title: Myoelectrically driven functional electrical stimulation may increase motor recovery of upper limb in poststroke subjects: a randomized controlled pilot study.
abstract: The objective of this randomized controlled pilot study was to assess the feasibility and effectiveness of myoelectrically controlled functional electrical stimulation (MeCFES) for rehabilitation of the upper limb in poststroke subjects. Eleven poststroke hemiparetic subjects with residual proximal control of the arm, but impaired volitional opening of the paretic hand, were enrolled and randomized into a treated and a control group. Subjects received 3 to 5 treatment sessions per week until totaling 25 sessions. In the experimental group, myoelectric activity from wrist and finger extensors was used to control stimulation of the same muscles. Patients treated with MeCFES (n = 5) had a significant (p = 0.04) and clinically important improvement in Action Research Arm Test score (median change 9 points), confirmed by an Individually Prioritized Problem Assessment self-evaluation score. This improvement was maintained at follow-up. The control group did not show a significant improvement (p = 0.13). The reduced sample size of participants, together with confounding factors such as spontaneous recovery, calls for larger studies to draw definite conclusions. However, the large and persistent treatment effect seen in our results indicate that MeCFES could play an important role as a clinical tool for stroke rehabilitation.
authors.affiliation: Biomedical Technology Department, IRCCS S. Maria Nascente, Fondazione Don Gnocchi Onlus, Via Capecelatro 66, 20148 Milano, Italy. rthorsen@dongnocchi.it.
authors.forename: Rune
authors.initials: R
authors.lastname: Thorsen
authors.forename: M
authors.initials: M
authors.lastname: Cortesi
authors.forename: J
authors.initials: J
authors.lastname: Jonsdottir
authors.forename: I
authors.initials: I
authors.lastname: Carpinella
authors.forename: D
authors.initials: D
authors.lastname: Morelli
authors.forename: A
authors.initials: A
authors.lastname: Casiraghi
authors.forename: M
authors.initials: M
authors.lastname: Puglia
authors.forename: M
authors.initials: M
authors.lastname: Diverio
authors.forename: M
authors.initials: M
authors.lastname: Ferrarin
mesh_terms: D000328:Adult; D004311:Double-Blind Method; D004599:Electric Stimulation Therapy / Q000379:methods; D005260:Female; D005385:Fingers / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000503:physiopathology; D010291:Paresis / Q000209:etiology* / Q000534:rehabilitation*; D010865:Pilot Projects; D011597:Psychomotor Performance; D020521:Stroke / Q000150:complications* / Q000503:physiopathology; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome; D014953:Wrist / Q000503:physiopathology