What is the Effectiveness of Electrical Stimulation Therapy on Increased Function of the Upper Extremity for Adults With a Spinal Cord Injury?
Physical Agent Modalities, Neuromuscular Rehabilitation, Occupational Therapy
Spinal cord injury (SCI) can be obtained as a result of a traumatic incident to the spinal cord or disease or degeneration to the area of the spinal column. Approximately 302,000 individuals in the United States live with a SCI and an additional 18,000 individuals acquire one annually. Individuals with a SCI can have a range of symptoms including but not limited to the loss of motor and sensory function at or below the level of injury. Function of the upper extremities can be impacted in 50% of SCI cases and those with limitations in upper extremity (UE) function collectively agree that addressing those limitations is a priority in rehabilitation. This critically appraised topic (CAT) is aimed at determining the effectiveness of electrical stimulation therapy (ESTIM) on increased function of the UE for adults with a SCI. Methods for article selection included evidence levels 1A-3B that were peer-reviewed, published within the last 10 years, participants over the age of 18 years with a SCI, utilized ESTIM, and had outcomes regarding functional health indicators. This appraisal found that ESTIM of the UE demonstrated improvements in UE function in adults with SCIs. ESTIM resulted in improved bilateral hand function, maintenance of range of motion with acute treatment, and more efficient grasp and release. When combined with other modalities such as blood flow resistance training or arm cycling exercise, improvements in strength and peak power of UE were found. In relation to occupational therapy (OT) practices, ESTIM interventions can effectively be applied to clinical and community-based treatments, support healthcare delivery and health policies, be incorporated into education and training of OT students, and refine and advance factual knowledge or theories in order to benefit SCI patients. In the future, further research is needed to address limitations in study design for the utilization of ESTIM in the SCI population due to small sample size and lack of generalizability to decrease risk of Type II error. In addition, variability of ESTIM parameters requires further exploration for refinement to support evidence based practice for treatment of the SCI population.
Copyright is retained by the Author. A non-exclusive distribution right is granted to Creighton University