Highlighting gaps in spinal cord injury research in activity-based interventions for the upper extremity: A scoping review

Article type: Review Article

Authors: Grampurohit, Namrata^{a; *} | Bell, Alison^a | Duff, Susan V.^b | Mulcahey, MJ^a | Thielen, Christina Calhoun^a | Kaplan, Gary^c | Marino, Ralph J.^d

Affiliations: [a] Jefferson College of Rehabilitation Sciences, Thomas Jefferson University, Philadelphia, PA, USA | [b] Crean College of Health and Behavioral Sciences, Chapman University, Irvine, CA, USA | [c] Scott Memorial Library, Academic Commons, Thomas Jefferson University, Philadelphia, PA, USA | [d] Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA

Correspondence: [*] Address for correspondence: Namrata Grampurohit, PhD, OTR/L, 901 Walnut Street, Suite 600, Philadelphia, PA 19107, USA; Tel.: +1 215 503 9421; E-mail: namrata.grampurohit@jefferson.edu.

Abstract: BACKGROUND:Upper extremity activity-based therapy for neurologic disorders employs high-intensity, high repetition functional training to exploit neuroplasticity and improve function. Research focused on high-intensity upper extremity activity-based therapy for persons with spinal cord injury (SCI) is limited. OBJECTIVE:To summarize high-intensity activity-based interventions used in neurological disorders for their current or potential application to SCI. METHODS:The scoping review included articles from MEDLINE, CINAHL, Cochrane CENTRAL, and OTSeeker with the criteria: non-invasive activity-based interventions delivered at least three times/week for two weeks, upper extremity functional outcomes, age 13 years or older, English language, and neurological disorders three months post onset/injury. RESULTS:The search yielded 172 studies. There were seven studies with SCI, all in adults. Activity-based interventions in SCI included task-specific training and gaming, with and without electrical stimulation, and a robotic exoskeleton. The other populations found in the review included studies in stroke, cerebral palsy, and multiple sclerosis. Thirty-four different interventions were reported in other populations. In comparison to the extensive stroke research, work in SCI was not found for high-intensity interventions using virtual reality, brain stimulation, rehabilitation devices, and applications to the home and telerehab settings. CONCLUSION:The results highlight critical gaps within upper extremity high-intensity activity-based research in SCI.

Keywords: Activity-based, high-intensity, rehabilitation, therapy, scoping review, upper extremity, neurological conditions, spinal cord injury

DOI: 10.3233/NRE-210042

Journal: NeuroRehabilitation, vol. 49, no. 1, pp. 23-38, 2021