Article

OBJECTIVE: To examine and compare efficacy of 30-, 60-,
and 120-minute repetitive
task-specific practice (RTP) sessions incorporating use of an electrical
stimulation neuroprosthesis (ESN) on affected upper-extremity (UE) movement.
DESIGN: Prospective, single-blinded, randomized controlled trial. SETTING:
Outpatient rehabilitation hospital. PARTICIPANTS: Chronic stroke subjects (N=32)
exhibiting moderate, stable affected UE motor deficits. INTERVENTIONS: Subjects
participated in 30-, 60-, or 120-minute therapy sessions involving RTP
incorporating the ESN, occurring every weekday for 8 weeks. During sessions, they
wore the ESNs to enable performance of valued activities that they had
identified. A fourth group participated in a 30-minute per weekday home exercise
program. MAIN OUTCOME MEASURES: Outcomes were evaluated using the UE section of
the Fugl-Meyer Assessment of Sensorimotor Impairment (FM), the Arm Motor Ability
Test (AMAT), the Action Research Arm Test (ARAT), and Box and Block (B&B) 1 week
before and 1 week after intervention. RESULTS: After intervention, subjects in
the 120-minute condition were the only ones to exhibit significant score
increases on the FM (P=.0007), AMAT functional ability scale (P=.002), AMAT
quality of movement scale (P=.0002), and ARAT (P=.02). They also exhibited the
largest changes in time to perform AMAT tasks and in B&B score, but these changes
were nonsignificant, (P=.15 and P=.10, respectively). CONCLUSIONS: One hundred
and twenty minutes a day of RTP augmented by ESN use elicits the largest and most
consistent UE motor changes in moderately impaired stroke subjects.
CI - Copyright (c) 2012 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS