title: The effect of EMG triggered electrical stimulation plus task practice on arm function in chronic stroke patients with moderate-severe arm deficits.
abstract: OBJECTIVE
  We examined the feasibility and outcome of electromyographically triggered electrical muscle stimulation (EMG-ES) plus unilateral or bilateral task specific practice on arm function in chronic stroke survivors with moderate-severe hemiplegia. Transcranial magnetic stimulation was used to examine inter-hemispheric inhibition (IHI) acting on the stroke-affected hemisphere in a subset of eight participants.
  
  
  METHODS
  Twenty-one stroke survivors (14 males; mean time post stroke 57.9 months) participated in this pilot investigation. Participants underwent a six-week program of daily EMG-ES training with random assignment to concurrent task practice using the stroke-affected hand only or both hands. The upper-extremity subscale of the Fugl-Meyer (FMUE) and the Arm Motor Ability Test (AMAT) were completed at baseline, 0-, 1-, and 3-months post-intervention.
  
  
  RESULTS
  Following the intervention, FMUE (F(3, 57) = 3.89, p = .01, ηp2 = .17) and AMAT (F(3, 57) = 12.6, p = .01, ηp2 = .39) scores improved, and remained better than baseline at three months re-assessment. The difference between groups was not significant. A non-significant decrease in IHI was observed post-intervention.
  
  
  CONCLUSIONS
  An intensive program of EMG-ES assisted functional training is feasible, well tolerated, and leads to improvements in moderate-severe deficits of arm function post stroke. Larger placebo controlled studies are needed to explore any advantage of bilateral over unilateral EMG-ES assisted training.
authors: The Centre for Musculoskeletal Studies, School of Surgery, The University of Western Australia, Perth, WA, Australia.
authors: Barbara J
authors: BJ
authors: Singer
authors: Ann-Maree
authors: AM
authors: Vallence
authors: Sarah
authors: S
authors: Cleary
authors: Ian
authors: I
authors: Cooper
authors: Andrea M
authors: AM
authors: Loftus
mesh_terms: D000368:Aged; D001132:Arm / Q000503:physiopathology*; D002908:Chronic Disease; D016208:Databases, Factual; D004599:Electric Stimulation Therapy / Q000379:methods*; D004576:Electromyography / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D005385:Fingers / Q000502:physiology; D007839:Functional Laterality / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009048:Motor Skills / Q000502:physiology; D011214:Practice, Psychological; D011597:Psychomotor Performance / Q000502:physiology; D020127:Recovery of Function / Q000502:physiology; D020521:Stroke / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D050781:Transcranial Magnetic Stimulation; D016896:Treatment Outcome; D034941:Upper Extremity / Q000502:physiology; D014953:Wrist / Q000502:physiology
keywords: Stroke; bilateral training; electrical stimulation; interhemispheric inhibition; upper limb