Original Article

Spinal Cord (2007) 45, 475–484; doi:10.1038/sj.sc.3101993; published online 21 November 2006

Activity performance and upper extremity function in cervical spinal cord injury patients according to the Klein–Bell ADL Scale

A Dahlgren1, A-K Karlsson1, Å Lundgren-Nilsson1, J Fridén2 and L Claesson1,3

  1. 1Department of Clinical Neuro Science and Rehabilitation, The Sahlgrenska Academy at Göteborg University, Institute of Neuro Science and Physiology, Göteborg University, Goteborg, Sweden
  2. 2Department of Hand Surgery, The Sahlgrenska Academy at Göteborg University, Göteborg University, Goteborg, Sweden
  3. 3Department of Occupational Therapy, Audiology, Physiotherapy and Logopedics, The Sahlgrenska Academy at Göteborg University, Institute of Neuro Science and Physiology, Göteborg University, Goteborg, Sweden

Correspondence: A Dahlgren, Department of Clinical Neuro Science and Rehabilitation, The Sahlgrenska Academy at Göteborg University, Institute of Neuro Science and Physiology, Guldhedsgatan 19, 413 45 Göteborg, Sweden

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Abstract

Study design:

 

Cross-sectional study.

Objectives:

 

(1) To examine whether the Klein–Bell ADL Scale (K–B Scale) discriminates cervical spinal cord injury (SCI) patients in daily activities and to explore its applicability in this group of patients. (2) To examine the association between basic ADL and upper extremity function. (3) To investigate if grip ability can be discerned in the scale.

Setting:

 

Spinal Cord Injury Unit, Sahlgrenska University Hospital, Göteborg, Sweden.

Methods:

 

Fifty-five patients with cervical SCI with no prior reconstructive hand surgery were included in the study. Analyses of the patient's independence were made according to the K–B Scale. Three additional analyses were carried out, the first examined whether the use of assistive devices and house and car adaptations influenced independence. The last two used different approaches to investigate whether arm and grip function could be detected in the K–B scale.

Results:

 

Raw score in the K–B Scale can discriminate for independence in daily activities but the scale's weight scheme does not function for cervical SCI patients. Assistive devices and car and house adaptations can compensate for dependence in daily activities. Lack of grip function decreases the patient's ability to become independent. Diagnosis-related activities cannot be assessed in all items.

Conclusion:

 

The K–B Scale's raw score was useful assessing daily activities in cervical SCI patients. Its reliability in conjunction with arm and grip function in patients with cervical SCI has yet to be proven.

Keywords:

Klein–Bell ADL Scale, tetraplegia, outcome measurement, ADL

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