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Clinical Assessment and Rehabilitation of the Upper Limb Following Cervical Spinal Cord Injury

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Neurorehabilitation Technology

Abstract

The impairment of upper extremity function following a cervical spinal cord injury (SCI) has a significant impact on independence and quality of life due to its bilateral and often symmetrical nature. Upper extremity function following spinal cord injury is commonly assessed with clinical measures of capacity, performance, quantitative sensory testing, and surrogate markers such as electrophysiological and biomedical recordings. More recently novel techniques, such as the use of robotics and senor technology, are beginning to be employed for this purpose. Most currently these assessments are based on ordinal scales with rather subjective rating criteria, and for this reason, a new generation of objective and precise upper extremity functional assessment tests is required. For example, the RULER is a novel scale developed by the authors which is a detailed functional classification of the upper extremity and can distinguish different levels of impairment where changes between these levels can be considered clinically meaningful.

In order to effect changes in function that can be assessed with various devices, physical therapy training is essential. Therapy increases neural plasticity and thereby improves motor function. New rehabilitation therapies based on robots, passive workstations, functional electrical stimulation (FES) systems and novel sensor technology have been developed but mostly focus on the stroke field. Thus, despite huge promise and a large amount of research in stroke, the overall clinical value of these new technology-based therapies in SCI patients’ still needs to be evaluated fully.

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Authors and Affiliations

  1. Spinal Cord Injury Research Lab, Spinal Cord Injury Centre, Balgrist University Hospital, University of Zurich, 340 Forchstrasse, 8008, Zurich, Switzerland

    Michelle Louise Starkey MA, MSc, PhD & Armin Curt

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  1. Michelle Louise Starkey MA, MSc, PhD
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  2. Armin Curt
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Correspondence to Michelle Louise Starkey MA, MSc, PhD .

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  1. Department of Mechanical and Aerospace Engineering, Department of Anatomy and Neurobiology, Department of Biomedical Engineering, Department of Physical Medicine and Rehabilitation, University of California at Irvine, Irvine, California, USA

    David J. Reinkensmeyer

  2. Spinal Cord Injury Center, University Hospital Balgrist, ZĂĽrich, Switzerland

    Volker Dietz

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Starkey, M.L., Curt, A. (2016). Clinical Assessment and Rehabilitation of the Upper Limb Following Cervical Spinal Cord Injury. In: Reinkensmeyer, D., Dietz, V. (eds) Neurorehabilitation Technology. Springer, Cham. https://doi.org/10.1007/978-3-319-28603-7_7

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