title: Effects of training on upper limb function after cervical spinal cord injury: a systematic review.
abstract: OBJECTIVE
  To summarize the evidence for the effectiveness of exercise training in promoting recovery of upper extremity function after cervical spinal cord injury.
  
  
  METHODS
  Medline, Cochrane, CINAHL, EMBASE and PEDro were used to search the literature.
  
  
  METHODS
  Two reviewers independently selected and summarized the included studies. Methodological quality of the selected articles was scored using the Downs and Black checklist.
  
  
  RESULTS
  A total of 16 studies were included, representing a total of 426 participants. Overall, the internal validity and reporting of the studies was fair to good, while power and external validity were poor. Interventions included exercise therapy, electrical stimulation, functional electrical stimulation, robotic training and repetitive transcranial magnetic stimulation. Most of the studies reported improvements in muscle strength, arm and hand function, activity of daily living or quality of life after intervention.
  
  
  CONCLUSIONS
  Training including exercise therapy, electrical stimulation, functional electrical stimulation of the upper limb following cervical spinal cord injury leads to improvements in muscle strength, upper limb function and activity of daily living or quality of life. Further research is needed into the effects of repetitive transcranial magnetic stimulation and robotic training on upper limb function.
authors.affiliation: Department of Rehabilitation, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China luxiao1972@163.com.
authors.forename: Xiao
authors.initials: X
authors.lastname: Lu
authors.affiliation: Physiotherapy Department, The University of Melbourne, Parkville, Victoria 3010, Australia.
authors.forename: Camilla R
authors.initials: CR
authors.lastname: Battistuzzo
authors.affiliation: Physiotherapy Department, The University of Melbourne, Parkville, Victoria 3010, Australia.
authors.forename: Maryam
authors.initials: M
authors.lastname: Zoghi
authors.affiliation: Physiotherapy Department, The University of Melbourne, Parkville, Victoria 3010, Australia.
authors.forename: Mary P
authors.initials: MP
authors.lastname: Galea
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D066193:Cervical Cord / Q000293:injuries*; D016206:Databases, Bibliographic; D004599:Electric Stimulation Therapy; D005081:Exercise Therapy / Q000379:methods; D006801:Humans; D008875:Middle Aged; D053580:Muscle Strength / Q000502:physiology; D010043:Outcome and Process Assessment, Health Care; D026741:Physical Therapy Modalities; D011788:Quality of Life; D020127:Recovery of Function; D012371:Robotics; D013119:Spinal Cord Injuries / Q000150:complications / Q000523:psychology / Q000534:rehabilitation*; D050781:Transcranial Magnetic Stimulation; D034941:Upper Extremity / Q000503:physiopathology*; D055815:Young Adult
keywords: Spinal cord injury; systematic review; training; upper limb