title: Functional electrical stimulation therapy of voluntary grasping versus only conventional rehabilitation for patients with subacute incomplete tetraplegia: a randomized clinical trial.
abstract: BACKGROUND
  Functional electrical stimulation therapy (FET) has a potential to improve voluntary grasping among individuals with tetraplegia secondary to traumatic spinal cord injury (SCI).
  
  
  OBJECTIVE
  This single-site, randomized controlled trial examined the efficacy of 40 hours of FET with conventional occupational therapy (COT) compared with COT alone to improve grasping.
  
  
  METHODS
  Twenty-four subjects with subacute traumatic incomplete SCI (C4-C7, AIS B-D) consented to participate in 40 hours of therapy over 8 weeks, beyond the conventional rehabilitation program. Subjects were randomized to receive FET + COT (n = 9) or COT (n = 12). The key outcomes were changes in Functional Independence Measure (FIM) self-care subscores, Spinal Cord Independence Measure (SCIM) self-care subscores, and Toronto Rehabilitation Institute Hand Function Test (TRI-HFT) performed at baseline and follow-up.
  
  
  RESULTS
  At the end of the treatments, the change in mean FIM self-care subscore for the FET + COT group was 20.1 versus 10 (P = .015) for the COT group. Subjects randomized to FET + COT also had greater improvements in the SCIM and TRI-HFT. No longer term follow-up was feasible.
  
  
  CONCLUSIONS
  FET significantly reduced disability and improved voluntary grasping beyond the effects of considerable conventional upper extremity therapy in individuals with tetraplegia.
authors.affiliation: University of Toronto, Toronto, Ontario, Canada. milos.popovic@utoronto.ca
authors.forename: Milos R
authors.initials: MR
authors.lastname: Popovic
authors.forename: Naaz
authors.initials: N
authors.lastname: Kapadia
authors.forename: Vera
authors.initials: V
authors.lastname: Zivanovic
authors.forename: Julio C
authors.initials: JC
authors.lastname: Furlan
authors.forename: B Cathy
authors.initials: BC
authors.lastname: Craven
authors.forename: Colleen
authors.initials: C
authors.lastname: McGillivray
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D004185:Disability Evaluation; D004599:Electric Stimulation Therapy; D005260:Female; D018737:Hand Strength; D006801:Humans; D008297:Male; D008875:Middle Aged; D009788:Occupational Therapy; D011782:Quadriplegia / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D013119:Spinal Cord Injuries / Q000150:complications; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult