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Activity performance and upper extremity function in cervical spinal cord injury patients according to the Klein-Bell ADL Scale.

Journal article
Authors A Dahlgren
Ann-Katrin Karlsson
Åsa Lundgren Nilsson
Jan Fridén
Lisbeth Claesson
Published in Spinal cord : the official journal of the International Medical Society of Paraplegia
Volume 45
Issue 7
Pages 475-84
ISSN 1362-4393
Publication year 2007
Published at Institute of Neuroscience and Physiology, Department of Audiology, Logopedics, Occupational Therapy & Physiotherapy
Institute of Neuroscience and Physiology, Department of Clinical Neuroscience and Rehabilitation
Institute of Clinical Sciences
Pages 475-84
Language en
Keywords Activities of Daily Living, Adolescent, Adult, Aged, Cross-Sectional Studies, Disability Evaluation, Female, Humans, Male, Middle Aged, Motor Activity, physiology, Pain Measurement, Psychomotor Performance, physiology, Retrospective Studies, Sacrococcygeal Region, Severity of Illness Index, Spinal Cord Injuries, pathology, physiopathology, psychology, Upper Extremity, physiopathology
Subject categories Surgery, Occupational Therapy


STUDY DESIGN: Cross-sectional study. OBJECTIVES: (1) To examine whether the Klein-Bell ADL Scale (K-B Scale) discriminates cervical spinal cord injury (SCI) patients in daily activities and to explore its applicability in this group of patients. (2) To examine the association between basic ADL and upper extremity function. (3) To investigate if grip ability can be discerned in the scale. SETTING: Spinal Cord Injury Unit, Sahlgrenska University Hospital, Göteborg, Sweden. METHODS: Fifty-five patients with cervical SCI with no prior reconstructive hand surgery were included in the study. Analyses of the patient's independence were made according to the K-B Scale. Three additional analyses were carried out, the first examined whether the use of assistive devices and house and car adaptations influenced independence. The last two used different approaches to investigate whether arm and grip function could be detected in the K-B scale. RESULTS: Raw score in the K-B Scale can discriminate for independence in daily activities but the scale's weight scheme does not function for cervical SCI patients. Assistive devices and car and house adaptations can compensate for dependence in daily activities. Lack of grip function decreases the patient's ability to become independent. Diagnosis-related activities cannot be assessed in all items. CONCLUSION: The K-B Scale's raw score was useful assessing daily activities in cervical SCI patients. Its reliability in conjunction with arm and grip function in patients with cervical SCI has yet to be proven.

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