Rebecca Martin, Kristin Johnston, Cristina Sadowsky; Neuromuscular Electrical Stimulation–Assisted Grasp Training and Restoration of Function in the Tetraplegic Hand: A Case Series. Am J Occup Ther 2012;66(4):471-477. doi: 10.5014/ajot.2012.003004.
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OBJECTIVE. This study investigated the immediate effects of repetitive neuromuscular electrical stimulation (NMES)–assisted grasp-and-release activities on the hand of patients with tetraplegia.
METHOD. Three participants with C-5–C-6 tetraplegia underwent grasp training with sequential application of NMES to wrist extensors, finger flexors, and finger extensors to assist participants in grasping and then releasing balls. Before the intervention, participants were assessed with the Jebsen–Taylor Hand Function Test and the Box and Block Test. They were evaluated with the same measures after the first and eighth sessions of intervention. Participants participated in eight 30-min sessions over 14 days.
RESULTS. Within-participant improvements in performance were observed in all outcome measures. Subtests of the Jebsen–Taylor Hand Function Test requiring grasping function showed the greatest improvements. Participants reported reduction of spasticity and more effective grasp.
CONCLUSION. NMES-assisted grasp paired with repetitive task practice resulted in improved performance on functional tests and subjectively improved hand function in the participants.
What does it mean to have limited hand function?
What changes did you experience going through therapy?
What kind of impact did the therapy have?
Within-participant improvements were observed, as measured by the JTHFT and BBT, across each time point.
Improvements were observed after the first session of training, indicating an immediate effect occurring within 30 min of the treatment session, and 24 hr after the final training session, indicating a carryover effect.
Participants reported subjective improvements in tone and quality of movement.
Moreover, participants experienced changes in the quality of movement, relearning movement, and an increase in independence through participation in NMES-assisted grasp training.
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