scholarly journals Effect of Intensive Functional Electrical Stimulation Therapy on Upper-Limb Motor Recovery after Stroke: Case Study of a Patient with Chronic Stroke

2013 ◽  
Vol 65 (1) ◽  
pp. 20-28 ◽  
Author(s):  
Noritaka Kawashima ◽  
Milos R. Popovic ◽  
Vera Zivanovic
Keyword(s):  
Electrical Stimulation ◽  
Upper Limb ◽  
Functional Electrical Stimulation ◽  
Chronic Stroke ◽  
Motor Recovery ◽  
Electrical Stimulation Therapy ◽  
Stroke Case

Restoration of gait and motor recovery by functional electrical stimulation therapy in persons with stroke

2010 ◽  
Vol 32 (19) ◽  
pp. 1594-1603 ◽  
Author(s):  
Sukanta K. Sabut ◽  
Chanda Sikdar ◽  
Ramkrishna Mondal ◽  
Ratnesh Kumar ◽  
Manjunatha Mahadevappa
Keyword(s):  
Electrical Stimulation ◽  
Functional Electrical Stimulation ◽  
Motor Recovery ◽  
Electrical Stimulation Therapy

CLINICAL USE OF FUNCTIONAL ELECTRICAL STIMULATION FOR CORRECTION OF FOOT DROP: A COMPARISON BETWEEN SUBACUTE AND CHRONIC STROKE PATIENTS

2011 ◽  
Vol 11 (05) ◽  
pp. 1165-1177 ◽  
Author(s):  
SUKANTA K. SABUT ◽  
CHHANDA SIKDAR ◽  
RATNESH KUMAR ◽  
MANJUNATHA MAHADEVAPPA
Keyword(s):  
Electrical Stimulation ◽  
Lower Extremity ◽  
Functional Electrical Stimulation ◽  
Rehabilitation Program ◽  
Chronic Stroke ◽  
Motor Recovery ◽  
Calf Muscle ◽  
Foot Drop ◽  
Stroke Patients ◽  
Muscle Spasticity

Functional electrical stimulation (FES) allows active exercises for correction of foot drop in stroke patients. Our objective is to evaluate and compare the effects of FES therapy in walking ability, calf muscle spasticity, and lower-extremity motor recovery between subacute and chronic stroke patients. Twenty consecutive hemiplegic patients having foot drop were assigned either to subacute or chronic group. Both group subjects were treated with conventional rehabilitation program combined with FES therapy for 12 weeks. All subjects received the electrical stimulation to the peroneal nerve of paretic limb for 15–30 min while walking.After being treated with FES-based rehabilitation program, subacute subjects showed a mean increase in walking speed of 31.3% and chronic subjects of 19.1% and the physiological cost index (PCI), with a reduction of 66.7% in subacute subjects and 46.4% in chronic subjects between the beginning and end of the trial. Improvement was also measured in gait parameters such as cadence, step and stride lengths, ankle joint range of motion (ROM), calf muscle spasticity, and lower-extremity motor recovery assessed by Fugl-Meyer score in both group subjects, but subacute subjects improved better compared with chronic subjects. In conclusion, early and intensive interventions of FES therapy combine with conventional rehabilitation program could significantly improve the waking ability and recovery of lower-extremity motor functions in stroke survivors.

scholarly journals Cortical Re-organization After Traumatic Brain Injury Elicited Using Functional Electrical Stimulation Therapy: A Case Report

2021 ◽  
Vol 15 ◽  
Author(s):  
Matija Milosevic ◽  
Tomoya Nakanishi ◽  
Atsushi Sasaki ◽  
Akiko Yamaguchi ◽  
Taishin Nomura ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Electrical Stimulation ◽  
Brain Injury ◽  
Motor Function ◽  
Upper Limb ◽  
Functional Electrical Stimulation ◽  
Male Participant ◽  
Electrical Stimulation Therapy ◽  
Improve Motor Function

Functional electrical stimulation therapy (FEST) can improve motor function after neurological injuries. However, little is known about cortical changes after FEST and weather it can improve motor function after traumatic brain injury (TBI). Our study examined cortical changes and motor improvements in one male participant with chronic TBI suffering from mild motor impairment affecting the right upper-limb during 3-months of FEST and during 3-months follow-up. In total, 36 sessions of FEST were applied to enable upper-limb grasping and reaching movements. Short-term assessments carried out using transcranial magnetic stimulation (TMS) showed reduced cortical silent period (CSP), indicating cortical and/or subcortical inhibition after each intervention. At the same time, no changes in motor evoked potentials (MEPs) were observed. Long-term assessments showed increased MEP corticospinal excitability after 12-weeks of FEST, which seemed to remain during both follow-ups, while no changes in CSP were observed. Similarly, long-term assessments using TMS mapping showed larger hand MEP area in the primary motor cortex (M1) after 12-weeks of FEST as well as during both follow-ups. Corroborating TMS results, functional magnetic resonance imaging (fMRI) data showed M1 activations increased during hand grip and finger pinch tasks after 12-weeks of FEST, while gradual reduction of activity compared to after the intervention was seen during follow-ups. Widespread changes were seen not only in the M1, but also sensory, parietal rostroventral, supplementary motor, and premotor areas in both contralateral and ipsilateral hemispheres, especially during the finger pinch task. Drawing test performance showed improvements after the intervention and during follow-ups. Our findings suggest that task-specific and repetitive FEST can effectively increase cortical activations by integrating voluntary motor commands and sensorimotor network through functional electrical stimulation (FES). Overall, our results demonstrated cortical re-organization in an individual with chronic TBI after FEST.

scholarly journals Bilateral Contralaterally Controlled Functional Electrical Stimulation Reveals New Insights Into the Interhemispheric Competition Model in Chronic Stroke

2019 ◽  
Vol 33 (9) ◽  
pp. 707-717 ◽  
Author(s):  
David A. Cunningham ◽  
Jayme S. Knutson ◽  
Vishwanath Sankarasubramanian ◽  
Kelsey A. Potter-Baker ◽  
Andre G. Machado ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Upper Limb ◽  
Functional Electrical Stimulation ◽  
Repeated Measures ◽  
Neuromuscular Electrical Stimulation ◽  
Chronic Stroke ◽  
Motor Impairments ◽  
Repeated Measures Design ◽  
Interhemispheric Competition ◽  
Wide Range

Background. Upper-limb chronic stroke hemiplegia was once thought to persist because of disproportionate amounts of inhibition imposed from the contralesional on the ipsilesional hemisphere. Thus, one rehabilitation strategy involves discouraging engagement of the contralesional hemisphere by only engaging the impaired upper limb with intensive unilateral activities. However, this premise has recently been debated and has been shown to be task specific and/or apply only to a subset of the stroke population. Bilateral rehabilitation, conversely, engages both hemispheres and has been shown to benefit motor recovery. To determine what neurophysiological strategies bilateral therapies may engage, we compared the effects of a bilateral and unilateral based therapy using transcranial magnetic stimulation. Methods. We adopted a peripheral electrical stimulation paradigm where participants received 1 session of bilateral contralaterally controlled functional electrical stimulation (CCFES) and 1 session of unilateral cyclic neuromuscular electrical stimulation (cNMES) in a repeated-measures design. In all, 15 chronic stroke participants with a wide range of motor impairments (upper extremity Fugl-Meyer score: 15 [severe] to 63 [mild]) underwent single 1-hour sessions of CCFES and cNMES. We measured whether CCFES and cNMES produced different effects on interhemispheric inhibition (IHI) to the ipsilesional hemisphere, ipsilesional corticospinal output, and ipsilateral corticospinal output originating from the contralesional hemisphere. Results. CCFES reduced IHI and maintained ipsilesional output when compared with cNMES. We found no effect on ipsilateral output for either condition. Finally, the less-impaired participants demonstrated a greater increase in ipsilesional output following CCFES. Conclusions. Our results suggest that bilateral therapies are capable of alleviating inhibition on the ipsilesional hemisphere and enhancing output to the paretic limb.

Functional electrical stimulation therapy for severe hemiplegia: Randomized control trial revisited

2017 ◽  
Vol 84 (2) ◽  
pp. 87-97 ◽  
Author(s):  
Cesar Marquez-Chin ◽  
Shaghayegh Bagher ◽  
Vera Zivanovic ◽  
Milos R. Popovic
Keyword(s):  
Electrical Stimulation ◽  
Upper Limb ◽  
Functional Electrical Stimulation ◽  
Randomized Control Trial ◽  
Functional Independence ◽  
Control Group ◽  
Electrical Stimulation Therapy ◽  
Limb Function ◽  
Upper Limb Function ◽  
Randomized Control

Background. Stroke is the leading cause of long-term disability. Stroke survivors seldom improve their upper-limb function when their deficit is severe, despite recently developed therapies. Purpose. This study aims to assess the efficacy of functional electrical stimulation therapy in improving voluntary reaching and grasping after severe hemiplegia. Method. A post hoc analysis of a previously completed randomized control trial ( clinicaltrials.gov , No. NCT00221078) was carried out involving 21 participants with severe upper-limb hemiplegia (i.e., Fugl-Meyer Assessment–Upper Extremity [FMA-UE] ≤ 15) resulting from stroke. Findings. Functional Independence Measure Self-Care subscores increased 22.8 (±6.7) points in the intervention group and 9 (±6.5) in the control group, following 40 hr of equal-intensity therapy. FMA-UE score changes were 27.2 (±13.5) and 5.3 (±11.0) for the intervention and control groups, respectively. Implications. The results may represent the largest upper-limb function improvements in any stroke population to date, especially in those with severe upper-limb deficit.

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