Possibility of Independence in ADL (Activities of Daily Living ) for the Patients with Cervical Spinal Cord Injuries - An Evaluation based on Zancolli Classification of Residual Arm Functions
Osamu Yoshimura, Kiyomi Takayanagi (Hiroshima University, Hiroshima, Japan)
For patients with cervical spinal cord injuries to become independent in their ADL, residual arm function is very important. Also, age, sex, physical strength, obesity, spasticity, sharp pain, contruture, and motivation are related. We investigated the possibility of independence in ADL for patients with cervical spinal cord injuries carrying out our evaluation based on the Zancolli Classification of Residual Arm Functions. Zancolli classification C6BII is taken as the boundary level for ADL independence. Rehabilitation is not only controlled by the patients with cervical spinal cord injuries but also by the ability of the rehabilitation staff. This implies that taking responsibility in rehabilitation is important.
RECONSTRUCTION OF LATERAL PINCH ON BILATERAL HAND FOR A C-6 TETRAPLEGIC THROUGH FUNCTIONAL ELECTRICAL STIMULATION
R. Yagi, Y. Matsumura, K. Ihashi, Y. Handa (Tohoku Univ., Sendai, Japan)
Purpose: The purpose of this study was to reconstruct lateral pinch function on bilateral hand for a tetraplegic patient by means of functional electrical stimulation (FES).
Method: The patient was a 22-year-old male who had been suffering from C-6 tetraplegia due to traumatic cervical cord injury for one year. Percutaneously indwelling wire electrodes were implanted into the extensor digitorum, extensor pollicis longus, flexor digitorum profundus, flexor pollicis longus, adductor pollicis and flexor pollicis brevis of his bilateral hand. A portable stimulator, FESMATE 1230 (NEC Co. Ltd) was used for electrical stimulation. This stimulator was designed to generate rectangular pulse trains with 0.2 ms of pulse width and 20 Hz of frequency and the amplitude was modulated from 0 to -15 volts. A wrist switch that works by the patient's voluntary wrist dorsiflexion was developed, and the patient controlled lateral pinch and release movements by himself.
Result: The patient skillfully used this FES system in some activities of daily living. Especially, restoration of lateral pinch on bilateral hand was useful in doing self-catheterization.
Conclusion: Lateral pinch function on bilateral hand was reconstructed for a C-6 tetraplegic through FES, and this was useful for some ADL.