Associations between upper extremity functioning and kinematics in people with spinal cord injury.
Lamprini Lili, Katharina S Sunnerhagen, Tiina Rekand and 1 others
PMID 34565401WHAT IT FOUND
In 25 people with spinal cord injury, how they drank from a cup tracked closely with clinical arm tests.
Wrist position, slow movement, and choppy movement explained most test scores; hand position sense added useful information.
Key findings
01For the ARAT, wrist angle combined with movement time or smoothness explained 82 to 83% of the variation.
02For the SHFT, wrist angle combined with movement time or smoothness explained 77 to 79% of the variation, and adding hand proprioception raised this to 86%.
03For the ISCI-Hand classification, wrist angle was the only significant kinematic variable, explaining 59.3% of the variation.
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
This was a cross-sectional association study, so it cannot show that any treatment caused better or worse function. Only 25 participants were analysed, and the thoracic subgroup had 8 participants, which was too small for firm subgroup conclusions. Participants had to be able to perform the drinking task with at least one arm, so the results do not apply to people with more severe upper limb limitation. The kinematic results came from a 5-camera motion capture system that is not commonly available in clinical settings. The ISCI-Hand classification was too crude for some subgroup analysis, and the ARAT and SHFT may not capture small differences in people with thoracic SCI. The exact role of hand proprioception was not established and needs further study.
Declared interests
The supplied text lists funders including Svenska Sällskapet för Medicinsk Forskning, ALF agreement, Vetenskapsrådet, Norrbacka-Eugeniastiftelsen, Forsknings- och utvecklingsstyrelsen för Göteborg och Södra Bohuslän, Sahlgrenska Universitetssjukhuset, Stiftelsen Promobilia, and University of Gothenburg. It does not provide an author conflict-of-interest statement.
The easy way to misread this
Do not read the strong associations as evidence that a treatment improved upper limb function. This study did not give an intervention; it compared movement patterns and clinical scores in 25 people at one time point, and the motion capture system is not usually available in clinics.