Abstract
Objective
To assess the feasibility of a new stroke rehabilitation therapy for the hemiparetic hand.
Design
Case series. Pre- and postintervention assessment with 1- and 3-month follow-ups.
Setting
Clinical research laboratory of a large public hospital.
Participants
Three subjects with chronic (>6mo postcerebrovascular accident) upper-extremity hemiplegia.
Intervention
Subjects used an electric stimulator to cause the paretic hand extensor muscles
to contract and thereby open the hand. Subjects controlled the
intensity of the stimulation, and thus the degree of hand opening, by
volitionally opening the unimpaired contralateral hand, which was
detected by an instrumented glove. For 6 weeks, subjects used the
stimulator to perform active repetitive hand-opening exercises 2 hours
daily at home and functional tasks 1.5 hours twice a week in the
laboratory.
Main Outcome Measures
Maximum
voluntary finger extension, maximum voluntary isometric
finger-extension moment, finger-movement control, and box and block test
(BBT) score at pre- and posttreatment and at 1 month and 3 months
posttreatment.
Results
Maximum
voluntary finger extension increased from baseline to end of treatment
and from the end of treatment to 1-month follow-up in 2 subjects.
Maximum voluntary isometric finger-extension moment, finger-movement
control, and BBT score increased from baseline to the end of treatment
and from the end of treatment to 1-month follow-up in all 3 subjects.
The improvements generally declined at 3 months.
Conclusions
The results suggest a positive effect on motor impairment, meriting further investigation of the intervention.
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