A functional electric stimulation-assisted exercise therapy system for hemiplegic hand function.

Abstract

OBJECTIVE: To test a functional electric stimulation (FES)-assisted exercise therapy system for improvement of motor function of the hemiplegic upper extremity. DESIGN: A before-after trial, with 2-month follow-up. SETTING: A university research laboratory. PARTICIPANTS: A convenience sample of 6 subjects (3 men, 3 women). Main inclusion criteria were that stroke had occurred more than 1 year before the study (mean time poststroke, 5.6+/-4.4y) and had resulted in hemiplegia, and that FES produced adequate hand opening. INTERVENTION: A prototype workstation with instrumented objects was used by subjects to perform a set of tasks with their affected hand during 1-hour sessions for 12 consecutive workdays. A FES stimulator was used to assist hand opening. Main outcome measures Kinematic data, provided by the workstation sensors, and 3 clinical tests. RESULTS: Kinematic data indicated statistically significant improvement in subjects' performance (pre-/posttreatment effect size [pre/post ES] of the mean performance scores=5.46; mean pretreatment/follow-up ES [pre/FU ES]=3.44). Two of 3 clinical tests showed improvement in hand function (mean pre/post ES=.51; mean pre/FU ES=.61). CONCLUSIONS: Improvement in hemiplegic hand function because of FES-assisted therapy was documented in a small group of people with hemiplegia whose motor impairment would exclude them from participation in constraint-induced movement therapy. However, the long-term clinical relevance of such improvement needs further study.