Jf. Ditunno et al., Recovery of upper-extremity strength in complete and incomplete tetraplegia: A multicenter study, ARCH PHYS M, 81(4), 2000, pp. 389-393
Objective: To examine upper-extremity motor recovery of subjects with tetra
plegia with both complete and incomplete injuries, to predict which patient
s and at what time they would recover a motor level.
Design: Prospective, multicenter clinical study of upper-extremity motor re
covery in subjects with acute traumatic spinal cord injury.
Setting: Three regional spinal cord injury centers.
Subjects: One hundred sixty-seven individuals with acute traumatic tetraple
gia (144 males [86%], and 23 females [14 %]) between the ages of 15 and 75
years (mean age, 35.5 yrs).
Methods: Subjects were examined and classified using sequential manual musc
le tests performed on admission, 72 hours, 1, 2, and 3 weeks, and 1, 2, 3,
6, 12, 18, and 24 months postinjury. C5 biceps, C6 extensor carpi radialis,
C7 triceps, and C8 flexor digitorum profundus were evaluated using a 0-5 s
cale. Analyses of the right motor levels used a series of logistic regressi
on models, and for multiple measurements on each subject, models were estim
ated using generalized estimating equations.
Results: The analysis for recovery of the biceps for the C4 group showed 70
% of complete compared with 90% of incomplete injuries recovered (p < .001)
; of the extensor carpi radialis in the C5 group, 75% complete and 90% inco
mplete recovered (p < .002); and of the triceps in the C6 group, 85% of com
plete and 90% of incomplete injuries recovered (P < .16).
Conclusion: Predicting future potential for upper-extremity motor recovery
and for independence in self-care in groups of patients at a specific motor
level is possible within the first week of injury.