Article

Contralaterally controlled functional electrical stimulation (CCFES)
is an experimental treatment intended to improve hand function after stroke.
OBJECTIVE: To compare the effects of 6 weeks of CCFES versus cyclic neuromuscular
electrical stimulation (NMES) on upper extremity impairment and activity
limitation in patients </=6 months poststroke. METHODS: Twenty-one participants
were randomized to CCFES or cyclic NMES. Treatment for both groups consisted of
daily stimulation-assisted repetitive hand-opening exercise at home plus
twice-weekly lab sessions of functional task practice. Assessments were made at
pretreatment and posttreatment and at 1 month and 3 months posttreatment. They
included maximum voluntary finger extension angle, finger movement tracking
error, upper extremity Fugl-Meyer score, Box and Blocks test, and Arm Motor
Abilities test. Treatment effects were estimated using a 2-factor repeated
measures analysis of variance with the value of the baseline measure as a
covariate. RESULTS: Seventeen patients completed the treatment phase (9 CCFES, 8
cyclic NMES). At all posttreatment time points, CCFES produced larger
improvements than cyclic NMES on every outcome measure. Maximum voluntary finger
extension showed the largest treatment effect, with a mean group difference
across the posttreatment time points of 28 degrees more finger extension for
CCFES. CONCLUSIONS: The results favor CCFES over cyclic NMES though the small
sample size limits the statistical power of the study. The effect size estimates
from this study will be used to power a larger trial.

Langue : ANGLAIS