Upper Extremity Activity-based Interventions for Functional Recovery in Spinal Cord Injury

Abstract

<h3>Research Objectives</h3> To summarize the characteristics of reported high-intensity activity-based interventions for upper extremity rehabilitation in spinal cord injury (SCI). <h3>Design</h3> The scoping review included articles from MEDLINE, CINAHL, Cochrane CENTRAL, and OTseeker. The following data was extracted, tabulated, and summarized by the research team: population, study design, setting, technology, and intervention. <h3>Setting</h3> N/A - Scoping Review. <h3>Participants</h3> Inclusion criteria were non-invasive upper extremity activity-based interventions duration at least 2 weeks, functional outcome measures, participants 13 years or older, English language, and SCI at least three months post onset/injury. <h3>Interventions</h3> N/A - Scoping Review. <h3>Main Outcome Measures</h3> N/A - Scoping Review. <h3>Results</h3> The search yielded 21 studies, all in adults. There were seven studies prior to 2017 and 14 studies from 2017-2020. Prior to 2017, studies consisted of task-specific training (TST) and gaming, with and without electrical stimulation, and one study utilized a robotic exoskeleton. The 14 studies done since 2017 also consisted of TST and gaming but also included several studies examining robotic exoskeletons and virtual reality, as well as one study utilizing brain stimulation. Study designs included nine RCT's, eight non-randomized clinical trials and four case reports. Over the past four years there has been an increase in non-randomized clinical trials, likely a reflection of studies piloting new technologies. Although the volume of studies being performed has increased since 2017 has increased, there remains limited variety in study environment with the overwhelming majority of studies being performed in the outpatient setting. Only two of the 21 studies utilized in-home interventions, and none examined telerehab interventions. <h3>Conclusions</h3> Over the past four years scholarly work investigating activity-based interventions for SCI rehabilitation has increased significantly in quantity and breadth. However, this area of research is still significantly lacking in rigorous study designs and home-based or telehealth studies. <h3>Author(s) Disclosures</h3> None.