Determining Effectiveness of the SaeboGlove With Spinal-Cord Injury (SCI): A Case Study

PURPOSE: With improvements in medical and rehabilitation care, individuals with SCI have a greater life expectancy following their injury. These individuals desire to participate in their communities, complete their daily tasks with independence, and achieve a high QOL. However, individuals with cervical SCI often experience reduced independence in daily tasks and QOL as a result of decreased arm and hand function. The SaeboGlove is designed for individuals with neurological and orthopedic conditions to increase incorporation and use of the hand in a functional manner. By improving engagement of the UE through wearing the device, individuals experience increased independence and motor recovery. Because the SaeboGlove is a relatively new device, there is a paucity of rehabilitation literature supporting its effectiveness, and the literature that does exist is based on individuals that have experienced a stroke. However, there is evidence supporting the use of massed practice and task-oriented training with individuals with SCI. Therefore, researchers desired to implement a massed practice / task specific protocol with use of the SaeboGlove with an individual with an incomplete SCI. The purpose of this study was to determine changes in performance and satisfaction in meaningful occupations and changes in UE motor recovery following use of the SaeboGlove with an individual with a SCI.

METHODS: Researchers used a pre/posttest case design to explore the effectiveness of the SaeboGlove on UE function and occupational performance with an individual with a SCI. The participant was a 19-year-old male with a current classification of C5 ASIA-D SCI sustained from sporting event 18 months prior to study. The participant desired to drive, cut his food, and hold his hockey stick; therefore, it was important to have functional bilateral use of his UEs. Because his right UE demonstrated greater function, the participant completed the study with the SaeboGlove on the left UE. The participant completed 1-hour sessions 2x per week for 6 weeks in an outpatient clinic. During the in-clinic sessions, the participant completed 5 exercises with high repetitions that combined proximal and distal movements to foster grasp and release, followed by 1 to 2 occupation-based interventions related to his prioritized goals. During the non-clinic days, the participant reported completion of 5 exercises with a designated number of repetitions at home. Pre and post-test outcome measures included: (1) Canadian Occupational Performance Measure (COPM), (2) Disabilities of the Arm, Shoulder and Hand (DASH), (3) Wolf Motor Function Test (WMFT), (4) Range of Motion (ROM), and (5) Manual Muscle Test (MMT).

RESULTS: The participant’s COPM scores improved by 2.5 for performance and 1 for satisfaction with 5 occupations. The DASH score decreased by 5.9 points and the time and strength improved in 12/17 items on the WOLF indicating greater UE function. After implementation of HEP and repetition of tasks using the SaeboGlove in therapy sessions, the participant reported improved use of left UE for daily tasks of cutting food and using the video game and remote controls. During the sessions, the participant’s dad also reported that his son did not need him for as much care, so dad was able to return back to part-time work because of his son’s increased independence and confidence.

CONCLUSION: Results indicate the SaeboGlove has potential to improve engagement in occupations and improved UE motor function with individuals with incomplete SCI. IMPACT: Because of a paucity of literature on the use of this device with SCI, occupational therapists can begin to further use and explore the effectiveness of the SaeboGlove with this population.

References

Lu, X., Battistuzzo, C. R., Zoghi, M., & Galea, M. P. (2015). Effects of training on upper limb function after cervical spinal cord injury: a systematic review. Clinical Rehabilitation, 29(1), 3-13.

Whitehurst, D. G. T., Noonan, V. K., Dvorak, M. F. S., & Bryan, S. (2012). A review of preference-based health-related quality of life questionnaires in spinal cord injury reserach. Spinal Cord, 50, 646-654.

Snoek, G. J., IJzerman, M. J., Hermens, H. J., Maxwell, D., & Biering-Sorenson, F. (2004). Survey of the needs of patients with spinal cord injury: impact and priority for improvement in hand function in tetraplegics. Spinal Cord, 42(9), 526.