Satisfaction and performance in patient selected goals after grip reconstruction in tetraplegia.

Abstract

Reconstruction of grip in tetraplegia aims to improve upper extremity performance and control in daily life. We evaluated the effects of surgery and rehabilitation on performance and satisfaction of patient identified activity goals in 20 patients (22 arms) who had grip reconstructions for both finger and thumb flexion. Patients assessed an improvement in both performance and satisfaction after surgery in all groups of activities assessed using the Canadian Occupational Performance Measure (COPM). The mean improvement at 6 and 12 months was 3.5 points better than the 2.5 points before surgery. Before surgery 36% of the goals identified were impossible to perform. After surgery, 78% of these goals were possible. The largest improvement was observed in the basic activity of 'eating' but significant improvement was also noted in activities generally regarded as complex and not measured in standard ADL such as 'doing housework' and taking part in 'leisure'.