Tele-Supervised FES-Assisted Exercise for Hemiplegic Upper Limb

IEEE Transactions on Neural Systems and Rehabilitation Engineering : a Publication of the IEEE Engineering in Medicine and Biology Society
Alison R BuickA Prochazka

Abstract

Stroke survivors often have upper limb (UL) hemiparesis, limiting their ability to perform activities of daily life (ADLs). Intensive, task-oriented exercise therapy (ET) can improve UL function, but motivation to perform sufficient ET is difficult to maintain. Here, we report on a trial in which a workstation was deployed in the homes of chronic stroke survivors to enable tele-coaching of ET in the guise of computer games. Participants performed six weeks of 1 h/day, five days/week ET. Hand opening and grasp were assisted with functional electrical stimulation (FES). The primary outcome measure was the Action Research Arm Test (ARAT). Secondary outcome measures included a quantitative test of UL function performed on the workstation, grasp force measurements and transcranial magnetic stimulation (TMS). Improvements were seen in the functional tests, but surprisingly, not in the TMS responses. An important finding was that participants commencing with intermediate functional scores improved the most. (1) Daily, tele-supervised FES-ET in chronic stroke survivors is feasible with commercially-available technology. (2) The intervention can significantly improve UL function, particularly in people who start with an intermediate lev...Continue Reading

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Citations

Jun 2, 2017·Journal of Neurophysiology·Arthur Prochazka
Feb 26, 2021·Journal of Neuroengineering and Rehabilitation·Bridee A NeiblingRuth N Barker
Aug 21, 2021·Annals of Clinical and Translational Neurology·Na-Teng HungMarc W Slutzky

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