Abstract
Objective
To determine the immediate effect of a portable, myoelectric elbow-wrist-hand orthosis
on paretic upper extremity (UE) impairment in chronic, stable, moderately impaired
stroke survivors.
Design
Observational cohort study.
Setting
Outpatient rehabilitation clinic.
Participants
Participants exhibiting chronic, moderate, stable, poststroke, UE hemiparesis (N=18).
Interventions
Subjects were administered a battery of measures testing UE impairment and function.
They then donned a fabricated myoelectric elbow-wrist-hand orthosis and were again
tested on the same battery of measures while wearing the device.
Main Outcome Measures
The primary outcome measure was the UE Section of the Fugl-Meyer Scale. Subjects were
also administered a battery of functional tasks and the Box and Block (BB) test.
Results
Subjects exhibited significantly reduced UE impairment while wearing the myoelectric
elbow-wrist-hand orthosis (FM: t17=8.56, P<.0001) and increased quality in performing all functional tasks while wearing the
myoelectric elbow-wrist-hand orthosis, with 3 subtasks showing significant increases
(feeding [grasp]: z=2.251, P=.024; feeding [elbow]: z=2.966, P=.003; drinking [grasp]: z=3.187, P=.001). Additionally, subjects showed significant decreases in time taken to grasp
a cup (z=1.286, P=.016) and increased gross manual dexterity while wearing a myoelectric elbow-wrist-hand
orthosis (BB test: z=3.42, P<.001).
Conclusions
Results suggest that UE impairment, as measured by the Fugl-Meyer Scale, is significantly
reduced when donning a myoelectric elbow-wrist-hand orthosis, and these changes exceeded
the Fugl-Meyer Scale's clinically important difference threshold. Further, utilization
of a myoelectric elbow-wrist-hand orthosis significantly increased gross manual dexterity
and performance of certain functional tasks. Future work will integrate education
sessions to increase subjects' ability to perform multijoint functional movements
and attain consistent functional changes.
Keywords
List of abbreviations:
BB (Box and Block), RTP (repetitive task-specific practice), UE (upper extremity)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: January 24, 2017
Footnotes
Supported by Myomo, Inc.
Disclosures: Peters, Page, and Persch have provided consultation services to Myomo, Inc.
Identification
Copyright
© 2017 Published by Elsevier Inc. on behalf of the American Congress of Rehabilitation Medicine
