scholarly journals Comparison of Task Oriented Therapy and Modified Constraint Induced Movement Therapy along with Functional Electrical Stimulation to Improve Hand Function In Sub Acute Stroke survivors: a Randomized Control Trial

2017 ◽  
Vol 84 (2) ◽  
pp. 87-97 ◽  
Author(s):  
Cesar Marquez-Chin ◽  
Shaghayegh Bagher ◽  
Vera Zivanovic ◽  
Milos R. Popovic

Background. Stroke is the leading cause of long-term disability. Stroke survivors seldom improve their upper-limb function when their deficit is severe, despite recently developed therapies. Purpose. This study aims to assess the efficacy of functional electrical stimulation therapy in improving voluntary reaching and grasping after severe hemiplegia. Method. A post hoc analysis of a previously completed randomized control trial ( clinicaltrials.gov , No. NCT00221078) was carried out involving 21 participants with severe upper-limb hemiplegia (i.e., Fugl-Meyer Assessment–Upper Extremity [FMA-UE] ≤ 15) resulting from stroke. Findings. Functional Independence Measure Self-Care subscores increased 22.8 (±6.7) points in the intervention group and 9 (±6.5) in the control group, following 40 hr of equal-intensity therapy. FMA-UE score changes were 27.2 (±13.5) and 5.3 (±11.0) for the intervention and control groups, respectively. Implications. The results may represent the largest upper-limb function improvements in any stroke population to date, especially in those with severe upper-limb deficit.


2008 ◽  
Vol 22 (6) ◽  
pp. 706-714 ◽  
Author(s):  
T. Adam Thrasher ◽  
Vera Zivanovic ◽  
William McIlroy ◽  
Milos R. Popovic

Objective. The aim of this study was to establish the efficacy of a therapeutic intervention based on functional electrical stimulation (FES) therapy to improve reaching and grasping function after severe hemiplegia due to stroke. Methods. A total of 21 subjects with acute stroke were randomized into 2 groups, FES plus conventional occupational and physiotherapy (FES group) or only conventional therapy (control group) 5 days a week for 12 to 16 weeks. A third group of 7 subjects with chronic hemiplegia (at least 5 months poststroke) received only FES therapy (chronic group) and pre—post training changes were compared. FES was applied to proximal and then distal muscle groups during specific motor tasks. At baseline and at the end of treatment, grasping function was assessed using the Rehabilitation Engineering Laboratory Hand Function Test, along with more standard measures of rehabilitation outcome. Results. The FES group improved significantly more than the control group in terms of object manipulation, palmar grip torque, pinch grip pulling force, Barthel Index, Upper Extremity Fugl—Meyer scores, and Upper Extremity Chedoke—McMaster Stages of Motor Recovery. The chronic stroke subjects demonstrated improvements in most categories, but the changes were not statistically significant. Conclusions. FES therapy with upper extremity training may be an efficacious intervention in the rehabilitation of reaching and grasping function during acute stroke rehabilitation.


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