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. 2024 Fall;30(4):35-44.
doi: 10.46292/sci23-00092. Epub 2024 Nov 28.

Accessing Rehabilitation after Upper Limb Reconstructive Surgery in Cervical Spinal Cord Injury: A Qualitative Study

Samantha B Randolph  1 , Allison J L'Hotta  2 , Katharine Tam  3   4 , Katherine C Stenson  3   4 , Catherine M Curtin  5   6 , Aimee S James  7 , Carie R Kennedy  8 , Doug Ota  6   9 , Christine B Novak  10 , Deborah Kenney  11 , Ida K Fox  8
Affiliations

Accessing Rehabilitation after Upper Limb Reconstructive Surgery in Cervical Spinal Cord Injury: A Qualitative Study

Samantha B Randolph et al. Top Spinal Cord Inj Rehabil. 2024 Fall.

Abstract

Objectives: To investigate the barriers and facilitators to rehabilitation experienced by individuals with cervical SCI after upper limb (UL) reconstructive surgery.

Methods: We conducted a prospective cohort study with a follow-up period of up to 24 months. Data collection occurred at two academic and two Veterans Affairs medical centers in the United States. Participants were purposively sampled and included 21 adults with cervical SCI (c-SCI) who had received nerve or tendon transfer surgeries and 15 caregivers. We administered semi-structured interviews about participants' experiences of accessing rehabilitation services after surgery.

Results: Four themes emerged from the data: (1) participants encountered greater obstacles in accessing therapy as follow-up time increased; (2) practical challenges (e.g., insurance coverage, opportunity costs, transportation) limited rehabilitation access; (3) individuals with c-SCI and their caregivers desired more information about an overall rehabilitation plan; and (4) external support systems facilitated therapy access.

Conclusion: Individuals with c-SCI experience multilevel barriers in accessing rehabilitation care after UL reconstructive surgeries in the United States. This work identifies areas of focus to mitigate these challenges, such as enhancing transparency about the overall rehabilitation process, training providers to work with this population, and developing, testing, and disseminating rehabilitation protocols following UL reconstruction among people with c-SCI.

Keywords: cervical spinal cord injury; nerve transfer surgery; postsurgical rehabilitation; rehabilitation; tendon transfer surgery.

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