Rehabilitation outcome of upper extremity skilled performance in persons with cervical spinal cord injuries

OBJECTIVE: To investigate changes in arm hand skilled performance during and after active rehabilitation in (sub)groups of subjects with cervical spinal cord injuries. DESIGN: Longitudinal multi-centre cohort study. PATIENTS: Persons with cervical spinal cord injuries during (n?=?57) and after (n?=?35) rehabilitation. METHODS: Patients from 8 Dutch rehabilitation centres received therapy as usual. At 3 time-points during active rehabilitation and one year after discharge arm hand skilled performance was measured using the Van Lieshout hand function test, the Grasp Release Test (for basic activities) and the Functional Independence Measure and the Quadriplegia Index of Function (for complex activities). RESULTS: Arm hand skilled performance continues to improve over the entire rehabilitation period, mostly in the first stage of active rehabilitation, and especially in persons with a motor incomplete lesion. Persons with a motor incomplete lesion achieve higher arm hand skilled performance outcome than those with a motor complete lesion. After rehabilitation arm hand skilled performance does not decline. CONCLUSION: Monitoring the outcome of arm hand skilled performance at the level of basic and complex activities during the whole rehabilitation phase may guide therapists in further optimizing therapy.