TY - JOUR
T1 - Accessing Rehabilitation after Upper Limb Reconstructive Surgery in Cervical Spinal Cord Injury
T2 - A Qualitative Study
AU - Randolph, Samantha B.
AU - L’Hotta, Allison J.
AU - Tam, Katharine
AU - Stenson, Katherine
AU - Curtin, Catherine M.
AU - James, Aimee
AU - Kennedy, Carie R.
AU - Ota, Doug
AU - Novak, Christine B.
AU - Kenney, Deborah
AU - Fox, Ida K.
N1 - Publisher Copyright:
© 2024 American Spinal Injury Association.
PY - 2024/9/1
Y1 - 2024/9/1
N2 - 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.
AB - 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.
KW - cervical spinal cord injury
KW - nerve transfer surgery
KW - postsurgical rehabilitation
KW - rehabilitation
KW - tendon transfer surgery
UR - http://www.scopus.com/inward/record.url?scp=85210997347&partnerID=8YFLogxK
U2 - 10.46292/sci23-00092
DO - 10.46292/sci23-00092
M3 - Article
C2 - 39619821
AN - SCOPUS:85210997347
SN - 1082-0744
VL - 30
SP - 35
EP - 44
JO - Topics in Spinal Cord Injury Rehabilitation
JF - Topics in Spinal Cord Injury Rehabilitation
IS - 4
ER -