Introduction
Upper extremity impairment post-stroke is common and results in decreased occupational engagement. For those with chronic stroke and severe hemiparesis, few treatment options are available. MyndMove™ is a functional electrical stimulation technology programmed to stimulate up to eight muscle groups in reach and grip patterns. A pre–post, cohort, feasibility study was conducted to inform the design of a randomized controlled trial examining the effectiveness of MyndMove™ therapy.
Method
Individuals enrolled had chronic severe upper extremity hemiparesis following a stroke (> 6 months) with Chedoke-McMaster Stroke Assessment Stage 1–2 (arm and hand) and a Fugl-Meyer Upper Extremity score less than 19. Treatment with Myndmove™, consisting of 20 one-hour sessions, 3–5 times per week over 4–6 weeks was provided.
Results
Of 25 enrolled participants, 24 (96%) completed treatment. Fifty-eight percent (14/24) of the participants demonstrated improvement equal to or exceeding the minimal clinically important difference of five on the Fugl-Meyer Upper Extremity test. Mean change from baseline Fugl-Meyer Upper Extremity overall score was 7.1 (SD 5.0) (p < 0.001). Mean time to complete treatment was 40 days (SD 6.0).
Conclusion
MyndMove™ therapy is feasible to deliver within outpatient settings and may be a suitable function-based treatment option for severe chronic stroke upper extremity impairment.
Hydrocephalus is a common neurosurgical pathology associated with high patient morbidity and systemwide healthcare costs. A significant portion of these costs are related to the failure of ventricular shunting systems. Despite decades of research and technological development, the rate of shunt failure and revision has not significantly improved. The Reflow™ Ventricular System (Anuncia, Inc., Lowell, MA) is a recent technological development with the potential to prolong the shunt lifespan. This system introduces a noninvasive means of flushing a shunt proximally with a controlled, repeatable pulse of cerebral spinal fluid (CSF) and of creating a new ventricular opening for occluded shunts. In this multicenter case series, we present the early clinical experiences with this device and discuss its potential.
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