Effect of Training Combining Hand-Arm Bimanual Intensive Therapy Concept and Postural Control Elements on Individuals With Chronic Incomplete Cervical Spinal Cord Injury: A Report of Two Cases

The complex nature of tetraplegia in individuals with incomplete cervical spinal cord injury (ICSCI) significantly impacts activities of daily living, with few interventions comprehensively addressing upper and lower limb and trunk dysfunction due to tetraplegia. This study aimed to investigate the effectiveness of intensive task-oriented training incorporating bimanual movement and postural control in individuals with ICSCI. This study included two cases: a man in his 30s (neurological level of injury (NLI) C5; American Spinal Injury Association Impairment Scale (AIS) grade D) and a man in his 50s (NLI C3; AIS grade D). The intervention consisted of 50-h task-oriented training over 15 days and a diary-based transfer package. Both cases demonstrated improvements in upper limb function and balance ability. Several goals were improved or achieved. This report indicates the efficacy of intensive task-oriented training for ICSCI. Bimanual activities in various postures, including standing, enhanced upper limb function, and balance ability. This indicates that interventions targeting upper limb function in ICSCI should consider both bimanual movement and postural control. This study highlights the ability of this comprehensive training to improve functional outcomes in individuals with ICSCI and provides valuable insights into spinal cord injury rehabilitation.