoid fracture, spinal cord injury, traction


2021 ◽  
Vol 76 (1) ◽  
Author(s):  
Stephanie Kubiak ◽  
Elliot Sklar

Importance: After spinal cord injury (SCI), as many as 45% of people experience at least one hospital readmission within 1 yr. Identification of feasible low-cost interventions to reduce hospital readmissions after SCI is needed. Objective: To explore whether a relationship exists between routine exercise and hospital readmission rates 1 yr after SCI. Design: We conducted a secondary analysis of data from the SCIRehab Project, a prospective cohort study. Setting: Five SCI inpatient rehabilitation facilities across the United States. Participants: Participants were people age 12 yr and older who had sustained an SCI, were admitted to a participating inpatient rehabilitation facility, completed the 12-mo postinjury interview, and reported exercising either monthly or not at all since discharge (N = 520). Outcomes and Measures: The SCIRehab Project conducted 12-mo post–inpatient rehabilitation discharge interviews. As part of the interviews, self-reported hospital readmissions and exercise frequencies since discharge (self-reported number of months, average days per week, and average minutes per day of exercise participation) were collected and analyzed. Results: A χ2 analysis determined that a significant correlation (φ = −.091, p = .038) exists between monthly exercise and hospital readmissions 1 yr postinjury. Compared with those who did not exercise, participants who exercised monthly had 8.4% fewer hospital readmissions. Conclusions and Relevance: A relationship exists between exercise and hospital readmission, but follow-up research is needed to determine whether regular exercise reduces hospital readmissions among this population. What This Article Adds: After discharge, 44% of the participants did not exercise during the first year after injury. Identifying or implementing accessible community exercise programs is an area of opportunity for occupational therapy practitioners and future researchers to explore.


2018 ◽  
Author(s):  
Ryan Martin ◽  
Lara Zimmermann ◽  
Kee D. Kim ◽  
Marike Zwienenberg ◽  
Kiarash Shahlaie

Traumatic spinal cord injury currently affects approximately 285,000 persons in the United States and carries with it significant morbidity and cost. Early management focuses on adequate ventilation and hemodynamic resuscitation of the patient and limiting motion of the spine to prevent a second injury. Medical management targets maintenance of adequate blood flow to the spinal cord, whereas surgical management focuses on decompression, realignment, and stabilization of the vertebral column. In this chapter, we discuss the approach to the patient with traumatic spinal cord injury, injury types, and medical and surgical management. This review contains 9 figures, 4 tables and 30 references Key Words: American Spinal Injury Association score, burst fracture, Chance fracture, compression fracture, hangman, mean arterial pressure therapy, odontoid fracture, spinal cord injury, traction


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