Effects of Technology-Assisted Rehabilitation After Spinal Cord Injury: Pilot Randomized Controlled Crossover Trial

Area of Science:

• Neurorehabilitation
• Robotics in Medicine
• Spinal Cord Injury Treatment

Background:

• Technology-assisted and robotic methods are increasingly used in neurorehabilitation.
• Evidence on their effects on upper extremity function after spinal cord injury (SCI), especially chronic stage, is scarce.

Purpose of the Study:

• To evaluate the effects of a 6-week technology-assisted upper extremity rehabilitation intervention.
• To assess outcomes in adults 1-8 years after incomplete cervical spinal cord injury.

Main Methods:

• Pilot randomized controlled crossover trial with 20 participants (incomplete cervical SCI).
• Intervention: 6 weeks, 3x/week, 1-hour sessions including ≥30 min technology-assisted devices (AMADEO, DIEGO, PABLO).
• Outcome measures: Action Research Arm Test, ASIA-UEMS, grip/pinch strength, Spinal Cord Independence Measure-Self Report, Goal Attainment Scale.

Main Results:

• Statistically insignificant effects on most measures compared to no intervention.
• Significant improvement in ASIA-Upper Extremity Motor Score (ASIA-UEMS) for one subgroup (P=.04).
• High feasibility (19/20 enrolled, 17/20 completed ≥80% sessions) and tolerability.
• 14/16 participants achieved rehabilitation goals focused on hand and arm use.

Conclusions:

• Technology-assisted upper extremity rehabilitation is safe and feasible for incomplete cervical SCI.
• Positive outcomes in goal attainment suggest potential for broader clinical application.
• Larger randomized controlled trials are needed to confirm findings due to study limitations (unpowered).