title: Effectiveness of hybrid assistive neuromuscular dynamic stimulation therapy in patients with subacute stroke: a randomized controlled pilot trial.
abstract: OBJECTIVE
  Hybrid assistive neuromuscular dynamic stimulation (HANDS) therapy was devised to facilitate the use of the hemiparetic upper extremity in daily life by combining assistive neuromuscular electrical stimulation, referred to as the integrated volitional electrical stimulator (IVES), with a splint. The aim of this study is to assess the effectiveness of HANDS therapy for patients with subacute stroke.
  
  
  METHODS
  The participants were 24 inpatients receiving rehabilitation for hemiparetic stroke within 60 days of onset. Entry criteria included inability to individuate finger extension. Patients were randomly assigned to 2 groups. The HANDS group (n = 12) used the IVES combined with a wrist splint for 8 hours a day for 3 weeks, and the control group (n = 12) wore a wrist splint alone. All patients received the same daily dose and length of standard poststroke multidisciplinary rehabilitation. Outcome measures were the upper extremity portion of the Fugl-Meyer Assessment (FMA), Action Research Arm Test (ARAT), and Motor Activity Log-14 (MAL).
  
  
  RESULTS
  In all, 10 patients in each group completed the interventions. Compared with the control group, the HANDS group showed significantly greater gains in distal (wrist/hand) portion of the FMA (P < .01) and improvement of the ARAT (P < .05). The gains in the MAL did not differ. No adverse effects occurred and the HANDS therapy was well accepted.
  
  
  CONCLUSIONS
  HANDS therapy in addition to conventional therapy may improve hand function in patients with moderate to severe hand impairment during early rehabilitation.
authors.affiliation: Tokyo Metropolitan Rehabilitation Hospital, Tokyo, Japan. krugreims@yahoo.co.jp
authors.forename: Keiichiro
authors.initials: K
authors.lastname: Shindo
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Fujiwara
authors.forename: Joji
authors.initials: J
authors.lastname: Hara
authors.forename: Hideki
authors.initials: H
authors.lastname: Oba
authors.forename: Fujiko
authors.initials: F
authors.lastname: Hotta
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Tsuji
authors.forename: Kimitaka
authors.initials: K
authors.lastname: Hase
authors.forename: Meigen
authors.initials: M
authors.lastname: Liu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy / Q000295:instrumentation / Q000379:methods*; D004599:Electric Stimulation Therapy / Q000295:instrumentation / Q000379:methods*; D005081:Exercise Therapy / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010291:Paresis / Q000503:physiopathology / Q000534:rehabilitation*; D010865:Pilot Projects; D012720:Severity of Illness Index; D013165:Splints; D020521:Stroke / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D055815:Young Adult