Article

Case series from a prospectively acquired database and phone
survey. OBJECTIVES: To assess the efficacy of upper limb reanimation (ULR)
protocols on acquisition of intermittent self-catheterization (ISC) in C5-C7 ASIA
tetraplegic patients. SETTING: University Hospital, Paris, France. METHODS: A prospectively acquired database of 152 tetraplegic patients followed in ULR
consultation between 1997 and 2008 in a rehabilitation unit was studied. A total
of 20 patients met the inclusion criteria, which mainly were traumatic C5-C7
tetraplegic adult patients who were unable to perform ISC, and who benefited from
ULR with the objectives of improving hand abilities and of ISC acquisition,
through urethral orifice for males or via a continent urinary stoma for females.
The main outcome measure was ISC acquisition (ISC+) proportion. Population
characteristics and secondary outcome measures: ISC+/ISC- patients were compared
regarding epidemiological and surgical data, key-grip strength, patient global
improvement score, activities of daily living and quality of life (PGI-I, Wuolle
questionnaire, verbal rating scale). RESULTS: ISC+ was 75%. It depended on
key-grip strength (P<0.05) and led to a statistically significant improvement of
urinary status compared with ISC- patients (P<0.01). ULR improved patients'
abilities and QoL in both ISC+ and ISC- patients. CONCLUSION: ULR protocols allow
ISC in most C5-C7 tetraplegic patients. Multidisciplinary care with surgeons and
PRM physicians improves patients' vital and functional prognosis by changing
their urological-management method.

Langue : ANGLAIS