{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T02:19:27Z","timestamp":1787710767219,"version":"build-2784847793"},"reference-count":0,"publisher":"Bon View Publishing Pte","license":[{"start":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T00:00:00Z","timestamp":1787702400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["SWT"],"abstract":"<jats:p>Cervical spinal cord injury (CSCI) leads to severe impairment of the upper limb, which leads to tetraplegia and decreased\u00a0independence in aspects of self-care and grasping. Conventional rehabilitation provides limited recovery, particularly in the case of complete American Spinal Injury Association (ASIA) Impairment Scale (AIS) A\u2013B injuries, and there is a growing interest in multimodal\u00a0rehabilitation strategies. This systematic review summarized evidence from 38 studies including pilot studies, preclinical investigations,\u00a0and randomized controlled trials published between 2016 and 2026. Interventions were systematically classified and data extracted for\u00a0the primary upper-limb outcomes, the Action Research Arm Test, grip strength, Graded Redefined Assessment of Strength, Sensibility\u00a0and Prehension, Upper Extremity Motor Score, and Spinal Cord Independence Measure. About three-quarters of the studies reported\u00a0improvements in at least one upper-limb outcome and almost half the studies had clinically meaningful improvements. However, 44%\u00a0of studies were judged to have a high or critical risk of bias due to small sample sizes and limited controls; more than 90% reported\u00a0no major safety concerns. Orthotic and robotic interventions maintained functional improvements, whereas hybrid neuromodulation\u00a0approaches led to the largest gains in grip strength. Pharmacological therapies were of little benefit. In conclusion, multimodal non-invasive rehabilitation strategies might be promising for the improvement of upper-limb recovery after CSCI, but larger, high-quality\u00a0clinical trials are needed.\nReceived: 24 March 2026 | Revised: 18 June 2026 | Accepted: 11 August 2026\nConflict of Interest\nThe authors declare that they have no conflicts of interest to this work.\n\nData Availability Statement\n\nData sharing is not applicable to this article as no new data were created or analyzed in this study.\n\nAuthor Contribution Statement\n\nKrishnakumar Sankar: Conceptualization, Methodology,\u00a0Validation, Investigation, Resources, Data curation, Writing\u00a0\u2013 original draft, Writing \u2013 review &amp; editing, Visualization,\u00a0Supervision, Project administration. Yazhini Arulselvam: Conceptualization, Investigation, Data curation, Writing \u2013 original\u00a0draft, Writing \u2013 review &amp; editing, Visualization. Supriya Harikrishna: Conceptualization, Investigation, Data curation, Writing \u2013\u00a0original draft, Writing \u2013 review &amp; editing, Visualization.<\/jats:p>","DOI":"10.47852\/bonviewswt62029744","type":"journal-article","created":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T01:51:10Z","timestamp":1787709070000},"source":"Crossref","is-referenced-by-count":0,"title":["Multimodal Interventions for Upper-Limb Recovery After Cervical Spinal Cord Injury: A Systematic Review and Quantitative Synthesis"],"prefix":"10.47852","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4193-6107","authenticated-orcid":true,"given":"Krishnakumar","family":"Sankar","sequence":"first","affiliation":[{"name":"Department of Biomedical Engineering, Rajalakshmi Engineering College, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-6357-7367","authenticated-orcid":true,"given":"Yazhini","family":"Arulselvam","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, Rajalakshmi Engineering College, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-4276-0878","authenticated-orcid":true,"given":"Supriya","family":"Harikrishna","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, Rajalakshmi Engineering College, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"27601","published-online":{"date-parts":[[2026,8,26]]},"container-title":["Smart Wearable Technology"],"original-title":[],"link":[{"URL":"https:\/\/ojs.bonviewpress.com\/index.php\/SWT\/article\/download\/9744\/2172","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/ojs.bonviewpress.com\/index.php\/SWT\/article\/download\/9744\/2172","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T01:51:11Z","timestamp":1787709071000},"score":1,"resource":{"primary":{"URL":"https:\/\/ojs.bonviewpress.com\/index.php\/SWT\/article\/view\/9744"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,26]]},"references-count":0,"URL":"https:\/\/doi.org\/10.47852\/bonviewswt62029744","relation":{},"ISSN":["3122-7570"],"issn-type":[{"value":"3122-7570","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,26]]}}}