BACKGROUND: Upper extremity activity-based therapy for neurologic disorders employs high-intensity, high repetition functional training to exploit neuroplasticity and improve function. Research focused on high-intensity upper extremity activity-based therapy for persons with spinal cord injury (SCI) is limited.
OBJECTIVE: To summarize high-intensity activity-based interventions used in neurological disorders for their current or potential application to SCI.
METHODS: The scoping review included articles from MEDLINE, CINAHL, Cochrane CENTRAL, and OTseeker with the criteria: non-invasive activity-based interventions delivered atleast three times/week for two weeks, upper extremity functional outcomes, 13 years or older, English language, and neurological disorders three months post onset/injury.
RESULTS: The search yielded 172 studies. There were seven studies with SCI, all in adults. Activity-based interventions in SCI included task-specific training and gaming, with and without electrical stimulation, and a robotic exoskeleton. The other populations found in the review included studies in stroke, cerebral palsy, and multiple sclerosis. Thirty-four different interventions were reported in other populations. In comparison to the extensive stroke research, work in SCI was not found for high-intensity interventions using virtual reality, brain stimulation, rehabilitation devices, and applications to the home and telerehab settings.
CONCLUSION: The results highlight critical gaps within upper extremity high-intensity activity-based research in SCI.
Grampurohit, Namrata; Bell, Alison; Duff, Susan; Mulcahey, M. J.; Thielen, Christina Calhoun; Kaplan, Gary; and Marino, Ralph J., "Highlighting gaps in spinal cord injury research in activity-based interventions for the upper extremity: A scoping review." (2021). Department of Occupational Therapy Faculty Papers. Paper 76.