Article

The aims of this study were to determine whether patients with
moderate-to-severe upper limb hemiplegia could use contralaterally controlled
functional electrical stimulation at the arm and hand (Arm+Hand CCFES) at home
and to evaluate the feasibility of Arm+Hand CCFES to reduce arm and hand motor
impairment. DESIGN: With Arm+Hand CCFES, the paretic elbow and hand extensors
were stimulated with intensities proportional to the degree of elbow extension
and hand opening, respectively, of the contralateral unimpaired side. For 12 wks,
four participants with chronic
(>/=6 mos) upper limb hemiplegia received
approximately 7 hrs per week of self-administered home-based stimulation-mediated
elbow extension and hand opening exercise plus approximately 2.5 hrs per week of
therapist-supervised laboratory-based stimulation-assisted functional task
practice. Assessments of upper limb impairment were made at pretreatment,
posttreatment, and 1 mo after treatment. RESULTS: All four participants were able
to use the Arm+Hand CCFES system at home either independently or with very
minimal assistance from a caregiver. All four participants had increases in the
Fugl-Meyer score (1-9 points) and the Wolf Motor Function Test (0.2-0.8 points)
and varying degrees of improvement in maximum hand opening, maximum elbow
extension, and simultaneous elbow extension and hand opening. CONCLUSIONS:
Arm+Hand CCFES can be successfully administered in stroke patients with
moderate-to-severe impairment and can reduce various aspects of upper limb
impairment. A larger efficacy study is warranted.

Langue : ANGLAIS