Sensorimotor rehabilitation and changes in upper limb function after acute cervical spinal disorders: a retrospective case series (n = 14)
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Inês Margarida Oliveira Agostinho1,2, Ana Temudo2, Sérgio Manuel Oliveira Gonçalves Bacelo2
1Universidade Catolica Portuguesa, Lisbon, Portugal.
Background:
Upper limb impairment is a common consequence of acute cervical spinal disorders and can substantially compromise functional independence, highlighting the need for rehabilitation strategies that address sensorimotor and functional impairments.
Objective:
To describe changes in upper limb function following a sensorimotor intervention incorporating a viscoelastic product in individuals with acute non-degenerative cervical spinal disorders.
Design:
Uncontrolled, before and after, observational retrospective longitudinal case series study with no comparator group, conducted over a 14-month period.
Setting:
Surgical inpatient unit.
Participants:
Fourteen participants with acute non-degenerative cervical spinal disorders receiving a rehabilitation nursing programme, with heterogeneous underlying diagnoses including disc herniation, fracture, space-occupying lesion, myelopathy, and spinal cord trauma.
Main Measures:
Spasticity assessed using the Modified Ashworth Scale, upper limb muscle strength assessed using the Medical Research Council Muscle Scale, and functional independence assessed using the Barthel Index.
Results:
Statistically significant changes in spasticity were observed between baseline and discharge (Z = -3.093; p < .001; r = 0.83), together with significant changes in muscle strength across all assessed upper extremity segments: fingers (Z = -3.330; p < .001; r = 0.89), wrist (Z = -3.324; p < .001; r = 0.89), forearm (Z = -2.953; p < .001; r = 0.79), elbow (Z = -3.084; p < .001; r = 0.82), and shoulder (Z = -2.555; p = .008; r = 0.68), as well as in functional independence (Z = -3.297; p < .001; r = 0.88).
Conclusions:
Changes in spasticity, upper limb muscle strength and functional independence were observed between baseline and discharge. Given the uncontrolled retrospective case-series design and absence of a control or comparison group, these findings should be interpreted with caution, as they cannot be attributed specifically to the intervention and should be considered hypothesis-generating for future research. Further prospective controlled studies are warranted to evaluate the effectiveness of this approach.
