Article

OBJECTIVE: To determine the immediate effect of a portable, myoelectric
elbow-wrist-hand orthosis on paretic upper extremity (UE) impairment in chronic,
stable, moderately impaired stroke survivors. DESIGN: Observational cohort study.
SETTING: Outpatient rehabilitation clinic. PARTICIPANTS: Participants exhibiting
chronic, moderate, stable, poststroke, UE hemiparesis
(N=18). INTERVENTIONS:
Subjects were administered a battery of measures testing UE impairment and
function. They then donned a fabricated myoelectric elbow-wrist-hand orthosis and
were again tested on the same battery of measures while wearing the device. MAIN
OUTCOME MEASURES: The primary outcome measure was the UE Section of the
Fugl-Meyer Scale. Subjects were also administered a battery of functional tasks
and the Box and Block (BB) test. RESULTS: Subjects exhibited significantly
reduced UE impairment while wearing the myoelectric elbow-wrist-hand orthosis
(FM: t17=8.56, P<.0001) and increased quality in performing all functional tasks
while wearing the myoelectric elbow-wrist-hand orthosis, with 3 subtasks showing
significant increases (feeding [grasp]: z=2.251, P=.024; feeding [elbow]:
z=2.966, P=.003; drinking [grasp]: z=3.187, P=.001). Additionally, subjects
showed significant decreases in time taken to grasp a cup (z=1.286, P=.016) and
increased gross manual dexterity while wearing a myoelectric elbow-wrist-hand
orthosis (BB test: z=3.42, P<.001). CONCLUSIONS: Results suggest that UE
impairment, as measured by the Fugl-Meyer Scale, is significantly reduced when
donning a myoelectric elbow-wrist-hand orthosis, and these changes exceeded the
Fugl-Meyer Scale's clinically important difference threshold. Further,
utilization of a myoelectric elbow-wrist-hand orthosis significantly increased
gross manual dexterity and performance of certain functional tasks. Future work
will integrate education sessions to increase subjects' ability to perform
multijoint functional movements and attain consistent functional changes.
CI - Copyright (c) 2017. Published by Elsevier Inc.

Langue : ANGLAIS