This past year, our worlds were turned upside down, our lives irreversibly changed. All over the country, Canadians had to learn how to exist and succeed in a new reality filled with limitations beyond our control. For around 750 Canadians, the life-altering event in question was not the onset of a global pandemic, but a devastating cervical spinal cord injury that resulted in upper limb paralysis, loss of independence, and permanent disability. These Canadians have spent the past year in a different type of lockdown, learning how to accomplish basic functions such as transferring, propelling a manual wheelchair, dressing, catheterization, and feeding; activities of daily living that many of us take for granted.


Cervical spinal cord injury (SCI) is a devastating event that results in upper limb paralysis, loss of independence, and disability. At an estimated lifetime cost of $3 million, cervical SCI places a substantial economic burden on the individual and the healthcare system. People living with cervical SCI have identified improvement of upper limb function as a top priority. Nerve and tendon transfer surgery has successfully restored upper limb function in cervical SCI, but is not universally used or available to all eligible individuals. The barriers preventing utilization of upper limb reconstruction are a complex interrelation of individual, healthcare provider and system level factors. Our exploratory qualitative study will use an implementation science approach to better understand these factors that influence access to upper limb reconstruction in the Canadian context and design an intervention to increase access to care. Image Design: Little Nrg Prints, Used with permission.

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