THE INFLUENCE OF EMG-INITIATED ELECTRICAL MUSCLE STIMULATION ON MOTORRECOVERY OF THE CENTRALLY PARETIC HAND

The present study compares the effect of EMG-initiated electrical stim ulation of hand extensors and flexors with the influence of a standard ized repetitive training of the hand that had been proven to ameliorat e arm and hand function significantly. Twenty hemiparetic stroke patie nts participated in the study. Following a 2 week baseline phase in wh ich conventional inpatient occupational and physiotherapy was applied, all patients received EMG-initiated electrical muscle stimulation twi ce daily during 20 min periods followed by a third phase with a standa rdized repetitive training of the hand. Both training procedures were conducted in addition to conventional occupational and physiotherapy. Grip strength, peak force of isometric hand extensions as well as peak acceleration of isotonic hand extensions were measured as indicators of motor performance. Spasticity of hand flexors was assessed by means of the modified Ashworth scale. Motor capacity of the affected arm wa s scored by means of the Rivermead motor assessment, arm section. Cont rary to usual occupational and physiotherapy, both the EMG-initiated s timulation and the repetitive training are appropriate to improve all biomechanical and functional parameters significantly whereas no diffe rence in the efficacy of both methods could be detected. The functiona l significance of frequent active repetition of identifcal movements a nd the role of time-locked afferent information about the unfolding mo vement for motor learning and recovery are discussed.