Afferent stimulation provided by glove electrode during task-specific arm exercise following stroke

• DOI: 10.1177/0269215512442915
• Publication Date: 2012-05-05T12:31:17Z
• Authors: Jane E Sullivan; Donna Hurley; Lois D Hedman
• Keywords: Male; Afferent Pathways; Stroke Rehabilitation; Electric Stimulation Therapy; Middle Aged; Exercise Therapy; Paresis; Stroke; 03 medical and health sciences; Treatment Outcome; 0302 clinical medicine; Arm; Humans; Female

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 (15–45) 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, −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.