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Article type: Research Article
Authors: Perini, Gloria | Bertoni, Rita | Thorsen, Rune | Carpinella, Ilaria | Lencioni, Tiziana | Ferrarin, Maurizio | Jonsdottir, Johanna*
Affiliations: IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy
Correspondence: [*] Corresponding author: Johanna Jonsdottir, IRCCS Fondazione Don Carlo Gnocchi, Onlus, Via Capecelatro 66, Milan, 20148, Italy. Tel.: +39 240308282; Fax: +39 2048498; E-mail: jjonsdottir@dongnocchi.it.
Abstract: BACKGROUND: Functional recovery of the plegic upper limb in post-stroke patients may be enhanced by sequentially applying a myoelectrically controlled FES (MeCFES), which allows the patient to voluntarily control the muscle contraction during a functional movement, and robotic therapy which allows many repetitions of movements. OBJECTIVE: Evaluate the efficacy of MeCFES followed by robotic therapy compared to standard care arm rehabilitation for post-stroke patients. METHODS: Eighteen stroke subjects (onset ⩾ 3 months, age 60.1 ± 15.5) were recruited and randomized to receive an experimental combination of MeCFES during task-oriented reaching followed by robot therapy (MRG) or same intensity conventional rehabilitation care (CG) aimed at the recovery of the upper limb (20 sessions/45 minutes). Change was evaluated through Fugl-Meyer upper extremity (FMA-UE), Reaching Performance Scale and Box and Block Test. RESULTS: The experimental treatment resulted in higher improvement on the FMA-UE compared with CG (P= 0.04), with a 10-point increase following intervention. Effect sizes were moderate in favor of the MRG group on FMA-UE, FMA-UE proximal and RPS (0.37–0.56). CONCLUSIONS: Preliminary findings indicate that a combination of MeCFES and robotic treatment may be more effective than standard care for recovery of the plegic arm in persons > 3 months after stroke. The mix of motor learning techniques may be important for successful rehabilitation of arm function.
Keywords: Stroke, arm function, myoelectrically controlled FES, robot rehabilitation, combined approaches
DOI: 10.3233/THC-202371
Journal: Technology and Health Care, vol. 29, no. 3, pp. 419-429, 2021
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