Document Type

Presentation

Publication Date

8-20-2013

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Abstract

Motor impairment often occurs following a spinal cord injury, limiting participation in functional tasks. Although the primary rehabilitative focus is to cure paralysis, not all patients experience full recovery. For those who may not regain complete motor function, rehabilitative interventions are needed to bridge the gap between disability and optimal participation. During rehabilitation, patients prioritize increasing independence and participation in meaningful activities (Rigby, Ryan, & Campbell, 2010). More specifically, regaining arm and hand function was reported as a top priority during treatment for individuals with complete spinal cord injury (Peckham, et al., 2001). Technology has been utilized to improve participation in individuals with tetraplegia, who may only regain partial function (Ripat & Woodgate, 2012). A review of current evidence was conducted to determine technological devices that are used to increase autonomy in individuals with high level spinal cord injury. The purpose of this session is to present an evidence based review focused on various modes of technologies that can be used both during the rehabilitation process and in the home.

A search of PubMed and CINAHL databases yielded approximately 1,200 resources, which were refined to sixteen journal articles that included evaluations of upper extremity interventions for adults and adolescents with cervical and thoracic level spinal cord. The selected articles for this review primarily focused on functional electrical stimulation, such as brain-computer-interface and neuroprostheses, as well as electronic aids of daily living. Articles were critically reviewed by two raters. Overall, individuals experienced increased participation when utilizing technology to perform functional tasks. Occupational therapists play an integral role in the implementation and patient-training of these devices to increase function and participation in daily activities. Examples of occupations in which technology has been integrated range from feeding and hygiene management to leisure pursuits. As technology continues to advance, therapists working with this population will need to increase their knowledge of these technologies and how to incorporate them into therapeutic interventions. Although existing evidence supports the use of these devices for facilitating function, there is a need for more high level evidence to further establish technology as an effective intervention with this population.

References:

Peckham, P. H., Keith, M. W., Kilgore, K. L., Grill, J. H., Wuolle, K. S., Thrope, G. B., ... & Wiegner, A. (2001). Efficacy of an implanted neuroprosthesis for restoring hand grasp in tetraplegia: a multicenter study. Archives of physical medicine and rehabilitation, 82(10), 1380-1388.

Rigby, P., Ryan, S., & Campbell, K., A. (2011). Electronic aids to daily living and quality of life for persons with tetraplegia. Disability & Rehabilitation: Assistive Technology, 6(3), 260-267. doi:10.3109/17483107.2010.522678

Ripat, J. D., & Woodgate, R. L. (2012). Self-perceived participation among adults with spinal cord injury: A grounded theory study. Spinal cord, 50, 908-914.

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