Inge-Marie Velstra1, Marc Bolliger2, Jörg Krebs3, Johan S Rietman4, Armin Curt2. 1. Clinical Trial Unit, Swiss Paraplegic Center, Nottwil, Switzerland inge-marie.velstra@paraplegie.ch. 2. Spinal Cord Injury Center, Balgrist University Hospital, Zurich, Switzerland European Multicenter Study about Human Spinal Cord Injury (EMSCI), Zurich, Switzerland. 3. Clinical Trial Unit, Swiss Paraplegic Center, Nottwil, Switzerland. 4. Roessingh Research and Development, Lab of Biomechanical Engineering, University of Twente, Enschede, Netherlands.
Abstract
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.
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.
Authors: K A Potter-Baker; D P Janini; F S Frost; P Chabra; N Varnerin; D A Cunningham; V Sankarasubramanian; E B Plow Journal: Spinal Cord Date: 2016-04-05 Impact factor: 2.772
Authors: Kelsey A Potter-Baker; Daniel P Janini; Yin-Liang Lin; Vishwanath Sankarasubramanian; David A Cunningham; Nicole M Varnerin; Patrick Chabra; Kevin L Kilgore; Mary Ann Richmond; Frederick S Frost; Ela B Plow Journal: J Spinal Cord Med Date: 2017-08-07 Impact factor: 1.985
Authors: Nathan Evaniew; Nader Fallah; Carly S Rivers; Vanessa K Noonan; Charles G Fisher; Marcel F Dvorak; Jefferson R Wilson; Brian K Kwon Journal: J Neurotrauma Date: 2019-04-10 Impact factor: 5.269