title: Effects of movement imagery and electromyography-triggered feedback on arm hand function in stroke patients in the subacute phase.
abstract: OBJECTIVE
  To investigate the effects of movement imagery-assisted electromyography (EMG)-triggered feedback (focused on paretic wrist dorsiflexors) on the arm-hand function of stroke patients.
  
  
  METHODS
  Single-blinded, longitudinal, multicentre randomized controlled trial. Measurements were performed (on average) 54 days post stroke (baseline), three months later (post training) and at 12 months post baseline.
  
  
  METHODS
  Two rehabilitation centres.
  
  
  METHODS
  Twenty-seven patients with a first-ever, ischaemic, subacute stroke.
  
  
  METHODS
  A reference group received conventional electrostimulation, while the experimental group received arm-hand function training based on EMG-triggered feedback combined with movement imagery. Both groups were trained for three months, 5 days/week, 30 minutes/day, in addition to their therapy as usual.
  
  
  METHODS
  Arm-hand function was evaluated using the upper extremity-related part of the Brunnstrom Fugl-Meyer test and the Action Research Arm test.
  
  
  RESULTS
  During training, Brunnstrom Fugl-Meyer scores improved 8.7 points and Action Research Arm scores by 19.4 points (P < 0.0001) in both groups relative to baseline results, rising to 13.3 and 28.4 points respectively at one year follow-up (P < 0.0001). No between-group differences were found at any time.
  
  
  CONCLUSIONS
  EMG-triggered feedback stimulation did not lead to more arm-hand function improvement relative to conventional electrostimulation. However, in contrast to many clinical reports, a significant improvement was still observed in both groups nine months after treatment ceased.
authors: Rehabilitation Foundation Limburg (SRL), Hoensbroek, The Netherlands. b.hemmen@srl.nl
authors: B
authors: B
authors: Hemmen
authors: H A M
authors: HA
authors: Seelen
mesh_terms: D000328:Adult; D000368:Aged; D001676:Biofeedback, Psychology / Q000379:methods*; D004576:Electromyography / Q000379:methods*; D005260:Female; D007839:Functional Laterality; D006801:Humans; D019018:Imagery, Psychotherapy; D008297:Male; D008875:Middle Aged; D026741:Physical Therapy Modalities; D020127:Recovery of Function; D016037:Single-Blind Method; D020521:Stroke / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome; D034941:Upper Extremity / Q000502:physiology*