Hybrid power-assisted functional electrical stimulation to improve hemiparetic upper-extremity function

Objective: The effect on spastic hemiparesis of a hybrid therapy consisting of functional electrical stimulation and block therapy was examined. Design: Sixteen consecutively enrolled stroke patients who had spastic upper-extremity impairments more than 1 yr after stroke were recruited for this nonblinded randomized controlled trial. Patients underwent hybrid functional electrical stimulation therapy on their extensor carpi radialis longus and brevis, extensor digitorum communis, and extensor indicis proprius muscles once or twice a week for 4 mos after motor point blocks at the spastic finger flexor muscles. Surface electrodes picked up the electromyography signal and stimulated those muscles in proportion to the integrated electromyography signal obtained by the functional electrical stimulation device. The root mean square of the extensor carpi radialis longus and extensor digitorum communis maximum voluntary electromyography, active range of motion of wrist extension, finger extension, Modified Ashworth Scale, and two clinical tests were examined before and after training. Results: Root mean square, active range of motion, Modified Ashworth Scale, and two clinical tests showed marked improvement in all patients as with the control subjects. Conclusions: The hybrid therapy was effective for patients with chronic hemiparesis. Proprioceptional sensory feedback may have an important role in power-assisted functional electrical stimulation therapy.