title: Hybrid power-assisted functional electrical stimulation to improve hemiparetic upper-extremity function.
abstract: OBJECTIVE
  The effect on spastic hemiparesis of a hybrid therapy consisting of functional electrical stimulation and block therapy was examined.
  
  
  METHODS
  Sixteen consecutively enrolled stroke patients who had spastic upper-extremity impairments more than 1 yr after stroke were recruited for this nonblinded randomized controlled trial. Patients underwent hybrid functional electrical stimulation therapy on their extensor carpi radialis longus and brevis, extensor digitorum communis, and extensor indicis proprius muscles once or twice a week for 4 mos after motor point blocks at the spastic finger flexor muscles. Surface electrodes picked up the electromyography signal and stimulated those muscles in proportion to the integrated electromyography signal obtained by the functional electrical stimulation device. The root mean square of the extensor carpi radialis longus and extensor digitorum communis maximum voluntary electromyography, active range of motion of wrist extension, finger extension, Modified Ashworth Scale, and two clinical tests were examined before and after training.
  
  
  RESULTS
  Root mean square, active range of motion, Modified Ashworth Scale, and two clinical tests showed marked improvement in all patients as compared with the control subjects.
  
  
  CONCLUSIONS
  The hybrid therapy was effective for patients with chronic spastic hemiparesis. Proprioceptional sensory feedback may have an important role in power-assisted functional electrical stimulation therapy.
authors.affiliation: Department of Rehabilitation Medicine, Nippon Medical School, Chiba Hokusoh Hospital, Japan.
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Hara
authors.forename: Shinji
authors.initials: S
authors.lastname: Ogawa
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Muraoka
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D003131:Combined Modality Therapy; D004599:Electric Stimulation Therapy / Q000295:instrumentation / Q000379:methods*; D004576:Electromyography; D005260:Female; D005384:Finger Joint; D006801:Humans; D008297:Male; D008875:Middle Aged; D009128:Muscle Spasticity / Q000534:rehabilitation; D009407:Nerve Block; D010291:Paresis / Q000534:rehabilitation*; D016059:Range of Motion, Articular; D000071939:Stroke Rehabilitation; D034941:Upper Extremity / Q000294:innervation; D014955:Wrist Joint