Passive Stabilization of the Trunk and Upper Arm in Hand Rehabilitation After Stroke
Condition: Stroke
MeSH terms: Stroke
Study type: Interventional

Summary: 
      This study aimed to assess correlations between muscle tone, stabilization of the trunk and
      the upper extremity, and parameters of hand/wrist motor coordination in post-stroke patients
      and neurologically healthy subjects with lower back pain.
    

Detailed description: 
      A Luna electromyography (EMG) (EGZOTech) was used to measure muscle tension, and a manual
      electronic dynamometer (EH 101) was used for grip strength measurement (error of measurement,
      0.5 kg/lb). A Hand Tutor device (composed of a safe and comfortable glove equipped with
      position and motion sensors, and the Medi Tutor (TM) software was used to measure the range
      of passive and active movement, as well as the speed/frequency of movement. The Hand Tutor
      glove was worn on the hand of the directly affected side in stroke patients and on the
      dominant extremity in patients with pain syndrome. Surface electrodes (single-use 55' and '40
      mm; ECG Electrodes; limited liability company and limited partnership (Sorimex), Poland were
      affixed to the subject's body according to the SENIAM (Surface ElectroMyoGraphy for the
      Non-Invasive Assessment of Muscles) procedure on the transverse abdominal, multifidus, and
      supraspinal muscles (on the side directly affected in stroke patients, and on the dominant
      side in patients with back pain syndrome). Before each exercise, the subject was instructed
      on how the exercise should be done.

      The examination consisted of two motor tasks, carried out in two different starting
      positions: sitting and lying down (supine).

      During the first examination, the subject sat on the therapeutic table (without back
      support), feet resting on the floor. The upper limb was examined in adduction of the humeral
      joint, with the elbow bent in the intermediate position between pronation and supination of
      the forearm, with free wrist and the hand.

      In the supine position, the upper limb was stabilized at the subject's body (adduction in the
      humeral joint, elbow flexion in the intermediate position, wrist and hand free).

      In each of the starting positions, after putting the glove on, the range of passive movement
      in the radial-carpal joint (flexion and extension) and fingers (global flexion and extension)
      was measured. Then the subject made active movement in the same order. Finally, the subject
      was asked to make moves as quickly and in as full a range as possible. Finally, the
      measurement of grip strength with a dynamometer was performed in both analyzed starting
      positions, after completing the range of motion and speed or frequency tests.

      First, the range of passive movement in the radial-carpal joint (flexion and extension) and
      fingers (global flexion and extension) was measured in each position (sitting or supine)
      using the Hand Tutor Device. Then the subject made active movements in the same order.
      Finally, the subject was asked to make moves as quickly and in as full a range as possible.
      The measurement of grip strength with a dynamometer was performed in both positions (sitting
      or supine) after the range of motion and speed/frequency tests. The reaction of the examined
      multifidus, transverse abdominal, and supraspinatus muscles (tension values reported in
      microvolts (µV) was also assessed during each of the exercise tasks using the surface
      electrodes (i.e., during movement of the wrist and during movement of the fingers).
    

Intervention name(s): hand motor coordination in a sitting position; hand motor coordination in a supine position
Intervention type(s): Procedure; Procedure
Intervention description(s): The subject sat on the therapeutic table (without back support), feet resting on the floor. The upper limb was to be examined in adduction of the humeral joint, with the elbow bent in the intermediate position between pronation and supination of the forearm, with free wrist and the hand. After putting the glove on, the range of passive movement in the radial-carpal joint (flexion and extension) and fingers (global flexion and extension) was measured. Then the subject made active movement in the same order. Finally, the subject was asked to make moves as quickly and in as full a range as possible. Finally, the measurement of grip strength with a dynamometer was performed.; In the supine position, the upper limb was stabilized at the subject's body (adduction in the humeral joint, elbow flexion in the intermediate position, wrist and the hand free). After putting the glove on, the range of passive movement in the radial-carpal joint (flexion and extension) and fingers (global flexion and extension) was measured. Then the subject made active movement in the same order. Finally, the subject was asked to make moves as quickly and in as full a range as possible. Finally, the measurement of grip strength with a dynamometer was performed.
Intervention model: Single Group Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: stroke; core stability; muscle tone; hand coordination