Upper Extremity Function in Individuals With Paraplegia: Relationships Between Endurance, Performance, and Symptoms
Upper Extremity Function in Individuals With Paraplegia: Relationships Between Endurance, Performance, and Symptoms
Spinal cord injury (SCI) is a serious condition that causes physical, psychological, and social functional impairments. Paraplegia is characterized by the loss of motor and/or sensory function at the thoracic, lumbar, or sacral levels of the spinal cord, affecting the trunk, lower extremities, and pelvic organ functions. Functional independence and the ability to use a wheelchair are primary goals of rehabilitation. In paraplegia, the upper extremities are preserved; however, overuse often leads to shoulder and wrist pain and overuse injuries such as carpal tunnel syndrome. Pain is the most common symptom negatively impacting patients' quality of life. Additionally, findings such as decreased muscle strength, spasticity, atrophy, and joint limitations reduce functional performance. This study aims to investigate the relationships between upper extremity function (endurance and performance) and symptoms including pain, sensory loss, atrophy, joint limitations, and grip strength in individuals with paraplegia. Assessment methods used include the ASIA scale, 6-Minute Pegboard and Ring Test, Purdue Pegboard Test, DASH questionnaire, hand dynamometer, and Functional Independence Measure (FIM).
Spinal cord injury (SCI) is a devastating condition that can cause physical, psychological, and social functional impairments. Paraplegia, a type of spinal cord injury, refers to the impairment or loss of motor and/or sensory functions of the thoracic, lumbar, or sacral spinal cord segments due to damage to neural structures within the spinal canal. Depending on the injury level, involvement of the trunk, lower extremities, and pelvic organs may occur.
Individuals with spinal cord injury need to have a good level of functional independence and the ability to use a wheelchair effectively in order to maintain their daily lives. Since individuals with SCI often rely heavily on wheelchairs during ambulation and daily activities, continuous load is placed on the bones, joints, and soft tissues of the upper extremities, which may lead to various upper limb problems.
Pain is the most common symptom affecting the quality of life in individuals with spinal cord injury. Additionally, shoulder pain, nerve neuropathies, motor and sensory loss, carpal tunnel syndrome, and muscle weakness can also be observed in these individuals.
Since paraplegic individuals must use a wheelchair, good upper extremity endurance is essential. However, there is a lack of studies in the literature assessing upper extremity endurance in this population. The performance of paraplegic individuals during daily activities is also important, yet no studies evaluating upper extremity performance in paraplegic individuals have been found. Our study is unique in that it aims to assess upper extremity endurance and performance in individuals with paraplegia.
In this study, the relationships between upper extremity function-endurance and performance-and symptoms such as pain, sensory loss, atrophy, joint restrictions, and grip strength associated with paraplegia were evaluated. The primary aim was to identify factors that hinder improvements in quality of life and independence by revealing the relationship between endurance, performance, and symptoms, and to provide data for rehabilitation programs to enhance the quality of life for these patients.
Thirty-two individuals with paraplegia participated in the study, which was conducted at Istinye University Physiotherapy and Rehabilitation Research and Application Center (İSÜFİZYOTEM). Neurological impairment was classified using the American Spinal Injury Association (ASIA) Impairment Scale. Upper extremity endurance was assessed with the 6-Minute Pegboard and Ring Test, upper extremity function with the Purdue Pegboard Test, symptoms with the Arm, Shoulder, and Hand Problems Questionnaire, hand grip strength with the Jamar dynamometer, functional independence with the Functional Independence Measure, and physical activity level with the Physical Activity Scale for Individuals with Physical Disabilities.
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Exclusion Criteria: