Examining a new functional electrical stimulation therapy with people with severe upper extremity hemiparesis and chronic stroke: A feasibility study

Abstract

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.

Functional electrical stimulation therapy for restoration of motor function after spinal cord injury and stroke: a review

“…It is not uncommon to fix one of these parameters while adjusting the other one. For example, in the stimulators that we use both for research and therapeutic applications, namely Compex Motion [19] and MyndMove [20], a fixed pulse duration is commonly used while the pulse amplitude is adjusted to regulate the stimulation intensity. In this stage, the intensity of the stimulation is increased gradually often in increments as small as the stimulator allows.…”

“…The system offers more than 30 reaching and grasping protocols, including some that can facilitate bimanual tasks as well as fine finger manipulations. The device has been used successfully to restore upper limb function in individuals with chronic severe hemiplegia [20], SCI, traumatic brain injury, cerebral palsy, cervical myelopathy and brachial plexus injuries.…”

“…After witnessing evidence of the benefits of using FEST for increasing muscle strength in individuals with hemiplegia in 1996 [40], several studies focused on the effects of the intervention to restore reaching and grasping function in both acute [41][42][43][44][45][46] and chronic [46][47][48][49][50][51][52] stroke populations. It is important to mention that FEST has been demonstrated to be effective in the rehabilitation of individuals with chronic severe hemiplegia resulting from stroke [20,44], a population for whom rehabilitation is traditionally considered to have little to no effect. iv.…”

Multicentre, single-blind randomised controlled trial comparing MyndMove neuromodulation therapy with conventional therapy in traumatic spinal cord injury: a protocol study

“…The proposed volume of therapy is guided by discussions with clinicians experienced with delivery of MyndMove therapy along with previous clinical research studies. 27 The type and frequency of protocols used will follow a standardised regimen in order to minimise cointervention variation across sites. 27 Training for MyndMove will be provided prior to the initiation of the study.…”

Functional Electrical Stimulation Therapy for Retraining Reaching and Grasping After Spinal Cord Injury and Stroke

“…However, the methodology of FES application discussed here is pertinent to any multichannel transcutaneous FES device. We have used transcutaneous FES to retrain reaching and grasping in individuals with both spinal cord injury and stroke ( Thrasher et al, 2008 ; Kapadia and Popovic, 2011 ; Kapadia et al, 2011 , 2013 ; Popovic et al, 2012 ; Hebert et al, 2017 ). The results obtained in both patient populations indicate functional improvements after 8–14 weeks of therapy (20–48 h of stimulation).…”