Recovery of strength at the zone of injury in motor complete and motor incomplete cervical spinal cord injured patients.
This study compared the time of recovery at the zone of injury between motor complete (Frankel A and B) and motor incomplete (Frankel C and D) cervical spinal cord injured patients for the biceps (C5), extensor carpi radialis (C6), and triceps (C7) muscles. Manual muscle testing was performed initially three to seven days postinjury, then weekly for four weeks, and then monthly for six months. Subjects between the ages of 15 and 70 years with C4, C5, C6, or C7 neurologic levels were classified according to whether their selected muscle was greater than 0/5 and less than 3/5 grade (n = 32) or greater than or equal to 3/5 grade (n = 28) at initial evaluation. Subjects were further classified based on their Frankel score. Motor incomplete patients with muscle strength less than 3/5 had an average time of recovery to grade 3/5 of 0.9 months (median = 2 weeks), and all seven patients achieved grade 3/5 by two months postinjury. Motor complete patients had an average time of recovery to grade 3/5 of 1.8 months (median = 2 months), and 18 of 25 patients achieved grade 3/5 by two months postinjury (p = 0.1). For muscles greater than or equal to 3/5, motor incomplete subjects had an average time for improvement of one full grade of 1.5 months (median = 2 months), and motor complete subjects had an average time for improvement of one grade of 2.3 months (median = 1 month, p = 0.1).(ABSTRACT TRUNCATED AT 250 WORDS)
Mange
K C
KC
Department of Rehabilitation Medicine, Jefferson Medical College, Thomas Jefferson University, Philadelphia, PA 19107.
Ditunno
J F
JF
Herbison
G J
GJ
Jaweed
M M
MM
D000293:Adolescent; D000328:Adult; D000368:Aged; D006801:Humans; D015601:Injury Severity Score; D008875:Middle Aged; D009119:Muscle Contraction; D009132:Muscles / Q000503:physiopathology*; D011379:Prognosis; D011446:Prospective Studies; D013119:Spinal Cord Injuries / Q000503:physiopathology*; D013997:Time Factors