Bilateral upper limb training with functional electric stimulation in patients with chronic stroke.
BACKGROUND
The recovery rate of upper limb function after stroke is poor when compared with independent walking. Therefore, effective methods are warranted for upper limb rehabilitation.


OBJECTIVE
The aim of this study was to investigate the effectiveness of functional electric stimulation (FES) with bilateral activities training on upper limb function.


METHODS
This study was a double-blinded randomized controlled trial. Twenty patients were recruited 6 months after the onset of stroke and completed 15 training sessions. Participants were randomly assigned to the FES group or to the control group. Each session consisted of stretching activities (10 minutes), FES with bilateral tasks (20 minutes), and occupational therapy treatment (60 minutes). The participants used a self-trigger mechanism, with an accelerometer as a motion detector, for generating an electric stimulation pattern that was synchronized with the bilateral upper limb activities during the training. The participants in the control group received the same duration of stretching and occupational therapy training except that they just received placebo stimulation with the bilateral tasks. The outcome measures included Functional Test for the Hemiplegic Upper Extremity (FTHUE), Fugl-Meyer Assessment (FMA), grip power, forward reaching distance, active range of motion of wrist extension, Functional Independence Measure, and Modified Ashworth Scale.


RESULTS
At baseline comparison, there was no significant difference in both groups. After 15 training sessions, the FES group had significant improvement in FMA (P = .039), FTHUE (P = .001), and active range of motion of wrist extension (P = .020) when compared with the control group.


CONCLUSIONS
Bilateral upper limb training with FES could be an effective method for upper limb rehabilitation of stroke patients after 15 training sessions.
Chan
Marko Ka-Leung
MK
Occupational Therapy Department, Kowloon Hospital, Hong Kong.
Tong
Raymond Kai-Yu
RK
Chung
Kenneth Yiu-Kwan
KY
D000328:Adult; D000368:Aged; D001132:Arm / Q000294:innervation / Q000503:physiopathology*; D002908:Chronic Disease; D004311:Double-Blind Method; D004599:Electric Stimulation Therapy / Q000379:methods*; D005260:Female; D007839:Functional Laterality / Q000502:physiology*; D018737:Hand Strength / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009069:Movement Disorders / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation*; D009119:Muscle Contraction / Q000502:physiology; D052580:Muscle Stretching Exercises / Q000379:methods; D017063:Outcome Assessment, Health Care / Q000379:methods; D026741:Physical Therapy Modalities; D016059:Range of Motion, Articular / Q000502:physiology; D020127:Recovery of Function / Q000502:physiology; D020521:Stroke / Q000150:complications / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome