{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T18:56:29Z","timestamp":1792090589951,"version":"4.4.0"},"reference-count":106,"publisher":"American Spinal Injury Association","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,1]]},"abstract":"\n Objectives:<\/jats:title>\n To investigate the barriers and facilitators to rehabilitation experienced by individuals with cervical SCI after upper limb (UL) reconstructive surgery.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n We conducted a prospective cohort study with a follow-up period of up to 24 months. Data collection occurred at two academic and two Veterans Affairs medical centers in the United States. Participants were purposively sampled and included 21 adults with cervical SCI (c-SCI) who had received nerve or tendon transfer surgeries and 15 caregivers. We administered semi-structured interviews about participants\u2019 experiences of accessing rehabilitation services after surgery.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n Four themes emerged from the data: (1) participants encountered greater obstacles in accessing therapy as follow-up time increased; (2) practical challenges (e.g., insurance coverage, opportunity costs, transportation) limited rehabilitation access; (3) individuals with c-SCI and their caregivers desired more information about an overall rehabilitation plan; and (4) external support systems facilitated therapy access.<\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n Individuals with c-SCI experience multilevel barriers in accessing rehabilitation care after UL reconstructive surgeries in the United States. This work identifies areas of focus to mitigate these challenges, such as enhancing transparency about the overall rehabilitation process, training providers to work with this population, and developing, testing, and disseminating rehabilitation protocols following UL reconstruction among people with c-SCI.<\/jats:p>\n <\/jats:sec>","DOI":"10.46292\/sci23-00092","type":"journal-article","created":{"date-parts":[[2024,7,2]],"date-time":"2024-07-02T04:48:41Z","timestamp":1719895721000},"page":"35-44","source":"Crossref","is-referenced-by-count":1,"title":["Accessing Rehabilitation after Upper Limb Reconstructive Surgery in Cervical Spinal Cord Injury: A Qualitative Study"],"prefix":"10.46292","volume":"30","author":[{"given":"Samantha B.","family":"Randolph","sequence":"first","affiliation":[{"name":"Program in Occupational Therapy, Washington University, St. Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allison J.","family":"L\u2019Hotta","sequence":"additional","affiliation":[{"name":"Brown School, Prevention Research Center, Washington University, St. Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katharine","family":"Tam","sequence":"additional","affiliation":[{"name":"Veterans Affairs St. Louis Healthcare System, St. Louis, Missouri"},{"name":"Division of Physical Medicine and Rehabilitation, Department of Orthopedic Surgery, Washington University, St. Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine C.","family":"Stenson","sequence":"additional","affiliation":[{"name":"Veterans Affairs St. Louis Healthcare System, St. Louis, Missouri"},{"name":"Division of Physical Medicine and Rehabilitation, Department of Orthopedic Surgery, Washington University, St. Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine M.","family":"Curtin","sequence":"additional","affiliation":[{"name":"Division of Plastic Surgery, Department of Surgery, Stanford University, Palo Alto, California"},{"name":"Veterans Affairs Palo Alto Healthcare System, Palo Alto, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aimee S.","family":"James","sequence":"additional","affiliation":[{"name":"Division of Public Health Sciences, Department of Surgery, Washington University, St. Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carie R.","family":"Kennedy","sequence":"additional","affiliation":[{"name":"Division of Plastic & Reconstructive Surgery, Department of Surgery, Washington University, St. Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doug","family":"Ota","sequence":"additional","affiliation":[{"name":"Veterans Affairs Palo Alto Healthcare System, Palo Alto, California"},{"name":"Division of Physical Medicine and Rehabilitation, Department of Orthopedic Surgery, Stanford University, Stanford, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine B.","family":"Novak","sequence":"additional","affiliation":[{"name":"Division of Plastic, Reconstructive & Aesthetic Surgery, Department of Surgery, University of Toronto, Toronto, Ontario"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah","family":"Kenney","sequence":"additional","affiliation":[{"name":"Robert A. Chase Hand & Upper Limb Center, Department of Orthopedic Surgery, Stanford University, Stanford, California"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ida K.","family":"Fox","sequence":"additional","affiliation":[{"name":"Division of Plastic & Reconstructive Surgery, Department of Surgery, Washington University, St. Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"25425","reference":[{"issue":"9","key":"b1","series-title":"Spinal Cord","first-page":"526","article-title":"Survey of the needs of patients with spinal cord injury: Impact and priority for improvement in hand function in tetraplegics","volume":"42","author":"Snoek\n GJ","year":"2004","unstructured":"Snoek\n GJ\n , IJzermanMJ, HermensHJ, MaxwellD, Biering-SorensenF. Survey of the needs of patients with spinal cord injury: Impact and priority for improvement in hand function in tetraplegics. 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