Augmenting Hand and Arm Function for Persons with Hemiparesis

So not surgery: Transcutaneous spinal cord stimulation (tSCS) is a non-invasive form of neuromodulation in which electrodes are placed on the skin and used to stimulate the spinal circuitries via an electrical current.(Why not use something similar to disrupt the spasticity signals sent from the spinal cord?)

Ask your competent? doctor if vagus nerve stimulation is better than this. 

 Augmenting Hand and Arm Function for Persons with Hemiparesis

Abstract

Background. 

 

Hand and arm dysfunction due to neural disorders significantly influences quality of life.
Activity-based training has been found to improve function. These improvements could be augmented
with transcutaneous spinal cord stimulation (tSCS) due to the modulatory effect it has on spinal and
supraspinal networks. 

 

Objective.

 

 The primary aim is to determine if a 4-week training program will improve hand and arm function. The secondary aim is to determine if the addition of tSCS to a second
4-week training session will further improve function. 

 

Design. 

 

This is a pre-posttest, controlled trial for persons 10-75 years of age, >6 months post stroke or with unilateral cerebral palsy.

 

Methods. 

 

Participants will engage in two 4-week training periods, 3x/week for 2 hours/day. The 1st period will include unimanual and bimanual training alone. The 2nd period will be augmented with low frequency tSCS to the C5-T1 spinal region. Stimulation intensity will be based on individual muscle activation during 3 tasks: 1) grip dynamometry; 2) grip-lift; and 3) target pointing. Outcome measures taken before, midway, and after training are: Canadian Occupational Performance Measure (COPM), dexterity, daylong arm use, grip/pinch strength, sensibility, questionnaires, bilateral hand/arm surface electromyography, and Upper Extremity Fugl-Meyer (UEFM). 

 

Results:

 

 Nine participants have completed the 1st 4-week training period without mtSCS. Individual data reveals improvements in the COPM, Grip strength, dexterity, and the UEFM. Findings for other measures after the 1st period are mixed or in process. 

 

Conclusion:

 

Preliminary findings from this ongoing study reveal that participants made improvements in most measures. The next phase of the study will determine if the addition of tSCS to training further augments hand and arm function.
DisciplinesDisciplines
Neurosciences | Physical Therapy
AuthorsAuthors
Brooke Stein, Susan Duff, Alison McKenzie, Bailey Advincula, Isaac An, Annie Jeon, Casey McWilliam, Will
Potter, Virginia Ruano, Paulina Vokulich, Audrey Howell, and Rahul Soangra