RESEARCH PRESENTED BY KATI JONES, OTS Effectiveness of Neuro-muscular Electrical Stimulation to Improve Upper Extremity Function.

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Presentation transcript:

RESEARCH PRESENTED BY KATI JONES, OTS Effectiveness of Neuro-muscular Electrical Stimulation to Improve Upper Extremity Function Following a CVA

Research Question What is the evidence for neuromuscular re-education using electrical stimulation to improve upper extremity function in adults with hemiparesis?

Use of functional electrical stimulation yields significant improvement in hand function and finger and thumb movements and is more effective than conventional physical and/or occupational therapy alone. (Thrasher, T. A., Zivanovic, V., McIlroy, W., & Popovic, M., 2008)

NMES, as part of a home program, is effective for promoting upper extremity range of motion, and improvements in force, selectivity, and abnormal tone. (Sullivan, J. E. & Hedman, L. D., 2007)

Use of NMES resulted in for motor recovery in adults with hemiparesis, specifically when coupled with bilateral movements. (Cauraugh, J. H. & Kim, J. H., 2003)

Mirror therapy combined with NMES yields significant improvement in hand and wrist power in individuals post- stroke. (Yun, G. J., Chun, M. H., Park, J. Y., & Kim, B. R., 2011)

NMES coupled with purposeful movements proved effective well beyond the first year of stroke injury, regardless of the level of disability. (Santos, M., Zahner, L. H., McKiernan, B. J., Mahnken, J. D., & Quaney, B., 2006)

Self-treatment at home by means of a neuroprosthetic neuromuscular stimulation system enhances recovery for those with partial hand motion secondary to stroke. (Ring, H. & Rosenthal, N., 2005)

Contralaterally Controlled Functional Electrical Stimulation (CFES) is more effective than cyclical NMES in improving hand function after a stroke. (Knutson, J. S., Harley, M. Y., Hisel, T. Z., Hogan, S. D., Maloney, M. M., & Chae, J., 2012)

The combined NMES-robot system is more effective than NMES or use of the robot alone. Hu, X. L., Tong, K. Y., Li, R., Xue, J. J., Ho, S. K., & Chen, P. (2012)

What Questions Do You Have?

References Cauraugh, J. H., & Kim, J. H. (2003). Progress towards motor recovery with active neuromuscular stimulation: Muscle activation pattern evidence after a stroke. Journal of the Neurological Sciences, 207, doi: /S X(02) Hu, X. L., Tong, K. Y., Li, R., Xue, J. J., Ho, S. K., & Chen, P. (2012). The effects of electromechanical wrist robot assistive system with neuromuscular electrical stimulation for stroke rehabilitation. Journal of Electromyography and Kinesiology, 22, doi: /j.jelekin Knutson, J. S., Harley, M. Y., Hisel, T. Z., Hogan, S. D., Maloney, M. M., & Chae, J. (2012). Contralaterally controlled functional electrical stimulation for upper extremity hemiplegia: An early-phase randomized clinical trial in subacute stroke patients. Neurorehabilitation and Neural Repair, 26, doi: / Ring, H., & Rosenthal, N. (2005). Controlled study of neuroprosthetic functional electrical stimulation in sub-acute post-stroke rehabilitation. Journal of Rehabilitative Medicine, 37, doi: /

References (cont.) Santos, M., Zahner, L. H., McKiernan, B. J., Mahnken, J. D., & Quaney, B. (2006). Neuromuscular electrical stimulation improves severe hand dysfunction for individuals with chronic stroke: A pilot study. Journal of Neurologic Physical Therapy, 30, Sullivan, J. E., & Hedman, L. D. (2007). Effects of home-based sensory and motor amplitude electrical stimulation on arm dysfunction in chronic stroke. Clinical Rehabilitation, 21, doi: / Thrasher, T. A., Zivanovic, V., McIlroy, W., & Popovic, M. (2008). Rehabilitation of reaching and grasping function in severe hemiplegic patients using functional electrical stimulation therapy. American Society of Neurorehabilitation, 22, doi: / Yun, G. J., Chun, M. H., Park, J. Y., & Kim, B. R. (2011). The synergic effects of mirror therapy and neuromuscular electrical stimulation for hand function in stroke patients. Annals of Rehabilitation Medicine, 35, doi: /arm

Additional Sources Kwakkel, G., Kollen, B. J., Van der Grond, J., & Prevo, A. J. H. (2003). Probability of regaining dexterity in the flaccid upper limb: Impact of severity of paresis and time since onset in acute stroke. Stroke, 34(2181), doi: / 01.STR CD Go, A. S., Mozaffarian, D., & Roger, V. L. (2013). Aha statistical update: Heart disease and stroke statistics—2014 update. Circulation, 129(28), 292. doi: /01.cir