Comparing Outcomes of Elbow Extension Tendon Transfers
|Cervical Spinal Cord Injury|
|Study Design:||Observational Model: Cohort
Time Perspective: Retrospective
|Official Title:||A Comparison of Two Surgical Procedures That Restore Elbow Extension|
- Elbow Extension Strength [ Time Frame: At least one year post surgery ]Elbow extension strength was measured as the maximum elbow extension moment that subject's could generate. We used an elbow moment transducer to measure elbow moments under isometric (no change in arm posture) conditions. Subjects performed three trials at maximum effort, holding maximum elbow extension for 5 to 7 seconds. The maximum moment was computed as the maximum average moment sustained over a 0.5 second window.
|Study Start Date:||August 2011|
|Study Completion Date:||December 2015|
|Primary Completion Date:||December 2014 (Final data collection date for primary outcome measure)|
Subjects with posterior deltoid-to-triceps tendon transfers
Subjects with biceps-to-triceps tendon transfers
Subjects with cervical SCI who have not had tendon transfers
Unimpaired control subjects
Voluntary control of elbow extension significantly improves functional abilities for individuals with tetraplegia. As a result, surgical reconstruction of elbow extension via tendon transfer is considered a fundamental intervention that benefits the patient, even if other tendon transfers aimed at improving hand function are never performed. Presently, there are two common tendon transfer surgeries used to restore elbow extension following spinal cord injury. These are the posterior deltoid to triceps transfer and the biceps to triceps transfer. Both surgeries significantly improve voluntary elbow extension, although there is variability in the amount of control that is restored among patients. This study will directly compare the performance of the posterior deltoid transfer to the biceps transfer with regard to: voluntary elbow extension strength, the ability to activate the transfer, and neural factors associated with voluntary and involuntary control of individual muscles. These comparisons will be made in functionally relevant postures and will provide fundamental information that will improve clinical understanding of the capacity of each of these two procedures to restore elbow extension.
The fundamental hypothesis of this proposal is that an inability to maximally activate the transferred posterior deltoid and the transferred biceps significantly limits the elbow extension moment that can be produced.
Please refer to this study by its ClinicalTrials.gov identifier: NCT01204736
|United States, Illinois|
|Edward Hines Jr. VA Hospital, Hines, IL|
|Hines, Illinois, United States, 60141-5000|
|Principal Investigator:||Wendy M Murray, PhD||Edward Hines Jr. VA Hospital, Hines, IL|