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Spinal Cord
Official Journal of the International Medical Society of Paraplegia |
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January 2001, Volume 39, Issue 1, Pages 37 - 43 |
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| Article |
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Hand function of C6 and C7 tetraplegics 1 - 16 years following injury
Correspondence to: |
| Keywords |
| tetraplegia;
upper limb function;
hand;
paralysis;
rehabilitation |
| Abstract |
Study design: Retrospective cohort study. Objective: To quantify the hand function of C6 and C7 tetraplegics 1 - 16 years after injury. Setting: Patients were assessed in their homes. Methods: Medical records of patients admitted to the Prince Henry Hospital Spinal Injuries Unit between 1984 and 1999 were used to identify all patients with C6 or C7 tetraplegia at 3 months post injury. Sixty-five patients (107 hands) were identified in this way. Forty-seven patients (81 hands) were located and agreed to partake in the study, and seven (nine hands) had died. Thus 81% of patients (83% of hands) still alive at follow-up were assessed. Main outcome measures: Unilateral hand function was assessed with the Grasp and Release Test (GRT) and a 10 item Activities of Daily Living (ADL) Test. Prevalance and severity of contractures, lateral grasp (key grip) strength and extensibility of the extrinsic finger flexor muscles were also determined. Results: All hands except one had been managed without surgical intervention. The median number of ADL tasks successfully completed was 9/10 (interquartile range=8 - 10) and the median number of objects successfully manipulated in the GRT was 3/6 (IQ range=3 - 5). Lateral grasp was poor (74% and 75% of hands could not use a lateral grasp to move the paperweight or depress the fork in the GRT, respectively), and the prevalence of contractures was low (53% of hands had full passive range of motion). Conclusion: In the long term, most C6 and C7 tetraplegics attain a high level of hand function despite poor lateral grasps. |
