Management of the tetraplegic upper limb v1
Research type
Research Study
Full title
Management of the tetraplegic upper limb: A mixed methods investigation of current clinical practice in UK spinal injury care
IRAS ID
339390
Contact name
Paul Strutton
Contact email
Sponsor organisation
Imperial College London
Duration of Study in the UK
1 years, 11 months, 31 days
Research summary
Spinal cord injury is a serious condition which significantly affects quality of life for patients and their families. It results in reduced strength and sensory loss and impacts on basic body functions such as heart rate, blood pressure and continence. Tetraplegia resulting from neck injuries presents a significant burden on UK healthcare resources since patients have impairments in all four limbs. This results in high lifetime care costs. Patients with tetraplegia report that recovery of upper limb function is their top priority, and this is a key focus of spinal injury rehabilitation.
Despite the importance of upper limb rehabilitation to this patient group, there is a lack of clear and consistent guidance on how this should be carried out. Guidance that exists is either generic, focussed on avoidance of secondary complications or highlights inconsistencies in the evidence. In addition to this, patients with spinal injuries are diverse in their impairments and potential for recovery, but there is limited evidence on how to personalise treatments. In the absence of quality guidance, it is not known how clinicians make treatment decisions for this patient group. Some qualitative research has investigated clinicians use of evidence but to date, no work has been done to establish how upper limb rehabilitation is carried out in UK spinal injury units, rehabilitation centres and acute hospitals.
This study will recruit UK clinicians involved in delivery of upper limb rehabilitation for spinal injuries, as well as patients with experience of this process. Through interviews and survey methods it aims to answer the overarching question “what is current practice for management of upper limb impairments in UK spinal injury rehabilitation?” The project will probe the nature of the rehabilitation offer that different spinal injury centres provide, and how these differ. It will also look what clinicians perceive optimal care to be, the barriers and facilitators to offering that care and how treatment decisions are made in daily practice.
Better understanding the delivery of care will provide a foundation for future improvement of care pathways, development of guidelines and introduction of new interventions that enable personalised approaches to spinal injury rehabilitation.
REC name
South Central - Hampshire B Research Ethics Committee
REC reference
24/SC/0187
Date of REC Opinion
10 Jun 2024
REC opinion
Further Information Favourable Opinion