title: Improving hand function in stroke survivors: a pilot study of contralaterally controlled functional electric stimulation in chronic hemiplegia.
abstract: OBJECTIVE
  To assess the feasibility of a new stroke rehabilitation therapy for the hemiparetic hand.
  
  
  METHODS
  Case series. Pre- and postintervention assessment with 1- and 3-month follow-ups.
  
  
  METHODS
  Clinical research laboratory of a large public hospital.
  
  
  METHODS
  Three subjects with chronic (>6mo postcerebrovascular accident) upper-extremity hemiplegia.
  
  
  METHODS
  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.
  
  
  METHODS
  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.
authors.affiliation: Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH, USA. jsk12@case.edu
authors.forename: Jayme S
authors.initials: JS
authors.lastname: Knutson
authors.forename: Mary Y
authors.initials: MY
authors.lastname: Harley
authors.forename: Terri Z
authors.initials: TZ
authors.lastname: Hisel
authors.forename: John
authors.initials: J
authors.lastname: Chae
mesh_terms: D000328:Adult; D000368:Aged; D004558:Electric Stimulation; D004864:Equipment and Supplies; D005260:Female; D006225:Hand; D006429:Hemiplegia / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D000071939:Stroke Rehabilitation