Task-specific, patient-driven neuroprosthesis training in chronic stroke: results of a 3-week clinical study.
OBJECTIVE
We examined the efficacy of a clinically based regimen in which a woman 16 months' poststroke participated in daily practice sessions of valued activities of daily living (ADLs). A unique aspect of this intervention was that it was largely patient driven, with the patient practicing ADLs while wearing an electrical stimulation neuroprosthesis.


METHODS
The Fugl-Meyer Assessment (FM), Action Research Arm Test (ARA), Arm Motor Activity Test (AMAT), and Canadian Occupational Performance Measure (COPM) were administered before intervention. Therapy consisted of 3-hr ADL training sessions every weekday during a 3-week period using a neuroprosthesis featuring functional electrical stimulation during treatment sessions. One week after the end of the treatment phase, the FM, ARA, AMAT, and COPM were again administered.


RESULTS
The patient exhibited reduced impairment (FM score change from 31 to 35), decreased time needed to complete AMAT tasks (from 998 s to 558 s), and increased ARA score (from 27 to 31).


CONCLUSIONS
Clinically meaningful changes were realized with distant or minimal therapist supervision, making this regimen a practical and efficacious alternative.
Hill-Hermann
Valerie
V
Department of Rehabilitation Sciences, University of Cincinnati Academic Medical Center (UCAMC), Cincinnati, OH, USA.
Strasser
Ashley
A
Albers
Bethany
B
Schofield
Kelly
K
Dunning
Kari
K
Levine
Peter
P
Page
Stephen J
SJ
D005260:Female; D006225:Hand; D006429:Hemiplegia / Q000534:rehabilitation*; D006801:Humans; D008875:Middle Aged; D009048:Motor Skills; D009788:Occupational Therapy / Q000295:instrumentation*; D019736:Prostheses and Implants; D012371:Robotics; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome; D014584:User-Computer Interface