Credit: Cleveland FES Center (http://fescenter.org)
BY SARAH OWENS
For patients whose stroke affected their ability to use their hand, a new electrical stimulation device may help. The device allows patients to control their impaired hand using their unaffected hand, and to control the timing and intensity of electrical stimulation. In a study published online on September 8 in Stroke, the new method led to improvements in hand dexterity.
Patient-Controlled Electrical Stimulation
Electrical stimulation is already widely available and used in stroke rehabilitation to help patients recover the use of their limbs. Traditional electrical stimulation, known as cyclic neuromuscular electric stimulation (cNMES), is controlled by a therapist and requires no active participation from the patient. By contrast, the new method, called contralaterally controlled functional electrical stimulation or CCFES, allows patients to exercise an impaired hand by controlling electrical stimulation to the impaired hand using their strong hand (or contralateral hand) and performing tasks.
The researchers hypothesized that because CCFES allows patients to use both hands, is done in real time, and involves tasks, it may result in better, faster rehabilitation compared to cNMES.
Researchers at MetroHealth Medical Center in Cleveland, Ohio enrolled 80 patients who had had a stroke and were partially paralyzed in one of their upper limbs for at least six weeks. Half the patients received 10 sessions per week of the new stimulation method, and half received 10 sessions of the traditional stimulation, for six months.
After the six months, the researchers administered the Box and Block Test (BBT) to gauge improvements in hand dexterity. The test counts how many times a person can pick up a block, move it over a partition, and release it in a target area within 60 seconds.
Patients who received CCFES had greater improvement in dexterity as measured by the Box and Block Test than patients who underwent cNMES. Patients who’d had a stroke less than two years prior to the study and had moderate, not severe, hand impairment at the start of the study had the biggest improvements.
A New Option for Stroke Rehabilitation
For recent stroke patients with moderate hand impairment, CCFES is a better option than cNMES, the study authors say, possibly because CCFES happens in real time, requires patients to open both hands at once, and/or allows patients to practice tasks with the impaired hand. They added that with CCFES—unlike with cNMES—patients can control the timing and intensity of tasks.
Watch a video showing the new stimulation device in action here:
Source: Neurology Now