Effect of repeated muscle strengthening of upper extremity muscles for patients with incomplete tetraplegic spinal cord injury.

Abstract

Purpose: Spinal Cord Injury is described as one of the most devastating neurological impairment. Individual with cervical injury has paralysis of both upper and lower limb. The present study was conducted to analyze and identify the therapeutic effect of repeated muscle strengthening training of upper extremity muscles for the treatment of patient with incomplete tetraplegic spinal cord injury. This study made the comparison, in order to discover the most effective treatment to alleviate the symptoms of the condition. Objectives: The objectives of the study is to investigate the effect of repeated muscle strengthening training of upper extremity muscles for following muscles strength (Elbow flexor, Elbow extensor, Wrist flexor, Wrist extensor) and VO2max among the patients with incomplete tetraplegic SCI. Methodology: The study was randomized control trial design. Total 30 samples were selected conveniently and then randomly assigned to experimental and control groups from inpatient treatment service of Spinal Cord Injury Unit, Physiotherapy Department, Centre for the Rehabilitation of the Paralysed (CRP), Savar, Dhaka. Structured questionnaire was used to assess the socio-demographic and other information of the participants. Pre-test was performed before beginning the treatment. The same procedure was performed to take post-test at the end of 4 weeks of treatment. Total treatment sessions were 5 sessions per week for 4 weeks. Single blinding procedure was used during data collection. Outcome measurement tools: Oxford Grade Scale and Manual Muscle Testing were used to measure muscle strength. Analysis of data: Inferential statistics such as Mann-Whitney U test, Wilcoxon sign rank test, Unpaired t test and Paired t test was done using SPSS version 20. Result: The results were found to be significant in between group analysis, in case of right elbow extensor muscle strength (p value=0.04 for Oxford Grade Scale and p value= 0.013 for Manual Muscle testing scale) and VO2max (P value= 0.034). But it was not found to be significant in case of left elbow extensor, right and left elbow flexor and right and left wrist flexor and extensor muscles strength. In within Group analysis, in case of the above mentioned variables, the results were found to be significant more in experimental group than control group. Conclusion: The study concluded as the repeated muscle strengthening training of upper extremity muscles for patients with incomplete tetraplegic spinal cord injury may not significantly capable of producing beneficial effects within this 4 weeks period on the improvement of their muscle strength comparing with conventional physiotherapy alone.

Keywords: SCI, tetraplegic, conventional physiotherapy, repeated muscle strengthening training.