Effect of Electrical Stimulation Following Hand Activities for Grasping in Incomplete Spinal Cord Injury: A Case Report

Abstract

Backgroud: Spinal cord injury (SCI) is one of the most disastrous injury of the central nervous system which results in permanent neurological deficit. Typically, spinal cord injury occurs in young or healthy adults due to trauma. spinal cord injury occurs in between age group 16-30 years. Spinal cord injury is classified as acute or chronic, there is no clear separation as when to classify as acute injury and when it gets convert into chronic injury. The time period between initial hours and few weeks after injury is consider as acute phase, while the time period between months to years is considered as chronic phase. The clinical classification of these two phases is necessary as there is significant difference in these two and needs different strategies to manage and regain it’s functional recovery Purpose: Traumatic spinal cord injury (SCI) affects cervical spine in most of the cases. These causes limitation of activities of daily living and impairs quality of life due to paralysis of hand and arm. These leads to difficulties in feeding, grooming, or performing other upper extremity motor tasks. So in such cases the restoration of hand and arm functions is first priority of treatment before bladder, bowel, sexual or lower extremity dysfunction.[9] There are limited studies for improving hand function with help of electrical stimulation following motor function activities. Methodology: A 41 year old male mesomorphic in built and farmer by occupation came to Pravara Rural Hospital, Loni, Ahmednagar with chief complaints of unable to move his both lower limbs and difficulty in his upper limb activity (grasping) . the patient had difficulty in basic activities of daily living. The patient had history of fall from tree. He was diagnosed with traumatic cervical spine injury with complete paraplegia and quadriparesis with bowel and bladder involvement. So the patient was operated on 11th July 2019 for cervical spine disectomy + fusion (C6 – C7 ). Intervention: The patient received Electrical stimulation following hand exercises for improvement in hand function for 5 days a week for 3 weeks. Result: In this study we assessed the patient on action reach arm test (ARAT) for hand function, Functional Independence Measure for Quality of life (FIM), Spinal Cord Independence Measure (SCIM) which showed significant improvement in results. Conclusion: it is concluded that electrical stimulation following hand function activities help in improving hand function in patients with spinal cord injury.