Assessments and interventions on body functions, structures and activity to prepare adults with acute spinal cord injury or disease for participation: a scoping review.
Sophie Irrgang, Sandra Himmelhaus, Kirstin Allek and 5 others
PMID 38601217WHAT IT FOUND
Early therapy after spinal cord injury is safe and assessments like SCIM III and ISNCSCI are usable in the acute phase.
However, evidence for specific interventions to improve muscle or hand function is weak, with trials showing no significant benefit over control groups.
Key findings
01Assessments such as the SCIM III, ISNCSCI, and GRASSP are considered suitable for use in the early acute phase to track patient development.
02Randomized trials comparing functional electrical stimulation cycling to passive cycling, or electrical stimulation to conventional training, found no significant difference in outcomes.
03Most therapeutic recommendations for the acute phase derive from clinical practice guidelines based on expert opinion rather than high-quality evidence.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The search was limited to English and German studies and publication years 2012–2023, potentially missing relevant evidence. Methodological quality of included studies was highly variable, with all three systematic reviews rated as critically low quality and several guidelines lacking rigorous evidence bases. Definitions of the 'acute phase' varied across included studies (e.g., minutes to six months), making direct comparison and synthesis difficult. The review included only 12 studies, with small sample sizes in the randomized trials (n=24 and n=29), limiting the power to detect subtle differences between interventions.
Declared interests
The Swiss Paraplegic Research supported the review by providing materials and access to databases. The authors declared financial support for the research, authorship, and publication.
The easy way to misread this
Do not interpret the safety findings as evidence of efficacy for specific high-tech interventions like robotic training or electrical stimulation in the acute phase. The trials showed these methods were safe and feasible, but they did not demonstrate significant improvement in muscle atrophy or hand function compared to control groups or conventional therapy.