Post Stroke Hand Functions: Bilateral Movements and Electrical Stimulation Treatments
Condition: Cerebrovascular Accident; Hemiplegia
MeSH terms: Stroke; Hemiplegia
Intervention: Bilateral movements and neuromuscular electrical stimulation; Bilateral movements and neuromuscular electrical stimulation; Bilateral movements and sham electrical stimulation
Intervention description: Participants practice moving their paretic arm at the same time as they move their non-paretic arm in the same movement patterns. Neuromuscular electrical stimulation triggered by the participants' own contracting muscles is provided to the paretic arm during the movements. Training period was 4 times per week for 2 weeks.; Participants practice moving both their paretic and non-paretic arms at the same time in the same movement patterns. Neuromuscular electrical stimulation triggered by the participants' own contracting muscles is provided to the paretic arm during the movements. Training period was 2 times per week for 2 weeks.; Participants practice moving both their paretic and non-paretic arms at the same time in the same movement patterns. Sham electrical stimulation (low level electrical stimulation that can be felt but is insufficient to trigger a muscle contraction) is provided to the paretic arm during the movement. Training period was 2 times per week for 2 weeks.
Phase: Phase 2
Study type: Interventional
Primary purpose: Treatment
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Outcomes Assessor)
Enrollment: 30.0
Sex: All
Minimum age: 44 Years
Maximum age: 86 Years
Healthy volunteers: No
Keywords: Rehabilitation; Physical Therapy Techniques; Occupational Therapy; Upper Extremity; Motor skills

Summary:

      The purpose of this study was to determine the effect of two amounts of treatment therapy on
      post stroke motor recovery in the arms. The therapy is bilateral movement training combined
      with electrical stimulation on the impaired limb.
    

Eligibility criteria:

        Inclusion Criteria:

          -  an ability to complete 10º of wrist or finger extension from a 60 - 65 º flexed
             position

          -  score less than a 56 on the UE subscale of the Fugl-Meyer Assessment

          -  an ability to voluntarily activate slight movements in the wrist and fingers so that
             the EMG activity reaches a minimal level on the microprocessor for electrical
             stimulation to be activated

          -  unilateral, first stroke of ischemic or hemorrhagic origin in the carotid artery
             distribution

          -  free of major post stroke complications

          -  able to attend therapy 2 days/week or 4 days/week for 2 weeks

          -  score at least a 16 on the Mini Mental Status Examination

          -  able to discriminate sharp from dull and light touch using traditional sensation
             tests.

        Exclusion Criteria:

          -  hemiparetic arm is insensate

          -  motor impairments from stroke on opposite side of body

          -  pre-existing neurological disorders such as Parkinson's disease, Multiple Sclerosis,
             or dementia

          -  Legal blindness or severe visual impairment; 5) Life expectancy less than one year

          -  Severe arthritis or orthopedic problems that limit passive ranges of motion of upper
             extremity (passive finger extension < 40º; passive wrist extension < 40º; passive
             elbow extension <40º; shoulder flexion/abduction < 80º)

          -  History of sustained alcoholism or drug abuse in the last six months

          -  Has pacemaker or other implanted device

          -  pregnant