ArticleSpinal cord series and cases2022
Donor activation focused rehabilitation approach to hand closing nerve transfer surgery in individuals with cervical level spinal cord injury.
Article in Spinal cord series and cases, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed, 15 citations in OpenAlex.
- Building an Interdisciplinary Clinic for Upper Extremity Reconstruction in Spinal Cord Injury: The Montreal TetraHand Experience.Plastic and reconstructive surgery. Global open · 2026Article
- Donor Activation-focused Rehabilitation Approach: Maximizing Outcomes After Lower Extremity Nerve Transfers.Plastic and reconstructive surgery. Global open · 2025Article
- Accessing Rehabilitation after Upper Limb Reconstructive Surgery in Cervical Spinal Cord Injury: A Qualitative Study.Topics in spinal cord injury rehabilitation · 2024Article
- Article
- Caregiving for People With Spinal Cord Injury Undergoing Upper Extremity Reconstructive Surgery: A Prospective Exploration of Lived Experiences, Perioperative Care, and Change Across Time.Topics in spinal cord injury rehabilitation · 2023Article
- Clinical electrodiagnostic evaluation for nerve transfer surgery in spinal cord injury: a new indication and clinical pearls.Journal of neurophysiology · 2022Review
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Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
STUDY
designCase Series.
objectivesTo describe the donor activation focused rehabilitation approach (DAFRA) in the setting of the hand closing nerve transfers in cervical spinal cord injury (SCI) so that therapists may apply it to treatment of individuals undergoing this procedure.
settingUnited States of America-Academic Level 1 Trauma Center.
methodsWe reviewed the records of individuals with cervical SCI who underwent nerve transfer to restore hand closing and post-surgery DAFRA therapy at our institution. The three post-surgery phases of DAFRA included (1) early phase (0-12 months) education, limb preparation, and donor activation exercises, (2) middle phase (12-24 months) volitional recipient muscle activation and (3) late phase (18 + months) strengthening and incorporation of motion in activities of daily living.
resultsSubtle gains in hand closing were first observed at a mean of 8.4 months after hand closing nerve transfer surgery. Remarkable improvements including discontinuation of assistive devices, independence with feeding and urinary function, and measurable grip were observed. Function continued to improve slowly for one to two more years.
conclusionsA deliberate, slow-paced (monthly for >2 years post-surgery) and incremental therapy program-DAFRA-can be used to improve outcomes after nerve transfer to restore hand closing in cervical SCI. SPONSORSHIP: This work was made possible by funding from the Craig H. Neilsen Foundation Spinal Cord Injury Research on the Translation Spectrum (SCIRTS) Grant: Nerve Transfers to Restore Hand Function in Cervical Spinal Cord Injury (PI: Ida Fox).
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