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Activity gains after upper limb surgery for spasticity in patients with spinal cord injury

Journal article
Authors Johanna Wangdell
Carina Reinholdt
Jan Fridén
Published in Journal of Hand Surgery-European Volume
Volume 43
Issue 6
Pages 613-620
ISSN 1753-1934
Publication year 2018
Published at Institute of Clinical Sciences, Department of Orthopaedics
Pages 613-620
Language en
Links dx.doi.org/10.1177/1753193418758852
Keywords Spasticity, tetraplegia, upper-limb, surgery, activity of daily living, life satisfaction, people, hand, tetraplegia, experiences, quality, issues, pain, grip, Orthopedics, Surgery
Subject categories Orthopedics

Abstract

Spasticity is a common and increasingly prevalent secondary complication of spinal cord injury. The aim of the study was to evaluate patient-experienced gains in prioritized activities after surgery to reduce the effects of spasticity in upper limbs in tetraplegia. The study includes evaluation of 30 operations for 27 patients performed on hypertonic tetraplegic hands during 2007-2015 using the Canadian Occupational Performance Measure. Activity performance increased at both 6 months and 12 months by a mean of 3.0 and 2.9 points, respectively. Satisfaction increased by 3.3 and 3.4, respectively. All types of activities improved, with wheelchair manoeuvring as one of the highest rated. The intervention increased prioritized activity performance and persisted at least 12 months after surgery. Patients with mild upper limb impairment showed greater improvement after surgery. After operation, patients were able to perform 71% of their prioritized activities, which they could not perform before. Patients' satisfaction with the performance was high. Level of evidence: IV

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