NEUROLOGICAL RECOVERY AND FUNCTIONAL OUTCOME FOLLOWING TETRAPLEGIA
Toshikatsu Tominaga (Yamaguchi Rosai Hospital, Onoda, Japan)
Purpose; The purpose of this study is to qualify the relation between the impairment and disability level in those patients suffering from spinal cord injuries.
Method; Neurological recovery and functional outcome were examined in sixty five individuals with a diagnosis of tetraplegia due to trauma. The mean age of all cases (61 men and 4 women) was 55.2±13.2 years at the time of injury (range, 17 to 83 years). The average time from injury to admission was 1.3±1.6 days (range, 1 to 5 days). 80% of the injuries (52 cases) were the result of motor vehicle accidents. The remaining 13 cases were caused by falls (8 cases), diving (2 cases), sports (2 cases) and a motor cycle accident (1 case). These consisted of Frankel A; 26 cases, B; 7 cases, C; 25 cases, D; 7 cases at the initial examination which were performed according to the Standards of American Spinal Injury Association. 66% of all injuries (52 cases) underwent surgery (43 cases; decompression and spinal fusion, 9 cases; laminoplasty).
Result and conclusion; Ambulation status closely correlated with the six month lower extremity motor scores, which averaged 10.3±7.5 for nonambulators, 28.4±6.2 for household ambulators, and 38.2±7.3 for community ambulators in those patients with incomplete injuries. Self-care status moderately correlated with six month upper extremity motor scores, which averaged 40.3±5.2 for social independence, 32.3±4.3 for independence at home, 21.5±7.4 for stay at home with some assistance, and 10.2±8.3 for stay at a nursing home in those with complete injuries.
The Functional Outcome in C6 Tetraplegia: Relationship between shoulder muscle strength and FIM score
Toshiyuki Fujiwara, Yukihiro Hara, Kazuto Akaboshi, (Murayama Hospital, Tokyo, Japan ) Naoichi Chino (Keio university, Tokyo, Japan)
The purpose of this study was to analyze the relationship between shoulder muscle strength and disability level among C6 tetraplegic patients. Ten C6 level complete tetraplegic patients were examined. Functional Independent Measure (FIM) motor score and ASIA motor score of all patients were assessed on discharge. We evaluated muscle strength of bilateral serratus anterior, pectoralis major (clavicle branch) and latissimus dorsi by manual muscle testing (MMT). Those six MMT scores were summated as the total shoulder score. The total shoulder score significantly correlated with FIM motor score with Spearman rank test (r=0.96) than ASIA motor score(r=0.74). It was supposed that shoulder muscle strength was the important factor for predicting functional outcomes among C6 complete tetraplegic patients.