Rehabilitation of hand function after spinal cord injury using a novel handgrip device: a pilot study

doi:10.1186/s12984-017-0234-1

Clinical Trial

. 2017 Mar 21;14(1):22.

doi: 10.1186/s12984-017-0234-1.

Rehabilitation of hand function after spinal cord injury using a novel handgrip device: a pilot study

Haydn Hoffman¹, Tiffany Sierro¹, Tianyi Niu¹, Melanie E Sarino², Majid Sarrafzadeh^{3

4}, David McArthur¹, V Reggie Edgerton^{1

5}, Daniel C Lu^{6

7

8

9}

Affiliations

¹ Department of Neurosurgery, University of California, Los Angeles, 300 Stein Plaza, Ste. 536, Los Angeles, CA, 90095-6901, USA.
² Rancho Los Amigos National Rehabilitation Center, Downey, CA, 90242, USA.
³ Wireless Health Institute, University of California Los Angeles, Los Angeles, CA, USA.
⁴ Department of Computer Science, University of California Los Angeles, Los Angeles, CA, USA.
⁵ Brain Research Institute, University of California, Los Angeles, Los Angeles, CA, 90095, USA.
⁶ Department of Neurosurgery, University of California, Los Angeles, 300 Stein Plaza, Ste. 536, Los Angeles, CA, 90095-6901, USA. dclu@mednet.ucla.edu.
⁷ Department of Orthopedic Surgery, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, 90095, USA. dclu@mednet.ucla.edu.
⁸ Neuromotor Recovery and Rehabilitation Center, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, 90095, USA. dclu@mednet.ucla.edu.
⁹ Brain Research Institute, University of California, Los Angeles, Los Angeles, CA, 90095, USA. dclu@mednet.ucla.edu.

PMID: 28327161
PMCID: PMC5361778
DOI: 10.1186/s12984-017-0234-1

Clinical Trial

Rehabilitation of hand function after spinal cord injury using a novel handgrip device: a pilot study

Haydn Hoffman et al. J Neuroeng Rehabil. 2017.

. 2017 Mar 21;14(1):22.

doi: 10.1186/s12984-017-0234-1.

Authors

Haydn Hoffman¹, Tiffany Sierro¹, Tianyi Niu¹, Melanie E Sarino², Majid Sarrafzadeh^{3

4}, David McArthur¹, V Reggie Edgerton^{1

5}, Daniel C Lu^{6

7

8

9}

Affiliations

¹ Department of Neurosurgery, University of California, Los Angeles, 300 Stein Plaza, Ste. 536, Los Angeles, CA, 90095-6901, USA.
² Rancho Los Amigos National Rehabilitation Center, Downey, CA, 90242, USA.
³ Wireless Health Institute, University of California Los Angeles, Los Angeles, CA, USA.
⁴ Department of Computer Science, University of California Los Angeles, Los Angeles, CA, USA.
⁵ Brain Research Institute, University of California, Los Angeles, Los Angeles, CA, 90095, USA.
⁶ Department of Neurosurgery, University of California, Los Angeles, 300 Stein Plaza, Ste. 536, Los Angeles, CA, 90095-6901, USA. dclu@mednet.ucla.edu.
⁷ Department of Orthopedic Surgery, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, 90095, USA. dclu@mednet.ucla.edu.
⁸ Neuromotor Recovery and Rehabilitation Center, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, 90095, USA. dclu@mednet.ucla.edu.
⁹ Brain Research Institute, University of California, Los Angeles, Los Angeles, CA, 90095, USA. dclu@mednet.ucla.edu.

PMID: 28327161
PMCID: PMC5361778
DOI: 10.1186/s12984-017-0234-1

Abstract

Background: Activity-based therapy (ABT) for patients with spinal cord injury (SCI), which consists of repetitive use of muscles above and below the spinal lesion, improves locomotion and arm strength. Less data has been published regarding its effects on hand function. We sought to evaluate the effects of a weekly hand-focused therapy program using a novel handgrip device on grip strength and hand function in a SCI cohort.

Methods: Patients with SCI were enrolled in a weekly program that involved activities with the MediSens (Los Angeles, CA) handgrip. These included maximum voluntary contraction (MVC) and a tracking task that required each subject to adjust his/her grip strength according to a pattern displayed on a computer screen. For the latter, performance was measured as mean absolute accuracy (MAA). The Spinal Cord Independence Measure (SCIM) was used to measure each subject's independence prior to and after therapy.

Results: Seventeen patients completed the program with average participation duration of 21.3 weeks. The cohort included patients with American Spinal Injury Association (ASIA) Impairment Scale (AIS) A (n = 12), AIS B (n = 1), AIS C (n = 2), and AIS D (n = 2) injuries. The average MVC for the cohort increased from 4.1 N to 21.2 N over 20 weeks, but did not reach statistical significance. The average MAA for the cohort increased from 9.01 to 21.7% at the end of the study (p = .02). The cohort's average SCIM at the end of the study was unchanged compared to baseline.

Conclusions: A weekly handgrip-based ABT program is feasible and efficacious at increasing hand task performance in subjects with SCI.

Keywords: Activity-based therapy; Hand function; Neurorehabilitation; Spinal cord injury.

PubMed Disclaimer

Figures

**Fig. 1**
The handgrip device used to detect maximum voluntary contraction (*left*) and the sinusoidal tracking pattern that was displayed for the subjects to follow by adjusting grip strength (*right*). Figure adapted with permission from Getachew et al. [15]

**Fig. 2**
Change in average maximum voluntary contraction with standard error over time for the cohort

**Fig. 3**
Change in average mean absolute accuracy (MAA) with standard error on the sinusoidal tracking task over time for the cohort

**Fig. 4**
Average Spinal Cord Independence Measure (SCIM) scores with standard error at the beginning and end of the study for each group

See this image and copyright information in PMC

Cited by

Peak Torque Prediction Using Handgrip and Strength Predictors in Men and Women With Motor Complete Spinal Cord Injury.
Neto FR, Dorneles JR, Carneiro Leão Veloso JH, Gonçalves CW, Gomes Costa RR. Neto FR, et al. Top Spinal Cord Inj Rehabil. 2021 Fall;27(3):49-59. doi: 10.46292/sci20-00027. Epub 2021 Aug 13. Top Spinal Cord Inj Rehabil. 2021. PMID: 34456546 Free PMC article.
Minimal handgrip force is needed for transcutaneous electrical stimulation to improve hand functions of patients with severe spinal cord injury.
Huang R, Nikooyan AA, Moore LD, Zdunowski S, Morikawa E, Sierro T, Sayenko D, Gad P, Homsey T, Le T, Madhavan MA, Abdelshahid M, Abdelshahid M, Zhou Y, Nuwer MR, Sarrafzadeh M, Edgerton VR, Leiter JC, Lu DC. Huang R, et al. Sci Rep. 2022 May 11;12(1):7733. doi: 10.1038/s41598-022-11306-5. Sci Rep. 2022. PMID: 35545644 Free PMC article. Clinical Trial.
Combinatorial Effects of Transcutaneous Spinal Stimulation and Task-Specific Training to Enhance Hand Motor Output after Paralysis.
Oh J, Scheffler MS, Mahan EE, King ST, Martin CA, Dinh J, Steele AG, O'Malley MK, Sayenko DG. Oh J, et al. Top Spinal Cord Inj Rehabil. 2023 Fall;29(Suppl):15-22. doi: 10.46292/sci23-00040S. Epub 2023 Nov 17. Top Spinal Cord Inj Rehabil. 2023. PMID: 38174129 Free PMC article.
The Efficacy of Anterior Cervical Corpectomy and Fusion and Posterior Total Laminectomy on Cervical Spinal Cord Injury and Quality of Life.
Yin Y, Yang X, Tian Y, Zhang Y, Zhang P, Jia Y, Yao Y, Du X, Li T, Li X. Yin Y, et al. Comput Math Methods Med. 2022 Sep 29;2022:8216339. doi: 10.1155/2022/8216339. eCollection 2022. Comput Math Methods Med. 2022. PMID: 36213573 Free PMC article.
The effectiveness of robotic-assisted upper limb rehabilitation to improve upper limb function in patients with cervical spinal cord injuries: a systematic literature review.
Ho JS, Ko KS, Law SW, Man GC. Ho JS, et al. Front Neurol. 2023 Aug 9;14:1126755. doi: 10.3389/fneur.2023.1126755. eCollection 2023. Front Neurol. 2023. PMID: 37621855 Free PMC article. Review.

See all "Cited by" articles

References

1. Curt A, Van Hedel HJ, Klaus D, et al. Recovery from a spinal cord injury: significance of compensation, neural plasticity, and repair. J Neurotrauma. 2008;25:677–85. doi: 10.1089/neu.2007.0468. - DOI - PubMed
1. Wirth B, van Hedel HJ, Kometer B, et al. Changes in activity after a complete spinal cord injury as measured by the Spinal Cord Independence Measure II (SCIM II) Neurorehabil Neural Repair. 2008;22:279–87. - PubMed
1. Lim PA, Tow AM. Recovery and regeneration after spinal cord injury: a review and summary of recent literature. Ann Acad Med Singapore. 2007;36:49–57. - PubMed
1. Jones ML, Evans N, Tefertiller C, et al. Activity-based therapy for recovery of walking in individuals with chronic spinal cord injury: results from a randomized clinical trial. Arch Phys Med Rehabil. 2014;95:2239–46. doi: 10.1016/j.apmr.2014.07.400. - DOI - PubMed
1. Beekhuizen KS, Field-Fote EC. Sensory stimulation augments the effects of massed practice training in persons with tetraplegia. Arch Phys Med Rehabil. 2008;89:602–8. doi: 10.1016/j.apmr.2007.11.021. - DOI - PubMed

Publication types

Actions

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions

Grants and funding

LinkOut - more resources

Full Text Sources
Other Literature Sources
- scite Smart Citations
Medical
- MedlinePlus Health Information

[1] Curt A, Van Hedel HJ, Klaus D, et al. Recovery from a spinal cord injury: significance of compensation, neural plasticity, and repair. J Neurotrauma. 2008;25:677–85. doi: 10.1089/neu.2007.0468. - DOI - PubMed

[2] Curt A, Van Hedel HJ, Klaus D, et al. Recovery from a spinal cord injury: significance of compensation, neural plasticity, and repair. J Neurotrauma. 2008;25:677–85. doi: 10.1089/neu.2007.0468. - DOI - PubMed

[3] Wirth B, van Hedel HJ, Kometer B, et al. Changes in activity after a complete spinal cord injury as measured by the Spinal Cord Independence Measure II (SCIM II) Neurorehabil Neural Repair. 2008;22:279–87. - PubMed

[4] Wirth B, van Hedel HJ, Kometer B, et al. Changes in activity after a complete spinal cord injury as measured by the Spinal Cord Independence Measure II (SCIM II) Neurorehabil Neural Repair. 2008;22:279–87. - PubMed

[5] Lim PA, Tow AM. Recovery and regeneration after spinal cord injury: a review and summary of recent literature. Ann Acad Med Singapore. 2007;36:49–57. - PubMed

[6] Lim PA, Tow AM. Recovery and regeneration after spinal cord injury: a review and summary of recent literature. Ann Acad Med Singapore. 2007;36:49–57. - PubMed

[7] Jones ML, Evans N, Tefertiller C, et al. Activity-based therapy for recovery of walking in individuals with chronic spinal cord injury: results from a randomized clinical trial. Arch Phys Med Rehabil. 2014;95:2239–46. doi: 10.1016/j.apmr.2014.07.400. - DOI - PubMed

[8] Jones ML, Evans N, Tefertiller C, et al. Activity-based therapy for recovery of walking in individuals with chronic spinal cord injury: results from a randomized clinical trial. Arch Phys Med Rehabil. 2014;95:2239–46. doi: 10.1016/j.apmr.2014.07.400. - DOI - PubMed

[9] Beekhuizen KS, Field-Fote EC. Sensory stimulation augments the effects of massed practice training in persons with tetraplegia. Arch Phys Med Rehabil. 2008;89:602–8. doi: 10.1016/j.apmr.2007.11.021. - DOI - PubMed

[10] Beekhuizen KS, Field-Fote EC. Sensory stimulation augments the effects of massed practice training in persons with tetraplegia. Arch Phys Med Rehabil. 2008;89:602–8. doi: 10.1016/j.apmr.2007.11.021. - DOI - PubMed

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Rehabilitation of hand function after spinal cord injury using a novel handgrip device: a pilot study

Affiliations

Rehabilitation of hand function after spinal cord injury using a novel handgrip device: a pilot study

Authors

Affiliations

Abstract

Figures

Similar articles

Cited by

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Other Literature Sources

Medical