The effect of combining electrical stimulation and splinting on upper limb function after stroke

Shannon Williams

Research output: ThesisMaster's Thesis

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Abstract

Although evidence supports the use of electrical stimulation and repetitive task training for improving upper limb function after stroke, patients with minimal wrist and hand movement are often excluded from this treatment option. An important limitation of traditional electrical stimulation in this low level population is that the hand does not achieve a sufficiently open position to perform functional activities. The aim of this study was to examine the effect of combining a simple wrist-hand splint to stabilise the wrist and allow better hand opening, with electrical stimulation (ES) of the wrist and finger extensor muscles, in addition to functional practice in the sub acute stroke population. A case study design was employed that included four subjects who were average of 36.7 days post stroke and presented with palpable muscle activity of the wrist extensors. Subjects completed a 2 week period of therapy consisting of two conventional physiotherapy sessions a day, followed by a two week period of Electromyogram (EMG) triggered electrical ES in conjunction with splinting and functional practice in lieu of one physiotherapy session a day. Measurement of arm function (Chedoke Arm and Hand Activity Inventory), spasticity (Modified Tardieu Scale), grip strength (Jaymar dynamometry) and active wrist extension was performed repeatedly throughout the conventional treatment and trial intervention phases. Four subjects were recruited. One subject was withdrawn during the study as he could no longer trigger the stimulator at the commencement of the intervention phase. Subject responses were very variable. Case one showed no change in arm function or active wrist extension during the conventional or intervention phases. Grip strength improved more during the intervention compared to conventional phase, although the difference between phases did not reach statistical significance. Case two showed clinically significant gains in arm function with both conventional
Original languageEnglish
QualificationMasters
Publication statusUnpublished - 2010

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