title: Evaluation of a task-oriented client-centered upper extremity skilled performance training module in persons with tetraplegia.
abstract: METHODS
  Clinical intervention study.
  
  
  OBJECTIVE
  Arm hand skilled performance (AHSP) has a major role in the rehabilitation of persons with cervical spinal cord injury (C-SCI). A task-oriented client-centered upper extremity skilled performance-training (ToCUEST) module was developed. The present study aims to evaluate effects of ToCUEST on specific and general AHSP in C-SCI, during and after rehabilitation.
  
  
  METHODS
  Adelante Rehabilitation Centre (The Netherlands).
  
  
  METHODS
  C-SCI persons, either during or after rehabilitation, completed the ToCUEST training; a control group of patients during rehabilitation received standard rehabilitation. The training module was focused on patient's individual needs, combining principles of motor learning and training physiology. Three self-selected goals were trained 3 days per week, in three sessions of 30 min per day for 8 weeks. Measures were taken at 3 months after the start of the active rehabilitation (T0), before training (T1), after training (T2), at follow-up (3 months post-training; T3) and at discharge.
  
  
  RESULTS
  For both ToCUEST groups during (n=11) and after (n=12) rehabilitation, an improvement (P<0.001) on specific AHSP (using the Goal Attainment Scale and the Canadian Occupational Performance Measure (satisfaction and performance)) was found between T1-T2 and T1-T3. Also an improvement (P<0.02) in general AHSP (using the Van Lieshout Test, the QIF and the motor FIM) was found in the total ToCUEST group between T1-T2 and T1-T3. No significant difference in improvement of general AHSP was found between the ToCUEST rehab and control group.
  
  
  CONCLUSIONS
  The ToCUEST module leads to improvement in AHSP, not only persons with C-SCI during rehabilitation, but also after finishing rehabilitation. These effects remain at follow-up.
authors.affiliation: Adelante Centre of Expertise in Rehabilitation and Audiology, Hoensbroek, The Netherlands. a.spooren@adelante-zorggroep.nl
authors.forename: A I F
authors.initials: AI
authors.lastname: Spooren
authors.forename: Y J M
authors.initials: YJ
authors.lastname: Janssen-Potten
authors.forename: E
authors.initials: E
authors.lastname: Kerckhofs
authors.forename: H M H
authors.initials: HM
authors.lastname: Bongers
authors.forename: H A M
authors.initials: HA
authors.lastname: Seelen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001132:Arm / Q000503:physiopathology*; D002574:Cervical Vertebrae / Q000293:injuries; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D009629:Person-Centered Psychotherapy / Q000379:methods*; D011782:Quadriplegia / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D013119:Spinal Cord Injuries / Q000534:rehabilitation*; D013647:Task Performance and Analysis; D013663:Teaching / Q000379:methods*; D055815:Young Adult