Document Detail


The effect of a flexion contracture of the elbow on the ability to transfer in patients who have quadriplegia at the sixth cervical level.
MedLine Citation:
PMID:  8816657     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We studied six patients (twelve upper extremities) who had quadriplegia at the sixth cervical level. Our purpose was to evaluate how the loss of terminal extension of the elbow adversely affected the ability of the patient to perform transfers with a sliding board and so-called depression raises (lifting of the body with use of the extended upper extremities to reduce the pressure on the ischial tuberosities). Function of the triceps muscle was considered to be absent in eight upper extremities and present in four. A flexion contracture of the elbow was simulated with use of a specially fabricated, hinged elbow brace. Terminal extension was progressively limited, in 5-degree increments, until the patient was no longer able to perform the transfer or the depression raise. The mean flexion contracture at which the patient could not perform the transfer or the depression raise was approximately 25 degrees when function of the triceps was absent and approximately 50 degrees when function of the triceps was intact. The results of this study emphasize the importance of maintaining the full range of motion of the elbow in a patient who has high-level quadriplegia. In a patient who has quadriplegia at the sixth cervical level who otherwise would be independent with regard to transfer skills and mobility in bed, a flexion contracture of the elbow of approximately 25 degrees or more can result in the loss of a functional level and render the patient as dependent as one who has quadriplegia at the fifth cervical level.
Authors:
J Grover; H Gellman; R L Waters
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of bone and joint surgery. American volume     Volume:  78     ISSN:  0021-9355     ISO Abbreviation:  J Bone Joint Surg Am     Publication Date:  1996 Sep 
Date Detail:
Created Date:  1996-10-24     Completed Date:  1996-10-24     Revised Date:  2010-10-25    
Medline Journal Info:
Nlm Unique ID:  0014030     Medline TA:  J Bone Joint Surg Am     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1397-400     Citation Subset:  AIM; IM    
Affiliation:
University of Southern California Department of Orthopaedics, Rancho Los Amigos Medical Center, Downey, California 90262, USA.
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MeSH Terms
Descriptor/Qualifier:
Activities of Daily Living
Adult
Braces
Cervical Vertebrae
Contracture / physiopathology*
Elbow Joint / physiopathology*
Equipment Design
Female
Humans
Male
Movement
Muscle Contraction
Muscle, Skeletal / physiopathology
Quadriplegia / classification,  physiopathology*,  rehabilitation
Range of Motion, Articular*
Spinal Cord Injuries / classification
Weight-Bearing

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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