{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T20:07:45Z","timestamp":1789416465392,"version":"build-2803163510"},"reference-count":82,"publisher":"American Spinal Injury Association","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022]]},"abstract":"\n Objectives<\/jats:title>\n To evaluate upper extremity (UE) function, strength, and dynamic sitting balance in individuals with spinal cord injury (SCI) who received an intensive outpatient therapy program focused on UE training augmented with wide pulse\/high frequency functional electrical stimulation (WPHF-FES).<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n This prospective case series was conducted in an outpatient (OP) clinic in an SCI-specific rehabilitation hospital. Participants were a convenience sample (\n N<\/jats:italic>\n = 50) of individuals with tetraplegia receiving OP therapy focused on UE recovery. Individuals participated in 60 minutes of UE functional task-specific practice (FTP) in combination with WPHF-FES 5 times\/week for an average of 72 sessions. The primary outcome for this analysis was the Capabilities of Upper Extremity Test (CUE-T). Secondary outcomes include UE motor score (UEMS) and the modified functional reach (MFR).\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Fifty individuals (13 motor complete; 37 motor incomplete SCI) completed an OP UE training program incorporating WPHF-FES and were included in this analysis. On average, participants demonstrated significant improvements in the total CUE-T score of 14.1 (\n SD<\/jats:italic>\n = 10.0,\n p<\/jats:italic>\n < .0001) points; significant changes were also noted in UEMS and MFR, improving an average of 4.6 (\n SD<\/jats:italic>\n = 5.2,\n p<\/jats:italic>\n < .0001) points and 13.6 (\n SD<\/jats:italic>\n = 15.8,\n p<\/jats:italic>\n < .0001) cm, respectively.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Individuals with tetraplegia demonstrated significant improvements in UE strength, function, and dynamic sitting trunk balance after receiving UE training augmented with WPHF-FES. Future comparative effectiveness studies need to be completed to guide efficacious treatment interventions in OP therapy.<\/jats:p>\n <\/jats:sec>","DOI":"10.46292\/sci21-00004","type":"journal-article","created":{"date-parts":[[2022,1,14]],"date-time":"2022-01-14T10:07:59Z","timestamp":1642154879000},"page":"139-152","source":"Crossref","is-referenced-by-count":8,"title":["Improving Upper Extremity Strength, Function, and Trunk Stability Using Wide-Pulse Functional Electrical Stimulation in Combination With Functional Task-Specific Practice"],"prefix":"10.46292","volume":"28","author":[{"given":"Candace","family":"Tefertiller","sequence":"first","affiliation":[{"name":"Research Department, Craig Hospital, Englewood, Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Bartelt","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy, Craig Hospital, Englewood, Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maureen","family":"Stobelaar","sequence":"additional","affiliation":[{"name":"Department of Occupational Therapy, Craig Hospital, Englewood, Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susie","family":"Charlifue","sequence":"additional","affiliation":[{"name":"Research Department, Craig Hospital, Englewood, Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitch","family":"Sevigny","sequence":"additional","affiliation":[{"name":"Research Department, Craig Hospital, Englewood, Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Vande Griend","sequence":"additional","affiliation":[{"name":"Research Department, Craig Hospital, Englewood, Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meghan","family":"Rozwod","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy, Craig Hospital, Englewood, Colorado"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"25425","reference":[{"issue":"10","key":"i1945-5763-28-2-139-b1","series-title":"J Neurotrauma","first-page":"1371","article-title":"Targeting recovery: Priorities of the spinal cord-injured population","volume":"21","year":"2004","unstructured":"Anderson\n KD.\n \n \n Targeting recovery: Priorities of the spinal cord-injured population.\n\t\t\t\t\tJ Neurotrauma.\n\t\t\t\t\t2004;\n\t\t\t\t\t21(\n\t\t\t\t\t10):\n\t\t\t\t\t1371\u2013\n\t\t\t\t\t1383."},{"key":"i1945-5763-28-2-139-b2","series-title":"NeuroRehabilitation.","article-title":"Highlighting gaps in spinal cord injury research in activity-based interventions for the upper extremity: A scoping review [published online ahead of print May 6, 2021]","unstructured":"Grampurohit\n N,\n \n \n Bell\n A,\n \n \n Duff\n S,\n \n \n .\n\t\t\t\t\tHighlighting gaps in spinal cord injury research in activity-based interventions for the upper 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Rehabil.\n\t\t\t\t\t2012;\n\t\t\t\t\t93(\n\t\t\t\t\t9):\n\t\t\t\t\t1518\u2013\n\t\t\t\t\t1529."},{"issue":"24","key":"i1945-5763-28-2-139-b33","series-title":"J Neurotrauma","first-page":"2181","article-title":"Assessment of functional improvement without compensation for human spinal cord injury: Extending the neuromuscular recovery scale to the upper extremities","volume":"33","year":"2016","unstructured":"Harkema\n SJ,\n \n \n Shogren\n C,\n \n \n Ardolino\n E,\n \n \n Lorenz\n DJ.\n \n \n Assessment of functional improvement without compensation for human spinal cord injury: Extending the neuromuscular recovery scale to the upper extremities.\n\t\t\t\t\tJ Neurotrauma.\n\t\t\t\t\t2016;\n\t\t\t\t\t33(\n\t\t\t\t\t24):\n\t\t\t\t\t2181\u2013\n\t\t\t\t\t2190."},{"issue":"3","key":"i1945-5763-28-2-139-b34","series-title":"Eur J Phys Rehabil Med","first-page":"373","article-title":"Distribution-based estimates of clinically significant changes in the International Standards for Neurological Classification of Spinal Cord Injury motor and sensory scores","volume":"49","year":"2013","unstructured":"Scivoletto\n G,\n \n \n Tamburella\n F,\n \n \n Laurenza\n L,\n \n \n Molinari\n M.\n \n \n Distribution-based estimates of clinically significant changes in the International Standards for Neurological Classification of Spinal Cord Injury motor and sensory scores.\n\t\t\t\t\tEur J Phys Rehabil Med.\n\t\t\t\t\t2013;\n\t\t\t\t\t49(\n\t\t\t\t\t3):\n\t\t\t\t\t373\u2013\n\t\t\t\t\t384."},{"issue":"1","key":"i1945-5763-28-2-139-b35","series-title":"Neurorehabil Neural Repair","first-page":"33","article-title":"Massed practice versus massed practice with stimulation: Effects on upper extremity function and cortical plasticity in individuals with incomplete cervical spinal cord injury","volume":"19","year":"2005","unstructured":"Beekhuizen\n KS,\n \n \n Field-Fote\n EC.\n \n \n Massed practice versus massed practice with stimulation: Effects on upper extremity function and cortical plasticity in individuals with incomplete cervical spinal cord injury.\n\t\t\t\t\tNeurorehabil Neural Repair.\n\t\t\t\t\t2005;\n\t\t\t\t\t19(\n\t\t\t\t\t1):\n\t\t\t\t\t33\u2013\n\t\t\t\t\t45."},{"issue":"4","key":"i1945-5763-28-2-139-b36","series-title":"Arch Phys Med Rehabil","first-page":"602","article-title":"Sensory stimulation augments the effects of massed practice training in persons with tetraplegia","volume":"89","year":"2008","unstructured":"Beekhuizen\n KS,\n \n \n Field-Fote\n EC.\n \n \n Sensory stimulation augments the effects of massed practice training in persons with tetraplegia.\n\t\t\t\t\tArch Phys Med Rehabil.\n\t\t\t\t\t2008;\n\t\t\t\t\t89(\n\t\t\t\t\t4):\n\t\t\t\t\t602\u2013\n\t\t\t\t\t608."},{"issue":"7","key":"i1945-5763-28-2-139-b37","series-title":"Arch Phys Med Rehabil","first-page":"702","article-title":"Electrical stimulation and biofeedback effect on recovery of tenodesis grasp: A controlled study","volume":"77","year":"1996","unstructured":"Kohlmeyer\n KM,\n \n \n Hill\n JP,\n \n \n Yarkony\n GM,\n \n \n Jaeger\n RJ.\n \n \n Electrical stimulation and biofeedback effect on recovery of tenodesis grasp: A controlled study.\n\t\t\t\t\tArch Phys Med Rehabil.\n\t\t\t\t\t1996;\n\t\t\t\t\t77(\n\t\t\t\t\t7):\n\t\t\t\t\t702\u2013\n\t\t\t\t\t706."},{"issue":"5","key":"i1945-5763-28-2-139-b38","series-title":"Neurorehabil Neural Repair","first-page":"412","article-title":"In-home tele-rehabilitation improves tetraplegic hand function","volume":"25","year":"2011","unstructured":"Kowalczewski\n J,\n \n \n Chong\n SL,\n \n \n Galea\n M,\n \n \n Prochazka\n A.\n \n \n In-home tele-rehabilitation improves tetraplegic hand function.\n\t\t\t\t\tNeurorehabil Neural Repair.\n\t\t\t\t\t2011;\n\t\t\t\t\t25(\n\t\t\t\t\t5):\n\t\t\t\t\t412\u2013\n\t\t\t\t\t422."},{"issue":"2","key":"i1945-5763-28-2-139-b39","series-title":"Muscle Nerve","first-page":"135","article-title":"Persistent inward currents in motoneuron dendrites: Implications for motor output","volume":"31","year":"2005","unstructured":"Heckmann\n CJ,\n \n \n Gorassini\n MA,\n \n \n Bennett\n DJ.\n \n \n Persistent inward currents in motoneuron dendrites: Implications for motor output.\n\t\t\t\t\tMuscle Nerve.\n\t\t\t\t\t2005;\n\t\t\t\t\t31(\n\t\t\t\t\t2):\n\t\t\t\t\t135\u2013\n\t\t\t\t\t156."},{"issue":"3","key":"i1945-5763-28-2-139-b40","series-title":"Neuroscientist","first-page":"264","article-title":"Persistent inward currents in spinal motoneurons and their influence on human motoneuron firing patterns","volume":"14","year":"2008","unstructured":"Heckman\n CJ,\n \n \n Johnson\n M,\n \n \n Mottram\n C,\n \n \n Schuster\n J.\n \n \n Persistent inward currents in spinal motoneurons and their influence on human motoneuron firing patterns.\n\t\t\t\t\tNeuroscientist.\n\t\t\t\t\t2008;\n\t\t\t\t\t14(\n\t\t\t\t\t3):\n\t\t\t\t\t264\u2013\n\t\t\t\t\t275."},{"key":"i1945-5763-28-2-139-b41","series-title":"Adv Exp Med Biol","first-page":"213","article-title":"Plateau potentials and their role in regulating motoneuronal firing","volume":"508","year":"2002","unstructured":"Hultborn\n H.\n \n \n Plateau potentials and their role in regulating motoneuronal firing.\n\t\t\t\t\tAdv Exp Med Biol.\n\t\t\t\t\t2002;\n\t\t\t\t\t508:\n\t\t\t\t\t213\u2013\n\t\t\t\t\t218."},{"issue":"10","key":"i1945-5763-28-2-139-b1","series-title":"J Neurotrauma","first-page":"1371","article-title":"Targeting recovery: Priorities of the spinal cord-injured population","volume":"21","year":"2004","unstructured":"Anderson\n KD.\n \n \n Targeting recovery: Priorities of the spinal cord-injured population.\n\t\t\t\t\tJ Neurotrauma.\n\t\t\t\t\t2004;\n\t\t\t\t\t21(\n\t\t\t\t\t10):\n\t\t\t\t\t1371\u2013\n\t\t\t\t\t1383."},{"key":"i1945-5763-28-2-139-b2","series-title":"NeuroRehabilitation.","article-title":"Highlighting gaps in spinal cord injury research in activity-based interventions for the upper extremity: A scoping review 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program","volume":"80","year":"1999","unstructured":"Scremin\n AM,\n \n \n Kurta\n L,\n \n \n Gentili\n A,\n \n \n .\n\t\t\t\t\tIncreasing muscle mass in spinal cord injured persons with a functional electrical stimulation exercise program.\n\t\t\t\t\tArch Phys Med Rehabil.\n\t\t\t\t\t1999;\n\t\t\t\t\t80(\n\t\t\t\t\t12):\n\t\t\t\t\t1531\u2013\n\t\t\t\t\t1536."},{"issue":"11","key":"i1945-5763-28-2-139-b5","series-title":"Arch Phys Med Rehabil","first-page":"2166","article-title":"Electrically induced resistance training in individuals with motor complete spinal cord injury","volume":"94","year":"2013","unstructured":"Ryan\n TE,\n \n \n Brizendine\n JT,\n \n \n Backus\n D,\n \n \n McCully\n KK.\n \n \n Electrically induced resistance training in individuals with motor complete spinal cord injury.\n\t\t\t\t\tArch Phys Med Rehabil.\n\t\t\t\t\t2013;\n\t\t\t\t\t94(\n\t\t\t\t\t11):\n\t\t\t\t\t2166\u2013\n\t\t\t\t\t2173."},{"issue":"3","key":"i1945-5763-28-2-139-b6","series-title":"J Spinal Cord Med","first-page":"378","article-title":"Multi-muscle electrical stimulation and stand training: Effects on standing","volume":"42","year":"2019","unstructured":"Momeni\n K,\n \n \n Ramanujam\n A,\n \n \n Garbarini\n EL,\n \n \n Forrest\n GF.\n \n \n Multi-muscle electrical stimulation and stand training: Effects on standing.\n\t\t\t\t\tJ Spinal Cord Med.\n\t\t\t\t\t2019;\n\t\t\t\t\t42(\n\t\t\t\t\t3):\n\t\t\t\t\t378\u2013\n\t\t\t\t\t386."},{"issue":"4","key":"i1945-5763-28-2-139-b7","series-title":"J Neurophysiol","first-page":"2380","article-title":"Musculoskeletal plasticity after acute spinal cord injury: Effects of long-term neuromuscular electrical stimulation training","volume":"95","year":"2006","unstructured":"Shields\n RK,\n \n \n Dudley-Javoroski\n S.\n \n \n Musculoskeletal plasticity after acute spinal cord injury: Effects of long-term neuromuscular electrical stimulation training.\n\t\t\t\t\tJ Neurophysiol.\n\t\t\t\t\t2006;\n\t\t\t\t\t95(\n\t\t\t\t\t4):\n\t\t\t\t\t2380\u2013\n\t\t\t\t\t2390."},{"issue":"1","key":"i1945-5763-28-2-139-b8","series-title":"Phys Ther","first-page":"48","article-title":"Influence of a locomotor training approach on walking speed and distance in people with chronic spinal cord injury: A randomized clinical trial","volume":"91","year":"2011","unstructured":"Field-Fote\n EC,\n \n \n Roach\n KE.\n \n \n Influence of a locomotor training approach on walking speed and distance in people with chronic spinal cord injury: A randomized clinical trial.\n\t\t\t\t\tPhys Ther.\n\t\t\t\t\t2011;\n\t\t\t\t\t91(\n\t\t\t\t\t1):\n\t\t\t\t\t48\u2013\n\t\t\t\t\t60."},{"issue":"6","key":"i1945-5763-28-2-139-b9","series-title":"Spinal Cord","first-page":"357","article-title":"Gait training regimen for incomplete spinal cord injury using functional electrical stimulation","volume":"44","year":"2006","unstructured":"Thrasher\n TA,\n \n \n Flett\n HM,\n \n \n Popovic\n MR.\n \n \n Gait training regimen for incomplete spinal cord injury using functional electrical stimulation.\n\t\t\t\t\tSpinal Cord.\n\t\t\t\t\t2006;\n\t\t\t\t\t44(\n\t\t\t\t\t6):\n\t\t\t\t\t357\u2013\n\t\t\t\t\t361."},{"issue":"1\u20133","key":"i1945-5763-28-2-139-b10","series-title":"Brain Res Brain Res Rev","first-page":"274","article-title":"The effect of locomotor training combined with functional electrical stimulation in chronic spinal cord injured subjects: Walking and reflex studies","volume":"40","year":"2002","unstructured":"Barbeau\n H,\n \n \n Ladouceur\n M,\n \n \n Mirbagheri\n MM,\n \n \n Kearney\n RE.\n \n \n The effect of locomotor training combined with functional electrical stimulation in chronic spinal cord injured subjects: Walking and reflex studies.\n\t\t\t\t\tBrain Res Brain Res Rev.\n\t\t\t\t\t2002;\n\t\t\t\t\t40(\n\t\t\t\t\t1\u20133):\n\t\t\t\t\t274\u2013\n\t\t\t\t\t291."},{"issue":"1","key":"i1945-5763-28-2-139-b11","series-title":"Clin Rehabil","first-page":"3","article-title":"Effects of training on upper limb function after cervical spinal cord injury: A systematic review","volume":"29","year":"2015","unstructured":"Lu\n X,\n \n \n Battistuzzo\n CR,\n \n \n Zoghi\n M,\n \n \n Galea\n MP.\n \n \n Effects of training on upper limb function after cervical spinal cord injury: A systematic review.\n\t\t\t\t\tClin Rehabil.\n\t\t\t\t\t2015;\n\t\t\t\t\t29(\n\t\t\t\t\t1):\n\t\t\t\t\t3\u2013\n\t\t\t\t\t13."},{"issue":"3","key":"i1945-5763-28-2-139-b12","series-title":"Artif Organs","first-page":"212","article-title":"Functional electrical stimulation therapy for grasping in traumatic incomplete spinal cord injury: Randomized control trial","volume":"35","year":"2011","unstructured":"Kapadia\n NM,\n \n \n Zivanovic\n V,\n \n \n Furlan\n JC,\n \n \n Craven\n BC,\n \n \n McGillivray\n C,\n \n \n Popovic\n MR.\n \n \n Functional electrical stimulation therapy for grasping in traumatic incomplete spinal cord injury: Randomized control trial.\n\t\t\t\t\tArtif Organs.\n\t\t\t\t\t2011;\n\t\t\t\t\t35(\n\t\t\t\t\t3):\n\t\t\t\t\t212\u2013\n\t\t\t\t\t216."},{"issue":"5","key":"i1945-5763-28-2-139-b13","series-title":"Neurorehabil Neural Repair","first-page":"433","article-title":"Functional electrical stimulation therapy of voluntary grasping versus only conventional rehabilitation for patients with subacute incomplete tetraplegia: A randomized clinical trial","volume":"25","year":"2011","unstructured":"Popovic\n MR,\n \n \n Kapadia\n N,\n \n \n Zivanovic\n V,\n \n \n Furlan\n JC,\n \n \n Craven\n BC,\n \n \n McGillivray\n C.\n \n \n Functional electrical stimulation therapy of voluntary grasping versus only conventional rehabilitation for patients with subacute incomplete tetraplegia: A randomized clinical trial.\n\t\t\t\t\tNeurorehabil Neural Repair.\n\t\t\t\t\t2011;\n\t\t\t\t\t25(\n\t\t\t\t\t5):\n\t\t\t\t\t433\u2013\n\t\t\t\t\t442."},{"issue":"3","key":"i1945-5763-28-2-139-b14","series-title":"Spinal Cord","first-page":"143","article-title":"Functional electrical therapy: Retraining grasping in spinal cord injury","volume":"44","year":"2006","unstructured":"Popovic\n MR,\n \n \n Thrasher\n TA,\n \n \n Adams\n ME,\n \n \n Takes\n V,\n \n \n Zivanovic\n V,\n \n \n Tonack\n MI.\n \n \n Functional electrical therapy: Retraining grasping in spinal cord injury.\n\t\t\t\t\tSpinal Cord.\n\t\t\t\t\t2006;\n\t\t\t\t\t44(\n\t\t\t\t\t3):\n\t\t\t\t\t143\u2013\n\t\t\t\t\t151."},{"issue":"4","key":"i1945-5763-28-2-139-b15","series-title":"J Physiother","first-page":"197","article-title":"Early intensive hand rehabilitation is not more effective than usual care plus one-to-one hand therapy in people with sub-acute spinal cord injury (\u201cHands On\u201d): A randomised trial","volume":"63","year":"2017","unstructured":"Harvey\n LA,\n \n \n Dunlop\n SA,\n \n \n Churilov\n L,\n \n \n Galea\n MP,\n \n Spinal Cord Injury Physical Activity Hands On Trial Collaborators.\n \n Early intensive hand 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contributions to contractions evoked by tetanic neuromuscular electrical stimulation","volume":"35","year":"2007","unstructured":"Collins\n DF.\n \n \n Central contributions to contractions evoked by tetanic neuromuscular electrical stimulation.\n\t\t\t\t\tExerc Sport Sci Rev.\n\t\t\t\t\t2007;\n\t\t\t\t\t35(\n\t\t\t\t\t3):\n\t\t\t\t\t102\u2013\n\t\t\t\t\t109."},{"key":"i1945-5763-28-2-139-b20","series-title":"Front Physiol","first-page":"1310","article-title":"Optimizing neuromuscular electrical stimulation pulse width and amplitude to promote central activation in individuals with severe spinal cord injury","volume":"10","year":"2019","unstructured":"Arpin\n DJ,\n \n \n Ugiliweneza\n B,\n \n \n Forrest\n G,\n \n \n Harkema\n SJ,\n \n \n Rejc\n E.\n \n \n Optimizing neuromuscular electrical stimulation pulse width and amplitude to promote central activation in individuals with severe spinal cord injury.\n\t\t\t\t\tFront 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