new electrical stimulation therapy helped stroke
survivors with hand weakness improve hand
dexterity more than an existing stimulation
technique, according to new research in the
American Heart Association’s journal Stroke.
Stroke usually results in some degree of paralysis or
partial paralysis on one side of the body, which can result
in survivors having difficulty opening a hand. A common
therapy in stroke rehabilitation uses low levels of electric
current to stimulate the paralyzed muscles to open the
hand, improve muscle strength and possibly restore hand
function. Stimulation intensity, cycle timing and repetitions
are set by a therapist.
In the new experimental therapy developed by researchers
at the MetroHealth System, Case Western Reserve University
and the Cleveland Functional Electrical Stimulation Center,
patients control the stimulation to their weak hand by wearing
a glove with sensors on the opposite, unaffected hand.
When the patient opens their unaffected hand, they receive a
corresponding amount of stimulation that opens their stroke-affected hand. This puts the patient back in control of their
hand and enables them to participate in therapy with the
assistance of electrical stimulation.
Researchers enrolled 80 stroke survivors. For 12
weeks, half received therapy using the new glove, and the
remainder received the current standard of care therapy.
Both groups used an electrical stimulator on their own
at home for 10 hours a week, plus 3 hours per week
practicing hand tasks with an occupational therapist in a
practice laboratory. Hand function was measured before
and after therapy with a standard dexterity test that
measured the number of blocks participants can pick up,
lift over a barrier and release in another area on a table
within a 60-second period. The study found:
• Patients who received the new therapy had greater
improvement on the dexterity test called Box and Blocks
(moving blocks from one side of the box to the other),
( 4. 6 blocks) than the common group ( 1. 8 blocks).
• Patients who had the greatest improvements in hand
dexterity following the new therapy were less than
two years post-stroke and had at least some finger
movement when they started the study. These patients
saw an improvement of 9. 6 blocks on the dexterity
test, compared to 4. 1 blocks in the common group.
• Patients with no finger movement saw improvements
in arm movement after the new therapy.
• At treatment end, 97 percent of the participants who
received the new therapy agreed that they could use
their hand better than at the start of the study.
Because the therapy is new and this was a single-site
study, researchers don’t know if similar results will be seen
in other rehab centers. They plan to perform a multi-site
study to confirm their results, as well as measure quality of
life improvements for patients. And while the researchers
speculate that the new therapy may be changing neural
connections in the brain that control hand dexterity,
additional studies are needed to determine what effects it
may have on the central nervous system.
The study also demonstrates that stroke patients
can effectively use technology for self-administered
therapy at home. “Home-based therapy is becoming
increasingly important to offset increasing
healthcare costs and to meet the need for
high doses of therapy that are critical for
attaining the best outcomes,” said Jayme S.
Knutson, Ph.D., senior author of the study and
an assistant professor of Physical Medicine
and Rehabilitation at Case Western Reserve
University School of Medicine in Cleveland,
Ohio. “The more therapy a patient can get, the
better potential outcome they will get.”
Source: American Heart Association News
New electrical stimulation therapy may
improve hand function after stroke