Article

OBJECTIVE: To evaluate the effects of electrically assisted movement therapy
(EAMT) in which patients use functional electrical stimulation, modulated by a
custom device controlled through the patient's unaffected hand, to produce or
assist task-specific upper limb movements, which enables them to engage in
intensive goal-oriented training. DESIGN: Randomized, crossover,
assessor-blinded, 5-week trial with follow-up at 18 weeks. SETTING:
Rehabilitation university hospital. PARTICIPANTS: Patients with chronic, severe
stroke (N=11; mean age, 47.9y) more than 6 months poststroke (mean time since
event, 46.3mo). INTERVENTIONS: Both EAMT and the control intervention
(dose-matched, goal-oriented standard care) consisted of 10 sessions of 90
minutes per day, 5 sessions per week, for 2 weeks. After the first 10 sessions,
group allocation was crossed over, and patients received a 1-week therapy break
before receiving the new treatment. MAIN OUTCOME MEASURES: Fugl-Meyer Motor
Assessment for the Upper Extremity, Wolf Motor Function Test, spasticity, and
28-item Motor Activity Log. RESULTS: Forty-four individuals were recruited, of
whom 11 were eligible and participated. Five patients received the experimental
treatment before standard care, and 6 received standard care before the
experimental treatment. EAMT produced higher improvements in the Fugl-Meyer scale
than standard care (P<.05). Median improvements were 6.5 Fugl-Meyer points and 1
Fugl-Meyer point after the experimental treatment and standard care,
respectively. The improvement was also significant in subjective reports of
quality of movement and amount of use of the affected limb during activities of
daily living (P<.05). CONCLUSIONS: EAMT produces a clinically important
impairment reduction in stroke patients with chronic, severe upper limb paresis.
CI - Copyright (c) 2016 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS