Article

Individuals with chronic tetraplegia prioritize recovery of hand
function as an important factor in improving their quality of life. Interventions
that may improve hand function and increase corticomotor excitability are
functional electrical stimulation (FES), somatosensory stimulation (SS), and
task-oriented training.
We compared functional and corticomotor
outcomes in a control condition to changes associated with FES (triggered via
electromygraphic signals) and with SS (constant trains), each combined with
either unimanual or bimanual training. METHODS: Using a randomized, clinical
trial design, comparisons were made to a delayed intervention control group.
Participants (n = 24) had chronic tetraplegia, with the ability to activate
thenar muscles, and were randomly assigned to either the immediate intervention
(intervention) or control/ delayed intervention groups. Primary analyses compared
intervention (FES or SS) to control/delayed intervention. Secondary analyses
compared subgroups of FES versus SS (regardless of uni- or bilateral training)
and uni- versus bimanual training (regardless of stimulation type). Outcomes were
assessed before and after the control and the intervention period. RESULTS:
Compared to control/delayed intervention, the intervention group had greater
changes in unimanual function and corticomotor area, regardless of whether
practice was combined with FES or with SS. Irrespective of stimulation type, the
bimanual subgroups improved to a greater extent than the unimanual subgroups on
the bimanual hand function test. CONCLUSIONS: Hand training combined with either
SS or FES was associated with improved hand use and corticomotor activity in
persons with chronic tetraplegia. Both interventions appear to be equally
effective.

Langue : ANGLAIS