title: Arm hand skilled performance in persons with a cervical spinal cord injury--long-term follow-up.
abstract: METHODS
  Retrospective cohort study.
  
  
  OBJECTIVE
  To assess development of arm hand skilled performance (AHSP) during and after in-patient rehabilitation in persons with cervical spinal cord injury (CSCI) and to determine factors that influence the outcome.
  
  
  METHODS
  Eight rehabilitation centres in the Netherlands with specialised spinal cord injury departments.
  
  
  METHODS
  AHSP was assessed using the Van Lieshout test (VLT) in persons admitted with recent CSCI. Assessment was carried out at the beginning (t1), after 3 months (t2), at the end (t3) of in-patient rehabilitation, and 1 and 5 years thereafter (t4, t5). Multilevel regression analysis was performed to determine development of AHSP and associations between AHSP and age, gender, motor completeness, lesion level (high or low CSCI), motor scores of upper extremity (MSUE), and pain in the tested arm.
  
  
  RESULTS
  Fifty-five participants were included with mean age 38 years (range 18–64). There were 73% male, 80% had high CSCI (C3–C6) and 69% had motor complete lesion. Scores of VLT improved significantly during in-patient rehabilitation (mean: t1=25; t3=33) (P=0.005), scores remained unchanged at 1 year (t4=32) and 5 years (t5=32) (P=0.903) after in-patient rehabilitation. Motor completeness, MSUE and pain were significantly related to the VLT score (P<0.001, P<0.001, P=0.015, respectively). Age, gender and lesion level had no significant relationship.
  
  
  CONCLUSIONS
  AHSP improved during in-patient rehabilitation. It was then stable during the next 5 years after discharge. Persons with an incomplete lesion, high MSUE and no pain in the tested arm perform best on the VLT.
authors.affiliation: Rehabilitation Centre Het Roessingh, Enschede, The Netherlands. C.Franke@zgt.nl
authors.forename: A C
authors.initials: AC
authors.lastname: Franke
authors.forename: G J
authors.initials: GJ
authors.lastname: Snoek
authors.forename: S
authors.initials: S
authors.lastname: de Groot
authors.forename: A V
authors.initials: AV
authors.lastname: Nene
authors.forename: A I F
authors.initials: AI
authors.lastname: Spooren
authors.forename: M W M
authors.initials: MW
authors.lastname: Post
mesh_terms: D000293:Adolescent; D000328:Adult; D001132:Arm / Q000502:physiology*; D002574:Cervical Vertebrae; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006225:Hand / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011597:Psychomotor Performance / Q000502:physiology*; D012189:Retrospective Studies; D013119:Spinal Cord Injuries / Q000534:rehabilitation*; D013995:Time; D016896:Treatment Outcome; D055815:Young Adult