Article

OBJECTIVE: To determine which single or combined upper limb muscles as defined by
the International Standards for the Neurological Classification of Spinal Cord
Injury (ISNCSCI); upper extremity motor score (UEMS) and the Graded Redefined
Assessment of Strength, Sensibility, and Prehension (GRASSP), best predict upper
limb function and independence in activities of daily living (ADLs) and to assess
the predictive value of qualitative grasp movements (QlG) on upper limb function
in individuals with acute tetraplegia. METHOD:
As part of a Europe-wide,
prospective, longitudinal, multicenter study ISNCSCI, GRASSP, and Spinal Cord
Independence Measure (SCIM III) scores were recorded at 1 and 6 months after SCI.
For prediction of upper limb function and ADLs, a logistic regression model and
unbiased recursive partitioning conditional inference tree (URP-CTREE) were used.
Results: Logistic regression and URP-CTREE revealed that a combination of ISNCSCI
and GRASSP muscles (to a maximum of 4) demonstrated the best prediction
(specificity and sensitivity ranged from 81.8% to 96.0%) of upper limb function
and identified homogenous outcome cohorts at 6 months. The URP-CTREE model with
the QlG predictors for upper limb function showed similar results. CONCLUSION:
Prediction of upper limb function can be achieved through a combination of
defined, specific upper limb muscles assessed in the ISNCSCI and GRASSP. A
combination of a limited number of proximal and distal muscles along with an
assessment of grasping movements can be applied for clinical decision making for
rehabilitation interventions and clinical trials.
CI - (c) The Author(s) 2015.

Langue : ANGLAIS