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Essential gains and health after upper-limb tetraplegia surgery identified by the International classification of functioning, disability and health (ICF)

Journal article
Authors Lina Bunketorp Käll
Carina Reinholdt
Jan Fridén
Johanna Wangdell
Published in Spinal Cord
Volume 55
Issue 9
Pages 857-863
ISSN 1362-4393
Publication year 2017
Published at Institute of Neuroscience and Physiology, Department of Clinical Neuroscience
Institute of Clinical Sciences, Department of Orthopaedics
Pages 857-863
Language en
Keywords spinal-cord-injury, quality-of-life, tendon transfer surgery, upper-extremity surgery, parkinsons-disease, hand function, surgical, reconstruction, grip reconstruction, decision-making, satisfaction, Neurosciences & Neurology, Rehabilitation
Subject categories Neurosciences


Study Design: A questionnaire-based survey. Objectives: To describe functional gains and health following upper-limb tetraplegia surgery using the International Classification of Functioning, Disability and Health (ICF) as a reference and to explore interconnections across different dimensions of functioning and health. Setting: A specialized center for advanced reconstruction of extremities at Sahlgrenska University Hospital, Gothenburg, Sweden. Methods: Fifty-seven individuals who participated in a satisfaction survey were included in the present study. Besides questions concerned with the respondents' satisfaction with different aspects of surgery, the measures included perceived overall health status (EQ-VAS) and achieved grip strength. Univariate analyses were used to explore interconnections between measures. Results: The gains could be subcategorized and linked to the ICF domains 'mobility', 'self-care', 'communication', 'domestic life', and 'community, social and civic life', with 'handling objects' and 'maneuvering a wheelchair' as the most frequently reported gains. The mean EQ-VAS score was 67 +/- 22. No significant correlation was shown between grip strength and activity gains, nor between grip strength and perceived overall health. The degree of satisfaction was, however, associated with self-reported overall health among participants. Conclusion: The functional gains achieved after tetraplegia surgery could be applied to the ICF constructs' body functions/structures and activity with possible implications on participation. The overall health perception was relatively high and could be linked to the degree of satisfaction among participants. Muscle strength is not necessarily transferable to activity performance. This emphasizes the importance of addressing factors other than strength in the post-surgical rehabilitation and assessments.

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