Electrically Assisted Movement Therapy in Chronic Stroke Patients With Severe Upper Limb Paresis: A Pilot, Single-Blind, Randomized Crossover Study

Carda, Stefano; Biasiucci, Andrea; Maesani, Andrea; Ionta, Silvio; Moncharmont, Julien; Clarke, Stéphanie; Murray, Micah M.; Millán, José del R.

doi:10.1016/j.apmr.2017.02.020

Cited by 23 publications

(23 citation statements)

References 26 publications

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“…Since the patients in the present study were relatively severely paralyzed, articles in which the participants' FMA score was less than 15 points were selected to discuss the effect size of interventions. Using these inclusion criteria, six articles were selected (Stinear et al, 2008;Ramos-Murguialday et al, 2013, 2019Colomer et al, 2016;Grimm et al, 2016;Carda et al, 2017). Among those, the effect size was more than medium (Cohen's d > 0.5) in only two articles.…”

Section: Discussionmentioning

confidence: 99%

“…Recently, clinical trials for patients with stroke in the chronic phase were reported. The effect size of the mirror therapy (Colomer et al, 2016) or functional electrical stimulation (Carda et al, 2017) intervention may be insufficient. Additionally, clinical trials using the brain-machine interface have demonstrated a higher effect size (Ramos-Murguialday et al, 2013, 2019.…”

Section: Introductionmentioning

confidence: 99%

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A Case Series Clinical Trial of a Novel Approach Using Augmented Reality That Inspires Self-body Cognition in Patients With Stroke: Effects on Motor Function and Resting-State Brain Functional Connectivity

Kaneko

Shindo

Yoneta

et al. 2019

Front. Syst. Neurosci.

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Barring a few studies, there are not enough established treatments to improve upper limb motor function in patients with severe impairments due to chronic stroke. This study aimed to clarify the effect of the kinesthetic perceptional illusion induced by visual stimulation (KINVIS) on upper limb motor function and the relationship between motor function and resting-state brain networks. Eleven patients with severe paralysis of upper limb motor function in the chronic phase (seven men and four women; age: 54.7 ± 10.8 years; 44.0 ± 29.0 months post-stroke) participated in the study. Patients underwent an intervention consisting of therapy using KINVIS and conventional therapeutic exercise (TherEX) for 10 days. Our originally developed KiNvis TM system was applied to induce KINVIS while watching the movement of the artificial hand. Clinical outcomes were examined to evaluate motor functions and resting-state brain functional connectivity (rsFC) by analyzing blood-oxygen-level-dependent (BOLD) signals measured using functional magnetic resonance imaging (fMRI). The outcomes of motor function (Fugle-Meyer Assessment, FMA) and spasticity (Modified Ashworth Scale, MAS) significantly improved after the intervention. The improvement in MAS scores for the fingers and the wrist flexors reached a minimum of clinically important differences. Before the intervention, strong and significant negative correlations between the motor functions

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A Case Series Clinical Trial of a Novel Approach Using Augmented Reality That Inspires Self-body Cognition in Patients With Stroke: Effects on Motor Function and Resting-State Brain Functional Connectivity

Kaneko

Shindo

Yoneta

et al. 2019

Front. Syst. Neurosci.

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“…Amongst all, these selected trials were different in study quality: besides 12 17,18,26,[28][29][30][31][32][33][34][35][36] blind trials were at low risk of bias, one study 27 was assessed as high risk of bias out of not blind. 2 35, 36 trials adopted concealed allocation, which were regarded as low risk of bias.…”

Section: Data Qualitymentioning

confidence: 99%

“…One study 34 was at high risk of bias due to incomplete outcome data. Moreover, 6 studies 17,18,28,31,33,35 were at low risk of bias due to random sequence generation by computer or pseudorandom number sequence. One study 36 was at high risk of bias for free of other sources of bias.…”

Section: Data Qualitymentioning

confidence: 99%

Effects of Neuromuscular Electrical Stimulation on Hemiplegic Upper Limb of Stroke Survivors: A Meta-Analysis of Randomized Controlled Trials

Zhang¹,

Pei²,

Huang³

et al. 2019

Preprint

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Background: Whether NMES helps the recovery of upper limb function in patients with hemiparesis has not been confirmed. We conducted this meta-analysis to examine the effectiveness of neuromuscular electrical stimulation (NMES) for upper limb hemiparesis after stroke.Methods: Data sources such as Pubmed, Embase and Cochrane library databases were searched for all relevant studies that were carried out before December 1, 2018.We selected the randomized controlled trials (RCTs) which included chronic and acute stroke patients with upper extremity dysfunction. Then the intervention group which applied NMES was compared with a control group without NMES. Results: A total of 16 RCTs involving 691 patients were discerned from 248 searched articles. According to the forest plot ,NMES had a significant benefit on FMA-ue scale(SMD=0.44,95%CI 0.13 to 0.74,P=0.006).Also, NMES was positive for ARAT(SMD=0.31,95%CI 0.05 to 0.58,P=0.019)and MAL-AOU(SMD=0.59,95%CI 0.15 to1.04,P=0.009),but not for wrist MAS(SMD=-0.12,95%CI -0.43 to 0.19,P=0.434) or BI(SMD=0.51,95%CI -0.65 to 1.66,P=0.392).Conclusion: NMES application has beneficial impacts on upper extremity motor function in patients with stroke. This study suggests that NMES ought to be applied as a beneficial rehabilitation means in improving the upper function.

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“…Other limitations of the latest wearable, wireless FES systems include the low resolution of induced muscle contraction, the absence of veri iable algorithms to expand the utility of FES to train non-walking daily functions including training to stand up and sit down independently. The limited availability of clinically valued coupling of FES with other rehabilitation technologies such as EEG controlled FES [55,56], or wearable robots and virtual reality systems [57], is also recognized in the literature [36]. Attempts to improve the resolution of FES induced muscle contraction by using multiplexers and arrays of small electrodes [39,58] or manipulation of pulse parameters [1] have yielded some interesting discoveries and electronic innovations.…”

Section: Fes As a Clinical Training Toolmentioning

confidence: 99%

Functional Electrical Stimulation (FES): Clinical successes and failures to date

Alon¹

2018

J Nov Physiother Rehabil

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Non-invasive electrical stimulation in the form of neuromuscular electrical stimulation (NMES) and functional electrical stimulation (FES) has been documented as an optional assessment and treatment technology for decades. In contrast, translation of the robust clinical evidence supporting the effectiveness of FES' enhancement of muscle force generation and adding to the recovery of motor control following damage to the brain appears limited. Furthermore, enabling many patients to regain locomotion ability though utilization of FES as a standard care option in rehabilitation medicine remains unmet. This perspective evolved over years of collaborative experience in clinical research, teaching, and patient care having a common goal of advancing patients' rehabilitation outcomes. The clinical successes are supported by repeated evidence of FES utilization across the life span, from toddlers to elders, from hospitals' critical care units to the home environment. The utilization include managing multiple defi cits associated with the musculo-skeletal, neurological, cardio-pulmonary, or peripheral vascular systems. These successes were achieved in no small part because of the technological advancement leading to today's wearable wireless FES systems that are being used throughout the continuum of rehabilitation care. However, failures to benefi t from FES utilization are likewise numerous, collectively depriving most patients from using the technology to maximize their rehabilitation gains. The most critical failures are both clinical and technological. Whereas numerous barriers to NMES and FES utilization have been published, the focus of this perspective is on barriers not considered to date.

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Electrically Assisted Movement Therapy in Chronic Stroke Patients With Severe Upper Limb Paresis: A Pilot, Single-Blind, Randomized Crossover Study

Abstract: EAMT produces a clinically important impairment reduction in stroke patients with chronic, severe upper limb paresis.

Cited by 23 publications

References 26 publications

A Case Series Clinical Trial of a Novel Approach Using Augmented Reality That Inspires Self-body Cognition in Patients With Stroke: Effects on Motor Function and Resting-State Brain Functional Connectivity

A Case Series Clinical Trial of a Novel Approach Using Augmented Reality That Inspires Self-body Cognition in Patients With Stroke: Effects on Motor Function and Resting-State Brain Functional Connectivity

Effects of Neuromuscular Electrical Stimulation on Hemiplegic Upper Limb of Stroke Survivors: A Meta-Analysis of Randomized Controlled Trials

Functional Electrical Stimulation (FES): Clinical successes and failures to date

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