Effectiveness of Hybrid Assistive Neuromuscular Dynamic Stimulation Therapy in Patients With Subacute Stroke: A Randomized Controlled Pilot Trial
By Shindo, Keiichiro; Fujiwara, Toshiyuki; Hara, Joji; Oba, Hideki; Hotta, Fujiko; Tsuji, Tetsuya; Hase, Kimitaka; Liu, Meigen; Neurorehabilitation and Neural Repair, Volume 25, Number 9, pages 830-837Publication Date: November/December 2011
Study assessed the effectiveness of hybrid assistive neuromuscular dynamic stimulation (HANDS) therapy for patients with subacute stroke. HANDS is defined as a therapy devised to facilitate the use of the hemiparetic upper extremity in daily life by combining assistive neuromuscular electrical stimulation, referred to as the integrated volitional electrical stimulator (IVES), with a splint. The IVES is a portable surface EMG controlled, single channel neuromuscular electrical stimulator which changes its stimulation intensity in proportion to the amplitude of the voluntary EMG of the target muscles. Participants were 24 hospital inpatients receiving rehabilitation for hemiparetic stroke within 60 days of onset. Entry criteria included inability to individuate finger extension. Participants were randomly assigned to two groups of 12 members each. The HANDS group used the IVES combined with a wrist splint for 8 hours a day for 3 weeks, and the control group wore a wrist splint alone. All participants received the same daily dose and length of standard poststroke multidisciplinary rehabilitation. Outcome measures were the upper extremity portion of the Fugl-Meyer Assessment (FMA), Action Research Arm Test (ARAT), and Motor Activity Log-14 (MAL). In all, 10 patients in each group completed the interventions. Compared with the control group, the HANDS group showed significantly greater gains in the wrist/hand portion of the FMA and improvement of the ARAT. The gains in the MAL did not differ. No adverse effects occurred and the HANDS therapy was well accepted. Study limitations and implications for future research are discussed.
Published by: Sage Publications (Website:http://www.sagepub.com)
American Society of Neurorehabilitation (Web Site: http://www.asnr.com )
