Tools & Techniques to Maximize Arm and Hand Function After Spinal Cord Injury

A spinal cord injury (SCI) is damage to any part of the spinal cord. This damage can lead to loss of function and sensation in the parts of the body served by the spinal cord below the location of the injury. Individuals whose injury occurs above cervical vertebrae C6 and C7 usually experience paralysis or loss of function in their arms and hands. Through physical rehabilitation and exercise, many patients can redevelop some motor function and regain some level of independence. Technology and our collective understanding of SCI are continuously advancing, and because arm and hand function is widely considered to be the most debilitating result of SCI, helping individuals restore function is a top priority amongst researchers, medical providers, and scientists. Below are some techniques for maximizing arm and hand function for performing basic tasks post-SCI.

Eating and Drinking

There are several techniques and tools that can be used to assist with eating and drinking. Eating Utensils with Longer Handles: Specialized utensils with longer handles help with grip, angling, and maneuvering forks, knives, and spoons. Plate Guard and/or Bowl with High Sides: Plates and bowls with higher sides make it easier to scoop food. Dorsal Wrist Splint: For weakness in wrist and/or fingers, a dorsal wrist splint can help with grasping and maneuvering. Rocker Knife: Assists with one-handed cutting of food. Dining with Dignity Device: Dining with Dignity utensils are worn on the thumb and forefingers to assist with grip impairments. Drinking Extra Long Straws: Long, bendy straws that can be inserted into drinks and will reach the mouth. Cable/Zip Ties: Can be used to create a loop and then affixed to a water bottle (or other beverage) to assist with gripping/holding. Drink Holders: A drink holder with a non-skid surface on the interior of the strap helps to hold drinks in place. Camelbak Drinking System: Can be used with a Loc-Line on the back of a wheelchair, or worn and tubing can be clipped to the front of the shirt. Specialized Mugs: Thermal mugs with an open-bottomed handle or an open hand slot are easier to grip.

Grooming

Brushing: Slip-on handle hair and body brushes make gripping easier. Body Washing: Long-handled loofahs and/or washing mitts that slip on make gripping and reaching easier. Motion-Activated Dispensers: Hand soap and toothpaste in motion-activated dispensers are easier to operate. Stable (wide-bottomed) soap dispensers are another option. Showering: A Selecta Band is a plastic strap with holes that can be attached in the shower handle and provides a sturdy hold. Hair Styling: A hair-dryer stand allows for two hands to be available for hair drying and styling. Shaving: A specialized U-Cuff can be attached to an electric razor to make gripping easier.

Getting Dressed

Pants: Gloves for Life with a rubber insert assist with pulling up pants. Zippers: Zipper pulls are commercially available, but can also be fashioned out of cord, zip ties, or rings. Buttons: MagnaReady shirts have buttons that contain magnets for easy fastening. Clothing: There are quite a few companies that offer adaptive clothing. Endless Ability jeans are one example; they have a high-rise rear for full coverage, lowered front pocket, removal of rear pockets for comfort and an option of a catheter zipper for foley or self catheter access. Silverts, Izzy Camilleri, Able2Wear, and Adaptations by Adrian are some other examples. These are just a few examples of ways to maximize hand and arm function post-SCI; there are many more tools and techniques available! For a more complete list of ideas, please see this article by the University of Washington’s Rehabilitation Medicine Department.

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