Home-based electromyography-triggered stimulation in chronic stroke.
OBJECTIVE
(1) To determine the feasibility of a home-based electromyography-triggered neuromuscular stimulation (ETMS) programme; and (2) to determine ETMS efficacy in increasing affected wrist extension and reducing affected arm impairment.


METHODS
Randomized, controlled, pre-post, cross-over design.


METHODS
Outpatient rehabilitation hospital.


METHODS
Twelve chronic stroke patients with palpable muscle contraction in their affected wrist extensors but no movement (7 males; mean age = 59.75 years, age range 44-75 years; mean time since stroke = 52.75 months, range 13-131 months).


METHODS
Subjects were randomly assigned to receive either: (a) ETMS use twice every weekday in 35-min increments during an eight-week period followed by an eight-week home exercise programme (ETMS/home exercise programme) (n=8); or (b) an eight-week home exercise programme followed by use of ETMS twice every weekday in 35-min increments during an eight-week period (home exercise programme) (n=4).


METHODS
The Fugl-Meyer, Action Research Arm Test and goniometry.


RESULTS
After home exercise programme participation, subjects showed nominal or no changes on any of the outcome measures. After ETMS, patients showed modest impairment reductions, as shown by the Fugl-Meyer, and no Action Research Arm Test changes. However, both groups showed a 21 degree increase in active affected wrist extension after ETMS use.


CONCLUSIONS
ETMS use is feasible in the home environment. Neither participation in a traditional home exercise programme nor ETMS use conveyed changes on the Fugl-Meyer or Action Research Arm Test. However, ETMS use increased active affected limb extension. This new movement may provide a potential pathway for subjects to participate in other interventions, such as modified constraint induced therapy.
Gabr
Usama
U
Department of Physical Medicine and Rehabilitation, University of Cincinnati College of Medicine, 3202 Eden Ave, Suite 275, Cincinnati, OH 45267, USA.
Levine
Peter
P
Page
Stephen J
SJ
D000328:Adult; D000368:Aged; D001132:Arm / Q000503:physiopathology; D018592:Cross-Over Studies; D004185:Disability Evaluation; D004599:Electric Stimulation Therapy; D004576:Electromyography; D005081:Exercise Therapy; D005240:Feasibility Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000503:physiopathology*; D016059:Range of Motion, Articular / Q000502:physiology; D016037:Single-Blind Method; D020521:Stroke / Q000503:physiopathology / Q000628:therapy*; D014955:Wrist Joint / Q000503:physiopathology