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Randomized Controlled Trial
. 2017 Jan-Feb;49(1):46-54.
doi: 10.1080/00222895.2016.1152220. Epub 2016 Oct 17.

Portable Myoelectric Brace Use Increases Upper Extremity Recovery and Participation But Does Not Impact Kinematics in Chronic, Poststroke Hemiparesis

Affiliations
Randomized Controlled Trial

Portable Myoelectric Brace Use Increases Upper Extremity Recovery and Participation But Does Not Impact Kinematics in Chronic, Poststroke Hemiparesis

Nienke W Willigenburg et al. J Mot Behav. 2017 Jan-Feb.

Abstract

The authors examined the efficacy of an 8-week regimen combining repetitive task-specific practice (RTP) with a myoelectric brace (RTP+Myomo) on paretic upper extremity (UE; use in valued activities, perceived recovery, and reaching kinematics) in 12 subjects (4 men; M age = 53.5 years; mean time poststroke = 61.7 months). Seven subjects were administered RTP+Myomo therapy, and 5 were administered RTP only. Both groups participated in individualized, 45-min therapy sessions occurring 3 days/week over an 8-week period. The arm, hand ability, activities of daily living, and perceptions of recovery subscales of the Stroke Impact Scale (SIS), as well as UE reaching kinematics, assessed before and after the intervention. Subjects in the RTP+Myomo group showed greater improvements on all SIS subscales, with the recovery scale reaching statistical significance (p = .03). Subjects in the RTP-only group showed a greater increase in hand velocity in the reach up task (p = .02), but no changes were observed in the range of shoulder flexion or elbow extension during reaching. None of the changes in kinematic outcome measures significantly correlated with any of the changes in SIS subscales. RTP integrating myoelectric bracing may be more beneficial than RTP only in improving self-reported function and perceptions of overall recovery. The authors observed no changes in the range of elbow extension, and no relationship between self-reported improvements and changes in reaching kinematics.

Keywords: hemiplegia; kinematics; neurorehabilitation; stroke.

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Figures

Figure 1
Figure 1
(a) Myoelectric brace used in the study and (b) screenshot of software that remotely controls the amount of support provided by the brace
Figure 2
Figure 2
Kinematic Model of a Subject in the Starting Position
Figure 3
Figure 3
Individual Changes in Paretic Limb Kinematics from Pretest to Posttest for the Reach Up (upper panel) and Reach Out Tasks (lower panel).

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