By the time you're chronic there is no way to get all this equipment together for your rehab.
Effects of combining robot-assisted therapy with neuromuscular electrical stimulation on motor impairment, motor and daily function, and quality of life in patients with chronic stroke: a double-blinded randomized controlled trial
Ya-yun Lee
1,2
, Keh-chung Lin
3,4
, Hsiao-ju Cheng
3
, Ching-yi Wu
1,2*
, Yu-wei Hsieh
1,2
and Chih-kuang Chen
5,6
Robot-assisted therapy (RT) is a widely used intervention approach to enhance motor recovery inpatients after stroke, but its effects on functional improvement remained uncertain. Neuromuscular electrical stimulation (NMES) is one potential adjuvant intervention approach to RT that could directly activate the stimulated muscles and improve functional use of the paretic hand.
1,2
, Keh-chung Lin
3,4
, Hsiao-ju Cheng
3
, Ching-yi Wu
1,2*
, Yu-wei Hsieh
1,2
and Chih-kuang Chen
5,6
Abstract
Background:Robot-assisted therapy (RT) is a widely used intervention approach to enhance motor recovery inpatients after stroke, but its effects on functional improvement remained uncertain. Neuromuscular electrical stimulation (NMES) is one potential adjuvant intervention approach to RT that could directly activate the stimulated muscles and improve functional use of the paretic hand.
Methods:
This was a randomized, double-blind, sham-controlled study. Thirty-nine individuals with chronic stroke were randomly assigned to the RT combined with NMES (RT+ ES) or to RT with sham stimulation (RT+Sham) groups. The participants completed the intervention 90 to 100 minutes/day, 5 days/week for 4 weeks. The outcome measures included the upper extremity Fugl-Meyer Assessment (UE-FMA), modified Ashworth scale (MAS), Wolf Motor Function Test (WMFT), Motor Activity Log (MAL), and Stroke Impact Scale 3.0 (SIS). All outcome measures were assessed before and after intervention, and the UE-FMA, MAL, and SIS were reassessed at 3 months of follow-up.
This was a randomized, double-blind, sham-controlled study. Thirty-nine individuals with chronic stroke were randomly assigned to the RT combined with NMES (RT+ ES) or to RT with sham stimulation (RT+Sham) groups. The participants completed the intervention 90 to 100 minutes/day, 5 days/week for 4 weeks. The outcome measures included the upper extremity Fugl-Meyer Assessment (UE-FMA), modified Ashworth scale (MAS), Wolf Motor Function Test (WMFT), Motor Activity Log (MAL), and Stroke Impact Scale 3.0 (SIS). All outcome measures were assessed before and after intervention, and the UE-FMA, MAL, and SIS were reassessed at 3 months of follow-up.
Results:
Compared with the RT+Sham group, the RT +ES group demonstrated greater improvements in wrist flexorMAS score, WMFT quality of movement, and the hand function domain of the SIS. For other outcome measures, both groups improved significantly after the interventions, but no group differences were found.
Compared with the RT+Sham group, the RT +ES group demonstrated greater improvements in wrist flexorMAS score, WMFT quality of movement, and the hand function domain of the SIS. For other outcome measures, both groups improved significantly after the interventions, but no group differences were found.
Conclusion:
RT +ES induced significant benefits in reducing wrist flexor spasticity and in hand movement quality inpatients with chronic stroke.
Trial registration:
ClinicalTrials.gov. NCT01655446
Keywords:
Stroke, Robot-assisted therapy, Electrical stimulation, Rehabilitation
* Correspondence: cywu@mail.cgu.edu.tw
1
Department of Occupational Therapy and Graduate Institute of BehavioralSciences, College of Medicine, Chang Gung University, 259 Wenhua 1st Rd, Taoyuan, Taiwan
2
Healthy Aging Research Center, Chang Gung University, Taoyuan, TaiwanFull list of author information is available at the end of the article
JNER
JOURNAL OF NEUROENGINEERINGAND REHABILITATION
© 2015 Lee et al.
Open Access
This article is distributed under the terms of the Creative Commons Attribution 4.0International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, andreproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link tothe Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver(http://creativecommons.org/publicdomain/zero/1.0/ ) applies to the data made available in this article, unless otherwise stated.
Lee
et al. Journal of NeuroEngineering and Rehabilitation
(2015) 12:96
DOI 10.1186/s12984-015-0088-3
RT +ES induced significant benefits in reducing wrist flexor spasticity and in hand movement quality inpatients with chronic stroke.
Trial registration:
ClinicalTrials.gov. NCT01655446
Keywords:
Stroke, Robot-assisted therapy, Electrical stimulation, Rehabilitation
* Correspondence: cywu@mail.cgu.edu.tw
1
Department of Occupational Therapy and Graduate Institute of BehavioralSciences, College of Medicine, Chang Gung University, 259 Wenhua 1st Rd, Taoyuan, Taiwan
2
Healthy Aging Research Center, Chang Gung University, Taoyuan, TaiwanFull list of author information is available at the end of the article
JNER
JOURNAL OF NEUROENGINEERINGAND REHABILITATION
© 2015 Lee et al.
Open Access
This article is distributed under the terms of the Creative Commons Attribution 4.0International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, andreproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link tothe Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver(http://creativecommons.org/publicdomain/zero/1.0/ ) applies to the data made available in this article, unless otherwise stated.
Lee
et al. Journal of NeuroEngineering and Rehabilitation
(2015) 12:96
DOI 10.1186/s12984-015-0088-3
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