Using "functional hand" protocol to improve hand function following a spinal cord injury: an explorative study.

BACKGROUND AND AIM OF THE WORK: A cervical spinal cord injury often affects hand control, causing ineffective grasping and handling functions, with a negative impact on patient's independence and quality of life. Literature recognises scientific evidence only for surgical or instrumental re-education approaches. The purpose of this study is to present the "functional hand" protocol, a physiotherapy tool that, to date, represents a good clinical practice but has no supporting literature. RESEARCH DESIGN AND METHODS: a longitudinal-single cohort study was conducted at Spinal Unit- Azienda Usl Piacenza. Patients with spinal cord injury at C5-C7 neurologic level, older than 18 years, with correct comprehension of Italian language were recruited. All patients were evaluated with Action Research Arm Test (ARAT) scale to state hand functionality; positive/negative history of Functional Hand protocol was deducted by physiotherapy discharge letters on first spinal unit hospitalisation. RESULTS: six patients were involved in the study; three of them had a positive history of protocol application. ARAT scores differences showed that patients who underwent functional hand protocol had a lower impairment, a better ability to produce cylindrical and cuboid sockets. CONCLUSIONS: Functional hand protocol reached a preliminary evidence as effective tool to improve hand recovery in tetraplegic patients; future studies should confirm these conclusions on larger samples, and verify protocol effectiveness in addition to other treatment strategies (functional electric stimulation/ transcranial direct current stimulation/robotic assisted therapy).

The Examination of Conscience: A Preliminary Study on the Effects on Metamemory After a 2-Week Practice.

Examination of conscience (EC) is a contemplative practice that consists in examining daily the actions performed during the day (evening examination, immediately before going to bed) and the actions to be performed on the coming day (morning examination, immediately after sleep). While research on contemplative practices such as mindfulness has seen a large increase of studies in recent years, research into the psychological effects related to the practice of the EC has been largely ignored in the scientific literature. On the other hand, on a careful historical and philosophical analysis, it appears evident that references to it abound in many cultural contexts and in different eras. Here, we examined the effects of a 2-week program of this practice that participants performed using a digital application developed ad hoc for this experiment. A control group performed an activity of the same duration, also with the support of a digital application, but which consisted of listening to audio excerpts of an Italian literary novel. Measurements taken from both groups before and after the 2-week period consisted of self-assessments of metamemory capacity, that is, awareness and knowledge of their own memory processes. Results showed that participants reported a significant decrease in two properties of their metamemory after training, specifically vividness and coherence. No other significant changes were found between the two groups. Specifically, we found no differences in other metamemory characteristics, no differences in prospective or retrospective memory, and no differences in changes in stress levels. These results, although preliminary, suggest that a relatively short period of EC does indeed make people metacognitively more aware of the limitations and errors of their memory, in particular concerning vividness and coherence.