Effect of Modified Bimanual Massed Practice on Hand Function and Occupational Performance in Patients with Incomplete Cervical Spinal Cord Injury: A Single-Subject Research Design

Objective: The purpose of this study is to investigate the effect of modified bimanual massed practice training on hand function and occupational performance of a incomplete tetraplegia patient. Methods: The participant was a 27 years old man diagnosed with C7/C7(s), C6/C6(m) incomplete tetraplegia ASIA-C. The patient performed developed modified bimanual massed practice with a total of 20 sessions, 30 minute 5 sessions per each week for 4 weeks modified according to domestic clinical setting. Results: The mean value of dynamometer on the right hand progressively improved through baseline A1(mean 2.96 kg), intervention B(mean 3.07 kg), baseline A2(mean 3.50 kg). And on the left hand, it also increased from B(mean 2.64 kg) to A2(mean 3.04 kg). In the Box and block test, the right hand improved from A1(47 unit) to B(52.55 unit) and maintained for A2, and the left hand improved through A1(46.4 unit), B(47.2 unit), and A2(49.8 unit). And the results of Assessment of Motor and Process skills showed that motor skills improved from before (0.0 logit) to after(0.7 logit), and process skills also improved from 0.7 logit to 1.0 logit. Conclusion: This study results support that the modified bimanual massed practice training is beneficial in improving hand function and occupational performance in a incomplete cervical spinal cord injury patient.