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Afferent stimulation provided by glove electrode during task-specific arm exercise following stroke [with consumer summary] |
Sullivan JE, Hurley D, Hedman LD |
Clinical Rehabilitation 2012 Nov;26(11):1010-1020 |
clinical trial |
8/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: Yes; Blind therapists: No; Blind assessors: Yes; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed* |
BACKGROUND: Sensory amplitude electrical stimulation (SES) and repetitive task practice reduce impairments and arm dysfunction when delivered separately following stroke. OBJECTIVE: To determine if home-based, task-specific arm exercise was more effective when administered concurrent with SES. METHODS: Thirty-eight subjects with chronic stroke and mean Fugl-Meyer Assessment (FMA) score 28/66 (15 to 45) participated. Subjects were randomly assigned to an SES (n = 20) or sham stimulation (n = 18) group. Subjects engaged in task-based home exercise for 30 minutes, twice daily, for four weeks while wearing a glove electrode on the impaired hand. Experimental subjects received SES while control subjects received sham stimulation during exercise. PRIMARY OUTCOME MEASURES: FMA and Arm Motor Ability Test (AMAT). RESULTS: There were no significant between-group differences for outcome measures. There was a significant difference between the pre- and post-test scores in the SES group AMAT median time (p = 0.003, 95% confidence interval (CI) -14.304 to -6.365; effect size 0.84). Practice time was not associated with changes in outcomes. Subjects with more sensorimotor dysfunction had significantly greater improvements on AMAT median time (p = 0.037). There was a significant relationship between baseline FMA score and FMA change score (r = 0.402; p = 0.006). CONCLUSIONS: This study describes a unique SES delivery system via glove electrode that enabled delivery of SES during home-based arm task practice in stroke survivors. Task practice with concurrent SES did not demonstrate significantly better effects than task practice with sham stimulation, however there was a trend for greater improvement in one activity measure.
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