Task-oriented Arm/Hand Skill Rehabilitation and Therapy Dose Dimensions in Subacute Spinal Cord Injury Rehabilitation

Study Overview
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Brief Summary
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The study is a multicenter longitudinal observational study. The therapy content and the therapy dosage of arm/skill training for patients with cervical spinal cord injury (SCI) will be observed for the primary objective. The aim is to get insight into the current therapy content and the current therapy dosage in arm/hand skill training, with the overall aim to optimize the arm/hand skill training. For the secondary objective, in addition to the patients with cervical SCI also, patients with paraplegia as a result of SCI are included. The aim is to assess the difference between the patient's perceived dose and the therapist's estimation of the therapy dose. This will give insight into the patient's and therapist's views on therapy dose; this information will contribute to optimizing therapy dose in exercise therapy in SCI. The third aim is a pilot study to explore the usability of evening reports in SCI rehabilitation.

Official Title
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Task-oriented Arm/Hand Skill Rehabilitation and Therapy Dose Dimensions in Subacute Spinal Cord Injury Rehabilitation

Conditions
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Spinal Cord Injuries

Intervention / Treatment
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* Other: Observation and questionnaire of active therapy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Primary objective Have sustained a traumatic or non-traumatic SCI between C1 and T1. Have an AIS A, B, C or D Are older than 16 years Being able to follow standard arm/hand skill training. Patients in the subacute phase (4-30 weeks post-injury) Receiving usual care Able to understand the purpose of the study (understanding Dutch, English, French and German). Secondary objective Add patients with: Persons with SCI (C1-S4) having an AIS A, B, C, D; Are older than 16 years; Patients in the subacute phase (4-30 weeks post-injury) receiving standard care or more intensive care as defined by the SCI-MT trial - Therapists Physiotherapists, occupational therapists and sports therapists with at least two years of experience in SCI rehabilitation Exclusion Criteria: have any significant medical or physical condition (including pregnancy) or psychiatric illness that could prevent the person from participating in the study are unable/unwilling to provide informed consent.

Ages Eligible for Study
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Minimum Age: 16 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Patients<br>Patients will be observed during their active training sessions. Patients will be asked questions about: fatigue physical fatigue pain the difficulty of the session motivation | Other: Observation and questionnaire of active therapy<br>* There will be an observation of the usual care; no intervention will be added.<br>|
| Therapists<br>Therapists will be asked questions about the observed training sessions of the patients. The questions will be about: Estimation of active training time Estimation of patient's fatigue Estimation of the patient's perceived difficulty of the session Estimation of the patient's perceived physical fatigue of the session Estimation of the patient's perceived motivation for the session | Other: Observation and questionnaire of active therapy<br>* There will be an observation of the usual care; no intervention will be added.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Task-oriented and therapy dose dimensions and the change in time of these components in arm/hand skill training in usual care in cervical SCI during subacute rehabilitation | An observer reports the therapy content (endurance training, strength training and skill training) on a data report Active training time is measured with accelerometers on both wrists An observer with a hand counter measures movement repetitions The prescribed, planned and given therapy hours are reported on a data form | Patients will be observed for three weeks between 4 and 20 weeks post-injury. There will be three random days of observations. Data will be collected from every therapy session with at least 50% arm/hand skill training | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Perceived dose in spinal cord injury in the subacute rehabilitation | Patients and therapists answers questions before and after the sessions Patients get questions on: Fatigue Pain Difficulty Physical fatigue Motivation Therapists get questions on: Estimation of active training time Estimation of patient's fatigue Estimation of the patient's perceived difficulty of the session Estimation of the patient's perceived physical fatigue of the session Estimation of the patient's perceived motivation of the session | Patients will be observed for three weeks between 4 and 20 weeks post-injury. There will be three random days of observations. Data will be collected before and after every active therapy session. | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Spinal cord rehabilitation, Therapy content in arm/hand skill training, Therapy dose in spinal cord rehabilitation