Article

The electromyographic bridge (EMGB) detects surface electromyographic
signals from a non-paretic limb. It then generates electric pulse trains
according to the electromyographic time domain features, which can be used to
stimulate a paralysed or paretic limb in real time. This strategy can be used for
the contralateral control of neuromuscular electrical stimulation (NMES) to
improve motor function after stroke. The aim of this study was to compare the
treat-ment effects of EMGB vs cyclic NMES on wrist and finger impairments in
subacute stroke patients. METHODS: A total of 42 hemiplegic patients within 6
months of their cerebrovascular accidents were randomly assigned to 4-week
treatments with EMGB or cyclic NMES. Each group underwent a standard
rehabilitation programme and 10 sessions per week of hand training with EMGB or
cyclic NMES. Outcome measures were: Brunnstrom stage, upper extremity components
of the Fugl-Meyer Assessment, Motor Status Scale, voluntary surface
electromyographic ratio and active range of motion of the wrist and finger
joints. RESULTS: The EMGB group showed significantly greater improvements than
the cyclic NMES group on the following measures: Brunnstrom stages for the hand,
upper extremity - Fugl-Meyer Assessment, Motor Status Scale, and the voluntary
surface electromyographic ratio of wrist and finger extensors. Eleven and 4
participants of the EMGB group who had no active wrist and finger movements,
respectively, at the start of the treatment could perform measurable wrist and
finger extensions after EMGB training. The corresponding numbers in the cyclic
NMES group were only 4 and 1. CONCLUSION: In the present group of subacute stroke
patients, the results favour EMGB over cyclic NMES for augmenting the recovery of
volitional wrist and finger motion.

Langue : ANGLAIS