WHOM very specifically is going to do the followup research that will get this to persist. I want an EXACT name. Leaders assign concrete goals and expect completion of those goals. The stroke medical world has NO LEADERS, which is why nothing in stroke is ever solved.
A novel functional electrical stimulation treatment for recovery of hand function in hemiplegia: 12-week pilot study
2008, Neurorehabilitation and Neural Repair
Jayme S. Knutson, PhD
,
Terri Z. Hisel, OTR/L
,
Mary Y. Harley, OTR/L
, and
John Chae, MD
Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio (JSK,JC); Department of Physical Medicine and Rehabilitation, MetroHealth Medical Center,Cleveland, Ohio (TZH, MYH, JC); and Department of Physical Medicine and Rehabilitation, CaseWestern Reserve University, Cleveland, Ohio (JC)
Loss of finger extension is common after stroke and can severely limit hand function. Contralaterally controlled functional electrical stimulation (CCFES) is a new treatment aimed at restoring volitional finger and thumb extension. A previous pilot study showed reductions in hand impairment after 6 weeks of CCFES, but the effect did not persist after end of treatment.
Objective—
This study aimed to evaluate the feasibility of achieving greater and more persistent gains with CCFES by increasing the treatment period to 12 weeks.
Methods—
CCFES uses neuromuscular electrical stimulation to open the paretic hand in direct proportion to the degree of volitional opening of the unimpaired contralateral hand, which isdetected by an instrumented glove. Three subjects with chronic hemiplegia participated in a 12-week CCFES treatment, which consisted of daily CCFES-assisted active repetitive hand-opening exercises and twice weekly functional task practice with CCFES.
Results—
Maximum voluntary finger extension increased by 101° and 68° for subjects 1 and 2,respectively, but subject 3 had no improvement in finger extension. Box and Block score increasedby 6, 15, and 7 blocks, and upper extremity Fugl-Meyer score increased by 11, 15, and 7 points forsubjects 1, 2, and 3, respectively. The finger extension gains declined at the 1-month and 3-monthfollow-up for subjects 1 and 2, but the gains in Box and Block and Fugl-Meyer scores persisted at follow-up.
Conclusions—
Greater reductions in hand impairment were achieved by extending the treatment period. The effect and its longevity may be related to baseline impairment level.
Keywords
Stroke
;
Hemiplegia
;
Contralaterally controlled functional electrical stimulation
;
Rehabilitation
;
Medical device
Loss of hand function is one of the most frequently persisting consequences of stroke and isoften characterized by inability to open the hand.
1
,
2
Although routine occupational therapy is beneficial, it remains limited in its effectiveness in restoring full independent use of the impaired upper extremity and consequently many stroke survivors never regain the function of their affected hand.
© 2009 The American Society of Neurorehabilitation Address correspondence to Jayme S. Knutson, PhD, Cleveland FES Center, MetroHealth Medical Center, 2500 MetroHealth Drive,Hamann 601, Cleveland, OH 44109. jsk12@case.edu..
Jayme S. Knutson, PhD
,
Terri Z. Hisel, OTR/L
,
Mary Y. Harley, OTR/L
, and
John Chae, MD
Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio (JSK,JC); Department of Physical Medicine and Rehabilitation, MetroHealth Medical Center,Cleveland, Ohio (TZH, MYH, JC); and Department of Physical Medicine and Rehabilitation, CaseWestern Reserve University, Cleveland, Ohio (JC)
Abstract
Background—Loss of finger extension is common after stroke and can severely limit hand function. Contralaterally controlled functional electrical stimulation (CCFES) is a new treatment aimed at restoring volitional finger and thumb extension. A previous pilot study showed reductions in hand impairment after 6 weeks of CCFES, but the effect did not persist after end of treatment.
Objective—
This study aimed to evaluate the feasibility of achieving greater and more persistent gains with CCFES by increasing the treatment period to 12 weeks.
Methods—
CCFES uses neuromuscular electrical stimulation to open the paretic hand in direct proportion to the degree of volitional opening of the unimpaired contralateral hand, which isdetected by an instrumented glove. Three subjects with chronic hemiplegia participated in a 12-week CCFES treatment, which consisted of daily CCFES-assisted active repetitive hand-opening exercises and twice weekly functional task practice with CCFES.
Results—
Maximum voluntary finger extension increased by 101° and 68° for subjects 1 and 2,respectively, but subject 3 had no improvement in finger extension. Box and Block score increasedby 6, 15, and 7 blocks, and upper extremity Fugl-Meyer score increased by 11, 15, and 7 points forsubjects 1, 2, and 3, respectively. The finger extension gains declined at the 1-month and 3-monthfollow-up for subjects 1 and 2, but the gains in Box and Block and Fugl-Meyer scores persisted at follow-up.
Conclusions—
Greater reductions in hand impairment were achieved by extending the treatment period. The effect and its longevity may be related to baseline impairment level.
Keywords
Stroke
;
Hemiplegia
;
Contralaterally controlled functional electrical stimulation
;
Rehabilitation
;
Medical device
Loss of hand function is one of the most frequently persisting consequences of stroke and isoften characterized by inability to open the hand.
1
,
2
Although routine occupational therapy is beneficial, it remains limited in its effectiveness in restoring full independent use of the impaired upper extremity and consequently many stroke survivors never regain the function of their affected hand.
© 2009 The American Society of Neurorehabilitation Address correspondence to Jayme S. Knutson, PhD, Cleveland FES Center, MetroHealth Medical Center, 2500 MetroHealth Drive,Hamann 601, Cleveland, OH 44109. jsk12@case.edu..
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