title: Feasibility study of a combined treatment of electromyography-triggered neuromuscular stimulation and mirror therapy in stroke patients: a randomized crossover trial.
abstract: BACKGROUND
  Mirror therapy (MT) and electromyography-triggered neuromuscular stimulation (ETMS) are both effective treatments for impaired upper limbs following stroke. A combination of these two treatments (ETMS-MT) may result in greater gain than either treatment alone.
  
  
  OBJECTIVE
  The feasibility and possible effects of ETMS-MT upon upper extremity function were investigated in stroke patients.
  
  
  METHODS
  Thirteen post-acute stroke patients were randomly assigned to an immediate ETMS-MT group or a delayed ETMS-MT group and then underwent an 8-week training program. The immediate ETMS-MT group received ETMS-MT in addition to physical and occupational therapy (PT+OT) for 4 weeks. They then received only PT+OT for the next 4 weeks. In the delayed ETMS-MT group, interventions were provided in the reverse order. The main outcome measure was the Fugl-Meyer Assessment (FMA).
  
  
  RESULTS
  The immediate ETMS-MT group showed significantly greater gain in FMA in the first 4 weeks. The delayed ETMS-MT group showed significantly greater gain in active range of motion during the latter 4 weeks. No adverse effects were reported following ETMS-MT.
  
  
  CONCLUSIONS
  ETMS-MT might be as effective as independent MT or ETMS without causing any side effects. Future research should focus upon the direct comparisons between independent and combined interventions.
authors.affiliation: Department of Rehabilitation Medicine, Nishiyamato Rehabilitation Hospital, Nara, Japan Graduate School of Health Science, Kio University, Nara, Japan.
authors.forename: Kosuke
authors.initials: K
authors.lastname: Kojima
authors.affiliation: Department of Rehabilitation Medicine, Nishiyamato Rehabilitation Hospital, Nara, Japan.
authors.forename: Koki
authors.initials: K
authors.lastname: Ikuno
authors.affiliation: Department of Rehabilitation, Hanna Central Hospital, Nara, Japan.
authors.forename: Yuta
authors.initials: Y
authors.lastname: Morii
authors.affiliation: Department of Rehabilitation Medicine, Nishiyamato Rehabilitation Hospital, Nara, Japan.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Tokuhisa
authors.affiliation: Department of Rehabilitation Medicine, Nishiyamato Rehabilitation Hospital, Nara, Japan.
authors.forename: Shigeru
authors.initials: S
authors.lastname: Morimoto
authors.affiliation: Graduate School of Health Science, Kio University, Nara, Japan.
authors.forename: Koji
authors.initials: K
authors.lastname: Shomoto
mesh_terms: D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy / Q000379:methods; D018592:Cross-Over Studies; D004599:Electric Stimulation Therapy / Q000379:methods*; D004576:Electromyography / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D007839:Functional Laterality / Q000502:physiology*; D006429:Hemiplegia / Q000209:etiology / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D026741:Physical Therapy Modalities; D010865:Pilot Projects; D016059:Range of Motion, Articular / Q000502:physiology; D020127:Recovery of Function; D020521:Stroke / Q000150:complications; D000071939:Stroke Rehabilitation; D016896:Treatment Outcome; D034941:Upper Extremity
keywords: Electromyography-triggered neuromuscular stimulation; hemiplegia; mirror therapy; stroke rehabilitation; upper extremity