HYBRID FUNCTIONAL ELECTRICAL-STIMULATION ORTHOSIS SYSTEM FOR THE UPPER-LIMB - EFFECTS ON SPASTICITY IN CHRONIC STABLE HEMIPLEGIA

A new hybrid functional electrical stimulation orthosis system for the upper limb has been designed to allow for ease of use in the home as a daily treatment modality, as well as offer the opportunity for funct ion enhancement. In a pilot study, the system was used by ten patients with chronic stable hemiparesis secondary to cerebral vascular accide nt and head injuries. The patients were referred by their treating phy sicians or therapists after meeting the inclusion criteria of good gen eral health, being greater than one year after head injury, or being t en months post-stroke, with no observed neurologic changes in the prio r six weeks. Each of these patients had received prolonged physical th erapy, either continuous from the initial inpatient rehabilitation tre atment or on an intermittent basis over a period of years. The baselin e status for factors related to increased muscle tone, i.e., passive r ange of motion at the wrist and elbow posture at rest, posture immedia tely following activity, and spasticity were quantified before the tre atment protocol with the functional electrical stimulation orthosis. A ctive range of motion and tests of functional use of the involved uppe r limb were also assessed. The patients were instructed in the protoco l, trained in the use of the system, and then used the electrical orth osis at home for up to several hours per day. Follow-up assessments we re at six months. A statistically significant improvement was noted in all muscle tone/spasticity parameters measured. A separate report wil l describe the effects on voluntary motion and functional capabilities .