title: Portable Myoelectric Brace Use Increases Upper Extremity Recovery and Participation But Does Not Impact Kinematics in Chronic, Poststroke Hemiparesis.
abstract: The authors examined the efficacy of an 8-week regimen combining repetitive task-specific practice (RTP) with a myoelectric brace (RTP+Myomo) on paretic upper extremity (UE; use in valued activities, perceived recovery, and reaching kinematics) in 12 subjects (4 men; M age = 53.5 years; mean time poststroke = 61.7 months). Seven subjects were administered RTP+Myomo therapy, and 5 were administered RTP only. Both groups participated in individualized, 45-min therapy sessions occurring 3 days/week over an 8-week period. The arm, hand ability, activities of daily living, and perceptions of recovery subscales of the Stroke Impact Scale (SIS), as well as UE reaching kinematics, assessed before and after the intervention. Subjects in the RTP+Myomo group showed greater improvements on all SIS subscales, with the recovery scale reaching statistical significance (p = .03). Subjects in the RTP-only group showed a greater increase in hand velocity in the reach up task (p = .02), but no changes were observed in the range of shoulder flexion or elbow extension during reaching. None of the changes in kinematic outcome measures significantly correlated with any of the changes in SIS subscales. RTP integrating myoelectric bracing may be more beneficial than RTP only in improving self-reported function and perceptions of overall recovery. The authors observed no changes in the range of elbow extension, and no relationship between self-reported improvements and changes in reaching kinematics.
authors.affiliation: a Sports Health and Performance Institute, OSU Sports Medicine , The Ohio State University , Columbus , Ohio.|b Joint Research, Department of Orthopaedic Surgery , OLVG , Amsterdam , the Netherlands.
authors.forename: Nienke W
authors.initials: NW
authors.lastname: Willigenburg
authors.affiliation: c Department of Orthopaedics , Sports Health and Performance Institute, OSU Sports Medicine, The Ohio State University , Columbus , Ohio.
authors.forename: Michael P
authors.initials: MP
authors.lastname: McNally
authors.affiliation: d Departments of Physiology & Cell Biology, Family Medicine, Biomedical Engineering, and Orthopaedics , Sports Health and Performance Institute, OSU Sports Medicine, The Ohio State University , Columbus , Ohio.|e Department of Orthopedics , Mayo Clinic, Rochester , Minnesota , USA.
authors.forename: Timothy E
authors.initials: TE
authors.lastname: Hewett
authors.affiliation: f Better Rehabilitation and Assessment for Improved Neurorecovery Laboratory , Division of Occupational Therapy, School of Health and Rehabilitation Sciences, The Ohio State University Medical Center , Columbus , Ohio , USA.
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Page
mesh_terms: D000203:Activities of Daily Living; D001696:Biomechanical Phenomena; D001915:Braces; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010291:Paresis / Q000150:complications / Q000503:physiopathology / Q000534:rehabilitation*; D011214:Practice, Psychological; D020127:Recovery of Function; D020521:Stroke / Q000150:complications / Q000503:physiopathology; D000071939:Stroke Rehabilitation / Q000379:methods*; D034941:Upper Extremity / Q000503:physiopathology
keywords: hemiplegia; kinematics; neurorehabilitation; stroke