Article

Electrical stimulation of the upper extremity may reduce impairment
in patients following stroke. Stimulation triggered on demand combined with task
practice may be an effective means of promoting recovery of function.
The authors investigated the feasibility of using accelerometer-controlled
electrical stimulation for the elbow, wrist, and finger extensors to enable
functional task practice in patients with chronic hemiparesis. METHODS: Following
a 4-week baseline, participants received 2 weeks of cyclic stimulation exercise
to elbow and forearm extensor muscles, followed by 10 weeks of triggered
stimulation to practice functional reaching. Participants were reassessed 12
weeks later as well. Outcome measures were the Action Research Arm Test (ARAT),
Modified Ashworth Scale (MAS), Canadian Occupational Performance Measure (COPM),
Psychosocial Impact of Assistive Devices Scale (PIADS), and Use of Device
Questionnaire (UDQ).
RESULTS: Fifteen volunteers who had at least 45 degrees of
forward shoulder flexion and could initiate elbow extension and grasp completed
the study. The ARAT score improved from 19 to 32 (P = .002); the MAS score for
elbow, wrist, and finger flexor spasticity was reduced from 2 each to 1, 0, and 1
(P < .05); the COPM performance and satisfaction scores improved (P = .001); and
the PIADS became positive for competence (P = .005), adaptability (P = .008), and
self-esteem (P = .008). Gains were maintained 12 weeks later. CONCLUSIONS:
Accelerometer-triggered electrical stimulation to augment task training for the
hemiplegic arm is feasible and may improve functional ability and quality of life
which may be maintained 12 weeks after treatment. A randomized trial design is
required to evaluate efficacy and cost benefit.

Langue : ANGLAIS