Stroke rehabilitation summer school Upper limb therapy dose during (sub)acute rehabilitation of people with a cervical spinal cord injury

Abstract

Purpose This study aims to inventory the current therapy dose dimensions (TDD) in upper limb motor training. Methods In this longitudinal observational study in three rehabilitation centers, active upper limb training during usual care for patients with a cervical spinal cord injury (4-8 post-injury weeks at inclusion) was observed three days of the week during three separate weeks and recorded on video. Sessions with 25% of the time upper limb training were included. TDD were retrieved from observations, and subjective difficulty and intensity perceived by the patient were assessed using a Visual Analogue Scale. Patient characteristics and TDD were reported using means (M), standard deviations (SD), and percentages. Results In the ongoing study, 84 sessions were examined, involving eight patients (AIS B-D, lesion C1-C5, mean age 56.1 years (SD: 12.1) and mean post-injury weeks 7.5 (SD: 1.6) at inclusion). The sessions had a mean planned time of 54’06’’ (SD: 29’15’’), with a mean session length of 40’56’’ (SD: 25’25’’), and a mean session length spent on the upper limb of 33’00’’ (SD: 23’25’’). The sessions had a mean active time of 20’31’’ (SD: 13’56’’). Patients indicated a subjective difficulty of, on average, 3.9 (SD: 2.4) and a subjective intensity of, on average, 3.9 (SD: 2.2). Conclusions These preliminary results showed session lengths of only 75.6% of the planned time and 62.2% active time during upper limb training. Patients indicated a relatively low subjective difficulty and intensity. Future research is needed to optimize and implement TDD into upper limb motor training.