Evidence for your Practice: Early intensive hand rehabilitation for sub-acute spinal cord injury

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Article for Review:

Harvey, L. A., Dunlop, S. A., Churilov, L., Galea, M. P., Hands, S. C. I. P. A. S., & Collaborators, O. T. (2017). Early intensive hand rehabilitation is not more effective than usual care plus one-to-one hand therapy in people with sub-acute spinal cord injury (‘Hands On’): a randomised trial. Journal of Physiotherapy, 63(4), 197-204.

This study examined the effect of an intensive task-specific hand-training program involving functional electrical stimulation for people with sub-acute tetraplegia. The experimental intervention consisted of training with an instrumented exercise workstation in conjunction with functional electrical stimulation for 1 hour per day, 5 days per week for 8 weeks. Both groups received usual care and 15 minutes of one-to-one hand therapy 3x/week without functional electrical stimulation. The primary outcome was the modified Action Research Arm Test reflecting arm and hand function.

Conclusion: Adding an intensive task-specific hand-training program involving functional electrical stimulation to a combination of usual care plus three 15-minute sessions per week of one-to-one hand therapy does not improve hand function in people with sub-acute tetraplegia.

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