Article

OBJECTIVE: To test whether treatment with assisted movement with enhanced
sensation (AMES) using vibration to the antagonist muscle would reduce
impairments and restore upper limb function in people with incomplete
tetraplegia. DESIGN: Prospective, pre-post study. SETTING: Laboratory and
rehabilitation hospital. PARTICIPANTS: We recruited 15 arms from 10 individuals
(8 men; mean age, 40.5 y; mean years postspinal cord injury [SCI], 3) with
chronic, incomplete tetraplegia. INTERVENTION: Two or three 20-minute sessions
per week over 9 to 13 weeks (25 sessions total) on the AMES device, which
combines repeated movement with targeted vibration to the antagonist muscle. MAIN
OUTCOME MEASURES: Strength and active motion tests on the AMES device;
International Standards for the Neurological Classification of SCI (ISNCSCI)
motor and sensory examinations; Modified Ashworth Scale (MAS); grasp and release
test (GRT); Van Lieshout Test (VLT); and Capabilities of Upper Extremity
questionnaire (CUE). RESULTS: The AMES strength test scores improved
significantly in metacarpophalangeal flexion (P=.024) and extension (P=.007) and
wrist flexion (P=.001) and extension (P<.000). The AMES active motion scores
improved in the hand (P=.001) and wrist (P=.001). The MAS and ISNCSCI scores
remained unchanged, whereas the GRT scores increased (P=.025). Post hoc analysis
showed a trend from pre- to posttreatment (P=.068) and a significant change from
pretreatment to 3-month follow-up (P=.046). There was no significant change in
the VLT (P=.951) or the CUE (P=.164). Five of the 10 participants reported a
return of sensation to the digits after the first, second, or third treatment
session. CONCLUSIONS: People with chronic, incomplete tetraplegia may experience
improvements in impairments and function after treatment on a device combining
assisted movement and proprioceptive stimulation. Further investigation is
warranted.
CI - Copyright (c) 2014 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS