Rehabilitation of Reaching and Grasping Function in Severe Hemiplegic Patients Using Functional Electrical Stimulation Therapy

Thrasher, T. Adam; Zivanovic, Vera; McIlroy, William E.; Popović, Miloš R.

doi:10.1177/1545968308317436

Cited by 209 publications

(185 citation statements)

References 28 publications

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“…Although many hemiplegic survivors after stroke achieve independent ambulatory functions with orthotic devices, half of them are unable to use their upper extremity in their activities of daily living (ADL) after months of standard stroke rehabilitation (31). A common approach in rehabilitation for upper limb hemiplegia in chronic stage has been training the healthy side, especially if it contains the nondominant hand, and learning to perform tasks with only one arm.…”

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Effect of electrical stimulation therapy on upper extremity functional recovery and cerebral cortical changes in patients with chronic hemiplegia

et al. 2012

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Hemiplegia is a common sequel of stroke and assisted living care is needed in many cases. The purpose of this study was to evaluate the effect of using surface electrode stimulation device in rehabilitation, in terms of functional improvement in upper limb and the changes in brain activation related to central nervous system reconstruction. Five patients with chronic hemiplegia received electrical stimulation therapy using the orthosis-type surface electrode stimulation device for 12 weeks. Training time was 30 min/day for the first weeks, and increased 30 min/day in every 4 weeks. Upper limb outcome measures included Brunnstrom stage, range of motion, Fugl-Meyer assessment and manual function test. Brain activation was measured using functional MRI. After therapy with therapeutic electrical stimulation (TES) for 12 weeks upper limb function improved in all cases. The results of brain activation showed two patterns. In the first, the stimulation produced an activity in the bilateral somatosensory cortices (SMC), which was seen to continue over time. The second, activation was bilateral and extensive before stimulation, but localized to the SMC after intervention. Treatment with TES using an orthosis-type electrode stimulation device improves upper limb function in chronic hemiplegia patients. The present findings suggest that there are not only efferent but also afferent effects that may promote central nervous system remodeling.Stroke is the main cause of disability in industrialized countries, with a significant impact on individual, family, and societal healthcare. Although many hemiplegic survivors after stroke achieve independent ambulatory functions with orthotic devices, half of them are unable to use their upper extremity in their activities of daily living (ADL) after months of standard stroke rehabilitation (31). A common approach in rehabilitation for upper limb hemiplegia in chronic stage has been training the healthy side, especially if it contains the nondominant hand, and learning to perform tasks with only one arm. In recent years, it has been recognized that the phenomenon of "learned non-use" (30, 33), which results from use of the healthy side only, invites a state of further inability to use the affected side. Because this can lead to exacerbation of secondary disorders such as edema, pain, decreased range of motion, and shoulder subluxation, attention has focused on approaches for rehabilitating the affected upper limb based on the plasticity of the central nervous system. Reports that rehabilitation for the affected upper limb produces reconstruction of the central nervous system as upper limb function improves (27) have also attracted attention. One of the most promising alternate interventions to help hemiplegic survivors recover upper limb function is functional electrical stimulation (FES). FES is a method of restoring functionality to upper or lower extremities by electrically stimulating the lower motor neurons of hemiplegic survivors after stroke (26). FES training involves t...

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Effect of electrical stimulation therapy on upper extremity functional recovery and cerebral cortical changes in patients with chronic hemiplegia

et al. 2012

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“…NMES artificially contracts muscle groups by applying external stimulation current. Closed-loop control of NMES can be used to generate advanced functional tasks (in this case NMES is also called functional electrical stimulation (FES)) such as walking [2,3], single leg extension [4][5][6][7][8][9], and upper extremity grasping and reaching [10][11][12].…”

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Robust compensation of electromechanical delay during neuromuscular electrical stimulation of antagonistic muscles

Qiu

Alibeji

Sharma

2016

2016 American Control Conference (ACC)

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“…Hence, the hope was that TRI-HFT will be used to help detect improvements in function secondary to neuroplasticity. Recent articles published by our team 2,8,27,28 suggest that TRI-HFT is very effective in detecting improvements in function secondary to neuroplasticity.…”

Section: Graded Redefined Assessment Of Strength Sensibility and Prementioning

confidence: 99%

Toronto Rehabilitation Institute–Hand Function Test: Assessment of Gross Motor Function in Individuals With Spinal Cord Injury

Kapadia

Zivanovic

Verrier

et al. 2012

Topics in Spinal Cord Injury Rehabilitation

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Rehabilitation of Reaching and Grasping Function in Severe Hemiplegic Patients Using Functional Electrical Stimulation Therapy

Abstract: FES therapy with upper extremity training may be an efficacious intervention in the rehabilitation of reaching and grasping function during acute stroke rehabilitation.

Cited by 209 publications

References 28 publications

Effect of electrical stimulation therapy on upper extremity functional recovery and cerebral cortical changes in patients with chronic hemiplegia

Effect of electrical stimulation therapy on upper extremity functional recovery and cerebral cortical changes in patients with chronic hemiplegia

Robust compensation of electromechanical delay during neuromuscular electrical stimulation of antagonistic muscles

Toronto Rehabilitation Institute–Hand Function Test: Assessment of Gross Motor Function in Individuals With Spinal Cord Injury

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