Effects of Activity Based Therapy on Upper Limb Strength and Transfer in Spinal Cord Injury Patients
Condition: Spinal Cord Injuries
MeSH terms: Spinal Cord Injuries; Wounds and Injuries
Study type: Interventional

Summary: 
      In our society spinal cord injury is a major problem.activity based therapy and conventional
      therapy has a potentional to improve upper limb strength and transfer in tetraplegic
      patients.

      The aim of this study is to determine the effects of activity based therapy versus
      conventional therapy to improve the upper limb strength and transfer in spinal cord injury.

      The study design used was randomized clinical trial. The study was conducted at the
      paraplegic center Peshawar in 6 weeks after the approval of synopsis. A sample size of 16
      participants was taken with complete and incomplete spinal cord injury received using lottery
      method. Subjects were randomly divided into 2 groups. Group A was treated with activity based
      therapy + baseline therapy and group B was treated with conventional therapy + baseline
      therapy. 8 subjects in each group. Pre and post treatment evaluation were done by using
      Spinal cord independence measure scale (SCIM) and International standards for neurological
      classification of spinal cord injury upper extremity measurement scale (ISNCSCI- UEMS).

      Post spinal cord independence measure activity based group mean 26.87±12.87 and conventional
      group mean 31.50±23.82. The results indicate that conventional therapy and activity based
      therapy both are helpful in improving upper limb strength and transfer total spinal cord
      independence measure pre sig.0.96 and post sig.0.57.

      Both activity based therapy and conventional therapy equally effective for improving the
      upper limb strength and transfer in spinal cord injury.

      entional therapy.
    

Detailed description: 
      Spinal cord is the cylindrical structure of nerve fibers and tissues that is enclosed in the
      spine and provides connection between the brain and all parts of the body. The spinal cord is
      particularly prone to injury. The spinal cord does not have the ability to repair other parts
      of the body, if it is damaged. A spinal cord injury happens when the spinal cord is affected
      by trauma, loss of its normal blood flow, or tumor or infection compression. Lesions in the
      spinal cord are described as either complete or incomplete.In a complete spinal cord injury,
      the body suffers complete loss of sensation and muscle control below the injury stage. In an
      incomplete injury to the spinal cord, there is a certain stay behind feature below injury
      point. In most cases all sides of the body are similarly affected. Neck injuries to the upper
      portion of the spinal cord can cause quadriplegia-paralysis of both arms and legs. If the
      spinal cord injury occurs lower in the back then it can only induce paraplegia-paralysis of
      both legs. The incidence of SCI to be between 13 and 33 cases per million per year, and their
      estimate of the incidence of SCI was between 110 and 1120 per million populations.
      Quadriplegia term refers to the motor and sensory function of cervical spinal cord because
      neurons inside the neuron damaged the spinal canal. Quadriplegia can cause in the arms,
      trunk, legs and pelvic organs. Not including brachial plexus or peripheral nervous
      injury.Trauma is the principal cause of spinal cord injury. Nearly half of the incidents are
      attributed to accidents involving motor vehicles. Certain forms of trauma include: falling to
      the spine from a height, stabbing or gunshot wound and sports injuries. Spinal cord damage
      may also be caused by tumor, infection, or inflammation caused by compression of the spinal
      cord. Many patients have normal backbone canal and a higher risk of spinal cord injurySome
      prognostic factors are related to survival, includes demographic, injury, and psychosocial
      variables. The most important prognostic factors are age and severity of injury including the
      level of the nervous system, the degree of damage integrity, and ventilator dependence
      Patients with spinal cord injury (SCI), especially those with higher levels of disease, rely
      on care and assistance in their daily activities, most of which are provided by informal
      caregivers. Where home caregivers are involved, low usage of home services is observed.
      Provides care based on a doctor's prescription based on care needs, assessed by a qualified
      service provider using standardized procedures.
    

Intervention name(s): Activity base therapy; Strength training
Intervention type(s): Other; Other
Intervention description(s): activity based therapy
Weight bearing activities of daily living like vertical lifting, bilateral body weight shifting, lifting and shifting, forward reaching and sideways reaching.; Strengthening exercises of upper limb involved muscles (elbow extensors, shoulder adductors, abductors, wrist extensors, shoulder protractors and retractors
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment