A home-based rehabilitation program for the hemiplegic upper extremity by power-assisted functional electrical stimulation

Abstract

Daily power-assisted FES home program therapy can effectively improve wrist and finger extension and shoulder flexion. Proprioceptional sensory feedback might play an important role in power-assisted FES therapy.

Effects of Integrated Volitional Control Electrical Stimulation (IVES) on Upper Extremity Function in Chronic Stroke

“…20 Fujiwara et al 9 reported that treatment with IVES combined with a wrist-hand splint induced restoration of presynaptic and long loop inhibitory connections as well as disynaptic reciprocal inhibition. Previous studies 3,5,7,8 have demonstrated that electrical stimulation combined with volitional efforts or additional therapy is more effective than electrical stimulation alone in the recovery process. Bhatt et al 21 showed that combined intervention may have a more beneficial influence on brain reorganization than either treatment alone.…”

“…However, if muscle contraction is detected, IVES stimulates the muscles at an intensity level proportional to the detected volitional EMG signals. With regard to IVES treatment for patients with chronic stroke, Hara et al 7 indicated that daily IVES therapy at home resulted in enhanced motor recovery in patients with partial hand or shoulder motion. In addition, they reported the efficacy of combined IVES and motor point block for antagonist muscles in patients with chronic stroke.…”

Rehabilitation with Functional Electrical Stimulation in Stroke Patients

“…Daily EMG-controlled FES home program therapy can effectively improve wrist, finger extension and shoulder flexion. Home-based EMG-controlled FES made hemiparetic patients to increase the chance of regaining use of the hemiparetic arm in ADLs [21].…”

“…This novel EMG-controlled FES device has the specific function for setting parameter memory compared to the former version one. Two experimental trials by the EMG-controlled FES were applied for stroke patients to improve arm and hand function [20,21].…”

“…Repetitive movement therapy where the subject is cognitively involved in generating the movement is more likely to be important and meaningful than therapy where the subject is not cognitively involved [30]. EMG-controlled FES device stimulates hemiparetic muscles in proportion to the integrated EMG signal picked up from the target muscles, enabling more delicate stimulation of muscles compared to EMG-triggered neuromuscular electrical stimulation, and thus has potential for use in such rehabilitation training methods as muscle relaxation and task-oriented exercise [21]. It appears that the specific stimulus parameters may not be crucial in determining the effect of electrical stimulation [31].…”