Jan Kowalczewski, Valeriya Gritsenko, Nigel Ashworth, Peter Ellaway and Arthur Prochazka
The purpose of the study was to test the efficacy of functional electric stimulation (FES)?assisted exercise therapy (FES-ET) on a workstation in the subacute phase of recovery from a stroke. The study was a single-blind, randomly controlled comparison of high- and low-intensity treatment, with 19 participants. All participants had had a stroke within 3 months of the onset of the trial, had severe upper-limb dysfunction, and produced adequate hand opening with FES. Participants used an FES stimulator and an exercise workstation with instrumented objects to perform specific motor tasks with their affected upper extremity. Ten subjects in the high-intensity group received FES-ET for 1 hour a day on 15 to 20 consecutive workdays. Nine subjects in the low-intensity group received 15 minutes of sensory electric stimulation 4 days a week and on the fifth day they received 1 hour of FES-ET. The primary outcome measure was the Wolf Motor Function Test (WMFT) and secondary outcome measures were the Motor Activity Log (MAL) and the upper-extremity portion of the Fugl-Meyer Assessment (FMA). Participants in the high-intensity FES-ET group showed significantly greater improvements on the WMFT than those performing low-intensity FES-ET. However, this was not reflected in subjectsâ€™ self-assessments (MAL) or in their FMA scores. The authors concluded that the clinical significance of the result was open to debate.
Archives of Physical Medicine and Rehabilitation, 2007, 88 (7), 833-839.