The natural course of passive tenodesis grip in individuals with spinal cord injury with preserved wrist extension power but paralyzed fingers and thumbs

Spinal Cord. 2018 Sep;56(9):900-906. doi: 10.1038/s41393-018-0137-4. Epub 2018 May 22.

Abstract

Study design: Cross-sectional.

Objectives: To investigate the natural course of passive tenodesis grip in individuals with spinal cord injury (SCI) with no experience of tenodesis splint application and the related factors for success of the grip.

Setting: Community-dwelling persons with chronic SCI in South Korea.

Methods: Individuals with cervical SCI with preserved wrist extensor power, but completely paralyzed fingers and thumbs, were recruited. For each hand, success or failure of passive tenodesis lateral grip was assessed both in the opening and closing phase. The key task in the Graded and Redefined Assessment of Strength, Sensibility, and Prehension (GRASSP) test was also assessed.

Results: Fifty-eight hands of 37 individuals with SCI were analyzed. In 35 of the 58 hands, both opening and closing phases of the grip were achieved. During the closing phase of the passive tenodesis lateral grip, the mean (s.d.) value of the second MP joint flexion angle (°) in the success group was 55.1 (13.6), compared to 38.6 (17.8) in the failure group. The key task in GRASSP was completed in only 14 out of 58 hands. Hands with a wrist extensor power of grade 4 or 5 on a manual muscle test showed higher GRASSP scores than those with a grade 3 wrist extensor power.

Conclusions: The passive tenodesis lateral grip can be achieved in a large number of hands without splint application after SCI, but its use in the key task of the GRASSP is limited.

MeSH terms

  • Biomechanical Phenomena
  • Chronic Disease
  • Cross-Sectional Studies
  • Female
  • Fingers / physiopathology*
  • Hand Strength* / physiology
  • Humans
  • Male
  • Middle Aged
  • Motor Skills* / physiology
  • Paresis / etiology
  • Paresis / physiopathology*
  • Paresis / rehabilitation
  • Spinal Cord Injuries / complications
  • Spinal Cord Injuries / physiopathology*
  • Spinal Cord Injuries / rehabilitation
  • Splints
  • Wrist / physiopathology*