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Research Article  |   July 2008
Task-Specific, Patient-Driven Neuroprosthesis Training in Chronic Stroke: Results of a 3-Week Clinical Study
Author Affiliations
  • Valerie Hill-Hermann, MS, OTR/L, is Research Occupational Therapist in the Department of Rehabilitation Sciences, University of Cincinnati Academic Medical Center (UCAMC), and Member of the Neuromotor Recovery and Rehabilitation Laboratory (NMRRL), Drake Rehabilitation Center, Cincinnati, OH
  • Ashley Strasser, Bethany Albers, and Kelly Schofield are students in the Department of Rehabilitation Sciences, UCAMC
  • Kari Dunning, PhD, PT, is Assistant Professor in the Department of Physical Therapy, UCAMC, and Director of Research, Drake Rehabilitation Center, Cincinnati, OH
  • Peter Levine, PTA, is Senior Research Assistant, Department of Rehabilitation Sciences, UCAMC, and Codirector, NMRRL, Cincinnati, OH
  • Stephen J. Page, PhD, FAHA, is Director of Research and Associate Professor, Departments of Rehabilitation Sciences, Physical Medicine and Rehabilitation, and Neurosciences; Member of the Greater Cincinnati/Northern Kentucky Stroke Team; and Scholar, Institute for the Study of Health, UCAMC. Dr. Page is also Director of the NMRRL, 3202 Eden Avenue, Suite 310, Cincinnati, OH 45267; Stephen.Page@uc.edu
Article Information
Neurologic Conditions / Stroke / Rehabilitation, Disability, and Participation
Research Article   |   July 2008
Task-Specific, Patient-Driven Neuroprosthesis Training in Chronic Stroke: Results of a 3-Week Clinical Study
American Journal of Occupational Therapy, July/August 2008, Vol. 62, 466-472. doi:10.5014/ajot.62.4.466
American Journal of Occupational Therapy, July/August 2008, Vol. 62, 466-472. doi:10.5014/ajot.62.4.466
Abstract

OBJECTIVE. We examined the efficacy of a clinically based regimen in which a woman 16 months’ post-stroke participated in daily practice sessions of valued activities of daily living (ADLs). A unique aspect of this intervention was that it was largely patient driven, with the patient practicing ADLs while wearing an electrical stimulation neuroprosthesis.

METHOD. The Fugl-Meyer Assessment (FM), Action Research Arm Test (ARA), Arm Motor Activity Test (AMAT), and Canadian Occupational Performance Measure (COPM) were administered before intervention. Therapy consisted of 3-hr ADL training sessions every weekday during a 3-week period using a neuroprosthesis featuring functional electrical stimulation during treatment sessions. One week after the end of the treatment phase, the FM, ARA, AMAT, and COPM were again administered.

RESULTS. The patient exhibited reduced impairment (FM score change from 31 to 35), decreased time needed to complete AMAT tasks (from 998 s to 558 s), and increased ARA score (from 27 to 31).

CONCLUSION. Clinically meaningful changes were realized with distant or minimal therapist supervision, making this regimen a practical and efficacious alternative.