Abstract
IntroductionMore knowledge of the relationships between kinematic measures and clinical assessments is required to guide clinical decision making and future research.ObjectivesTo determine which kinematic variables obtained during a drinking task were associated with clinical assessments of upper extremity functioning in people with spinal cord injury (SCI).MethodsIn total, 25 individuals with chronic cervical (n = 17) or thoracic (n = 8) complete (n = 14) or motor incomplete (n = 11) SCI (mean age 58.4, SD 13.8) were included. Kinematic data, including movement time, smoothness and joint angles was captured with a 5-camera optoelectronic system during a unimanual drinking task. Action Research Arm Test (ARAT), Sollerman Hand Function Test (SHFT) and basic hand classification of the Upper Extremity Data Set (ISCI-Hand) were used as clinical assessments. Multiple regression analysis was used to identify kinematic variables associated with clinical assessments after controlling for potential confounding factors, such as, age, severity of SCI, sensory function, and hand surgery.ResultsMovement time, smoothness and movement pattern kinematics including trunk displacement, elbow and wrist joint angles were correlated (p < 0.05) with all three clinical scales while the velocity-related kinematics and inter-joint coordination showed low correlations. Multiple regression analysis revealed that wrist angle combined with movement time or smoothness explained 82% and 77% of the total variance in ARAT and SHFT, respectively. Wrist angle alone explained 59% of the variance in ISCI-Hand. The proprioception of the hand increased the explanatory power in the models of ARAT and SHFT. Associations between kinematics and clinical assessments in the subgroup with cervical SCI were equivalent to the whole group analyses. The number of participants in the subgroup with thoracic SCI was small and only allowed limited analysis.ConclusionsWrist angle, movement time, movement smoothness are the most important kinematic variables associated with upper extremity clinical assessments in people with SCI. The results are most valid for individuals with cervical SCI. All three assessments are appropriate for SCI. Further research with larger representative sample of thoracic SCI needed.
Highlights
More knowledge of the relationships between kinematic measures and clinical assessments is required to guide clinical decision making and future research
Wrist angle, movement time, movement smoothness are the most important kinematic variables associated with upper extremity clinical assessments in people with Spinal cord injury (SCI)
The aim of this study was to determine which kinematic variables obtained during a drinking task were associated with clinical assessments of upper extremity functioning in people with spinal cord injury after controlling for impact of other relevant clinical and demographic factors
Summary
More knowledge of the relationships between kinematic measures and clinical assessments is required to guide clinical decision making and future research. About 50% of people with SCI have cervical and 30% thoracic injury. The cervical SCI impacts directly the functioning of upper extremities, injuries at thoracic level will to some degree impact upper limb functioning and trunk stability during upper extremity tasks. Upper extremity function plays an important role for person’s autonomy in activities of daily living and quality of life [2, 3]. Upper extremity function and recovery is one of the highest priorities reported by individuals with SCI [4]. Even though the ability to grasp and manipulate objects predominantly depends on the neurological impairment, compensative strategies, such as, passive tenodesis grasp acquired by learning during rehabilitation or active tenodesis grasp enabled by surgical hand reconstruction, are important for person’s functioning in everyday life [5, 6]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
